Hearing Research最新文献_第2页

Dose-response relationship of aspirin and sudden sensorineural hearing loss risk in type 2 diabetes

IF 2.5 2区医学 Q1 AUDIOLOGY & SPEECH-LANGUAGE PATHOLOGY

Hearing Research

Pub Date : 2025-02-07 DOI: 10.1016/j.heares.2025.109217

Chih Chiang Liu , Wan-Ming Chen , Ben-Chang Shia , Szu-Yuan Wu , Wen-Jung Chou

Background

Sudden sensorineural hearing loss (SSNHL) affects 5 to 27 per 100,000 annually, often leading to permanent hearing loss and reduced quality of life. Type 2 diabetes (T2D) may heighten SSNHL risk via vascular damage. Aspirin is used in T2D for cardiovascular protection, yet its effect on SSNHL is uncertain and may vary by dose.

Methods

We conducted a cohort study using Taiwan's National Health Insurance Research Database to assess SSNHL risk associated with aspirin use in T2D patients. Eligible T2D patients were categorized based on cumulative aspirin exposure (cDDD ≥ 28 vs. <28) and matched on key covariates. Cox proportional hazards models and Fine and Gray's competing risk model assessed SSNHL and all-cause mortality across quartiles of cumulative aspirin dose.

Results

Among 51,657 matched pairs, SSNHL incidence was similar between aspirin users and non-users, but a dose-response effect emerged: patients in the highest cDDD quartile (Q4) had a significantly reduced SSNHL risk (adjusted HR 0.43, 95 % CI, 0.32–0.58; p < 0.0001), while lower quartiles showed increased risks. Aspirin use was associated with reduced all-cause mortality (adjusted HR 0.77, 95 % CI, 0.75–0.80). Fine and Gray's competing risk model confirmed that this reduction in mortality did not bias the observed dose-dependent protective effect of aspirin on SSNHL. Even after accounting for competing mortality risk, aspirin's protective association with SSNHL remained significant in the highest quartile (Q4, aHR 0.46, 95 % CI, 0.34–0.62; p < 0.0001), indicating an independent protective effect.

Conclusions

Our findings suggest a dose-dependent relationship where high cumulative doses of aspirin reduce SSNHL risk in T2D patients, underscoring the importance of adequate dosing for potential protective effects. Further research is necessary to clarify this dose-response relationship.

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引用次数: 0

Ear-specific neuroplasticity for sound localization in individuals with single-sided deafness

IF 2.5 2区医学 Q1 AUDIOLOGY & SPEECH-LANGUAGE PATHOLOGY

Hearing Research

Pub Date : 2025-02-06 DOI: 10.1016/j.heares.2025.109207

Leeseul Shim , Jahee Kim , Gibbeum Kim , Hyo-Jeong Lee

Studies on cortical plasticity in individuals with single-sided deafness (SSD) show increased activity in the auditory cortex ipsilateral to the hearing ear, impacting auditory localization and rehabilitation outcomes. However, the direct relationship between neuroplastic changes and binaural processing in SSD remains unclear, as does the specificity of plasticity to the affected ear. In this study, two groups of SSD patients (left [Lt] SSD, 17; right [Rt] SSD, 18) of postlingual onset and 13 normal-hearing controls (NC) underwent fMRI during an auditory localization task. The NC group was also treated with earplugs to simulate acute monaural hearing. We compared the cortical networks involved in auditory localization and conducted correlation analyses to identify neural activity associated with SSD duration and localization performance. The response laterality in the auditory cortex was analyzed and compared across groups. Results indicated that extended SSD modulates auditory cortical response in the right primary auditory cortex. The posterior superior temporal gyrus and cingulo-opercular network were linked to improved localization performance. Findings suggest that cortical attentional resources are crucial for auditory spatial behavior in SSD, especially when the left ear is impaired.

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引用次数: 0

Channel crosstalk detected using ECAP measurements is associated with poorer speech perception in cochlear implant users

IF 2.5 2区医学 Q1 AUDIOLOGY & SPEECH-LANGUAGE PATHOLOGY

Hearing Research

Pub Date : 2025-02-04 DOI: 10.1016/j.heares.2025.109206

Chris J. James , Marie-Laurence Laborde , Carole Algans , Marjorie Tartayre , Mathieu Marx

The number and independence of channels in cochlear implants (CI) has long been considered to influence speech recognition, particularly in competing background noise. Measures of channel independence have been obtained via psychophysical and objective means, relying on interactions between probe and masker signals delivered on different channels. In the current study, electrically evoked compound action potentials (ECAP) obtained from 32 Nucleus CI recipients tested at one basal and one apical position were performed using a standard spread-of-excitation procedure. An alternative analysis method, comparing masked responses only, revealed distant maskers as effective or more effective than same-electrode maskers in 13/32 cases. This appears to indicate substantial crosstalk between channels, covering up to nine intracochlear electrodes in one subject. Subjects with atypical responses and no other limiting factors had significantly poorer sentence recognition in noise compared with those with no detected peripheral or cognitive limiting factors. We propose that channel crosstalk detected via ECAPs may be a biomarker for poor or patchy neural survival that leads to poorer speech perception in CI recipients.

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引用次数: 0

A modiolar-pillar gradient in auditory-nerve dendritic length: A novel post-synaptic contribution to dynamic range? 听觉神经树突长度的模柱-柱梯度：突触后对动态范围的新贡献？

IF 2.5 2区医学 Q1 AUDIOLOGY & SPEECH-LANGUAGE PATHOLOGY

Hearing Research

Pub Date : 2025-02-01 DOI: 10.1016/j.heares.2024.109172

Serhii Kostrikov , Jens Hjortkjaer , Torsten Dau , Gabriel Corfas , Leslie D. Liberman , M. Charles Liberman

Auditory-nerve fibers (ANFs) from a given cochlear region can vary in threshold sensitivity by up to 60 dB, corresponding to a 1000-fold difference in stimulus level, although each fiber innervates a single inner hair cell (IHC) via a single synapse. ANFs with high-thresholds also have low spontaneous rates (SRs) and synapse on the side of the IHC closer to the modiolus, whereas the low-threshold, high-SR fibers synapse on the side closer to the pillar cells. Prior biophysical work has identified modiolar-pillar differences in both pre- and post-synaptic properties, but a comprehensive explanation for the wide range of sensitivities remains elusive. Here, in guinea pigs, we used immunostaining for several neuronal markers, including Caspr, a key protein in nodes of Ranvier, to reveal a novel modiolar-pillar gradient in the location of the first ANF heminodes, presumed to be the site of the spike generator, just outside the sensory epithelium. Along the cochlea, from apex to base, the unmyelinated terminal dendrites of modiolar ANFs were 2–4 times longer than those of pillar ANFs. This modiolar-pillar gradient in dendritic length, coupled with the 2–4 fold smaller caliber of modiolar dendrites seen in prior single-fiber labeling studies, suggests there could be a large difference in the number of length constants between the synapse and the spike initiation zone for low- vs high-SR fibers. The resultant differences in attenuation of post-synaptic potentials propagating along these unmyelinated dendrites could be a key contributor to the observed range of threshold sensitivities among ANFs.

来自耳蜗特定区域的听神经纤维（ANFs）的阈值灵敏度差异可达60 dB，对应于刺激水平的1000倍差异，尽管每条纤维通过单个突触支配单个内毛细胞（IHC）。具有高阈值的anf也具有低自发率（SRs），并且突触位于靠近小梁的IHC一侧，而低阈值的高sr纤维突触位于靠近柱细胞的一侧。先前的生物物理工作已经确定了突触前和突触后特性的模柱差异，但对广泛的敏感性的全面解释仍然难以捉摸。在这里，在豚鼠中，我们使用了几种神经元标记物的免疫染色，包括Ranvier淋巴结中的关键蛋白Caspr，以揭示在第一ANF heminodes位置的一种新的modiolar-pillar梯度，假定是spike产生的位置，就在感觉上皮外。沿耳蜗方向，从耳尖到耳底，无髓鞘的毛母细胞终末树突比柱状毛母细胞长2 ~ 4倍。这种树突长度上的模摩尔-柱梯度，再加上在先前的单纤维标记研究中看到的模摩尔树突直径小2-4倍，表明在低sr纤维和高sr纤维中，突触和spike起始区之间的长度常数数量可能存在很大差异。由此产生的突触后电位沿这些无髓鞘树突传播的衰减差异可能是观察到的anf阈值敏感性范围的关键因素。

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引用次数: 0

Early signs of auditory aging: Hearing declines faster in individuals with extended high frequency hearing loss 听觉老化的早期迹象：听力下降速度更快的个人与延长高频听力损失。

IF 2.5 2区医学 Q1 AUDIOLOGY & SPEECH-LANGUAGE PATHOLOGY

Hearing Research

Pub Date : 2025-02-01 DOI: 10.1016/j.heares.2024.109171

Srikanta K Mishra , Udit Saxena , Hansapani Rodrigo

Hearing loss, particularly age-related hearing loss, significantly impacts health and quality of life worldwide. While much of the research has focused on older adults, the early stages of hearing decline remain relatively unexplored. Longitudinal studies examining hearing changes across the adult lifespan, especially at extended high frequencies (EHFs), are scarce. This prospective longitudinal study aimed to explore the rate of hearing threshold shift in young adults with clinically normal audiograms and to assess whether EHF hearing loss could predict future hearing decline in the standard audiometric range. Hearing thresholds were measured at standard audiometric frequencies (0.25 to 8 kHz) and EHFs (10, 12.5, 14, and 16 kHz) in 71 participants (24 females) aged 19 to 38 years (mean age = 27.8 years). Two testing sessions were conducted nearly 24 months apart. Results revealed that the annual rate of threshold shift was significantly higher for EHFs compared to standard audiometric frequencies. A higher EHF threshold, measured in the initial test session, was associated with a greater rate of threshold shift at standard audiometric frequencies, suggesting that EHF hearing loss may serve as an early marker for subsequent hearing decline. Even with a normal audiogram, individuals with EHF hearing loss are at an increased risk of accelerated hearing deterioration. These findings show preclinical, age-related changes in young adults with normal audiograms and underscore the importance of early detection and monitoring of EHF hearing loss to mitigate the impact of future hearing loss on their overall health and well-being.

听力损失，特别是与年龄有关的听力损失，严重影响全世界的健康和生活质量。虽然大部分研究都集中在老年人身上，但听力下降的早期阶段仍然相对未被探索。在成年人的整个生命周期中，特别是在延长的高频（EHFs）中，关于听力变化的纵向研究很少。这项前瞻性纵向研究旨在探讨临床听力图正常的年轻成年人的听阈漂移率，并评估EHF听力损失是否可以预测未来标准听力范围内的听力下降。在标准听力频率（0.25至8 kHz）和ehf（10、12.5、14和16 kHz）下测量71名年龄在19至38岁（平均年龄= 27.8岁）的参与者（24名女性）的听力阈值。两次测试相隔近24个月。结果显示，与标准听力学频率相比，ehf的年阈值移位率明显更高。在初始测试阶段测得的EHF阈值越高，在标准听力学频率下的阈值移位率越高，这表明EHF听力损失可能是随后听力下降的早期标志。即使听力图正常，EHF听力损失患者加速听力恶化的风险也会增加。这些发现显示了听力正常的年轻成年人的临床前、年龄相关变化，并强调了早期发现和监测EHF听力损失的重要性，以减轻未来听力损失对他们整体健康和福祉的影响。

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引用次数: 0

Ensemble responses of auditory midbrain neurons in the cat to speech stimuli at different signal-to-noise ratios 猫听觉中脑神经元对不同信噪比语音刺激的整体反应。

IF 2.5 2区医学 Q1 AUDIOLOGY & SPEECH-LANGUAGE PATHOLOGY

Hearing Research

Pub Date : 2025-02-01 DOI: 10.1016/j.heares.2024.109163

Anu Sabu , Dexter Irvine , David B. Grayden , James Fallon

Originally reserved for those who are profoundly deaf, cochlear implantation is now common for people with partial hearing loss, particularly when combined with a hearing aid. This combined intervention enhances speech comprehension and sound quality when compared to electrical stimulation alone, particularly in noisy environments, but the physiological basis for the benefits is not well understood. Our long-term aim is to elucidate the underlying physiological mechanisms of this improvement, and as a first step in this process, we have investigated in normal hearing cats, the degree to which the patterns of neural activity evoked in the inferior colliculus (IC) by speech sounds in various levels of noise allows discrimination between those sounds. Neuronal responses were recorded simultaneously from 32 sites across the tonotopic axis of the IC in anaesthetised normal hearing cats (n = 7). Speech sounds were presented at 20, 40 and 60 dB SPL in quiet and with increasing levels of additive noise (signal-to-noise ratios (SNRs) –20, –15, –10, –5, 0, +5, +10, +15, +20 dB). Neural discrimination was assessed using a Euclidean measure of distance between neural responses, resulting in a function reflecting speech sound differentiation across various SNRs. Responses of IC neurons reliably encoded the speech stimuli when presented in quiet, with optimal performance when an analysis bin-width of 5–10 ms was used. Discrimination thresholds did not depend on stimulus level and were best for shorter analysis binwidths. This study sheds light on how the auditory midbrain represents speech sounds and provides baseline data with which responses to electro-acoustic speech sounds in partially deafened animals can be compared.

人工耳蜗植入术最初是为那些重度失聪的人准备的，现在对于部分听力损失的人来说很常见，特别是当与助听器结合使用时。与单独的电刺激相比，这种联合干预可以提高语音理解能力和音质，特别是在嘈杂的环境中，但其生理基础尚未得到很好的理解。我们的长期目标是阐明这种改善的潜在生理机制，作为这一过程的第一步，我们在正常听力的猫中研究了不同噪音水平的语音在下丘（IC）中引起的神经活动模式在多大程度上允许区分这些声音。在麻醉的正常听力猫（n = 7）的IC上，同时记录32个部位的神经元反应。在安静的情况下，语音以20、40和60 dB声压级呈现，并随着附加噪声（信噪比(SNRs) -20、-15、-10、-5、0、+5、+10、+15、+20 dB）水平的增加而增加。神经辨别使用欧几里得测量神经反应之间的距离来评估，从而产生反映不同信噪比的语音分化的功能。在安静环境下，IC神经元的响应可靠地编码语音刺激，当分析盒宽度为5-10 ms时表现最佳。区分阈值不依赖于刺激水平，并且最适合于较短的分析双宽。这项研究揭示了听觉中脑如何代表语音，并提供了基线数据，可以比较部分失聪动物对电声语音的反应。

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引用次数: 0

Neural and behavioral binaural hearing impairment and its recovery following moderate noise exposure 中度噪声暴露后神经性和行为性双耳听力损伤及其恢复。

IF 2.5 2区医学 Q1 AUDIOLOGY & SPEECH-LANGUAGE PATHOLOGY

Hearing Research

Pub Date : 2025-02-01 DOI: 10.1016/j.heares.2024.109166

Monica A. Benson , John Peacock , Matthew D. Sergison , Dominik Stich , Daniel J. Tollin

Noise-induced cochlear synaptopathy has been studied for over 25 years with no known diagnosis for this disorder in humans. This type of “hidden hearing loss” induces a loss of synapses in the inner ear but no change in audiometric thresholds. Recent studies have shown that by two months post synaptopathy-inducing noise exposure, synapses in some animal species can regenerate. Animal studies to date have focused primarily on peripheral hearing measures to diagnose ribbon synapse loss, while suggesting binaural listening deficits such as speech-reception-in-noise result from this disorder, but haven't accounted for the possible regeneration of synapses. To address this, we measured binaural physiological and behavioral function, the latter utilizing the pre-pulse inhibition of acoustic startle method, in both male and female adult guinea pigs following exposure to noise that has been shown to induce cochlear synaptopathy. Physiological measurements extended to 2 months post noise exposure to characterize any deficit and subsequent recovery. While common audiological assessments showed temporary threshold shift, reduced evoked potential amplitudes indicative of synaptopathy and measurable binaural electrophysiological hearing deficits post exposure, all measures recovered by 2 months. Suspected regeneration of synaptic ribbons occurred by 2 months post exposure and cochlear histology revealed no synaptic loss 4 months post exposure. Our results show that the same noise exposure protocol demonstrated to cause synaptic loss in prior studies causes physiological binaural processing deficits in the brainstem and that the recovery of neural binaural processing coincides with the regeneration of synapses shown in previous studies and normal binaural hearing behavior.

噪声引起的耳蜗突触病已经研究了25年以上，但在人类中没有已知的诊断。这种类型的“隐性听力损失”导致内耳突触的损失，但听力阈值没有变化。最近的研究表明，在突触病诱发的噪音暴露两个月后，一些动物物种的突触可以再生。到目前为止，动物研究主要集中在外周听力的测量上，以诊断带状突触的丧失，同时表明双耳听力缺陷，如噪音中的语音接收，是由这种疾病引起的，但还没有考虑到突触可能的再生。为了解决这个问题，我们测量了雄性和雌性成年豚鼠在暴露于已被证明会诱发耳蜗突触病的噪音后的双耳生理和行为功能，后者利用声惊吓的预脉冲抑制方法。生理测量延长至噪声暴露后2个月，以表征任何缺陷和随后的恢复。虽然常见的听力学评估显示暂时的阈值移动，诱发电位振幅降低，表明突触病和可测量的双耳电生理听力缺陷，但所有测量都在2个月后恢复。暴露后2个月出现突触带再生，耳蜗组织学显示暴露后4个月无突触丢失。我们的研究结果表明，在先前的研究中被证明会导致突触丧失的噪声暴露方案会导致脑干的生理双耳处理缺陷，并且神经双耳处理的恢复与先前研究中显示的突触再生和正常的双耳听力行为相一致。

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引用次数: 0

Auditory working memory in noise in cochlear implant users: Insights from behavioural and neuronal measures 人工耳蜗使用者噪音中的听觉工作记忆：来自行为和神经元测量的见解。

IF 2.5 2区医学 Q1 AUDIOLOGY & SPEECH-LANGUAGE PATHOLOGY

Hearing Research

Pub Date : 2025-02-01 DOI: 10.1016/j.heares.2024.109167

Loes Beckers , Birgit Philips , Wendy Huinck , Emmanuel Mylanus , Andreas Büchner , Andrej Kral

Objective

We investigated auditory working-memory using behavioural measures and electroencephalography (EEG) in adult Cochlear Implant (CI) users with varying degrees of CI performance.

Methods

24 adult CI listeners (age: M = 61.38, SD = 12.45) performed the Sternberg auditory-digit-in-working-memory task during which EEG, accuracy, and promptness were captured. Participants were presented with 2, 4, or 6 digits at Signal-to-Noise Ratios (SNR) of 0, +5 and +10dB. They had to identify a probe stimulus as present in the preceding sequence. ANOVA models were used to compare conditions.

Results

ANOVA revealed that increasing memory load (ML) led to decreased task performance and CI performance interacted with ML and SNR. Centro-parietal alpha power increased during memory encoding but did not differ between conditions. Frontal alpha power was positively correlated with accuracy in conditions most affected by SNR (r = 0.57, r = 0.52) and theta power in conditions most affected by ML (r = 0.55, r = 0.57).

Conclusions

While parietal alpha power is modulated by the task, it is frontal alpha that relates quantitatively to sensory aspects of processing (noise) and frontal theta to memory load in this group of CI listeners.

Significance

These results suggest that alpha and theta show distinct relationships to behaviour, providing additional insight into neurocognitive (auditory working-memory) processes in CI users.

目的：利用行为测量和脑电图（EEG）研究具有不同程度人工耳蜗（CI）表现的成人耳蜗使用者的听觉工作记忆。方法：24名成年CI听众（年龄：M = 61.38, SD = 12.45）执行Sternberg工作记忆听觉数字任务，在此过程中捕获EEG，准确性和敏捷性。在信噪比（SNR）为0、+5和+10dB的情况下，向参与者呈现2、4或6个数字。他们必须在前面的序列中识别一个探针刺激。方差分析模型用于比较条件。结果：方差分析显示，记忆负荷增加导致任务绩效下降，CI绩效与记忆负荷和信噪比相互作用。在记忆编码过程中，中央-顶叶α能量增加，但在不同条件下没有差异。在受信噪比影响最大的条件下，额叶α功率与准确率呈显著正相关（r = 0.57, r = 0.52）；在受ML影响最大的条件下，额叶α功率与准确率呈显著正相关（r = 0.55, r = 0.57）。结论：虽然顶叶α能量受到任务的调节，但在这组CI听众中，额叶α能量与加工的感觉方面（噪音）和额叶θ能量与记忆负荷在数量上相关。意义：这些结果表明，α和θ与行为有明显的关系，为CI用户的神经认知（听觉工作记忆）过程提供了额外的见解。

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引用次数: 0

Exploring the impact of force direction and phase on bone conduction hearing with bone conduction actuator 利用骨传导作动器探讨受力方向和相位对骨传导听力的影响。

IF 2.5 2区医学 Q1 AUDIOLOGY & SPEECH-LANGUAGE PATHOLOGY

Hearing Research

Pub Date : 2025-02-01 DOI: 10.1016/j.heares.2024.109164

Jongwoo Lim , Namkeun Kim , Yong-Jin Yoon

A comprehensive understanding of the effects of bone conduction (BC) input force is essential for elucidating BC hearing mechanisms. However, this area remains underexplored due to the inherent difficulties in controlling input forces when BC transducers are anchored to the bone. In this study, the effects of both unilateral and bilateral BC input forces were investigated using a three-dimensional finite element (FE) model of the human head, which allows precise manipulation of input forces. For unilateral input, 16 distinct directions were created by combining eight in-plane vectors with two tilt angles based on the normal direction of the input force location, and the resulting promontory velocities were compared. Although the magnitude differences between input directions remained within 10 dB, anti-resonance shifts were observed between 1 and 3 kHz. In the bilateral case, phase differences of 0°, 90°, and 180° were applied between input forces at the right and left mastoid positions, and basilar membrane velocities were compared to examine the complex interactions between input forces. These findings provide deeper insights into the effects of input force direction and phase on BC hearing, advancing the understanding of BC hearing mechanisms.

全面了解骨传导（BC）输入力的影响对于阐明BC听力机制至关重要。然而，由于骨传导传感器固定在骨头上时难以控制输入力，因此这一领域的研究仍然不足。在本研究中，我们使用可精确控制输入力的人体头部三维有限元（FE）模型研究了单侧和双侧 BC 输入力的影响。对于单侧输入，根据输入力位置的法线方向，将八个平面内矢量与两个倾斜角相结合，创建了 16 个不同的方向，并对由此产生的海角速度进行了比较。虽然输入方向之间的幅度差保持在 10 dB 以内，但在 1 至 3 kHz 之间观察到了反共振偏移。在双侧情况下，在左右乳突位置的输入力之间施加 0°、90° 和 180°的相位差，并比较基底膜速度，以检查输入力之间复杂的相互作用。这些发现深入揭示了输入力的方向和相位对基底膜听力的影响，有助于加深对基底膜听力机制的理解。

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引用次数: 0

Tinnitus, lucid dreaming and awakening. An online survey and theoretical implications.

IF 2.5 2区医学 Q1 AUDIOLOGY & SPEECH-LANGUAGE PATHOLOGY

Hearing Research

Pub Date : 2025-01-31 DOI: 10.1016/j.heares.2025.109204

Robin Guillard , Nicolas Dauman , Aurélien Cadix , Charlotte Glabasnia Linck , Marco Congedo , Dirk De Ridder , Alain Londero

Background

Tinnitus is the perception of phantom sound in the absence of a corresponding external source. Previous studies reported that the presence of tinnitus is notably absent during dreams. This study aimed at replicating previous findings regarding tinnitus-free dreams, while also gaining a deeper understanding of tinnitus manifestations during dreams and after awakening.

Methods

For this observational study, 195 tinnitus patients answered an online survey on the mutual-help community Siopi.

Results

148 subjective tinnitus patients could recall their dreams. Among them, 94.6 % state they do not hear their tinnitus while dreaming. The rest (5.4 %) report higher tinnitus burden, higher stress and more often exhibit cophosis, tinnitus related to peripheral auditory pathology and/or associated with other health comorbidities. 12.2 % of the participants frequently experience lucid dreams. Among them, 38 % could perceive their tinnitus during lucid dreams, and this was strongly associated with the concomitant perception of external sounds during lucid dreaming. While the majority of patients report perceiving their tinnitus instantly upon awakening, during nocturnal awakenings, 17.2 % declared they could be awakened by their tinnitus and 10.0 % mentioned that their tinnitus can temporarily cease.

Conclusions

Our findings confirm the previous findings: tinnitus is rarely perceived during dreams. Remarkably, our study is the first to document the case of tinnitus during lucid dreaming. 64 % of these patients gain higher-order consciousness attributes while still experiencing a tinnitus-free state. Our observations suggest that the presence or absence of gating of external auditory information during dreams acts as a tinnitus on-off switch, refining the previously proposed integrative model of auditory phantom perception.

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引用次数: 0