Lateralization of the primary auditory cortex, in patients with unilateral tinnitus

Tinnitus, the chronic perception of ringing or other phantom sounds, is typically associated with hearing loss. The reduction of auditory input that conveys to auditory cortex leads to the changes in the balance of excitatory and inhibitory activation of the corresponding neurons in this area and is possibly the cause of tinnitus. From the other hand a recent study (Gordon et al. Beain 2013) has shown that bilateral input protects the cortex from unilaterally driven reorganization. Based on this finding we could expect that in patient with unilateral hearing loss and tinnitus the input from unimpaired ear has not been transfered sufficiently to the bilateral hemisphere and this loss of input has resulted in reorganization in neuronal activity of the auditory cortex. To test this hypothesis we compare the amplitude of the neuronal activity bold response of the auditory cortex in the ipsilateral and contralateral hemisphere to the hearing ear in response to different frequency tones. Ten tinnitus patients with chronic unilateral hearing loss and tinnitus and age-matched normal controls (ages 26-49) were tested. (Patients had chronic subjective non-pulsatile tinnitus associated with moderate to severe unilateral sensorineural hearing loss in one ear only with at least PTA>40dB on three consecutive frequencies between 1 and 4 KHz; tinnitus duration < 6 months). The recruitment of patients with unilateral hearing loss allowed unimpaired sound delivery via the unimpaired ear, bypassing any abnormal responsiveness at the peripheral level. Our high-resolution functional MRI at 7 Tesla (1.5 mm isotropic voxels) (Da Costa et al. J Neurosci 2011) provides us fine scale tonotopic maps in controls and tinnitus patients and using that we are able to compare the amplitude of the neural activity in the auditory cortex of the unilateral and ipsilateral hemisphere to the hearing ear for each group of different frequency responding neurons. Our first finding shows that the activity difference in tinnitus patient is higher than the activity difference in controls. In more detail the activity amplitude in the contralateral hemisphere to the hearing ear in tinnitus patient is much higher than the activity amplitude in ipsilateral hemisphere, in comparison to controls. This result suggests that the auditory pathway in tinnitus patients is less capable to convey the sound bilaterally and it could be a probable cause of their tinnitus.