The Neural Correlates of Central Auditory Dysfunction in Chronic Tinnitus: A Multimodal Approach

Objectives It was aimed at assessing the connection between tinnitus and central auditory dysfunction using both central auditory tests (CATs) and diffusion tensor imaging (DTI) for brain regions that are crucial for central auditory processing. Methods This prospective case–control study included 15 patients with persistent tinnitus and 20 healthy volunteers as controls. They underwent CATs for memory, attention, and DTI. The Tinnitus Handicap Inventory (THI) Questionnaire was applied as well. From several brain regions, the values of mean diffusivity (MD) and fractional anisotropy (FA) were determined. Results Comparing both groups, the tinnitus group showed statistically worse values as regards the CATs (memory for content, sequence memory, speech perception in noise (SPIN) at different signal‐to‐noise ratios, “SNRs”) compared with the control group. As regards DTI, the tinnitus group showed decreased FA in several brain areas, including the cingulum, prefrontal‐cortex (PFC), insula, and hippocampus. Furthermore, the tinnitus group showed significantly higher MD in the cingulum, BA‐46, and amygdala compared with the control group. FA values of BA‐46 were positively correlated with the SPIN‐SNR−10 scores. Also, FA values of the middle cingulum were positively correlated with SPIN‐SNRzero scores. MD values at BA‐46 were negatively correlated with SPIN‐SNR−10. THI scores were negatively correlated with FA at BA‐46; however, they were positively correlated with MD at the amygdala. Conclusions Central auditory dysfunction may be linked to the underlying neurophysiological changes in chronic tinnitus. Level of Evidence 2 Laryngoscope, 135:316–323, 2025 Although cognitive abnormalities are common among tinnitus sufferers, there is little research that uses an objective technique to investigate the nature of this impairment. Chronic tinnitus causes central auditory deficits. White‐matter changes were recorded in patient with chronic tinnitus at multi‐cortical level.