Abstract
Introduction
Tinnitus is hypothesized to be an auditory phantom phenomenon resulting from spontaneous neuronal activity somewhere along the auditory pathway. We performed fMRI of the entire auditory pathway, including the inferior colliculus (IC), the medial geniculate body (MGB) and the auditory cortex (AC), in 42 patients with tinnitus and 10 healthy volunteers to assess lateralization of fMRI activation.
Methods
Subjects were scanned on a 3T MRI scanner. A T2*-weighted EPI silent gap sequence was used during the stimulation paradigm, which consisted of a blocked design of 12 epochs in which music presented binaurally through headphones, which was switched on and off for periods of 50 s. Using SPM2 software, single subject and group statistical parametric maps were calculated. Lateralization of activation was assessed qualitatively and quantitatively.
Results
Tinnitus was lateralized in 35 patients (83%, 13 right-sided and 22 left-sided). Significant signal change (P corrected < 0.05) was found bilaterally in the primary and secondary AC, the IC and the MGB. Signal change was symmetrical in patients with bilateral tinnitus. In patients with lateralized tinnitus, fMRI activation was lateralized towards the side of perceived tinnitus in the primary AC and IC in patients with right-sided tinnitus, and in the MGB in patients with left-sided tinnitus. In healthy volunteers, activation in the primary AC was left-lateralized.
Conclusion
Our paradigm adequately visualized the auditory pathways in tinnitus patients. In lateralized tinnitus fMRI activation was also lateralized, supporting the hypothesis that tinnitus is an auditory phantom phenomenon.
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Acknowledgements
This study was made possible with funding from a European Union Marie-Curie Fellowship and from “Fonds voor Wetenschappelijk Onderzoek (FWO)-Flanders Wetenschappelijke Onderzoeksgemeenschap (WOG) on Advanced Nuclear Magnetic Resonance (NMR)”. The authors wish to thank Mr. P. Hamaekers, Senior Research Nurse, for technical support.
Conflict of interest statement
We declare that we have no conflict of interest.
The principal author (M.S.) received funding through a European Marie-Curie Fellowship and from FWO-Flanders WOG on Advanced NMR. The authors’ work was independent of the funding organizations. The funding organizations had no involvement in the study design, data collection and analysis, writing the report, or the decision to submit the paper for publication.
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Smits, M., Kovacs, S., de Ridder, D. et al. Lateralization of functional magnetic resonance imaging (fMRI) activation in the auditory pathway of patients with lateralized tinnitus. Neuroradiology 49, 669–679 (2007). https://doi.org/10.1007/s00234-007-0231-3
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DOI: https://doi.org/10.1007/s00234-007-0231-3