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, 29 (4), 361-370

Head, Neck, and Eye Movements That Modulate Tinnitus

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Head, Neck, and Eye Movements That Modulate Tinnitus

Richard Simmons et al. Semin Hear.

Abstract

Recent functional brain imaging studies in humans suggest that the neural generator(s) for tinnitus may reside in the central nervous system and involve both auditory as well as nonauditory centers. The contribution of nonauditory centers in the pathogenesis and regulation of tinnitus is reinforced by studies showing that many patients have somatic tinnitus whereby movements and manipulations of the eyes, head, neck, jaw, and shoulder can modulate the loudness and pitch of their tinnitus. In most cases, the maneuvers lead to increases in tinnitus loudness or pitch rather than decreases. Our results indicate that most tinnitus patients experience only a modest change in loudness or pitch when performing these maneuvers. However, some patients report that these maneuvers significantly modulate the loudness or pitch, sometimes by a factor of 2 to 3. The high prevalence of somatic tinnitus serves to illustrate the complex multimodal interactions that exist between the auditory pathway and other sensory-motor systems innervating the head, neck, shoulders, and eyes.

Figures

Figure 1
Figure 1
Thirty-five of 45 subjects were able to modulate their tinnitus with head, neck, jaw, and shoulder movements. Figure shows number of movements that resulted in a modulation for each of the 35 subjects. Horizontal dashed line shows mean value.
Figure 2
Figure 2
Percentage of all movements that evoked a modulation broken down by cranial nerves or peripheral nerve (cervical nerves 1 and 2). Cranial nerves controlling eye movements are grouped as one category because they are not easily isolated from one another.
Figure 3
Figure 3
Percentage of all modulations versus degree of modulation from the reference value of 5. Data from subset of patients that could modulate their tinnitus (>5 indicates increased loudness or pitch; <5 indicates decreased loudness or pitch).
Figure 4
Figure 4
Maneuvers involving the neck that resulted in modulation. Figure shows percentage of modulation elicited by force of the maneuver.

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