Frontostriatal Gating of Tinnitus and Chronic Pain

Trends Cogn Sci. 2015 Oct;19(10):567-578. doi: 10.1016/j.tics.2015.08.002.


Tinnitus and chronic pain are sensory-perceptual disorders associated with negative affect and high impact on well-being and behavior. It is now becoming increasingly clear that higher cognitive and affective brain systems are centrally involved in the pathology of both disorders. We propose that the ventromedial prefrontal cortex and the nucleus accumbens are part of a central 'gatekeeping' system in both sensory modalities, a system which evaluates the relevance and affective value of sensory stimuli and controls information flow via descending pathways. If this frontostriatal system is compromised, long-lasting disturbances are the result. Parallels in both systems are striking and mutually informative, and progress in understanding central gating mechanisms might provide a new impetus to the therapy of tinnitus and chronic pain.

Keywords: Tinnitus; chronic pain; nucleus; ventral striatum; ventromedial prefrontal cortex.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Chronic Pain / physiopathology*
  • Humans
  • Nucleus Accumbens / physiopathology*
  • Prefrontal Cortex / physiopathology*
  • Tinnitus / physiopathology*