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Limbic-Visual Disintegration and Salience-Control Specialization Characterize Tinnitus Network Topology.

Himanshu R Pandey1,2, Amit Keshri3, Neeraj Sinha1,2

  • 1Centre of Bio-Medical Research, Sanjay Gandhi Postgraduate Institute of Medical Sciences Campus, Lucknow, India.

The European Journal of Neuroscience
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Summary

Subjective tinnitus (ST) involves specific brain network changes, not global ones. These include altered connectivity in visual, limbic, and salience networks, linked to symptom severity and anxiety.

Keywords:
amygdalagraph theorynetwork‐based statisticsresting‐state fMRIsalience networktinnitusvoxel‐based morphometry

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Area of Science:

  • Neuroscience
  • Medical Imaging
  • Psychiatry

Background:

  • Subjective tinnitus (ST) is thought to stem from large-scale brain network reorganization.
  • The specific brain circuits involved and how they relate to symptom severity remain unclear.

Purpose of the Study:

  • To investigate the precise brain network alterations associated with subjective tinnitus.
  • To explore the relationship between tinnitus severity, anxiety, and specific network connectivity patterns.
  • To identify potential neuroimaging markers for patient stratification and treatment targeting in ST.

Main Methods:

  • Combined resting-state fMRI (graph theory, ROI-to-ROI connectivity) and VBM in 114 participants (57 ST, 57 controls).
  • Utilized a harmonized 50-ROI parcellation from the CONN atlas across 15 functional networks.
  • Employed multivariate modeling and node-wise analyses, controlling for covariates and multiple comparisons.

Main Results:

  • Identified selective, not global, network reorganization in ST patients.
  • Observed reduced integration in the left posterior parahippocampal gyrus and increased segregation in frontal/insular hubs.
  • Found hyperconnectivity in fronto-salience-language-cerebellar circuits and hypoconnectivity in default mode/dorsal attention pathways.
  • Linked higher tinnitus severity to reduced medial visual/limbic integration and increased frontal-temporal opercular connectivity.
  • Associated higher anxiety with increased integration in subcallosal/cerebellar/occipito-limbic areas and decreased putamen connectivity.
  • VBM revealed widespread white-matter reductions in specific brain regions.

Conclusions:

  • Subjective tinnitus is characterized by targeted network reorganization, specifically reduced medial temporal/visual-limbic integration and increased local specialization.
  • These findings provide strong evidence for ST reflecting specific circuit alterations rather than global brain changes.
  • The identified multimodal, symptom-linked signatures offer actionable circuit markers for clinical applications in ST.