The Enigma of the Tinnitus-Free Dream State in a Bayesian World

Abstract

There are pathophysiological, clinical, and treatment analogies between phantom limb pain and phantom sound (i.e., tinnitus). Phantom limb pain commonly is absent in dreams, and the question arises whether this is also the case for tinnitus. A questionnaire was given to 78 consecutive tinnitus patients seen at a specialized tinnitus clinic. Seventy-six patients remembered their dreams and of these 74 claim not to perceive tinnitus during their dreams (97%). This can be most easily explained by a predictive Bayesian brain model. That is, during the awake state the brain constantly makes predictions about the environment. Tinnitus is hypothesized to be the result of a prediction error due to deafferentation, and missing input is filled in by the brain. The heuristic explanation then is that in the dream state there is no interaction with the environment and therefore no updating of the prediction error, resulting in the absence of tinnitus.

The balance between Bayesian inference and default mode determines the generation of tinnitus from decreased auditory input: A volume entropy‐based study

“…The findings of this study can be interpreted in the context of the Bayesian brain to derive a model for tinnitus (De Ridder, Joos, & Vanneste, 2014;De Ridder, Vanneste, & Freeman, 2014;Hullfish, Sedley, & Vanneste, 2019;Lee et al, 2017;. Some individuals with HL develop tinnitus, which is characterized by increased information transmission efficiency in a network that comprises the lateral OFC, VLPFC, sgACC, and parahippocampal and hippocampal areas, as well as the insula.…”

Cortical Oscillatory Signatures Reveal the Prerequisites for Tinnitus Perception: A Comparison of Subjects With Sudden Sensorineural Hearing Loss With and Without Tinnitus

“…hearing loss (De Ridder et al, 2014a;Lee et al, 2017). In the same context, we have recently reported that approximately 70% of patients with unilateral SSNHL experience ipsilesional tinnitus (Lee et al, 2017), indicating that missing auditory information (i.e., prediction error) may stimulate neural circuit interactions between lower-order (peripheral auditory input) and higher-order (prediction-driving process of auditory perception) auditory systems to reduce uncertainty in a bottom-up fashion due to sudden hearing deterioration.…”

A neuroplastic deafferentation hypothesis for bipolar disorder

“…Tinnitus, they propose, is due to deafferentation causing erroneous prediction. However, they suggest that during dreaming, this prediction error is not generated, abolishing the tinnitus [7] .…”

“…Tinnitus can also be viewed as a ‘phantom sensation’ [7] . Interestingly, both insufficient and excessive sound exposure can result in tinnitus [1] .…”