Tinnitus What and Where: An Ecological Framework

Abstract

Tinnitus is an interaction of the environment, cognition, and plasticity. The connection between the individual with tinnitus and their world seldom receives attention in neurophysiological research. As well as changes in cell excitability, an individual’s culture and beliefs, and work and social environs may all influence how tinnitus is perceived. In this review, an ecological framework for current neurophysiological evidence is considered. The model defines tinnitus as the perception of an auditory object in the absence of an acoustic event. It is hypothesized that following deafferentation: adaptive feature extraction, schema, and semantic object formation processes lead to tinnitus in a manner predicted by Adaptation Level Theory (1, 2). Evidence from physiological studies is compared to the tenants of the proposed ecological model. The consideration of diverse events within an ecological context may unite seemingly disparate neurophysiological models.

The impact of tinnitus upon cognition in adults: A systematic review

“…In clinical settings, reports of cognitive difficulties are common amongst tinnitus sufferers (Andersson et al, 2009;Pierce et al, 2012;Searchfield, 2014). The present study unveiled a complex and multifaceted relationship between tinnitus and cognitive function.…”

“…Clinical management of patients reporting tinnitus and cognitive difficulties requires an understanding of the reciprocal relationship between tinnitus and cognitive function, with additive effects of anxiety, depression, and somatic cognitive bias. Further study is required to establish the impact of advancing age, hearing loss, anxiety, depression tinnitus duration, and distress upon cognitive function in people with invasive tinnitus.Key Words: Tinnitus, cognition, systematic review Subjective tinnitus describes the perception of sound in the absence of external stimuli (Searchfield, 2014). It may be experienced transiently as a spontaneous auditory perception, acutely resolving after a few minutes, up to several weeks, or it may become a chronic and debilitating symptom (Hall et al, 2011;Hoare et al, 2014).…”

The Personality Profile of Tinnitus Sufferers and a Nontinnitus Control Group

“…Welch and Dawes (2008) hypothesized that personality traits that increase tinnitus awareness shift the response criterion placement toward a low signal-detection threshold, such that any given level of a signal is more likely to be perceived as tinnitus (Welch and Dawes, 2008) (Figure 1). Searchfield et al (2012;2014) propose a similar reference point argument in the Adaptation Level Theory (ALT) model of tinnitus perception, whereby an internal adaptation level (AL) acts as the anchor/reference point used to estimate the magnitude of the tinnitus signal. A high internal AL for tinnitus can characterize louder tinnitus, as well as tinnitus which elicits greater negative emotions in an individual.…”

A Client Oriented Scale of Improvement in Tinnitus for Therapy Goal Planning and Assessing Outcomes

“…innitus is a common sensory-cognitive disorder with a complex etiology and pathophysiology (Searchfield, 2014). The importance of understanding the whole person in tinnitus management, not just their otological complaint, was recognized many years ago (Fowler, 1948).…”

“…The importance of understanding the whole person in tinnitus management, not just their otological complaint, was recognized many years ago (Fowler, 1948). The importance of a person's motiva-tion, and expectations, for treatment (Hoare et al, 2014) has reemerged recently, just as research exploring the heterogeneity of tinnitus has expanded (Cederroth et al, 2017) and tinnitus models have recognized the individual's environment, culture, and personality as important contributors to tinnitus (Searchfield, 2014). Audiologists usually manage tinnitus through a combination of counseling, hearing aids, and/or sound therapy (Hoare et al, 2014).…”