The Frontostriatal Gating Model of Tinnitus

Research on tinnitus over the past decade has made it abundantly clear that this highly prevalent disorder is not just due to changes in the peripheral and central auditory system, but also involves affective centers of the limbic system. Current research now focuses on the question of which of these brain regions are the drivers of the bothersome experience that is tinnitus. In other words, does chronic tinnitus originate from a learned association between auditory and affective signals, or is tinnitus the result of a failing frontostriatal gating system? In healthy individuals, the gating system has the ability to cancel the tinnitus signal via brain mechanisms involving medial prefrontal cortex (PFC) and ventral striatum (VS). Studies of tinnitus patients using different neuroimaging modalities, as well as theoretical considerations, make the existence of such a brain-based “noise cancellation” system likely. Neurostimulation approaches, some of which show promise for the treatment of mood disorders, may prove successful for the treatment of tinnitus as well.