Theta-gamma dysrhythmia and auditory phantom perception

J Neurosurg. 2011 Apr;114(4):912-21. doi: 10.3171/2010.11.JNS10335. Epub 2011 Jan 14.

Abstract

Tinnitus is considered an auditory phantom percept analogous to phantom pain. Thalamocortical dysrhythmia has been proposed as a possible pathophysiological mechanism for both tinnitus and pain. Thalamocortical dysrhythmia refers to a persistent pathological resting state theta-gamma coupling that is spatially localized at an area where normally alpha oscillations predominate. Auditory cortex stimulation via implanted electrodes has been developed to treat tinnitus, targeting an area of activation on functional MR imaging elicited by tinnitus-matched sound presentation. The authors describe a case in which clinical improvement was correlated with changes in intracranial recordings. Maximal tinnitus suppression was obtained by current delivery exactly at the blood oxygen level-dependent activation hotspot, which colocalizes with increased gamma and theta activity, in contrast to the other electrode poles, which demonstrated a normal alpha peak. These spectral changes normalized when stimulation induced tinnitus suppression, both on electrode and source-localized electroencephalography recordings. These data suggest that thetagamma coupling as proposed by the thalamocortical dysrhythmia model might be causally related to a conscious auditory phantom percept.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Audiology
  • Audiometry, Pure-Tone
  • Auditory Perception*
  • Electric Stimulation Therapy
  • Electrodes, Implanted
  • Electroencephalography
  • Hearing Tests
  • Humans
  • Image Processing, Computer-Assisted
  • Magnetic Resonance Imaging
  • Magnetoencephalography
  • Male
  • Neurosurgical Procedures
  • Oxygen / blood
  • Theta Rhythm*
  • Tinnitus / physiopathology*
  • Tinnitus / psychology
  • Tinnitus / surgery
  • Tomography, X-Ray Computed
  • Transcranial Magnetic Stimulation
  • Treatment Outcome

Substances

  • Oxygen