| Abstrakt: |
1. Tinnitus Retraining Therapy (TRT) is strictly based on the neurophysiological model of tinnitus. 2. Tinnitus is a phantom auditory perception, i.e. perception of tinnitus is not linked to any vibratory activity within the cochlea. 3. The model postulates that it is necessary to include interconnections within a network of systems in the brain in the study and treatment of tinnitus. 4. The auditory system, while needed for perception of tinnitus, is secondary for clinically relevant tinnitus (i.e. tinnitus which is bothersome to the extent of requiring treatment). 5. The limbic and autonomic nervous systems are the main systems responsible for negative tinnitus-evoked reactions. 6. Tinnitus is frequently accompanied by a decreased sound tolerance, consisting of hyperacusis and misophonia. 7. Hyperacusis results from an increased gain within the auditory pathways and is determined solely by physical characteristics of sound (i.e. its intensity and spectrum). 8. Misophonia results from enhanced functional connections between the auditory and the limbic and autonomic nervous systems, and reactions occur to specific patterns of sound, with the total spectral energy being secondary or irrelevant. 9. In misophonia, the meaning of sound and an -individual΄s past history of encountering it is crucial, with the auditory characteristics of the sound playing a secondary role. 10. There are two loops in network processing tinnitus signal: a. High loop, which involves cognitive processing of the signal and which is dominant at the initial stages of tinnitus. b. Low, subconscious loop, which appears to become dominant in chronic tinnitus. Connections within the neural networks that are involved in the adverse effects of tinnitus are governed by the principles of conditioned reflexes. 11. The primary goal of TRT is habituation of reactions evoked by tinnitus. 12. Habituation is initiated and further facilitated using the method of modified passive extinction of the conditioned reflexes and involves: a. Teaching/counseling aimed at reclassification of the tinnitus signal to the category of neutral stimuli. b. Sound therapy, which decreases the strength of the tinnitus signal by increasing the level of background neuronal activi [ABSTRACT FROM AUTHOR] |
