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Hearing research · 2026

Asymmetry of vestibular pathways predicts upper-brainstem auditory imbalance in subjective somatosensory tinnitus: A tract-specific chronological reorganization model.

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Kurt Duygu, Sendesen Eser, Türkyılmaz Meral Didem

Аннотация

OBJECTIVE: This study evaluated subcortical auditory and peripheral vestibular pathway alterations in normal-hearing individuals with unilateral subjective somatic tinnitus, isolating cross-modal electrophysiological relationships using an intra-subject, internally controlled paradigm.

METHODS: Twenty-four participants (aged 17-61 years) with unilateral subjective somatic tinnitus and symmetric normal hearing thresholds (≤15 dB HL across 0.125-8 kHz) underwent auditory brainstem response (ABR), cervical vestibular evoked myogenic potential (cVEMP), and ocular VEMP (oVEMP) testing. Mathematically normalized Interaural Asymmetry Indices (AI) isolated side-specific neural imbalances.

RESULTS: Conventional audiological profiles, middle ear compliance, and absolute ABR parameters (waves I-V) displayed interaural symmetry (p > .05). Conversely, absolute oVEMP evaluations demonstrated a statistically significant reduction in P1-N1 peak-to-peak amplitudes within the tinnitus-affected ears (M = 4.23 µV, SD = 2.98) relative to the healthy contralateral ears (M = 5.76 µV, SD = 4.72, p = .014), while absolute cVEMP parameters remained balanced (p = .396). Correlation analysis of normalized indices revealed a strong positive relationship between cVEMP AI and ABR wave V AI (r(22) = .555, p = .005). Multiple linear regression modeling showed that combined vestibulocollic (cVEMP) and vestibulo-ocular (oVEMP) neural asymmetries significantly predicted upper-brainstem auditory asymmetry at the level of the inferior colliculus, F(2, 21) = 8.66, p = .002, accounting for 45.2% of the variance in ABR wave V asymmetry (R2 = .452). Tinnitus chronicity showed an exploratory positive correlation with cVEMP AI (r(22) = .456, unadjusted p = .025; did not survive FDR correction).

CONCLUSION: Unilateral subjective somatic tinnitus appears to involve tract-specific subcortical electrophysiological asymmetries. We discuss these side-specific differences within a chronological reorganization framework. While acute ascending vestibulo-ocular suppression marks the initial gating failure, a progressively deepening descending vestibulocollic imbalance is strongly associated with upper auditory brainstem asymmetry. These outcomes validate combined VEMP indices as objective biomarkers and provide a neurophysiological rationale for future interventional trials to test whether early targeted bimodal neuromodulation can effectively reset subcortical hyperactivity before persistent neuroplastic consolidation.

Предметные рубрики MeSH

ИП Урсолов Владлен Сергеевич

ИНН 500118482352 · ОГРНИП 314500117700049

Реквизиты и контакты