听力损失对耳鸣相关脑重组的影响：来自多模态静息态功能磁共振成像的证据。
The impact of hearing loss on tinnitus-related brain reorganization: evidence from multimodal resting-state functional magnetic resonance imaging.
文献信息
| PMID | 42861109 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Ling Wang |
| 作者单位 | Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China. |
| 期刊 | Quantitative imaging in medicine and surgery |
| SCI 分区 | Q2 |
| IF | 3 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 耳科 |
中文摘要
背景： 听力损失是否从根本上改变耳鸣相关的脑重组仍不清楚。为解决这一问题，本研究比较了伴有听力损失的耳鸣患者（TIN + HL）与不伴听力损失的耳鸣患者（TIN - HL）的多模态静息态功能磁共振成像（rs-fMRI）特征。
方法： 共有38例耳鸣患者（23例TIN + HL和15例TIN - HL）和28名健康对照（HCs）接受了rs-fMRI检查。通过单因素方差分析（ANOVA）和事后t检验比较各组间的低频波动振幅（ALFF）、局部一致性（ReHo）以及基于双侧听觉皮层（AC）的功能连接（FC）。通过偏相关分析检验与临床特征的相关性。
结果： 与HC组相比，两个耳鸣组均表现出双侧前扣带皮层（ACC）ALFF降低，以及左侧枕中回（MOG）ALFF升高和ReHo降低[簇水平家庭wise误差（FWE）校正P<0.05]。此外，TIN + HL组显示双侧尾状核（CN）ALFF降低，右侧海马旁回（PHG）和额中回（MFG）ReHo降低，而TIN - HL组显示右侧直回ReHo降低。与HC组相比，两个耳鸣组均显示右侧AC与左侧颞上回（STG）之间的FC降低，其中TIN - HL组降低更为明显（P<0.05，Bonferroni校正）。耳鸣组左侧MOG的ALFF与抑郁评分呈负相关（r=-0.513；P=0.001）。
结论： 听力损失可能以不同方式塑造耳鸣相关的脑重组。尽管两种亚型在边缘系统和视觉关联区域存在共同改变，但TIN + HL似乎以感觉门控和认知控制回路紊乱为特征，而TIN - HL可能涉及情绪调节网络改变和更明显的听觉网络断开。这些发现为亚型特异性治疗提供了神经影像学基础。
英文摘要
BACKGROUND: Whether hearing loss fundamentally alters tinnitus-related brain reorganization remains unclear. To address this issue, this study compared features from multimodal resting-state functional magnetic resonance imaging (rs-fMRI) between tinnitus patients with hearing loss (TIN + HL) and those without hearing loss (TIN - HL).
METHODS: A total of 38 patients with tinnitus (23 TIN + HL and 15 TIN - HL) and 28 healthy controls (HCs) underwent rs-fMRI. Amplitude of low-frequency fluctuations (ALFF), regional homogeneity (ReHo), and bilateral auditory cortex (AC)-based functional connectivity (FC) were compared among groups via one-way analysis of variance (ANOVA) and post hoc t tests. Correlations with clinical characteristics were examined via partial correlation.
RESULTS: Compared with the HC group, both tinnitus groups exhibited decreased ALFF in the bilateral anterior cingulate cortex (ACC), along with increased ALFF and decreased ReHo in the left middle occipital gyrus (MOG) [cluster-level family-wise error (FWE)-corrected P<0.05]. Additionally, the TIN + HL group showed decreased ALFF in the bilateral caudate nucleus (CN) and decreased ReHo in the right parahippocampal gyrus (PHG) and middle frontal gyrus (MFG), while the TIN - HL group exhibited decreased ReHo in the right rectus gyrus. Compared with the HC group, both tinnitus groups showed reduced FC between the right AC and the left superior temporal gyrus (STG), with more pronounced reduction in the TIN - HL group (P<0.05, Bonferroni correction). The ALFF in left MOG negatively correlated with the depression scores in the tinnitus groups (r=-0.513; P=0.001).
CONCLUSIONS: Hearing loss may differentially shape tinnitus-related brain reorganization. Although both subtypes shared common alterations in limbic and visual association regions, TIN + HL appears to be characterized by disruptions in sensory gating and cognitive control circuits, whereas TIN - HL may involve emotion-regulation network alterations and more pronounced auditory network disconnection. These findings provide a neuroimaging basis for subtype-specific treatment.