Tinnitus: Sound and Reaction

There is plenty of evidence that it is not just the hearing brain that is involved with tinnitus. There are other parts of the brain called the amygdala (our emotional computer) and the hippocampus (related to memory storage) that seem to be linked to chronic and bothersome tinnitus. 

The amygdala is our emotional computer while memories are dealt with in the hippocampus. Both regions have been shown to be connected to the auditory system in our brain. It is believe that with tinnitus people can learn negative responses to the percept and over time encode it into something related to negative emotions.  All these regions cause a feedback loop that can make tinnitus feel worse or louder for some people.  

For some this circuit can be more active than others which may be why some can experience tinnitus and feel a lot of distress, while someone else with constant tinnitus may learn to ignore it.  More research has to be done on this topic.

However, as most people who have worked with tinnitus sufferers know, it is not just about the sound the person hears, but also their response to it and how much they feel it affects their life and has “always” affected their life.  A treatment approach that provides feelings of control and also addresses the uncertainty can be helpful because we are addressing these other brain regions.

There are two goals for tinnitus sufferers: addressing the reaction to and perception of tinnitus (Jastreboff, 2000). The reaction consists of issues like anxiety, depression and insomnia, whereas the perception is how loud or noticeable the sound is to the person.  It is important for tinnitus sufferers to regain a sense of control while working to manage or reduce their tinnitus.


Who Else Hears This Constant Sound?

Tinnitus does not always get the attention it deserves for different reasons. One reason we want to focus on today is the prevalence of tinnitus.  Just how many people have tinnitus and live with it?  We see different numbers put out there:  1-3% of the population all the way to 15% of the population.  But what is the true value?

Really it depends on how you want to define a tinnitus sufferer. If someone has occasionally experienced tinnitus in their life, do they count?  What about those who have recurring tinnitus but not all the time?  Then we can say there are people who always have it but are not bothered, who find it to be inconvenient, or those who have significant impacts on the quality of their life.  Because of this, end up with something of a messy picture of just how widespread tinnitus is.

However, we know that millions suffer because of tinnitus.  In fact, a recent estimate is that 5% of the population in North America has chronic tinnitus that moderately or severely impacts their life.  That is a significant number of people who deal with tinnitus on a daily basis.

Some populations are harder hit than others. For example over 14% of people between 60 and 69 deal with chronic tinnitus (Shargorodsky et al., 2010).  For Veterans Affairs tinnitus is among the most common disability claims. Those who have worked in or been exposed to noisy environments are also obviously more likely to deal with tinnitus.

Going forward, the prevalence of tinnitus is likely to increase due to an aging population.  However, there is a chance to stem the tide if people are proactive about protecting their hearing and dealing with potential causes of tinnitus.  We will speak about this in a future post.



Prevalence and characteristics of tinnitus among US adults.  Shargorodsky J, Curhan GC, Farwell WR. Am J Med. 2010 Aug;123(8):711-8.