Incorporating Auditory Cortex Potentials and Gap Pre-pulse Inhibition of Acoustic Startle: A Probable Way to Objectively Assess Tinnitus

Abstract

Background and Objectives: Tinnitus is a complex condition that varies in loudness, quality, location, and distress. Different definitions, heterogeneity, and lack of objective measuring have challenged the understanding the mechanisms involved and definitive cure. The integrative model correlates each of these characteristics to separate parallel and overlapping subnetworks that process tinnitus’s perception and emotional reaction. Many of these networks are common with the gap pre-pulse inhibition of acoustic startle (GPIAS) neural circuity. GPIAS, which measures tinnitus in animals, has recently been used for humans with various recording methods. The present study aimed to review the evidence achieved with gap stimuli in patients with tinnitus to support the potential of cortical responses recorded with the GPIAS stimulus and to objectively detect tinnitus in humans. Methods: Studies were identified by searching electronic databases with relevant keywords. Results: The role of the auditory cortex in processing short gaps, the possibility of evaluating the gap detection ability with GPIAS, and the advantage of cortical responses in reflecting both stimulus properties and different aspects of tinnitus emphasize the importance of this issue. The results of most studies have proven the gap detection deficiency in tinnitus. However, the validity of the auditory startle reflex still needs to be verified due to the inherent variability and different methods. Conclusion: Further human studies are recommended because the perception of tinnitus can be controlled. An appealing research line in this area is multi-channel cortical evoked potentials. Defects of GPIAS with cortical recording can indicate tinnitus.