Cochlear implant induced changes in cortical networks associated with tinnitus severity

Objective. We investigated tinnitus-related cortical networks in cochlear implant users who experience tinnitus and whose perception of tinnitus changes with use of their implant. Tinnitus, the perception of unwanted sounds which are not present externally, can be a debilitating condition. In individuals with cochlear implants, use of the implant is known to modulate tinnitus, often improving symptoms but worsening them in some cases. Little is known about underlying cortical changes with use of the implant, which lead to changes in tinnitus perception. In this study we investigated whether changes in brain networks with the cochlear implant turned on and off, were associated with changes in tinnitus perception, as rated subjectively. Approach. Using functional near-infrared spectroscopy, we recorded cortical activity at rest, from 14 cochlear implant users who experienced tinnitus. Recordings were performed with the cochlear implant turned off and on. For each condition, participants rated the loudness and annoyance of their tinnitus using a visual rating scale. Changes in neural synchrony have been reported in humans and animal models of tinnitus. To assess neural synchrony, functional connectivity networks with the implant turned on and off, were compared using two network features: node strength and diversity coefficient. Main results. Changes in subjective ratings of loudness were significantly correlated with changes in node strength, averaged across occipital channels ( r=-0.65, p=0.01). Changes in both loudness and annoyance were significantly correlated with changes in diversity coefficient averaged across all channels ( r=-0.79,p<0.001 and r=-0.86,p<0.001 ). More distributed connectivity with the implant on, compared to implant off, was associated with a reduction in tinnitus loudness and annoyance. Significance. A better understanding of neural mechanisms underlying tinnitus suppression with cochlear implant use, could lead to their application as a tinnitus treatment and pave the way for effective use of other less invasive stimulation-based treatments.