Objective: This project aimed to investigate the differences in the intra-regional brain activity and inter-regional functional connectivity in subjects with tinnitus only and subjects with hearing loss and tinnitus, using resting-state functional magnetic resonance imaging (rs-fMRI) technologies, including the Amplitude of Low-Frequency Fluctuations (ALFF), regional homogeneity (ReHo), and Voxel-Wise Functional Connectivity (FC). Method: We acquired rs-fMRI scans from 82 subjects (21 tinnitus subjects without hearing loss, 32 subjects with tinnitus and hearing loss, and 29 subjects as healthy control). Age, gender, and year of education were matched across all three groups. We consecutively performed ALFF, ReHo, and Voxel-Wise Functional Connectivity (FC) for all subjects. Result: Compared with the control group (CN), subjects with tinnitus only (T group) and with tinnitus and hearing loss (T+H group) manifested significantly reduced ALFF and ReHo activity within the left and right dorsolateral superior frontal gyrus (SFG). Additional Voxel-Wise Functional Connectivity (FC) revealed decreased connectivity between the dorsolateral SFG (left and right) and right Superior Parietal Gyrus (SPG), right Middle Frontal Gyrus (MFG), and left medial Superior Frontal Gyrus (mSFG) within these two groups. No significant differences were observed between the T and T+H groups. Conclusion: Upon analyzing our data, we suggested disruptions in brain regions responsible for attention and stimuli monitoring and orientations contribute to tinnitus generation. Thus, hearing loss might not be the primary cause of tinnitus.

The authors have declared no competing interest.

This work was supported by the National Natural Science Foundation of China (81970884); National Natural Science Foundation of China youth Science Foundation (82101223); The Project of Invigorating Health Care through Science, Technology and Education (ZDXKB2016015); and The Fellowship of China Postdoctoral Science Foundation (2020M681561).

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The Research Ethics Committee of the Affiliated Zhongda Hospital of Southeast University approved this study.

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