Tinnitus: Disturbed by phantom sounds

Ever heard a ringing sound that isn’t really there? 

That’s tinnitus - your brain making noise without an external source. This brain misfire can turn a minor annoyance into a life-altering condition.

Once thought to be just an ear problem, research reveals it’s deeply rooted in the brain’s auditory and emotional circuits. 

And it may be a good idea to go see an ENT before it gets on your nerves. Read about why, here:

What does phantom noise sound like?
Tinnitus is a common condition where individuals hear sounds, often described as ringing, buzzing, or hissing. It affects about 10–15% of the population and becomes more common with age. 

For most people, tinnitus is a minor or no disturbance. The noises may come and go during the day, and not every day. For others, it may be constant sound, but change in frequency from high-pitched to a deep buzz, or change intensity during the day. 

But for some again it may just be .. constant.

How the phantom noise alters the brain
The brain’s structure and function appear to change depending on the severity of tinnitus. That has been confirmed in brain imaging studies.

Advanced imaging techniques, such as functional MRI, have shown that different brain regions behave differently based on tinnitus severity. 

Brain regions that work together are connected by fibers that run between the brain cells. In severe tinnitus, some regions, display changed connectivity. That's particularly pronounced between areas involved in auditory processing and emotion regulation. 

Disruptions like that have also been found in “old” brain areas (such as the amygdala and hippocampus). That suggests a deeper neural involvement in tinnitus, affecting emotions and memory.

The strong connection between tinnitus and brain structure and brain function supports the idea that the condition is not just an auditory problem but involves complex brain networks.

What happens in the sound area of the brain?
The auditory cortex is the brain’s sound-processing center. Located in the temporal lobe, it helps us recognize and interpret sounds — from speech to music to background noise. It works by receiving signals from the ears and turning them into meaningful information. 

It turns out that the auditory cortex also plays a key role in tinnitus perception. In mild cases, it can control the extra noise and its activity remains relatively normal. 

However, this brain region becomes hyperactive as its coping mechanisms weaken in severe cases. This could explain why the noise seems louder and harder to ignore. 

Another key region is the angular gyrus. It plays a crucial role in processing language, reading, writing, and number comprehension. Additionally, it integrates sensory information helping us make sense of complex concepts. The angular gyrus is also overactive in tinnitus patients, showing that the brain is working hard to make sense of the phantom sounds.

This suggests that as tinnitus becomes more distressing, the brain constantly tries to adjust to the phantom sounds and adapt in ways that may unintentionally worsen the condition. 

Chronic tinnitus disturbs so many, so much
The emotional burden of tinnitus varies greatly from person to person. Research examining thousands of participants has revealed that even individuals with mild tinnitus can experience poor sleep quality and bad mood. 

Those with severe tinnitus often experience additional symptoms such as insomnia, anxiety, depression, and hearing loss, significantly reducing their quality of life. 

Researchers also observed changes in brain scans of regions responsible for emotional processing (such as the anterior cingulate cortex and superior frontal gyrus). The studies show that individuals with severe tinnitus often have heightened activity in the brain these regions linked to stress, anxiety, and self-reflection. 

The brain’s ability to regulate emotions and suppress unwanted auditory signals appears to weaken as tinnitus worsens. This could explain why severe tinnitus is associated with more intense anxiety and depressive symptoms. 

Additionally, sleep disturbances are closely linked to tinnitus severity. Brain regions involved in both auditory processing and sleep regulation (like the superior temporal gyrus and supramarginal gyrus), show altered activity in severe tinnitus cases.

Difficult to treat - new treatments underway
Traditional treatments, such as sound therapy and cognitive behavioral therapy, aim to reduce distress by retraining the brain’s response to tinnitus - while treatments for the actual disease have been lacking.

Newer approaches, including neuromodulation techniques, may help directly alter abnormal brain activity. Studies on transcranial magnetic stimulation show promising results in reducing tinnitus severity by targeting overactive auditory and emotional brain regions. 

As research progresses, combining brain imaging with clinical assessments may help develop more effective, individualized treatments for those struggling with this persistent condition.

About the scientific paper:

First author: Jiapei Xie, China
Published: Brain Research Bulletin, March 2025
Link to paper: https://www.sciencedirect.com/science/article/pii/S0361923025000620?via%3Dihub