Cervical Spine Disorders and its Association with Tinnitus: The “Triple” Hypothesis

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SOURCE:   Med Hypotheses. 2017 (Jan); 98: 2–4 ~ FULL TEXT

Federica Bressi, Manuele Casale, et al

Department of Physical and Rehabilitation Medicine,
Campus Bio-Medico University,
Rome, Italy.

Subjective tinnitus and cervical spine disorders (CSD) are among the most common complaints encountered by physicians. Although the relationship between tinnitus and CSD has attracted great interest during the past several years, the pathogenesis of tinnitus induced by CSD remains unclear.

Conceivably, cervical spine disorders could trigger a somatosensory pathway-induced disinhibition of dorsal cochlear nucleus (DCN) activity in the auditory pathway; furthermore, CSD can cause inner ear blood impairment induced by vertebral arteries hemodynamic alterations and trigeminal irritation.

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In genetically -predisposed CSD patients with reduced serotoninergic tone, signals from chronically stimulated DCNs could activate specific cortical neuronal networks and plastic neural changes resulting in tinnitus. Therefore, an early specific tailored CSD treatments and/or boosting serotoninergic activity may be required to prevent the creation of ‘tinnitus memory circuits’ in CSD patients.

 

From the Full-Text Article:

Introduction

Tinnitus is an auditory percept – often described as a ‘ringing in the ears’– in absence of a corresponding auditory stimulus and is experienced by approximately 10–20 % of the population. [1]

Tinnitus can result from many different aetiologies, it is usually caused by a disorder of the auditory system or somatosensory system, but it can also result for a combination of both of them. [1] A major challenge in tinnitus research is to identify the different causes of tinnitus in order to develop specific therapies for each tinnitus subtype. [2] Tinnitus could be associated with upper cervical spine disorders (CSD) such as prolapsed intervertebral disks or instability of the craniocervical junction, and neck withplash. [3] In the 1920s the Neri [4]-Barre [5]-Lieou [6] syndrome was described and it is characterized by a broad spectrum of osteoarticular (neck pain with or without root signs) and neurovascular symptoms (headache, auricular signs with vertigo, nystagmus, hypoacusia, retro-orbital pain, and photophobic diplopia).

Some patients with tinnitus could be evoked or modulated by input from the somatic system, for instance by forceful muscle contractions of the head, neck, and limbs, and pressure on myofascial trigger points; two-thirds of the individuals with tinnitus can modulate the loudness or pitch of their tinnitus by voluntary or external manipulations of the jaw, movements of the eyes, or pressure applied to head and neck regions. [7, 8]

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