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Peer-reviewedCC BYiScience

Tinnitus and tinnitus disorder: Genetic, neurobiological, and clinical differentiation

  • Dirk De Ridder1
  • Tobias Kleinjung2
  • Jae‐Jin Song3
  • Divya Bharatkumar Adhia1
  • Matt Hall1
  • Anusha Mohan4
  • Sven Vanneste4
  • Alain Londero5
  • Nathan Weisz6
  • Winfried Schlee7
  • Ana Belén Elgoyhen8
  • Christopher Robin Cederroth9
7 more authors
  • Jose Antonio Lopez-Escamez10
  • Silvano Gallus11
  • Stefan Schoisswohl12
  • William Sedley13
  • Grant Donald Searchfield14
  • Shi Nae Park15
  • Berthold Langguth12
15 affiliations
  1. 1Section of Neurosurgery, Department of Surgical Sciences, University of Otago, Dunedin, New Zealand
  2. 2Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Zurich, University of Zurich, Swiss Federal Institute of Technology Zurich, Zurich, Switzerland
  3. 3Department of Otorhinolaryngology, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
  4. 4Global Brain Health Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland
  5. 5Université Paris Cité, Institut Pasteur, AP-HP, Hôpital Lariboisière, Service ORL, INSERM, Fondation Pour l'Audition, IHU reConnect, Paris, France
  6. 6Centre for Cognitive Neuroscience, Department of Psychology, University of Salzburg, Salzburg, Salzburg, Austria
  7. 7Institute for Information and Process Management, Eastern Switzerland University of Applied Sciences, St. Gallen, Switzerland
  8. 8Department of Pharmacology, University of Buenos Aires, Buenos Aires, Argentina
  9. 9Laboratory of Experimental Audiology, Department of Physiology and Pharmacology, Karolinska Institute, Stockholm, Sweden
  10. 10The University of Sydney, School of Medical Sciences, Faculty of Medicine and Health, Sydney, NSW, Australia
  11. 11Department of Medical Epidemiology, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
  12. 12Department of Psychiatry and Psychotherapy, University of Regensburg at Bezirksklinikum Regensburg, Regensburg, Germany
  13. 13Translational and Clinical Research Institute, Newcastle University, Newcastle, UK
  14. 14Audiology, University of Auckland, Auckland, New Zealand
  15. 15Department of Otolaryngology-HNS, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Republic of Korea
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Abstract

Tinnitus is the conscious perception of sound in the absence of an external acoustic source. When accompanied by emotional distress, cognitive dysfunction, or autonomic arousal leading to behavioral and functional impairment, it is termed "tinnitus disorder." This perspective synthesizes genetic, epidemiological, and neuroimaging evidence supporting the distinction between tinnitus and tinnitus disorder. Genetic studies indicate that tinnitus is linked to multiple common variants of small effect size, whereas tinnitus disorder involves rarer variants exerting larger effects. Epidemiologically, hearing loss is the primary risk factor for tinnitus, whereas personality traits like neuroticism, mood, and sleep disturbances predict tinnitus disorder. Neuroimaging identifies three interrelated neural pathways: a lateral "loudness" pathway, a descending "inhibitory" pathway, and a medial "distress" pathway that is specifically activated in tinnitus disorder, providing a neural basis for tinnitus related suffering. Future needs include the establishment of standardized diagnostic criteria and a severity grading system of tinnitus disorder.

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Cite

BibTeXRIS
BibTeX
@article{ridder2026tinnitus,
  title = {{Tinnitus and tinnitus disorder: Genetic, neurobiological, and clinical differentiation}},
  author = {Dirk De Ridder and Tobias Kleinjung and Jae‐Jin Song and Divya Bharatkumar Adhia and Matt Hall and Anusha Mohan and Sven Vanneste and Alain Londero and Nathan Weisz and Winfried Schlee and Ana Belén Elgoyhen and Christopher Robin Cederroth and Jose Antonio Lopez-Escamez and Silvano Gallus and Stefan Schoisswohl and William Sedley and Grant Donald Searchfield and Shi Nae Park and Berthold Langguth},
  journal = {iScience},
  year = {2026},
  month = jun,
  doi = {10.1016/j.isci.2026.116080},
  url = {https://doi.org/10.1016/j.isci.2026.116080},
  note = {CC BY},
}
RIS
TY  - JOUR
TI  - Tinnitus and tinnitus disorder: Genetic, neurobiological, and clinical differentiation
AU  - Dirk De Ridder
AU  - Tobias Kleinjung
AU  - Jae‐Jin Song
AU  - Divya Bharatkumar Adhia
AU  - Matt Hall
AU  - Anusha Mohan
AU  - Sven Vanneste
AU  - Alain Londero
AU  - Nathan Weisz
AU  - Winfried Schlee
AU  - Ana Belén Elgoyhen
AU  - Christopher Robin Cederroth
AU  - Jose Antonio Lopez-Escamez
AU  - Silvano Gallus
AU  - Stefan Schoisswohl
AU  - William Sedley
AU  - Grant Donald Searchfield
AU  - Shi Nae Park
AU  - Berthold Langguth
PY  - 2026
DA  - 2026/06/01
JO  - iScience
DO  - 10.1016/j.isci.2026.116080
UR  - https://doi.org/10.1016/j.isci.2026.116080
AB  - Tinnitus is the conscious perception of sound in the absence of an external acoustic source. When accompanied by emotional distress, cognitive dysfunction, or autonomic arousal leading to behavioral and functional impairment, it is termed "tinnitus disorder." This perspective synthesizes genetic, epidemiological, and neuroimaging evidence supporting the distinction between tinnitus and tinnitus disorder. Genetic studies indicate that tinnitus is linked to multiple common variants of small effect size, whereas tinnitus disorder involves rarer variants exerting larger effects. Epidemiologically, hearing loss is the primary risk factor for tinnitus, whereas personality traits like neuroticism, mood, and sleep disturbances predict tinnitus disorder. Neuroimaging identifies three interrelated neural pathways: a lateral "loudness" pathway, a descending "inhibitory" pathway, and a medial "distress" pathway that is specifically activated in tinnitus disorder, providing a neural basis for tinnitus related suffering. Future needs include the establishment of standardized diagnostic criteria and a severity grading system of tinnitus disorder.
SN  - 2589-0042
ER  -