“…Central maladaptive plastic changes in response to peripheral insult has become central dogma in the field of tinnitus ( Figure 7(6) ; Roberts et al, 2010 ; Langguth et al, 2013 ; Auerbach et al, 2014 ; Henton and Tzounopoulos, 2021 ). Data from animals and humans have found many unique but likely overlapping mechanisms to explain the neural plastic changes related to tinnitus which include: increases in spontaneous (non-sound evoked) firing rate neural activity ( Longenecker and Galazyuk, 2011 ; Berger et al, 2014 ; Galazyuk et al, 2019 ); increased incidence of neurons burst firing ( Ma et al, 2006 ; Bauer et al, 2008 ), increased or decreased neural synchrony ( Eggermont and Tass, 2015 ; Marks et al, 2018 ), thalamocortical dysrhythmia ( De Ridder et al, 2015 ), altered balance between excitatory and inhibitory neurotransmission ( Middleton et al, 2011 ; Llano et al, 2012 ; Ma et al, 2020 ; Zhang et al, 2021 ), cortical reorganization ( Engineer et al, 2011 ; Jeschke et al, 2021 ), and neural inflammation ( Fuentes-Santamaría et al, 2017 ; Wang et al, 2019 ; Deng et al, 2020 ). The mechanisms of hyperacusis are much less studied but are thought to have similar etiologies as tinnitus ( Auerbach et al, 2014 ).…”