Introduction: The aim of the study was to investigate differences in the intra- and inter-network functional connectivity (FC) of the brain using resting-state functional magnetic resonance imaging (rs-fMRI) in patients with tinnitus, with (T + H) or without hearing loss (T). Methods: We performed rs-fMRI on 82 participants (21 T, 32 T + H, and 29 healthy controls). An independent component analysis (ICA) was performed to obtain the resting-state networks (RSNs) and calculate the differences in FC. Moreover, we investigated the relationships between networks using functional network connectivity analysis. Results: We identified nine major RSNs, including the auditory network; default mode network; executive control network (ECN), including the right frontoparietal network and left frontoparietal network (LFPN); somatomotor network (SMN); dorsal attention network; ventral attention network; salience network (SN); and visual network (VN). These RSNs were extracted in all groups using ICA. Compared with that in the control group, we observed reduced FC between the LFPN and VN in the T group and between the LFPN and SN in the T + H group. The inter-network connectivity analysis revealed decreased network interactions in the SMN (IC 22)-ECN (IC 2), SMN (IC 22)-VN (IC 8), and VN (IC 14)-SN (IC 3) connections in the T + H group, compared with the healthy control group. Furthermore, we observed significantly decreased network interactions in the SMN (IC 22)-VN (IC 8) in the T group. Conclusions: Our results indicated abnormalities within the brain networks of the T and T + H groups, including the SMN, ECN, and VN, compared with the control group. Furthermore, both T and T + H groups demonstrated reduced FC between the LFPN, VN, and SMN. There were no significant differences between the T and the T + H groups. Furthermore, we observed reduced FC between the right olfactory cortex and the orbital part of the right middle frontal gyrus, right precentral gyrus, left dorsolateral superior frontal gyrus, and right triangular part of the inferior frontal gyrus within the T and T + H groups. Thus, disruptions in brain regions responsible for attention, stimulus monitoring, and auditory orientation contribute to tinnitus generation.

Subjective tinnitus is a conscious auditory perception without a corresponding external source. It is one of the most common yet distressing otologic pathologies, affecting approximately 8–20% of the adult population. Tinnitus has different forms, degrees of severity, and onset duration, which can only be described by patients’ testimony and corresponding symptoms. Tinnitus involves multiple brain systems responsible for emotion, attention, memory, and executive function, but the exact mechanism by which tinnitus is generated has not been identified. However, since the etiology of tinnitus is often multifaceted, the neural mechanisms underlying tinnitus generation remain unclear despite gradual advances in this field. Therefore, this study investigated the differences in the intra- and inter-network functional connectivity of the brain using resting-state functional magnetic resonance imaging in patients with tinnitus, with (T + H) or without hearing loss (T). We believe that our study contributes significantly to the literature because our data suggest that disruptions in brain regions responsible for attention, stimuli monitoring, and auditory orientation generate tinnitus. Thus, hearing loss might not be the primary cause of tinnitus. Further, we believe this paper will interest the readership of your journal because our study provides insights into promising treatment options.

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