Aberrant auditory prediction patterns robustly characterize tinnitus

Phantom perceptions like tinnitus occur without any identifiable environmental or bodily source. The mechanisms and key drivers behind tinnitus are poorly understood. The dominant framework, suggesting that tinnitus results from neural hyperactivity in the auditory pathway following hearing damage, has been difficult to investigate in humans and has reached explanatory limits. As a result, researchers have tried to explain perceptual and potential neural aberrations in tinnitus within a more parsimonious predictive-coding framework. In two independent magnetoencephalography studies, participants passively listened to sequences of pure tones with varying levels of regularity (i.e. predictability) ranging from random to ordered. Aside from being a replication of the first study, the pre-registered second study, including 80 participants, ensured rigorous matching of hearing status, as well as age, sex, and hearing loss, between individuals with and without tinnitus. Despite some changes in the details of the paradigm, both studies equivalently reveal a group difference in neural representation, based on multivariate pattern analysis, of upcoming stimuli before their onset. These data strongly suggest that individuals with tinnitus engage anticipatory auditory predictions differently to controls. While the observation of different predictive processes is robust and replicable, the precise neurocognitive mechanism underlying it calls for further, ideally longitudinal, studies to establish its role as a potential contributor to, and/or consequence of, tinnitus.