Phantom percepts: Tinnitus and pain as persisting aversive memory networks

DE RIDDER; ELGOYHEN AB; LANGGUTH B; ROMO R

Proc Natl Acad Sci USA

National Academy of Sci USA

Año: 2011 vol. 108 p. 875 - 8080

1091-6490

Phantom perception refers to the conscious awareness of a percept in the absence of an external stimulus. Based on basic neuroscience on perception and clinical research in phantom pain and phantom sound, we propose a working model for their origin. Sensory deafferentation results in high frequency, gamma band, synchronized neuronal activity in the sensory cortex. This activity only becomes a conscious percept if it is connected to larger co-activated ‘(self-)awareness’ and ‘salience’ brain networks. Through the involvement of learning mechanisms, the phantom percept becomes associated to distress, which in turn is reflected by a simultaneously co-activated non-specific distress network consisting of the anterior cingulate cortex, anterior insula and amygdala. Memory mechanisms play a role in the persistence of the awareness of the phantom percept, as well as in the reinforcement of the associated distress. Thus, different dynamic overlapping brain networks should be considered as targets for the treatment of this disorder.