Well I sort of think that the auditory cortex can only work with what is delivered up to it, therefore what it delivers to the rest of your brain is a sum of all the elements that make up the sound you hear. Now, so far as I can see energy has to pass through a number of hurdles, all of which modify its progression in some way to reach the stage where it then converts to chemical/electrical signals, which follow yet more pathways with the final point being the perception of the sound by the cortex, and how it then interacts with all the other neurological senses. If a quick thumbnail summary of this forum is anything to go by, the relationship of tinnitus with hyperacusis isn't always clear-cut. Some have both, some have one without the other and so on. I know myself I have at least two kinds of sound going on, and frequently one of them alters while the other stays ever unchanging, and I have decreased sound tolerance on some days but not on others, yet I have tinnitus sounds 24/7. What I wonder is: Is the baseline tinnitus a neurological lost channel in the great graphic equalizer of human hearing (gain theory) and is hyperacusis more akin to a broken lead going in to the system? I know I'm being half-arsed here because really I don't have the background to think it through to my own satisfaction (as I'm sure someone will point out) but I just can't reconcile the variables in the relationship of T & H. I wouldn't mind knowing what other think or have researched. Japongus spends a lot of time on this.
My question would be is it the chicken or the egg? Is the hyperactivity coming from derangement of the cortical structure itself, or does the hyperactivity come from the cortex being swamped with deranged messages that it can't process in an orderly fashion? The very presence of ear pain I think is significant, and not given due attention.
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