Increased basal ganglia volume in older adults with tinnitus.

Tinnitus is the perception of sounds without external stimuli, affecting 10%-15% of the general population and up to 25% of individuals over 70 years of age. While traditionally viewed as an auditory phenomenon, growing evidence highlights the role of the central nervous system in its pathophysiology. One of the proposed mechanisms, the "gating hypothesis" of tinnitus, suggests an alteration in the modulation of sensory activity by the frontostriatal network. Although structural changes in frontal areas support this idea, gray matter differences in subcortical regions-such as the auditory pathway and basal ganglia-remain poorly understood. Here, we examined subcortical structures and auditory function in older adults with mild presbycusis from the ANDES cohort, including 51 tinnitus patients and 40 age-matched controls. We analyzed brain volume via structural magnetic resonance imaging and subcortical auditory functionality via auditory brainstem responses (ABRs). We found non-significant differences in age, hearing loss, cognitive impairment, and ABR amplitudes between the groups. Notably, tinnitus patients presented a significant increase in the volume of basal ganglia structures (striatum and pallidum) but not in auditory areas. These findings reinforce the role of the basal ganglia in age-related tinnitus pathophysiology.