[Tinnitus: clinical and pathogenetic aspects].

The article discusses the pathogenetic and clinical features of tinnitus. It is emphasized that various causes contribute to the appearance of tinnitus, including somatic diseases, excess body weight, iatrogenies, otological diseases with an outcome in hearing loss. The anatomical and physiological features of the structure of the central part of the auditory system are considered. It is suggested that the occurrence of tinnitus is associated with the processes of maladaptive neuroplasticity caused by pathological changes in the neuronal activity of cortical structures of the CNS, and not with changes in the peripheral part of the auditory analyzer - the structures of the cochlea. The results of recent studies, including those using functional neuroimaging methods, indicate the significance of cortical connection disorders (human connectome) in patients with tinnitus. In patients with tinnitus, there are changes in regional neuronal activity and connections not only in the auditory cortex, but also in areas not directly related to the analysis of auditory afferentation. Thus, tinnitus can be considered as one of the variants of dysfunction of the human connectome, triggered primarily from the «auditory input».