What Is the Neurophysiological Model of Tinnitus?

The neurophysiological model of tinnitus, first described by Jastreboff and Hazell in their landmark 1993 paper published in the British Journal of Audiology, explains tinnitus not as a simple ear problem but as a complex interaction between three neurological processes. Understanding this model is the foundation of every effective tinnitus treatment — including Neuromonics.

Up to 99% of tinnitus cases are subjective tinnitus — sound that is only audible to the affected individual, typically linked to hearing loss or auditory system dysfunction. While the trigger is usually in the ear, the tinnitus experience itself is generated and maintained entirely in the brain.

The Three Processes That Create Distressing Tinnitus

Process 1: Auditory System — the initial perception of tinnitus.

When hearing damage reduces cochlear input, the auditory cortex compensates by amplifying its own neural activity at the affected frequencies. Studies have shown that auditory deprivation causes the auditory system to become more active and more sensitive to sound. The cortex detects this amplified background neurological activity and interprets it as the ringing or buzzing sounds perceived in tinnitus. Changes in the auditory cortex also involve reorganization of the tonotopic map — the frequency map of sound that is laid out across the cortex.

Process 2: Attentional Filters — why you cannot stop noticing it.

The brain has powerful perceptual filters that constantly decide which sensory signals to bring to conscious attention and which to suppress. In tinnitus, an importance label gets attached to the tinnitus sound, causing the attentional filter to constantly monitor for and surface the signal — even when the brain could have filtered it out. This attentional lock-in is self-reinforcing: the more you attend to tinnitus, the more the filter confirms its importance.

Process 3: Limbic System and Autonomic Nervous System — the emotional reaction.

For those experiencing distressing tinnitus, the limbic system of the brain and the autonomic nervous system become engaged in response to the awareness of tinnitus. This causes a stressful state of high arousal and anxiety. This reaction also reinforces both the initial perception of and attentional response to tinnitus — leading to further increase in tinnitus loudness and awareness, which in turn increases the level of stress, in a self-perpetuating vicious cycle that makes tinnitus progressively worse over time.

The Self-Reinforcing Cycle

These three processes don't just coexist — they actively amplify each other. The auditory system generates the signal. The attentional system flags it as important. The limbic system generates distress. The distress activates the autonomic nervous system, increasing arousal and auditory sensitivity. Increased sensitivity makes the auditory signal stronger. The stronger signal receives even more attentional focus. The cycle continues, progressively worsening over time without intervention.

Effective tinnitus treatment must interrupt this cycle at every level simultaneously — which is why treatments that target only the ear rarely produce lasting results.

How Neuromonics Addresses All Three Processes

The Neuromonics approach was designed from the outset to address all three processes simultaneously, because the neurophysiological model makes clear that all three must be addressed for lasting results.

For the auditory system: personalized acoustic stimulation calibrated to the individual's audiogram delivers enriched input to the precise frequency regions where hearing loss has created auditory deprivation, reducing the auditory cortex's compensatory hyperactivity over time.

For the attentional filters: the specially-processed music engages and gradually retrains the attentional filter system. Through repeated experience of the tinnitus signal alongside engaging, emotionally-neutral acoustic input, the brain learns to reclassify the tinnitus as unimportant — removing the importance label that keeps it in conscious awareness.

For the limbic response: music engages the limbic system in a positive, emotionally-neutral way — directly counteracting the negative emotional conditioning that has linked the tinnitus signal to the anxiety response. Over time, the conditioned fight-or-flight reaction to tinnitus is replaced by a neutral association.

This is why Neuromonics produces results that persist after treatment ends. The neurological changes are genuine — the brain has been retrained across all three processes, not just temporarily suppressed.