Tinnitus and tinnitus disorder: Theoretical and operational definitions (an international multidisciplinary proposal)

Dirk De Ridder, Winfried Schlee, Sven Vanneste, Alain Londero, Nathan Weisz, Tobias Kleinjung, Giriraj Singh Shekhawat, Ana Belén Elgoyhen, Jae Jin Song, Gerhard Andersson, Divya Adhia, Andreia Aparecida de Azevedo, David M. Baguley, Eberhard Biesinger, Ana Carolina Binetti, Luca Del Bo, Christopher R. Cederroth, Rilana Cima, Jos J. Eggermont, Ricardo FigueiredoThomas E. Fuller, Silvano Gallus, Annick Gilles, Deborah A. Hall, Paul Van de Heyning, Derek J. Hoare, Eman M. Khedr, Dimitris Kikidis, Maria Kleinstaeuber, Peter M. Kreuzer, Jen Tsung Lai, Jose Miguel Lainez, Michael Landgrebe, Lieber Po Hung Li, Hubert H. Lim, Tien Chen Liu, Jose Antonio Lopez-Escamez, Birgit Mazurek, Aage R. Moller, Patrick Neff, Christo Pantev, Shi Nae Park, Jay F. Piccirillo, Timm B. Poeppl, Josef P. Rauschecker, Richard Salvi, Tanit Ganz Sanchez, Martin Schecklmann, Axel Schiller, Grant D. Searchfield, Richard Tyler, Veronika Vielsmeier, Johan W.S. Vlaeyen, Jinsheng Zhang, Yiwen Zheng, Matteo de Nora, Berthold Langguth

Research output: Chapter in Book/Report/Conference proceedingChapter

104 Scopus citations


As for hypertension, chronic pain, epilepsy and other disorders with particular symptoms, a commonly accepted and unambiguous definition provides a common ground for researchers and clinicians to study and treat the problem. The WHO's ICD11 definition only mentions tinnitus as a nonspecific symptom of a hearing disorder, but not as a clinical entity in its own right, and the American Psychiatric Association's DSM-V doesn't mention tinnitus at all. Here we propose that the tinnitus without and with associated suffering should be differentiated by distinct terms: “Tinnitus” for the former and “Tinnitus Disorder” for the latter. The proposed definition then becomes “Tinnitus is the conscious awareness of a tonal or composite noise for which there is no identifiable corresponding external acoustic source, which becomes Tinnitus Disorder “when associated with emotional distress, cognitive dysfunction, and/or autonomic arousal, leading to behavioural changes and functional disability.”. In other words “Tinnitus” describes the auditory or sensory component, whereas “Tinnitus Disorder” reflects the auditory component and the associated suffering. Whereas acute tinnitus may be a symptom secondary to a trauma or disease, chronic tinnitus may be considered a primary disorder in its own right. If adopted, this will advance the recognition of tinnitus disorder as a primary health condition in its own right. The capacity to measure the incidence, prevalence, and impact will help in identification of human, financial, and educational needs required to address acute tinnitus as a symptom but chronic tinnitus as a disorder.

Original languageEnglish (US)
Title of host publicationTinnitus - An Interdisciplinary Approach Towards Individualized Treatment
Subtitle of host publicationFrom Heterogeneity to Personalized Medicine
EditorsWinfried Schlee, Berthold Langguth, Tobias Kleinjung, Sven Vanneste, Sven Vanneste, Dirk De Ridder
PublisherElsevier B.V.
Number of pages25
ISBN (Print)9780128215869
StatePublished - Jan 2021

Publication series

NameProgress in Brain Research
ISSN (Print)0079-6123
ISSN (Electronic)1875-7855

Bibliographical note

Funding Information:
We would like to thankfully acknowledge the very valuable contributions to the manuscript by the following colleagues, who opted not to be listed as co-authors as they do not agree with all statements put forward in this manuscript:, Arnaud Norena, Pim van Dijk, Lucy Handscomb, James Henry, Fatima T. Husain, Margaret Jastreboff, Pawel J. Jastreboff, Elisabeth Marks, Laurence McKenna, Eui Cheol Nam, and William Sedley. We are looking forward to further fruitful discussions on a comprehensive definition of tinnitus in the future.

Publisher Copyright:
© 2021 Elsevier B.V.


  • Affective
  • Definition
  • Operational
  • Pain
  • Phantom
  • Sound
  • Theoretical
  • Tinnitus


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