Due to the complexity of its etiology and mechanisms, idiopathic tinnitus still lacks effective treatments. As the condition persists, it significantly impairs patients' quality of life. In recent years, with the rapid development of resting-state functional magnetic resonance imaging (rs-fMRI), this technique has been widely applied to investigate the pathological mechanisms of chronic idiopathic tinnitus. A growing body of research suggests that chronic idiopathic tinnitus involves plastic changes across multiple central brain regions.

This study aims to analyze and summarize the research progress over the past decade on the central mechanisms of chronic idiopathic tinnitus using rs-fMRI, clarify the mechanisms of central neural remodeling, and lay a solid foundation for constructing a central model of chronic idiopathic tinnitus.

Retrieval of studies related to the central mechanism of idiopathic tinnitus and rs-fMRI included in China National Knowledge Infrastructure (CNKI), Wanfang Data Knowledge Service Platform, VIP Journal Resource Integration Service Platform (VIP), and PubMed from January 1, 2013 to January 1, 2023, eight studies were included to explore alterations in functional activity in brain regions, while another seven studies investigated changes in functional connectivity within brain networks.

Compared with healthy subjects, patients with chronic idiopathic tinnitus exhibited an excitatory-inhibitory imbalance in the auditory cortex, along with aberrant coupling with limbic system regions such as the amygdala, hippocampus, and frontal-striatal circuit. In terms of brain networks, abnormal functional connectivity was observed in the auditory-visual network, default mode network, executive control network, salience network, attention network, and subcortical-cerebellar network.

This review summarizes current rs-fMRI research on the central mechanisms of chronic idiopathic tinnitus and suggests that the condition may result from neural remodeling involving the auditory pathway, limbic system, and multiple functional brain networks.

特发性耳鸣因其病因和机制的复杂性，尚缺乏有效的治疗方法，且随着病程的迁延，对患者的生活质量造成严重影响。近年来，静息态功能磁共振成像（rs-fMRI）技术快速发展，被广泛应用于慢性特发性耳鸣的病理机制研究，越来越多的研究认为，慢性特发性耳鸣涉及多个大脑中枢脑区的可塑性改变。

分析总结近10年rs-fMRI在慢性特发性耳鸣中枢机制领域的研究现状，梳理慢性特发性耳鸣中枢重塑机制，为塑造慢性特发性耳鸣的中枢模型夯实基础。

检索2013-01-01—2023-01-01中国知网（CNKI）、万方数据知识服务平台、维普期刊资源整合服务平台（VIP）、PubMed中收录的与特发性耳鸣中枢机制及rs-fMRI相关的研究，纳入8项研究探讨慢性特发性耳鸣脑区功能活动的改变，其余7项研究探讨大脑网络功能连接的改变。

本研究发现与健康受试者相比，慢性特发性耳鸣患者听觉中枢兴奋-抑制失衡，并与杏仁核、海马、额叶-纹状体环路等边缘系统脑区发生异常耦合；在脑网络方面，听视网络、默认网络、执行控制网络、突显网络、注意网络及皮层下-小脑网络均发生功能连接的异常。

本文总结目前慢性特发性耳鸣中枢机制的rs-fMRI研究，发现慢性特发性耳鸣可能是听觉通路、边缘系统及多个大脑功能网络神经重塑的结果。