{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T21:54:33Z","timestamp":1787003673592,"version":"build-2736575974"},"reference-count":90,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,3,18]],"date-time":"2025-03-18T00:00:00Z","timestamp":1742256000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"},{"start":{"date-parts":[[2025,3,18]],"date-time":"2025-03-18T00:00:00Z","timestamp":1742256000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"funder":[{"DOI":"10.13039\/100001170","name":"Hitchcock Foundation","doi-asserted-by":"publisher","award":["250-8006"],"award-info":[{"award-number":["250-8006"]}],"id":[{"id":"10.13039\/100001170","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100015359","name":"Connecticut Institute for the Brain and Cognitive Sciences","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100015359","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Munck-Pfefferkorn Novel and Interactive Grant program"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Sci Rep"],"DOI":"10.1038\/s41598-025-93664-4","type":"journal-article","created":{"date-parts":[[2025,3,18]],"date-time":"2025-03-18T15:08:31Z","timestamp":1742310511000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Altered auditory brainstem responses are post-acute sequela of SARS-CoV-2 (PASC)"],"prefix":"10.1038","volume":"15","author":[{"given":"Christopher","family":"Niemczak","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erika","family":"Skoe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samantha","family":"Leigh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linda","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Megan","family":"Dotzenrod","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annalise","family":"Kieley","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simon","family":"Stone","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey","family":"Parsonnet","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christina","family":"Martin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christin","family":"Ealer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Odile","family":"Clavier","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiang","family":"Gui","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angela","family":"Waszkiewicz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Roth","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jay","family":"Buckey","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,3,18]]},"reference":[{"key":"93664_CR1","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1007\/s11910-021-01130-1","volume":"21","author":"N Moghimi","year":"2021","unstructured":"Moghimi, N. et al. The neurological manifestations of post-acute sequelae of SARS-CoV-2 infection. Curr. Neurol. Neurosci. Rep. 21, 1\u201317 (2021).","journal-title":"Curr. Neurol. Neurosci. Rep."},{"issue":"11","key":"93664_CR2","doi-asserted-by":"publisher","first-page":"1328","DOI":"10.1016\/S2213-2600(21)00385-4","volume":"9","author":"AM Parker","year":"2021","unstructured":"Parker, A. M. et al. Addressing the post-acute sequelae of SARS-CoV-2 infection: A multidisciplinary model of care. Lancet Respiratory Med. 9 (11), 1328\u20131341 (2021).","journal-title":"Lancet Respiratory Med."},{"issue":"5","key":"93664_CR3","doi-asserted-by":"publisher","first-page":"267","DOI":"10.3949\/ccjm.88a.21010","volume":"88","author":"S Vehar","year":"2021","unstructured":"Vehar, S., Boushra, M., Ntiamoah, P. & Biehl, M. Post-acute sequelae of SARS-CoV-2 infection: Caring for the \u2018long-haulers\u2019. Cleve Clin. J. Med. 88 (5), 267\u2013272 (2021).","journal-title":"Cleve Clin. J. Med."},{"issue":"4","key":"93664_CR4","doi-asserted-by":"publisher","first-page":"626","DOI":"10.1038\/s41591-021-01292-y","volume":"27","author":"CH Sudre","year":"2021","unstructured":"Sudre, C. H. et al. Attributes and predictors of long COVID. Nat. Med. 27 (4), 626\u2013631 (2021).","journal-title":"Nat. Med."},{"issue":"6","key":"93664_CR5","doi-asserted-by":"publisher","first-page":"603","DOI":"10.1001\/jama.2020.12603","volume":"324","author":"A Carf\u00ec","year":"2020","unstructured":"Carf\u00ec, A., Bernabei, R. & Landi, F. Persistent symptoms in patients after acute COVID-19. Jama 324 (6), 603\u2013605 (2020).","journal-title":"Jama"},{"issue":"2","key":"93664_CR6","doi-asserted-by":"publisher","first-page":"61","DOI":"10.1080\/21641846.2020.1778227","volume":"8","author":"MF Islam","year":"2020","unstructured":"Islam, M. F., Cotler, J. & Jason, L. A. Post-viral fatigue and COVID-19: Lessons from past epidemics. Fatigue Biomed. Health Behav. 8 (2), 61\u201369. https:\/\/doi.org\/10.1080\/21641846.2020.1778227 (2020).","journal-title":"Fatigue: Biomed. Health Behav."},{"key":"93664_CR7","doi-asserted-by":"publisher","first-page":"18","DOI":"10.1016\/j.bbi.2020.03.031","volume":"87","author":"Y Wu","year":"2020","unstructured":"Wu, Y. et al. Nervous system involvement after infection with COVID-19 and other coronaviruses. Brain. Behav. Immun. 87, 18\u201322 (2020).","journal-title":"Brain. Behav. Immun."},{"key":"93664_CR8","doi-asserted-by":"publisher","unstructured":"Khateb, M., Bosak, N. & Muqary, M. Coronaviruses and central nervous system manifestations. Front. Neurol. 11doi https:\/\/doi.org\/10.3389\/fneur.2020.00715 (2020).","DOI":"10.3389\/fneur.2020.00715"},{"key":"93664_CR9","doi-asserted-by":"publisher","first-page":"1087896","DOI":"10.3389\/fneur.2022.1087896","volume":"13","author":"HF Haider","year":"2022","unstructured":"Haider, H. F. & Szczepek, A. J. Neurotological consequences of long COVID. Front. Neurol. 13, 1087896 (2022).","journal-title":"Front. Neurol."},{"key":"93664_CR10","doi-asserted-by":"crossref","unstructured":"Junior, G. Z. et al. Neurologic and neuropsychiatric symptoms in long-COVID 19 syndrome: A systematic review (Research Square Platform LLC, 2022).","DOI":"10.21203\/rs.3.rs-1359143\/v1"},{"key":"93664_CR11","doi-asserted-by":"publisher","first-page":"18","DOI":"10.1016\/j.bbi.2020.03.031","volume":"87","author":"Y Wu","year":"2020","unstructured":"Wu, Y. et al. Nervous system involvement after infection with COVID-19 and other coronaviruses. Brain Behav. Immun.. 87, 18\u201322. https:\/\/doi.org\/10.1016\/j.bbi.2020.03.031 (2020).","journal-title":"Brain Behav. Immun. Jul"},{"key":"93664_CR12","doi-asserted-by":"crossref","unstructured":"Alves de Sousa, F., Costa, R., Xar\u00e1, S., Pinto, A. & Almeida, E. S. SARS-CoV-2 and hearing: An audiometric analysis of COVID-19 hospitalized patients. J. Otol.(2021).","DOI":"10.1016\/j.joto.2021.01.005"},{"issue":"5","key":"93664_CR13","doi-asserted-by":"publisher","first-page":"2523","DOI":"10.1007\/s00405-021-07217-2","volume":"279","author":"H Verma","year":"2022","unstructured":"Verma, H., Shah, J., Akhilesh, K. & Shukla, B. Patients\u2019 perspective about speech, swallowing and hearing status post-SARS-CoV-2 (COVID-19) recovery: E-survey. Eur. Arch. Otorhinolaryngol. 279 (5), 2523\u20132532. https:\/\/doi.org\/10.1007\/s00405-021-07217-2 (2022).","journal-title":"Eur. Arch. Otorhinolaryngol."},{"key":"93664_CR14","doi-asserted-by":"crossref","unstructured":"Almishaal, A. A. & Alrushaidan, A. A. Short- and long-term self-reported audiovestibular symptoms of SARS-CoV-2 infection in hospitalized and nonhospitalized patients. Audiol. Neurotol. 1\u201315. (2022).","DOI":"10.1159\/000521963"},{"key":"93664_CR15","doi-asserted-by":"publisher","first-page":"S87","DOI":"10.14639\/0392-100X-suppl.1-42-2022-10","volume":"42","author":"P De Luca","year":"2022","unstructured":"De Luca, P. et al. Long COVID, audiovestibular symptoms and persistent chemosensory dysfunction: A systematic review of the current evidence. Acta Otorhinolaryngol. Ital. 42, S87\u2013S93 (2022).","journal-title":"Acta Otorhinolaryngol. Ital."},{"issue":"9","key":"93664_CR16","doi-asserted-by":"publisher","first-page":"810","DOI":"10.1017\/s0022215121001961","volume":"135","author":"\u00d6 Gedik","year":"2021","unstructured":"Gedik, \u00d6., H\u00fcsam, H., Ba\u015f\u00f6z, M., Tas, N. & Aksoy, F. The effect of coronavirus disease 2019 on the hearing system. J. Laryngol. Otol. 135 (9), 810\u2013814. https:\/\/doi.org\/10.1017\/s0022215121001961 (2021).","journal-title":"J. Laryngology Otology"},{"issue":"3","key":"93664_CR17","doi-asserted-by":"publisher","first-page":"103428","DOI":"10.1016\/j.amjoto.2022.103428","volume":"43","author":"B \u00d6zt\u00fcrk","year":"2022","unstructured":"\u00d6zt\u00fcrk, B., Kavruk, H. & Aykul, A. Audiological findings in individuals diagnosed with COVID-19. Am. J. Otolaryngol. 43 (3), 103428 (2022).","journal-title":"Am. J. Otolaryngol."},{"key":"93664_CR18","doi-asserted-by":"publisher","first-page":"1931","DOI":"10.2147\/IDR.S398126","volume":"16","author":"K Dorobisz","year":"2023","unstructured":"Dorobisz, K., Pazdro-Zastawny, K., Misiak, P., Kruk-Krzemie\u0144, A. & Zato\u0144ski, T. Sensorineural hearing loss in patients with Long-COVID-19: Objective and behavioral audiometric findings. Infect. Drug Resist. 16, 1931\u20131939 (2023).","journal-title":"Infect. Drug Resist."},{"key":"93664_CR19","doi-asserted-by":"crossref","unstructured":"Burkard, R. F. & Sims, D. The human auditory brainstem response to high click rates. (2001).","DOI":"10.1044\/1059-0889(2001\/008)"},{"issue":"2","key":"93664_CR20","doi-asserted-by":"publisher","first-page":"186","DOI":"10.1177\/000348947708600209","volume":"86","author":"M Don","year":"1977","unstructured":"Don, M., Allen, A. R. & Starr, A. Effect of click rate on the latency of auditory brain stem responses in humans. Ann. Otol. Rhinol. Laryngol. 86 (2), 186\u2013195 (1977).","journal-title":"Annals Otology Rhinology Laryngology"},{"issue":"2","key":"93664_CR21","doi-asserted-by":"publisher","first-page":"91","DOI":"10.1007\/bf00469746","volume":"222","author":"T Yagi","year":"1979","unstructured":"Yagi, T. & Kaga, K. The effect of the click repetition rate on the latency of the auditory evoked brain stem response and its clinical use for a neurological diagnosis. Arch. Oto-Rhino-Laryngol. 222 (2), 91\u201397. https:\/\/doi.org\/10.1007\/bf00469746 (1979).","journal-title":"Arch. Oto-Rhino-Laryngol."},{"issue":"3","key":"93664_CR22","first-page":"226","volume":"4","author":"G Paludetti","year":"1983","unstructured":"Paludetti, G., Maurizi, M. & Ottaviani, F. Effects of stimulus repetition rate on the auditory brain stem responses (ABR). Otol. Neurotol. 4 (3), 226\u2013234 (1983).","journal-title":"Otology Neurotology"},{"issue":"2","key":"93664_CR23","doi-asserted-by":"publisher","first-page":"115","DOI":"10.1097\/00003446-198704000-00009","volume":"8","author":"JT Jacobson","year":"1987","unstructured":"Jacobson, J. T., Murray, T. & Deppe, U. The effects of ABR stimulus repetition rate in multiple sclerosis. Ear Hear. 8 (2), 115\u2013120 (1987).","journal-title":"Ear Hear."},{"key":"93664_CR24","doi-asserted-by":"crossref","unstructured":"Johannesen, P. T. & Lopez-Poveda, E. A. Age-related central gain compensation for reduced auditory nerve output for people with normal audiograms, with and without tinnitus. Iscience 24(6) (2021).","DOI":"10.1016\/j.isci.2021.102658"},{"key":"93664_CR25","doi-asserted-by":"publisher","unstructured":"Rumschlag, J. A. et al., Age-related central gain with degraded neural synchrony in the auditory brainstem of mice and humans. Neurobiol. Aging. 115, 50\u201359. https:\/\/doi.org\/10.1016\/j.neurobiolaging.2022.03.014 (2022).","DOI":"10.1016\/j.neurobiolaging.2022.03.014"},{"key":"93664_CR26","doi-asserted-by":"publisher","unstructured":"White, K. R., Forsman, I., Eichwald, J. & Munoz, K. Apr. The evolution of early hearing detection and intervention programs in the United States. Seminars Perinatol. 34 (2), 170\u2013179 (2010). https:\/\/doi.org\/10.1053\/j.semperi.2009.12.009","DOI":"10.1053\/j.semperi.2009.12.009"},{"issue":"3\u20134","key":"93664_CR27","doi-asserted-by":"publisher","first-page":"349","DOI":"10.1016\/0531-5565(94)00052-5","volume":"30","author":"DM Caspary","year":"1995","unstructured":"Caspary, D. M., Milbrandt, J. C. & Helfert, R. H. Central auditory aging: GABA changes in the inferior colliculus. Exp. Gerontol. 30 (3\u20134), 349\u2013360 (1995).","journal-title":"Exp. Gerontol."},{"issue":"38","key":"93664_CR28","doi-asserted-by":"publisher","first-page":"7201","DOI":"10.1523\/jneurosci.0242-22.2022","volume":"42","author":"KC Harris","year":"2022","unstructured":"Harris, K. C. et al. Afferent loss, GABA, and central gain in older adults: Associations with speech recognition in noise. J. Neurosci. 42 (38), 7201\u20137212. https:\/\/doi.org\/10.1523\/jneurosci.0242-22.2022 (2022).","journal-title":"J. Neurosci."},{"key":"93664_CR29","doi-asserted-by":"publisher","unstructured":"Auerbach, B. D., Rodrigues, P. V. & Salvi, R. J. Central gain control in tinnitus and hyperacusis. Rev.  Front. Neurol.. 24 (206) (2014). https:\/\/doi.org\/10.3389\/fneur.2014.00206 (2014).","DOI":"10.3389\/fneur.2014.00206"},{"key":"93664_CR30","doi-asserted-by":"crossref","unstructured":"Roberts, L. E. & Salvi, R. Overview Hearing Loss, Tinnitus, Hyperacusis, and the Role of Central Gain, p. 1\u20137 (Elsevier, 2019).","DOI":"10.1016\/j.neuroscience.2019.03.021"},{"issue":"9904","key":"93664_CR31","doi-asserted-by":"publisher","first-page":"1600","DOI":"10.1016\/S0140-6736(13)60142-7","volume":"382","author":"D Baguley","year":"2013","unstructured":"Baguley, D., McFerran, D., Hall, D. & Tinnitus Lancet 382 (9904), 1600\u20131607 (2013).","journal-title":"Lancet"},{"key":"93664_CR32","first-page":"118","volume":"13","author":"A Shulman","year":"2007","unstructured":"Shulman, A., Goldstein, B. & Strashun, A. M. Central nervous system neurodegeneration and tinnitus: A clinical experience. Int. Tinnitus J. 13, 118\u2013131 (2007).","journal-title":"Int. Tinnitus J."},{"key":"93664_CR33","doi-asserted-by":"publisher","unstructured":"Vasilkov, V. et al. Evidence of cochlear neural degeneration in normal-hearing subjects with tinnitus. Sci. Rep. 13 (1). https:\/\/doi.org\/10.1038\/s41598-023-46741-5 (2023).","DOI":"10.1038\/s41598-023-46741-5"},{"key":"93664_CR34","doi-asserted-by":"publisher","first-page":"93","DOI":"10.1016\/j.neuroscience.2018.09.036","volume":"21","author":"BD Auerbach","year":"2019","unstructured":"Auerbach, B. D., Radziwon, K. & Salvi, R. Testing the central gain model: Loudness growth correlates with central auditory gain enhancement in a rodent model of hyperacusis. Neurosci. 21, 407:93\u2013107. https:\/\/doi.org\/10.1016\/j.neuroscience.2018.09.036 (2019).","journal-title":"Neurosci. May"},{"key":"93664_CR35","doi-asserted-by":"publisher","first-page":"36","DOI":"10.1016\/j.heares.2018.06.003","volume":"365","author":"JT Valderrama","year":"2018","unstructured":"Valderrama, J. T. et al. Effects of lifetime noise exposure on the middle-age human auditory brainstem response, tinnitus and speech-in-noise intelligibility. Hear. Res. 365, 36\u201348. https:\/\/doi.org\/10.1016\/j.heares.2018.06.003 (2018). 2018\/08\/01\/.","journal-title":"Hear. Res."},{"key":"93664_CR36","doi-asserted-by":"crossref","unstructured":"Gu, J. W., Halpin, C. F., Nam, E-C., Levine, R. A. & Melcher, J. R. Tinnitus, diminished sound-level tolerance, and elevated auditory activity in humans with clinically normal hearing sensitivity. J. Neurophysiol. (2010).","DOI":"10.1152\/jn.00226.2010"},{"key":"93664_CR37","doi-asserted-by":"publisher","first-page":"237","DOI":"10.3389\/fnagi.2017.00237","volume":"9","author":"V Milloy","year":"2017","unstructured":"Milloy, V., Fournier, P., Benoit, D., Nore\u00f1a, A. & Koravand, A. Auditory brainstem responses in tinnitus: A review of who, how, and what? Front. Aging Neurosci. 9, 237 (2017).","journal-title":"Front. Aging Neurosci."},{"issue":"6","key":"93664_CR38","doi-asserted-by":"publisher","first-page":"819","DOI":"10.1007\/s10162-012-0344-1","volume":"13","author":"JW Gu","year":"2012","unstructured":"Gu, J. W., Herrmann, B. S., Levine, R. A. & Melcher, J. R. Brainstem auditory evoked potentials suggest a role for the ventral cochlear nucleus in tinnitus. J. Assoc. Res. Otolaryngol. 13 (6), 819\u2013833. https:\/\/doi.org\/10.1007\/s10162-012-0344-1 (2012).","journal-title":"J. Assoc. Res. Otolaryngol."},{"issue":"5","key":"93664_CR39","doi-asserted-by":"publisher","first-page":"881","DOI":"10.1097\/aud.0000000000000544","volume":"39","author":"NF Bramhall","year":"2018","unstructured":"Bramhall, N. F., Konrad-Martin, D. & McMillan, G. P. Tinnitus and auditory perception after a history of noise exposure: Relationship to auditory brainstem response measures. Ear Hear. 39 (5), 881\u2013894. https:\/\/doi.org\/10.1097\/aud.0000000000000544 (2018).","journal-title":"Ear Hear."},{"issue":"38","key":"93664_CR40","doi-asserted-by":"publisher","first-page":"13452","DOI":"10.1523\/jneurosci.2156-11.2011","volume":"21","author":"R Schaette","year":"2011","unstructured":"Schaette, R. & McAlpine, D. Tinnitus with a normal audiogram: Physiological evidence for hidden hearing loss and computational model. J. Neurosci. Off. J. Soc. Neurosci. 21 (38), 13452\u201313457. https:\/\/doi.org\/10.1523\/jneurosci.2156-11.2011 (2011).","journal-title":"J. Neuroscience: Official J. Soc. Neurosci. Sep."},{"issue":"3","key":"93664_CR41","doi-asserted-by":"publisher","first-page":"1548","DOI":"10.1121\/1.2167147","volume":"119","author":"JW Tampas","year":"2006","unstructured":"Tampas, J. W. & Harkrider, A. W. Auditory evoked potentials in females with high and low acceptance of background noise when listening to speech. J. Acoust. Soc. Am. 119 (3), 1548\u20131561 (2006).","journal-title":"J. Acoust. Soc. Am."},{"issue":"8","key":"93664_CR42","doi-asserted-by":"publisher","first-page":"711","DOI":"10.1016\/j.amjmed.2010.02.015","volume":"123","author":"J Shargorodsky","year":"2010","unstructured":"Shargorodsky, J., Curhan, G. C. & Farwell, W. R. Prevalence and characteristics of tinnitus among US adults. Am. J. Med. 123 (8), 711\u2013718 (2010).","journal-title":"Am. J. Med."},{"issue":"6","key":"93664_CR43","doi-asserted-by":"publisher","first-page":"311","DOI":"10.3109\/00206099509071921","volume":"34","author":"SE Kramer","year":"1995","unstructured":"Kramer, S. E., Kapteyn, T. S., Festen, J. M. & Tobi, H. Factors in subjective hearing disability. Audiol.. 34 (6), 311\u2013320 (1995).","journal-title":"Audiol. Nov-Dec"},{"key":"93664_CR44","unstructured":"Beck, A. T., Steer, R. A. & Brown, G. K. Beck depression inventory. San Antonio TX (1987)."},{"key":"93664_CR45","unstructured":"Beck, A. T., Epstein, N., Brown, G. & Steer, R. Beck anxiety inventory. J. Consult. Clin. Psychol. (1993)."},{"key":"93664_CR46","doi-asserted-by":"crossref","unstructured":"Beck, A. T., Steer, R. A. & Brown, G. K. BDI-II, Beck Depression Inventory 2nd edn vi (Psychological Corp, 1996).","DOI":"10.1037\/t00742-000"},{"issue":"2","key":"93664_CR47","doi-asserted-by":"publisher","first-page":"147","DOI":"10.1016\/0022-3999(93)90081-p","volume":"37","author":"T Chalder","year":"1993","unstructured":"Chalder, T. et al. Development of a fatigue scale. J. Psychosom. Res. 37 (2), 147\u2013153. https:\/\/doi.org\/10.1016\/0022-3999(93)90081-p (1993).","journal-title":"J. Psychosom. Res."},{"issue":"1","key":"93664_CR48","doi-asserted-by":"publisher","first-page":"17","DOI":"10.1016\/j.jpsychores.2009.10.007","volume":"69","author":"M Cella","year":"2010","unstructured":"Cella, M. & Chalder, T. Measuring fatigue in clinical and community settings. J. Psychosom. Res. 69 (1), 17\u201322. https:\/\/doi.org\/10.1016\/j.jpsychores.2009.10.007 (2010).","journal-title":"J. Psychosom. Res. Jul"},{"issue":"1","key":"93664_CR49","doi-asserted-by":"publisher","first-page":"53","DOI":"10.1016\/s0022-3999(97)00291-2","volume":"45","author":"JH Loge","year":"1998","unstructured":"Loge, J. H., Ekeberg, O. & Kaasa, S. Fatigue in the general Norwegian population: Normative data and associations. J. Psychosom. Res. 45 (1), 53\u201365. https:\/\/doi.org\/10.1016\/s0022-3999(97)00291-2 (1998).","journal-title":"J. Psychosom. Res. Jul"},{"issue":"3","key":"93664_CR50","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1097\/00001199-199510030-00002","volume":"10","author":"KD Cicerone","year":"1995","unstructured":"Cicerone, K. D. & Kalmar, K. Persistent postconcussion syndrome: The structure of subjective complaints after mild traumatic brain injury. J. Head Trauma Rehabil. 10 (3), 1\u201317 (1995).","journal-title":"J. Head Trauma Rehabil."},{"issue":"6","key":"93664_CR51","doi-asserted-by":"publisher","first-page":"447","DOI":"10.1097\/HTR.0b013e3181d5bdbd","volume":"25","author":"LJ Caplan","year":"2010","unstructured":"Caplan, L. J. et al. The structure of postconcussive symptoms in 3 US military samples. J. Head Trauma Rehabil. 25 (6), 447\u2013458 (2010).","journal-title":"J. Head Trauma Rehabil."},{"key":"93664_CR52","doi-asserted-by":"publisher","first-page":"138","DOI":"10.1016\/j.heares.2017.01.003","volume":"349","author":"MC Liberman","year":"2017","unstructured":"Liberman, M. C. & Kujawa, S. G. Cochlear synaptopathy in acquired sensorineural hearing loss: Manifestations and mechanisms. Hear. Res. Jun. 349, 138\u2013147. https:\/\/doi.org\/10.1016\/j.heares.2017.01.003 (2017).","journal-title":"Hear. Res. Jun"},{"key":"93664_CR53","doi-asserted-by":"publisher","unstructured":"Hamdy, M. M., Hosny, N. A., Farag, R. G. & Elbohy, Z. M. Y. Assessment of cortical evoked potential (P300) and auditory brainstem response (ABR) in post-COVID-19 patients. Egypt. J. Otolaryngol. 40 (1). https:\/\/doi.org\/10.1186\/s43163-024-00612-6 (2024).","DOI":"10.1186\/s43163-024-00612-6"},{"issue":"4","key":"93664_CR54","doi-asserted-by":"publisher","first-page":"573","DOI":"10.1021\/acschemneuro.0c00793","volume":"17","author":"SJ Yong","year":"2021","unstructured":"Yong, S. J. Persistent brainstem dysfunction in Long-COVID: A hypothesis. ACS Chem. Neurosci.. 17 (4), 573\u2013580. https:\/\/doi.org\/10.1021\/acschemneuro.0c00793 (2021).","journal-title":"ACS Chem. Neurosci. Feb"},{"key":"93664_CR55","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1007\/s00401-020-02166-2","volume":"140","author":"RR Reichard","year":"2020","unstructured":"Reichard, R. R. et al. Neuropathology of COVID-19: A spectrum of vascular and acute disseminated encephalomyelitis (ADEM)-like pathology. Acta Neuropathol. 140, 1\u20136 (2020).","journal-title":"Acta Neuropathol."},{"issue":"4","key":"93664_CR56","doi-asserted-by":"publisher","first-page":"573","DOI":"10.1021\/acschemneuro.0c00793","volume":"12","author":"SJ Yong","year":"2021","unstructured":"Yong, S. J. Persistent brainstem dysfunction in long-COVID: A hypothesis. ACS Chem. Neurosci. 12 (4), 573\u2013580 (2021).","journal-title":"ACS Chem. Neurosci."},{"issue":"10","key":"93664_CR57","doi-asserted-by":"publisher","first-page":"737","DOI":"10.1080\/23744235.2021.1924397","volume":"53","author":"SJ Yong","year":"2021","unstructured":"Yong, S. J. Long COVID or post-COVID-19 syndrome: Putative pathophysiology, risk factors, and treatments. Infect. Dis. 53 (10), 737\u2013754 (2021).","journal-title":"Infect. Dis."},{"issue":"1\u20132","key":"93664_CR58","doi-asserted-by":"publisher","first-page":"28","DOI":"10.1016\/j.jns.2008.01.018","volume":"270","author":"J DeLuca","year":"2008","unstructured":"DeLuca, J., Genova, H. M., Hillary, F. G. & Wylie, G. Neural correlates of cognitive fatigue in multiple sclerosis using functional MRI. J. Neurol. Sci. 270 (1\u20132), 28\u201339 (2008).","journal-title":"J. Neurol. Sci."},{"issue":"7","key":"93664_CR59","doi-asserted-by":"publisher","first-page":"934","DOI":"10.1212\/WNL.55.7.934","volume":"55","author":"LB Krupp","year":"2000","unstructured":"Krupp, L. B. & Elkins, L. E. Fatigue and declines in cognitive functioning in multiple sclerosis. Neurology 55 (7), 934\u2013939 (2000).","journal-title":"Neurology"},{"issue":"1","key":"93664_CR60","doi-asserted-by":"publisher","first-page":"147","DOI":"10.1016\/0022-510X(78)90168-5","volume":"36","author":"K Robinson","year":"1978","unstructured":"Robinson, K. & Rudge, P. The stability of the auditory evoked potentials in normal man and patients with multiple sclerosis. J. Neurol. Sci. 36 (1), 147\u2013156 (1978).","journal-title":"J. Neurol. Sci."},{"issue":"1","key":"93664_CR61","doi-asserted-by":"publisher","first-page":"19870","DOI":"10.1038\/s41598-023-46741-5","volume":"13","author":"V Vasilkov","year":"2023","unstructured":"Vasilkov, V. et al. Evidence of cochlear neural degeneration in normal-hearing subjects with tinnitus. Sci. Rep. 13 (1), 19870 (2023).","journal-title":"Sci. Rep."},{"issue":"1\u20132","key":"93664_CR62","doi-asserted-by":"publisher","first-page":"52","DOI":"10.1016\/j.heares.2010.12.003","volume":"276","author":"JA Kaltenbach","year":"2011","unstructured":"Kaltenbach, J. A. Tinnitus: models and mechanisms. Hear. Res. 276 (1\u20132), 52\u201360 (2011).","journal-title":"Hear. Res."},{"issue":"6","key":"93664_CR63","doi-asserted-by":"publisher","first-page":"2580","DOI":"10.1073\/pnas.0915139107","volume":"107","author":"R Bhat","year":"2010","unstructured":"Bhat, R. et al. Inhibitory role for GABA in autoimmune inflammation. Proc. Natl. Acad. Sci. 107 (6), 2580\u20132585 (2010).","journal-title":"Proc. Natl. Acad. Sci."},{"issue":"5","key":"93664_CR64","doi-asserted-by":"publisher","first-page":"1138","DOI":"10.1016\/j.clinph.2021.03.001","volume":"132","author":"V Versace","year":"2021","unstructured":"Versace, V. et al. Intracortical GABAergic dysfunction in patients with fatigue and dysexecutive syndrome after COVID-19. Clin. Neurophysiol. 132 (5), 1138\u20131143 (2021).","journal-title":"Clin. Neurophysiol."},{"issue":"12","key":"93664_CR65","doi-asserted-by":"publisher","first-page":"1666","DOI":"10.3390\/brainsci13121666","volume":"13","author":"K Marinkovic","year":"2023","unstructured":"Marinkovic, K. et al. Cortical GABA levels are reduced in post-Acute COVID-19 syndrome. Brain Sci. 13 (12), 1666 (2023).","journal-title":"Brain Sci."},{"key":"93664_CR66","doi-asserted-by":"publisher","unstructured":"Isler, B. et al. Lower glutamate and GABA levels in auditory cortex of tinnitus patients: A 2D-JPRESS MR spectroscopy study. Sci. Rep. 12 (1). https:\/\/doi.org\/10.1038\/s41598-022-07835-8 (2022).","DOI":"10.1038\/s41598-022-07835-8"},{"issue":"4","key":"93664_CR67","doi-asserted-by":"publisher","first-page":"275","DOI":"10.1016\/0165-0327(95)00025-I","volume":"34","author":"F Petty","year":"1995","unstructured":"Petty, F. GABA and mood disorders: A brief review and hypothesis. J. Affect. Disord. 34 (4), 275\u2013281 (1995).","journal-title":"J. Affect. Disord."},{"key":"93664_CR68","unstructured":"Baldwin, C. L. Auditory Cognition and Human Performance: Research and Applications (CRC, 2012)."},{"issue":"1","key":"93664_CR69","doi-asserted-by":"publisher","first-page":"5S","DOI":"10.1097\/aud.0000000000000312","volume":"37","author":"MK Pichora-Fuller","year":"2016","unstructured":"Pichora-Fuller, M. K. et al. Hearing impairment and cognitive energy: The framework for Understanding effortful listening (FUEL). Ear Hear. 37 (1), 5S\u201327S. https:\/\/doi.org\/10.1097\/aud.0000000000000312 (2016).","journal-title":"Ear Hear."},{"issue":"1\u20132","key":"93664_CR70","doi-asserted-by":"publisher","first-page":"34","DOI":"10.1016\/S0022-510X(00)00411-1","volume":"179","author":"A Chaudhuri","year":"2000","unstructured":"Chaudhuri, A. & Behan, P. O. Fatigue and basal ganglia. J. Neurol. Sci. 179 (1\u20132), 34\u201342 (2000).","journal-title":"J. Neurol. Sci."},{"issue":"9413","key":"93664_CR71","doi-asserted-by":"publisher","first-page":"978","DOI":"10.1016\/S0140-6736(04)15794-2","volume":"363","author":"A Chaudhuri","year":"2004","unstructured":"Chaudhuri, A. & Behan, P. O. Fatigue in neurological disorders. Lancet 363 (9413), 978\u2013988 (2004).","journal-title":"Lancet"},{"key":"93664_CR72","doi-asserted-by":"publisher","first-page":"513","DOI":"10.1016\/j.neuroimage.2005.02.011","volume":"26","author":"G Lange","year":"2005","unstructured":"Lange, G. et al. Objective evidence of cognitive complaints in chronic fatigue syndrome: A BOLD fMRI study of verbal working memory. NeuroImage 26, 513\u2013524 (2005).","journal-title":"NeuroImage"},{"issue":"4","key":"93664_CR73","doi-asserted-by":"publisher","first-page":"316","DOI":"10.1212\/WNL.27.4.316","volume":"27","author":"JJ Stockard","year":"1977","unstructured":"Stockard, J. J. & Rossiter, V. S. Clinical and pathologic correlates of brain stem auditory response abnormalities. Neurology 27 (4), 316\u2013316 (1977).","journal-title":"Neurology"},{"issue":"4","key":"93664_CR74","doi-asserted-by":"publisher","first-page":"843","DOI":"10.1044\/2019_AJA-19-0063","volume":"28","author":"AM Kamerer","year":"2019","unstructured":"Kamerer, A. M. et al. The role of cognition in common measures of peripheral synaptopathy and hidden hearing loss. Am. J. Audiol. 28 (4), 843\u2013856 (2019).","journal-title":"Am. J. Audiol."},{"issue":"2","key":"93664_CR75","doi-asserted-by":"publisher","first-page":"198","DOI":"10.1016\/j.ijporl.2013.10.048","volume":"78","author":"P Allen","year":"2014","unstructured":"Allen, P. & Allan, C. Auditory processing disorders: Relationship to cognitive processes and underlying auditory neural integrity. Int. J. Pediatr. Otorhinolaryngol. 78 (2), 198\u2013208 (2014).","journal-title":"Int. J. Pediatr. Otorhinolaryngol."},{"issue":"11","key":"93664_CR76","doi-asserted-by":"publisher","first-page":"1781","DOI":"10.1242\/jeb.013581","volume":"211","author":"DM Caspary","year":"2008","unstructured":"Caspary, D. M., Ling, L., Turner, J. G. & Hughes, L. F. Inhibitory neurotransmission, plasticity and aging in the mammalian central auditory system. J. Exp. Biol. 211 (11), 1781\u20131791 (2008).","journal-title":"J. Exp. Biol."},{"issue":"4","key":"93664_CR77","doi-asserted-by":"publisher","first-page":"431","DOI":"10.2174\/1871527322666230418114446","volume":"23","author":"N Sivagurunathan","year":"2024","unstructured":"Sivagurunathan, N. & Calivarathan, L. SARS-CoV-2 infection to premature neuronal aging and neurodegenerative diseases: Is there any connection with hypoxia? CNS Neurol. Disord Drug Targets. 23 (4), 431\u2013448. https:\/\/doi.org\/10.2174\/1871527322666230418114446 (2024).","journal-title":"CNS Neurol. Disord Drug Targets"},{"key":"93664_CR78","doi-asserted-by":"publisher","unstructured":"Petersen, M. et al., Brain imaging and neuropsychological assessment of individuals recovered from a mild to moderate SARS-CoV-2 infection. Proc. Natl. Acad. Sci. 120 (22)https:\/\/doi.org\/10.1073\/pnas.2217232120 (2023).","DOI":"10.1073\/pnas.2217232120"},{"key":"93664_CR79","doi-asserted-by":"publisher","unstructured":"Auerbach, B. D., Rodrigues, P. V. & Salvi, R. J. Central gain control in tinnitus and hyperacusis. Front. Neurol. 5. https:\/\/doi.org\/10.3389\/fneur.2014.00206 (2014).","DOI":"10.3389\/fneur.2014.00206"},{"issue":"5","key":"93664_CR80","doi-asserted-by":"publisher","first-page":"1089","DOI":"10.1016\/j.neubiorev.2010.11.003","volume":"35","author":"AJ Nore\u00f1a","year":"2011","unstructured":"Nore\u00f1a, A. J. An integrative model of tinnitus based on a central gain controlling neural sensitivity. Neurosci. Biobehav. Rev. 35 (5), 1089\u20131109 (2011).","journal-title":"Neurosci. Biobehavioral Reviews"},{"key":"93664_CR81","doi-asserted-by":"publisher","first-page":"213","DOI":"10.1016\/j.neuroscience.2019.01.027","volume":"407","author":"W Sedley","year":"2019","unstructured":"Sedley, W. Tinnitus: Does gain explain? Neuroscience 407, 213\u2013228 (2019).","journal-title":"Neuroscience"},{"issue":"4","key":"93664_CR82","doi-asserted-by":"publisher","first-page":"802","DOI":"10.3390\/diagnostics12040802","volume":"12","author":"K-C Ting","year":"2022","unstructured":"Ting, K-C., Chang, C-C., Huang, C-Y., Chen, Y-F. & Cheng, Y-F. Are electrocochleographic changes an early sign of cochlear synaptopathy? A prospective study in tinnitus patients with normal hearing. Diagnostics 12 (4), 802. https:\/\/doi.org\/10.3390\/diagnostics12040802 (2022).","journal-title":"Diagnostics"},{"issue":"12","key":"93664_CR83","doi-asserted-by":"publisher","first-page":"e0189157","DOI":"10.1371\/journal.pone.0189157","volume":"12","author":"HJ Shim","year":"2017","unstructured":"Shim, H. J., An, Y. H., Kim, D. H., Yoon, J. E. & Yoon, J. H. Comparisons of auditory brainstem response and sound level tolerance in tinnitus ears and non-tinnitus ears in unilateral tinnitus patients with normal audiograms. PLoS ONE. 12 (12), e0189157. https:\/\/doi.org\/10.1371\/journal.pone.0189157 (2017).","journal-title":"PLoS One"},{"issue":"3","key":"93664_CR84","doi-asserted-by":"publisher","first-page":"1169","DOI":"10.3390\/jcm12031169","volume":"12","author":"B Hackenberg","year":"2023","unstructured":"Hackenberg, B. et al. Tinnitus and its relation to depression, anxiety, and stress\u2014a population-based cohort study. J. Clin. Med. 12 (3), 1169 (2023).","journal-title":"J. Clin. Med."},{"key":"93664_CR85","doi-asserted-by":"publisher","first-page":"122255","DOI":"10.3389\/fneur.2014.00271","volume":"5","author":"GD Searchfield","year":"2014","unstructured":"Searchfield, G. D. Tinnitus what and where: An ecological framework. Front. Neurol. 5, 122255 (2014).","journal-title":"Front. Neurol."},{"issue":"3","key":"93664_CR86","doi-asserted-by":"publisher","first-page":"636","DOI":"10.1097\/AUD.0000000000000642","volume":"40","author":"EM Colagrosso","year":"2019","unstructured":"Colagrosso, E. M., Fournier, P., Fitzpatrick, E. M. & H\u00e9bert, S. A qualitative study on factors modulating tinnitus experience. Ear Hear. 40 (3), 636\u2013644 (2019).","journal-title":"Ear Hear."},{"issue":"2","key":"93664_CR87","doi-asserted-by":"publisher","first-page":"143","DOI":"10.1001\/archotol.1996.01890140029007","volume":"122","author":"CW Newman","year":"1996","unstructured":"Newman, C. W., Jacobson, G. P. & Spitzer, J. B. Development of the tinnitus handicap inventory. Arch. Otolaryngol.\u2013Head Neck Surg. 122 (2), 143\u2013148 (1996).","journal-title":"Archives Otolaryngology\u2013Head Neck Surg."},{"issue":"3","key":"93664_CR88","doi-asserted-by":"publisher","first-page":"377","DOI":"10.1097\/MAO.0000000000002983","volume":"42","author":"Z Song","year":"2021","unstructured":"Song, Z. et al. Tinnitus is associated with extended high-frequency hearing loss and hidden high-frequency damage in young patients. Otol. Neurotol. 42 (3), 377\u2013383 (2021).","journal-title":"Otology Neurotology"},{"issue":"6","key":"93664_CR89","doi-asserted-by":"publisher","first-page":"1643","DOI":"10.1097\/AUD.0000000000001229","volume":"43","author":"Z Jafari","year":"2022","unstructured":"Jafari, Z., Baguley, D., Kolb, B. E. & Mohajerani, M. H. A systematic review and meta-analysis of extended high-frequency hearing thresholds in tinnitus with a normal audiogram. Ear Hear. 43 (6), 1643\u20131652 (2022).","journal-title":"Ear Hear."},{"key":"93664_CR90","doi-asserted-by":"publisher","first-page":"103293","DOI":"10.1016\/j.amsu.2022.103293","volume":"75","author":"SH Ahmed","year":"2022","unstructured":"Ahmed, S. H. et al. SARS-CoV-2 vaccine-associated-tinnitus: A review. Ann. Med. Surg. 75, 103293 (2022).","journal-title":"Annals Med. Surg."}],"container-title":["Scientific Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.nature.com\/articles\/s41598-025-93664-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-025-93664-4","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-025-93664-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,3,18]],"date-time":"2025-03-18T15:37:55Z","timestamp":1742312275000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.nature.com\/articles\/s41598-025-93664-4"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,3,18]]},"references-count":90,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["93664"],"URL":"https:\/\/doi.org\/10.1038\/s41598-025-93664-4","relation":{"has-review":[{"id-type":"doi","id":"10.14293\/S2199-1006.1.SOR-UNCAT.A11920441.v1.ROQKBC","asserted-by":"object"}]},"ISSN":["2045-2322"],"issn-type":[{"value":"2045-2322","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,3,18]]},"assertion":[{"value":"27 November 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"7 March 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"18 March 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"9387"}}