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Sound-level tolerance (SLT) was assessed in subjects (all men) with clinically normal or near-normal thresholds to form threshold-, age-, and sex-matched groups: 1) no tinnitus\/high SLT, 2) no tinnitus\/low SLT, 3) tinnitus\/high SLT, and 4) tinnitus\/low SLT. MOC function was measured from the ear canal as the change in magnitude of distortion-product otoacoustic emissions (DPOAE) elicited by broadband noise presented to the contralateral ear. The noise reduced DPOAE magnitude in all groups (\u201ccontralateral suppression\u201d), but significantly more reduction occurred in groups with tinnitus and\/or low SLT, indicating hyperresponsiveness of the MOC system compared with the group with no tinnitus\/high SLT. The results suggest hyperresponsiveness of the interneurons of the MOC system residing in the cochlear nucleus and\/or MOC neurons themselves. The present data, combined with previous human and animal data, indicate that neural pathways involving every major division of the cochlear nucleus manifest hyperactivity and\/or hyperresponsiveness in tinnitus and\/or low SLT. The overactivation may develop in each pathway separately. However, a more parsimonious hypothesis is that top-down neuromodulation is the driving force behind ubiquitous overactivation of the auditory brain stem and may correspond to attentional spotlighting on the auditory domain in tinnitus and hyperacusis. <\/jats:p>","DOI":"10.1152\/jn.00576.2014","type":"journal-article","created":{"date-parts":[[2014,9,18]],"date-time":"2014-09-18T03:44:09Z","timestamp":1411011849000},"page":"3197-3208","source":"Crossref","is-referenced-by-count":73,"title":["Increased contralateral suppression of otoacoustic emissions indicates a hyperresponsive medial olivocochlear system in humans with tinnitus and hyperacusis"],"prefix":"10.1152","volume":"112","author":[{"given":"Inge M.","family":"Knudson","sequence":"first","affiliation":[{"name":"Department of Otology and Laryngology, Harvard Medical School, Boston, Massachusetts;"},{"name":"Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts; 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