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However, effects of repeated or chronic noise exposures on the cochlear synapses especially medial olivocochlear (MOC) efferent synapses remain elusive. Based on a weeklong repeated exposure model of bandwidth noise over 2-20\u2009kHz for 2 hours at seven intensities (88 to 106\u2009dB SPL with 3\u2009dB increment per gradient) on C57BL\/6J mice, we attempted to explore the dose-response mechanism of prolonged noise-induced audiological dysfunction and cochlear synaptic degeneration. In our results, mice repeatedly exposed to relatively low-intensity noise (88, 91, and 94\u2009dB SPL) showed few changes on auditory brainstem response (ABR), ribbon synapses, or MOC efferent synapses. Notably, repeated moderate-intensity noise exposures (97 and 100\u2009dB SPL) not only caused hearing threshold shifts and the inner hair cell ribbon synaptopathy but also impaired MOC efferent synapses, which might contribute to complex patterns of damages on cochlear function and morphology. However, repeated high-intensity (103 and 106\u2009dB SPL) noise exposures induced PTSs mainly accompanied by damages on cochlear amplifier function of outer hair cells and the inner hair cell ribbon synaptopathy, rather than the MOC efferent synaptic degeneration. Moreover, we observed a frequency-dependent vulnerability of the repeated acoustic trauma-induced cochlear synaptic degeneration. This study provides a sight into the hypothesis that noise-induced cochlear synaptic degeneration involves both afferent (ribbon synapses) and efferent (MOC terminals) pathology. The pattern of dose-dependent pathological changes induced by repeated noise exposure at various intensities provides a possible explanation for the complicated cochlear synaptic degeneration in humans. The underlying mechanisms remain to be studied in the future.<\/jats:p>","DOI":"10.1155\/2021\/9919977","type":"journal-article","created":{"date-parts":[[2021,6,11]],"date-time":"2021-06-11T00:25:20Z","timestamp":1623371120000},"page":"1-12","source":"Crossref","is-referenced-by-count":12,"title":["Dose-Dependent Pattern of Cochlear Synaptic Degeneration in C57BL\/6J Mice Induced by Repeated Noise Exposure"],"prefix":"10.1155","volume":"2021","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5994-6552","authenticated-orcid":true,"given":"Minfei","family":"Qian","sequence":"first","affiliation":[{"name":"Department of Otolaryngology-Head and Neck Surgery, Ninth People\u2019s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China"},{"name":"Ear Institute, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China"},{"name":"Shanghai Key Laboratory of Translational Medicine on Ear and Nose Diseases, Shanghai 200011, China"},{"name":"Department 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