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Neural Plasticity
Volume 2014, Article ID 612147, 5 pages
Research Article

The Enigma of the Tinnitus-Free Dream State in a Bayesian World

1Department of Surgical Sciences, Dunedin School of Medicine, University of Otago, P.O. Box 56, Dunedin 9054, New Zealand
2BRAI²N & TRI, Sint Augustinus Hospital, Antwerp, Belgium
3Department of Translational Neuroscience, Faculty of Medicine, University of Antwerp, Belgium
4School of Behavioral and Brain Sciences, The University of Texas at Dallas, USA

Received 17 March 2014; Accepted 16 April 2014; Published 6 July 2014

Academic Editor: Berthold Langguth

Copyright © 2014 Dirk De Ridder et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


There are pathophysiological, clinical, and treatment analogies between phantom limb pain and phantom sound (i.e., tinnitus). Phantom limb pain commonly is absent in dreams, and the question arises whether this is also the case for tinnitus. A questionnaire was given to 78 consecutive tinnitus patients seen at a specialized tinnitus clinic. Seventy-six patients remembered their dreams and of these 74 claim not to perceive tinnitus during their dreams (97%). This can be most easily explained by a predictive Bayesian brain model. That is, during the awake state the brain constantly makes predictions about the environment. Tinnitus is hypothesized to be the result of a prediction error due to deafferentation, and missing input is filled in by the brain. The heuristic explanation then is that in the dream state there is no interaction with the environment and therefore no updating of the prediction error, resulting in the absence of tinnitus.