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Die Rolle der kochleären Neurotransmitter in Bezug auf Tinnitus

The role of cochlear neurotransmitters in tinnitus

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Zusammenfassung

Pathologische Veränderungen der Neurotransmission in der Kochlea, die z. B. durch intensive Lärmbelastung oder ototoxische Substanzen hervorgerufen werden, können zur Entstehung von Tinnitus beitragen. Dabei kommt es an den Schaltstellen zur Veränderung der Effizienz von inhibitorischen und exzitatorischen Neurotransmittern. Glutamat ist der wichtigste afferente Neurotransmitter im Innenohr. Eine massive Glutamatausschüttung als Folge einer Schädigung kann zur Exzitotoxizität und zum irreparablen Zelltod führen. Zu den efferenten Neurotransmittern in der Kochlea zählen Dopamin, γ-Aminobuttersäure (GABA), Acetylcholin (ACH) und Serotonin. Dopamin und GABA sind inhibitorische Transmitter, die vor Glutamatexzitotoxizität schützen. ACH reduziert wie GABA die Steifigkeit der äußeren Haarzellen und führt zu deren Motilitätszunahme. Serotonin ist in der Kochlea ein Neuromodulator der cholinergen und GABA-ergen Innervation und kann glutamaterge Impulse hemmen. Die neuen molekularbiologischen Erkenntnisse über die Neurotransmission in der Kochlea bilden die Grundlage für die Entwicklung neuer Therapieansätze bei Tinnitus. Da es hinsichtlich der Ursachen und der Entstehung verschiedene Formen des Tinnitus gibt, besteht zurzeit die Herausforderung darin, bei den Patienten die individuelle Ursache nachweisen zu können.

Abstract

Pathologic changes in the cochlear neurotransmission, e.g. as a result of intensive noise exposure or ototoxic drugs, can be a factor in the development of tinnitus. The efficiency of inhibitory and excitatory neurotransmitters may then be modulated at the switching points. Glutamate is the most important afferent neurotransmitter within the inner ear. A massive glutamate release induced by cochlear damage may result in excitotoxicity and irrevocable cell death. Efferent cochlear neurotransmitters include dopamine, gammaaminobutyric acid (GABA), acetylcholine (ACH) and serotonin. Dopamine and GABA are inhibitory transmitters that may protect the cochlea from excitotoxicity. ACH, like GABA, reduces the stiffness of the outer hair cells and increases their motility. Serotonin is a neuromodulator of the cholinergic and GABAergic innervation within the cochlea and can inhibit glutamatergic impulses. Our understanding of neurotransmission in the cochlea has been extended by advances in molecular biology, which has given rise to new approaches in the treatment of tinnitus. As there are several types of tinnitus, differing in aetiology and development, our present challenge is to achieve precise identification of the cause in individual cases of tinnitus.

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  1. HNO-Klinik und Poliklinik, Tinnituszentrum, Charité – Universitätsmedizin Berlin, Campus Charité Mitte, Charitéplatz 1, 10117, Berlin, Deutschland

    B. Mazurek, H. Haupt, J. Gross & A. Szczepek

  2. HNO-Klinik und Poliklinik, Medizinische Hochschule, Hannover, Deutschland

    T. Stöver

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  1. B. Mazurek
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Mazurek, B., Stöver, T., Haupt, H. et al. Die Rolle der kochleären Neurotransmitter in Bezug auf Tinnitus. HNO 55, 964–971 (2007). https://doi.org/10.1007/s00106-007-1624-7

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