What Is Tinnitus Habituation?

Most people are told the goal of tinnitus treatment is “habituation.” It’s often framed as learning to live with the sound, which can feel vague, passive, or even dismissive when the tinnitus is loud and intrusive. This framing misses what is actually happening in the brain.

Tinnitus habituation is a real process, and it can bring meaningful relief, but it does not work for everyone.

If your tinnitus fluctuates, spikes, or feels unpredictable, the brain will struggle to tune it out, even if you’re doing everything right. This reflects an underlying brain-based instability that needs to be addressed before habituation can work.

Table of Contents:

• What Tinnitus Habituation Actually Is — and What It’s Not
• The Neuroscience of Tinnitus Habituation
• How to Successfully Habituate to Tinnitus
• The 4 Stages of Tinnitus Habituation
• The Role of Sound Therapy in Tinnitus Habituation
• Using CBT Tools to Promote Tinnitus Habituation
• 7 Common Mistakes That Prevent Tinnitus Habituation
• FAQ: Tinnitus Habituation

What Tinnitus Habituation Is — and What It’s Not

Tinnitus habituation is real. Thousands of people have habituated to tinnitus, including people with loud, chronic, life-disrupting tinnitus.

That said, how habituation works is one of the most misunderstood concepts in tinnitus care. It is frequently described in ways that set patients up for confusion, disappointment, or the belief that they are doing something wrong.

Here’s the problem: Mainstream models fail to recognize that tinnitus stability is a prerequisite that determines whether habituation is even possible. Without it, you’re being asked to complete a process your brain is biologically incapable of.

>> So before anything else, let's establish how habituation works.

The Brain's Natural Signal Filtering System

Your brain is constantly receiving sensory information it actively ignores.

The feeling of your clothing against your skin. The hum of the air conditioning. The ambient noise of traffic outside.

You’re not ignoring these things through willpower or conscious effort — your brain is filtering them automatically, having classified them as familiar, stable, and non-threatening.

This filtering process is called habituation, and it is one of the most fundamental features of the nervous system. It operates across every sensory domain: touch, smell, vision, and hearing.

When a stimulus is repeated consistently and carries no meaningful consequence, the brain progressively reduces its response to it. It does not disappear, it simply recedes from conscious attention.

Tinnitus habituation works on the same principle. The tinnitus signal does not go away. What changes is the brain's response to it. The signal gets reclassified from “a threat requiring attention” to “irrelevant background noise”.

Tinnitus habituation reflects a process called sensory gating, where the brain filters out repetitive, non-threatening signals from conscious awareness.

With habituation, the sound is not eliminated, it just becomes irrelevant.

What Tinnitus Habituation Feels Like

Patients who achieve tinnitus habituation often describe a clear perceptual shift: the sound is still there if they listen for it, but it no longer pulls their attention automatically. It fades into the background of awareness.

If you ask them about it, they’ll usually pause and say something like, “I can still hear it if I look for it, but most of the time it doesn’t bother me.”

This reflects a reduction in both the attentional priority (salience) and the emotional weight assigned to the signal.

Does the sound disappear? No. But the amount of time you’re aware of it drops dramatically. It’s common for people to go long stretches, sometimes even weeks, without thinking about it at all.

Tinnitus habituation feels like not having tinnitus at all.

Tinnitus Habituation and Tinnitus Cure Are Different

Tinnitus habituation is not the same as a “cure.” A cure would mean eliminating the tinnitus signal at its biological source, which is not currently achievable for most chronic cases.

Habituation, by contrast, is when the awareness and distress caused by tinnitus are dramatically reduced, but the sound itself never truly goes away.

For most patients, habituation is a realistic and clinically meaningful goal. In fact, when I describe what habituation actually feels like, most patients immediately say, “If I could get there, I’d be happy.”

Why Tinnitus Habituation Often Fails

As great as it sounds, trying to habituate to tinnitus often fails, especially in those with severe tinnitus.

Many patients are directed toward habituation-based treatments such as tinnitus retraining therapy (TRT), cognitive behavioral therapy (CBT), or sound therapy (including the Lenire device).

The issue is not that these approaches are wrong, it’s that they are often applied to the wrong patients.

Habituation-based therapies work only when tinnitus is stable.

But a large subset of patients, especially those with the highest severity scores, have tinnitus that fluctuates, spikes, or reacts to triggers like stress, sleep, sound, or diet. In these cases, the signal is not consistent enough for the brain to filter.

Stability is a Prerequisite for Habituation

Habituation depends on predictability. The brain needs a stable signal it can recognize, classify as non-threatening, and gradually tune out. When tinnitus keeps changing in loudness, pitch, or reactivity, that process breaks down.

The brain cannot habituate to a moving target.

This is why habituation strategies often fail in more severe cases, even when patients are doing everything right. This is not a failure of effort or mindset. It reflects a biological limitation.

We recently published a review article in the American Academy of Otolaryngology Bulletin stating that tinnitus stability is the most important variable in tinnitus care. Once the underlying instability is addressed, the brain can begin to disengage from the signal, and habituation becomes possible.

Treatment has to follow this sequence: stabilize first, then habituate.

>> So what makes habituation possible in some cases and impossible in others?

The Neuroscience of Tinnitus Habituation

Most people understand habituation intuitively. A new sound is intrusive at first (like when the air conditioning first turns on), then fades into the background without effort. The brain has reclassified it as irrelevant.

This is what the brain does with tinnitus for the vast majority of people.

When habituation fails, it’s typically due to how the brain is processing sensory information. It’s not a psychological issue, it’s a biological one, and it's at work in most people with severe tinnitus.

The Hearing–Threat–Attention Circuit

There is a deeply preserved connection between auditory input, the limbic system (the fear center), and the salience network (the attention center). It exists because unexplained sounds demand investigation.

In tinnitus, this circuit gets hijacked.

When loud tinnitus comes out of nowhere, the brain’s fight-or-flight center treats it as uncertain and potentially dangerous. Next, the salience network — the brain's threat-priority system — locks attention onto it. Each detection reinforces the same loop.

At this point, the problem is no longer just the sound. It is the network built around it. The brain has decided the signal matters. Importantly, this decision operates below your conscious control.

Two Levels of Habituation — One System

Most people think of habituation as one thing: learning to ignore a sound. In practice, it operates at two distinct levels:

• Physiological habituation — a reduction in neural response to repeated stimuli. For example, when two identical clicks are presented in close succession, the second produces a smaller neural response. This is a preconscious, automatic process.
• Behavioral habituation — the clinical outcome most patients are working toward: tinnitus remains detectable but no longer drives attention or distress. This process takes intentional effort.

These two levels are not independent. Behavioral habituation depends on physiological habituation.

When the brain reduces its response at the neural level, the attention center loses its justification for prioritizing the signal. Attention releases. Awareness fades. This is automatic.

However, when physiological habituation is impaired, behavioral habituation becomes nearly impossible. Cognitive strategies can reduce distress — but they do not restore the underlying filtering mechanism.

>> Are there conditions where physiological habituation is impaired? Yes!

A systematic review from 2025 showed that people with migraine-related sensory processing disorders have nearly universal deficits in habituation [1]. Our team has been systematically building the case that severe tinnitus is, in fact, a form of atypical migraine (“otologic migraine”/”cochlear migraine”).

The Biology of Habituation Failure

Severe tinnitus is a form of atypical migraine, where impaired physiological habituation at the neural level drives altered sensory processing. This presents clinically as loud, intrusive, and often fluctuating tinnitus.

In this state, the brain does not respond normally to repeated signals. Instead of dampening with repetition (normal habituation), the tinnitus signal may persist or even amplify. This creates an unstable signal.

And that’s the problem. Habituation depends on consistency. The brain needs predictable input to classify a signal as safe and irrelevant. But when tinnitus fluctuates unpredictibly in loudness, pitch, or reactivity, each change is processed as a new event.

At the same time, this unpredictability repeatedly activates the threat system. Each spike reinforces the idea that the signal is important, keeping attention locked onto it.

So two things happen at once:

• Neurons fail to physiologically habituate the signal (and instead become sensitized).
• Brain networks react to the sensitized signal, prioritizing it as a threat.

>> This is why severe tinnitus feels both loud and impossible to ignore.

Migraine research shows this same pattern across sensory systems. Repeated stimuli fail to habituate and may even increase in intensity, confirming this is a biological trait, not a psychological response.

Bottom line: If you have an atypical migraine brain, habituation is blocked at its source.

Until the underlying instability is addressed medically, the brain won’t be able to habituate, no matter how much effort is applied.

Where Jastreboff's Model Falls Short

Pavel Jastreboff correctly identified that tinnitus distress is generated by limbic and autonomic systems, not the ear alone. This insight was foundational in establishing tinnitus retraining therapy (TRT), which can be quite effective when the underlying brain mechanisms support habituation.

The limitation is what the model does not account for: the possibility that a medical process —atypical migraine— is actively destabilizing the signal and impairing the brain's capacity to habituate.

Signal instability and physiological habituation deficits are outside Jastreboff's model's scope entirely. This is not a flaw in the logic, but rather a gap in what the model was designed to address.

TRT assumes the physiological habituation is intact, but for many patients with severe tinnitus, it is not.

For this group, no amount of sound enrichment or counseling can compensate for a physiological system that is working against the process.

Recognizing Unstable Tinnitus — and Why It Blocks Habituation

Habituation requires a stable signal. Unstable tinnitus creates the opposite.

In unstable tinnitus, the signal fluctuates. It spikes, shifts in loudness or pitch, and reacts to triggers. From the brain’s perspective, each spike is treated as a new signal, not a continuation of the same one. And the brain cannot habituate to something that keeps changing.

This is why patients often describe a frustrating pattern: making progress, then suddenly losing it and having to start from scratch. Each tinnitus spike resets the system, preventing habituation from consolidating.

These changes are not random. They are typically driven by the same triggers that activate the atypical migraine process, each capable of destabilizing the signal, causing central sensitivity, and interrupting habituation [2].

Trigger	Effect on tinnitus signal
Stress	Activates neuroinflammatory pathways, raises cortisol, increases limbic reactivity
Poor sleep	Elevates central gain, impairs consolidation of habituation progress
Dietary triggers	Caffeine, alcohol, aged cheeses, MSG, high-sodium foods activate migraine pathways
Hormonal fluctuations	Estrogen shifts (menstrual cycle, perimenopause) directly modulate auditory sensitivity
Dehydration	Reduces cochlear fluid regulation and lowers neurological stability thresholds
Barometric pressure changes	Triggers inner ear pressure changes and neuroinflammatory response
Sensory overload	Bright lights, crowds, and excessive noise accumulate and wind the system
Reactive tinnitus	Sound exposure itself triggers spikes — the primary tool of habituation therapy becomes destabilizing
Illness and inflammation	Systemic inflammation from infection or immune activation amplifies auditory hypersensitivity

No single trigger drives instability in every patient. In my experience, most patients have a complex personal trigger profile that needs to be uncovered. Identifying and managing these triggers is a core part of treatment.

How to Successfully Habituate to Tinnitus

As outlined above, if your tinnitus is unstable, fluctuating, spiking, or reactive, habituation requires a first step that most programs skip: medical stabilization.

A multimodal medical approach that targets the underlying drivers of instability must be implemented before habituation therapy can work.

Once a stable baseline is established, the brain’s filtering system has what it needs, and habituation can begin.

>> Successful habituation, therefore, depends on tinnitus stabilization.

The 4 Stages of Tinnitus Habituation

The four stages of tinnitus habituation come from Jastreboff’s neurophysiological model, which describes how the brain progressively reclassifies and filters the tinnitus signal. In the proper clinical context, this framework provides a useful map for understanding how habituation unfolds over time.

Habituation Stage	Summary
1. Detection	Signal is flagged as important and enters awareness at full strength
2. Reaction	Limbic system links signal to threat, amplifying distress
3. Habituation of reaction	Emotional response fades while sound persists
4. Habituation of perception	Signal is filtered out of awareness

Stage 1 — Detection: The brain flags tinnitus as a signal that requires attention. The ringing is passed through without filtering and feels intrusive and urgent. This is not anxiety — it is a normal response to an unfamiliar input. There is no voluntary control at this stage.

Stage 2 — Reaction: The limbic system forms a threat association. Each detection triggers a stress response: hypervigilance, autonomic activation, and increased salience. This is typically the most distressing stage, driven more by reaction than by the sound itself.

Stage 3 — Habituation of reaction: The threat response weakens. The tinnitus remains audible, but it no longer feels urgent or consuming. Patients often describe this shift as: “I can hear it, but it doesn’t bother me the same way.” This is the primary clinical milestone. Because most suffering is driven by reaction, Stage 3 alone is often sufficient for meaningful recovery. CBT is particularly effective in accelerating this transition.

Stage 4 — Habituation of perception: With reduced salience, the brain begins to filter the signal itself. The tinnitus fades into the background and may go unnoticed for long periods. When it is noticed, the emotional response is minimal. Not all patients reach this stage, but it is not required for a successful outcome.

The Tinnitus Habituation Timeline: How Long Does It Take?

The tinnitus habituation timeline depends on one variable above all others: signal stability.

• For stable tinnitus, the trajectory is gradual but usually evident early, within weeks. Patients begin to notice increasingly longer stretches when tinnitus awareness is minimal.
• For unstable tinnitus, there is no meaningful “habituation clock” until stability exists. However, once that instability is medically addressed, these same people will habituate on the same schedule as others.

Can habituation fail or revert after it’s been achieved? Yes, and I see this often. In most cases, it happens because the brain has re-entered a cycle of migraine-like reactivity. Once that underlying instability is addressed, habituation can return.

The Role of Sound Therapy in Tinnitus Habituation

Sound therapy works by changing the relative intensity of tinnitus, which is what the brain actually responds to. The issue isn’t just how loud the tinnitus is in isolation, it’s how much it stands out compared to the surrounding sound environment.

By introducing low-level background sound, you reduce that contrast. The tinnitus is no longer the dominant signal, so it carries less weight in the brain’s attention system.

Over time, this consistent reduction in relative intensity helps the brain deprioritize the signal. The connection between tinnitus and attention weakens, and awareness fades.

This is a form of neuroplasticity, the brain gradually learning that the signal is not important. This is what is meant by “retraining the brain”.

Sound Enrichment vs. Masking

Total masking is when the tinnitus is completely covered by external sound (like white noise). The problem is that the brain can no longer detect the tinnitus signal, so it has nothing to evaluate or reclassify. It cannot normalize a sound it cannot hear.

Partial masking through sound enrichment keeps the tinnitus audible while reducing its dominance. The signal is still present, but it no longer stands out.

This allows the brain to repeatedly experience the sound in a neutral context, which is what enables it to downgrade the signal’s importance over time.

The Mixing Point

Tinnitus habituation strategies often refer to the mixing point — where background sound and tinnitus share the same perceptual space.

• Too loud: tinnitus disappears — interferes with tinnitus “normalization”.
• Too quiet: contrast remains high — tinnitus stays too dominant.
• Mixing point: tinnitus present but can now be pushed into the background.

The right volume level may shift throughout the day, but in general, it should be low enough to reduce contrast without becoming a focus of attention.

What Sound Is Best For Tinnitus Habituation

There is no universally “correct” sound for tinnitus. In fact, when people are able to choose their own sound, they often end up selecting the one that works best for their brain.

Your goal is not to find one perfect sound. It is to build a toolbox of options you can rotate based on what your brain tolerates in the moment.

Sound preference is not fixed. A sound that works well in the morning may feel irritating later in the day. Some patients like crickets, others find them intolerable. This variability is expected. The task is to identify multiple options that are neutral, stable, and easy for your brain to ignore.

Here are some potential options:

• Broadband noise: white, pink, or brown noise
• Nature sounds: rainfall, ocean waves, wind, ambient environments
• Stable environmental sound: fans, air purifiers, low-level background hum
• Gentle music: relaxing instrumental music at a low-medium volume

These work because they are non-intrusive, allowing the brain to downregulate both the background sound and the tinnitus over time.

Notched Sound Therapy

Notched sound therapy is a technique that removes the frequency of your tinnitus from audio and has some evidence for reducing perceived loudness in certain patients. It requires that you have knowledge of your exact tinnitus frequency.

That said, notched sound therapy can be highly technique-dependent. If the notch is not accurately matched to your tinnitus frequency, it can be ineffective or even counterproductive. For that reason, I generally do not use it as a first-line approach.

What to Avoid

• Silence: increases contrast and makes tinnitus more dominant
• Highly variable audio: music with dynamic swings or sudden changes
• Triggering sounds: anything that reliably worsens your tinnitus, especially in reactive tinnitus

Acoustic predictability matters. The brain habituates to signals that are consistent and non-threatening. Your goal is to build a set of sounds that your brain can reliably tune out, not just once, but across different times of day and environments.

Hearing Aids and Tinnitus Habituation

Hearing aids for tinnitus can support habituation in the right clinical setting, but they are not a universal solution. They work best when two conditions are present:

• Meaningful hearing loss
• Relatively stable tinnitus

When hearing is reduced, the contrast between tinnitus and the surrounding environment increases. This makes tinnitus feel louder and more intrusive than it actually is.

Hearing aids restore ambient sound input, which lowers that contrast and creates a more acoustically enriched environment. This supports the brain’s ability to downregulate the tinnitus signal over time.

However, hearing aids are not appropriate for everyone. In cases of reactive tinnitus, hyperacusis, or normal hearing, amplification may offer limited benefit and can sometimes make symptoms worse.

Tinnitus Habituation CBT

Cognitive behavioral therapy (CBT) works by addressing the neural networks that perpetuate and amplify tinnitus distress.

Tinnitus becomes intrusive because the brain has classified it as important. Once that classification is in place, the fight or flight (limbic) system and attention networks reinforce it, keeping the signal prioritized regardless of its actual loudness.

CBT targets this directly. The goal is not to eliminate the sound, but to change how the brain responds when it detects it.

How CBT Helps The Brain Habituate

Tinnitus distress is maintained by a self-reinforcing loop: the sound is noticed, interpreted as a threat, and then attention locks onto it. Each cycle strengthens the brain’s interpretation of tinnitus as a “threat”, making the signal more persistent and harder to ignore.

CBT interrupts this loop by changing the meaning assigned to the signal. As the perceived threat decreases, the brain stops prioritizing it. Attention begins to release, and the tinnitus loses its urgency and intrusiveness.

At the same time, CBT addresses cognitive resistance. Trying to suppress, fight, or escape tinnitus keeps it in focus. Resistance is still attention, and attention sustains salience.

By shifting the response from resistance to neutrality, repeated exposures to the sound occur without triggering the threat system. Over time, this weakens the connection between tinnitus and alarm.

What CBT Can and Cannot Do

CBT cannot change the underlying tinnitus signal or correct physiological instability. It does not reduce fluctuations, reactivity, or the biological drivers of the condition, and it is not a cure.

What it does do is change how the brain responds to the signal. By reducing the cognitive and emotional reaction to tinnitus, it can significantly decrease how intrusive and distressing it feels.

7 Common Mistakes That Prevent Tinnitus Habituation

Understanding habituation is one thing. Achieving it is another. These are the most common ways people unintentionally block the process:

1. Trying to eliminate the sound: Fighting tinnitus increases its importance. The brain reads effort as a signal that it matters. Habituation requires allowing the sound to become irrelevant.
2. Over-masking: Completely covering tinnitus prevents the brain from reclassifying it. If it can’t hear it, it can’t learn it’s safe. Use sound to reduce contrast, not eliminate exposure.
3. Avoiding sound: Too little sound input raises central gain and increases sensitivity, making tinnitus more noticeable. The brain needs consistent, normal sound exposure.
4. Constant monitoring: Repeatedly checking the sound keeps attention locked on it. Each check reinforces its importance and strengthens the loop.
5. Ignoring sleep and stress: Poor sleep and chronic stress increase brain reactivity. These are core drivers of tinnitus intensity and habituation failure.
6. Ignoring medical instability: Trying to habituate to a fluctuating signal does not work. If tinnitus is reactive or unstable, stabilization must come first.
7. Expecting linear progress: Habituation is not steady. Spikes and setbacks are part of the process. Progress is measured over months, not day to day.

Conclusion: Habituation Is a Biological Process — Not a Willpower Problem

Tinnitus habituation is not about trying harder or forcing your attention away from the sound. It is a brain process that depends on the right conditions. When the signal is stable and no longer flagged as a threat, the brain naturally stops prioritizing it, and awareness fades.

If habituation isn’t happening, it’s not a failure of effort. It means something in the system is off, whether that’s signal instability, impaired sensory filtering, or an ongoing threat response.

The question is not “What am I doing wrong?”, but instead “What is preventing my brain from doing what it’s designed to do?”

If you’re not sure whether your tinnitus is stable, the easiest place to start is the Tinnitus Severity Assessment. It breaks down the key drivers, including stability, sound sensitivity, and brain reactivity, and helps clarify what may be getting in the way of habituation.

FAQ: Tinnitus Habituation

Can you habituate to tinnitus?

Yes, tinnitus habituation is achievable, even in people with loud or chronic symptoms. Many patients reach a point where the tinnitus is still present but no longer bothers them or interferes with daily life. The key factor is whether the brain can classify the signal as stable and non-threatening. When that happens, the natural filtering process can take over.

How long does tinnitus habituation take?

For stable tinnitus, meaningful habituation typically develops over 12 to 24 months with consistent sound therapy and cognitive behavioral strategies. Most patients notice improvement earlier, such as reduced distress or longer periods without noticing the sound. For unstable tinnitus, there is no reliable timeline until the signal is stabilized, because the brain cannot build a suppression response to a constantly changing signal.

Does tinnitus habituation mean silence?

No, tinnitus habituation does not mean the sound goes silent. The underlying neural activity that generates tinnitus usually remains. What changes is the brain’s response to it. The signal loses its priority in the brain, so it no longer draws attention or causes distress, even though it can still be heard in quiet environments.

Can tinnitus go away through habituation?

No, habituation does not eliminate the tinnitus signal itself. Instead, it changes how the brain processes the signal. The sound becomes background noise that is only noticed when actively focused on. For most patients, this functional outcome is equivalent to recovery, because the tinnitus no longer impacts sleep, concentration, or quality of life.

What are the 4 stages of tinnitus habituation?

The four stages of tinnitus habituation, described in Jastreboff’s model, are detection, reaction, habituation of reaction, and habituation of perception. The brain initially identifies the signal as a threat, then develops an emotional response, then gradually reduces that response, and finally filters the signal from awareness. Many patients reach meaningful relief at the stage where the reaction fades, even if the sound is still present.

How do I know if I am habituating to tinnitus?

Signs of habituation include noticing the tinnitus less frequently, having a reduced emotional reaction when it is noticed, and experiencing longer periods where it does not capture attention. The volume of the sound may not change significantly. The key indicator is that tinnitus takes up less mental space and interferes less with daily life over time.

What is the difference between habituation and a cure?

A cure would eliminate the underlying neural signal that produces tinnitus. Habituation does not remove the signal but changes how the brain responds to it. The sound becomes irrelevant to the brain, allowing normal function to return. This distinction is important, because habituation is achievable today, while a true cure remains limited for most chronic cases.

Can anxiety slow tinnitus habituation?

Yes, anxiety can slow tinnitus habituation by reinforcing the brain’s threat response to the signal. When the brain interprets tinnitus as dangerous or urgent, it increases attention and emotional reactivity, which keeps the signal prominent. While anxiety is often a response to tinnitus, it can also maintain the cycle that prevents the brain from filtering the signal effectively.

What sounds help tinnitus habituation?

Broadband sounds such as white noise, pink noise, and natural ambient sounds are most effective for tinnitus habituation because they reduce contrast without eliminating the tinnitus signal. The goal is sound enrichment at a level where tinnitus remains audible but no longer dominates perception. This allows the brain to repeatedly encounter the signal in a neutral context and gradually suppress it.

Can medical treatment speed up tinnitus habituation?

Medical treatment can significantly accelerate tinnitus habituation in patients with unstable symptoms. When tinnitus is driven by neuroinflammation, migraine-related mechanisms, or central sensitization, stabilizing the signal is often required before habituation can occur. Once stability is achieved, behavioral approaches such as sound therapy and CBT tend to work more effectively and progress more quickly.

What makes tinnitus habituation harder?

Tinnitus habituation is more difficult when the signal is unstable, such as when it fluctuates, spikes, or reacts to sound. Poor sleep, chronic stress, and untreated underlying neurological drivers can also interfere with the brain’s ability to filter the signal. These factors increase central gain and salience, making it harder for habituation to occur.

Does tinnitus retraining therapy work for habituation?

Yes, tinnitus retraining therapy is designed to promote habituation using sound enrichment and counseling. It can be effective for patients with stable tinnitus. However, it is less effective when tinnitus is unstable, because it does not address the underlying biological factors that prevent the brain from building a consistent suppression response.

Tinnitus Habituation References

[1] Ulutas S, Özçelik EU, Dabó LG, Bolla F, Tepe N, Yambao P, Ling YH, Pan LH, Wang SJ; International Headache Academy of the International Headache Society (IHS-iHEAD). Evoked potential studies in migraine: A systematic review of neurophysiological patterns across migraine subtypes. Cephalalgia. 2025 Dec;45(12):3331024251398792. doi: 10.1177/03331024251398792. Epub 2025 Dec 9. PMID: 41364425.

[2] Khlaifat GS, Tawk K, Lee EJ, Bhatt K, Abouzari M, Djalilian HR. Expanding the Spectrum of Central Sensitivity Syndrome: Integrating Otologic Migraine as Otologic Central Sensitivity Syndrome. Brain Sci. 2026 Feb 25;16(3):257. doi: 10.3390/brainsci16030257. PMID: 41892601; PMCID: PMC13023626.