 This study found that self-reported chronic tinnitus is associated with reduced cochlear nerve responses, weaker middle ear muscle reflexes, stronger medial olivocochlear efferent reflexes, and hyperactivity in the central auditory pathways. These results support the model of tinnitus generation where decreased neural activity from a damaged cochlear can elicit hyperactivity from decreased inhibition in the central nervous system. This article was authored by Vyacheslav Vasilkov, Benjamin Kassel midwinter, Yang Zhao, and others.