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Meta-analytic data indicate that tinnitus patients with normal hearing thresholds often exhibit significantly reduced ABR wave-I amplitudes, consistent with synaptic loss, and an increased wave-V/I ratio, suggesting central gain enhancement, although changes in wave-V amplitude are inconsistent across studies 43,63

Moreover, emerging evidence has shown that it participates in many other pathological and physiological processes, including fibrogenesis, ischemic injury, oxidative insult, and aging, as well as in cells in demand for high energy, such as kidney and corneal endothelium

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