To the Editor: We recently observed that tinnitus is associated with reduced auditory input that fails to increase neural gain due to diminished stimulus-evoked responses. 1–3 This was in contrast to views that suggested a homeostatic increase in neural gain to generate central hyper-excitability leading to tinnitus. 4 A curative therapy for tinnitus currently does not exist. Its progress is mostly impeded by the existing controversial views about the neural correlate of tinnitus that, depending on predictions, either would require the suppression or the enhancement of brain activity. We hypothesized that different neural correlates of tinnitus, whether with or without the co-occurrence of hyperacusis, contributed to this dilemma. To test this hypothesis, we recruited 43 controls and 50 audiologically examined tinnitus patients with and without a co-occurrence of hyperacusis (Tables S1 and S2) and performed brainstem audiometry (ABR) and functional imaging of brain activity (fMRI). Among the group of 50 tinnitus patients, 20 could be identified with the co-occurrence of hyperacusis (T+ H group) from the HKI hyperacusis questionnaire (Figure 1A). 5 The overall score of the Goebel and Hiller Score (GHS) tinnitus questionnaire 6 was significantly higher for the T+ H group than the tinnitus-only patients (T group)(Figure 1B, p<. 001***) for nearly all subscores (Figure S1, p<. 002***). In the T+ H group (Figure 1D) but not the T group (Figure 1C), auditory perceptional difficulty became worse for patients with self-rated tinnitus loudness≤ 15 dB HL (Figure 1E, Figure S2). The T and T+ H group differences in annoyance and distress were not linked to differences in hearing sensitivity (Figure S3A–C, p>. 5), since pure tone audiometry (PTA) thresholds (Supporting Material 1) were not different between groups. In contrast, supra-threshold ABR by brainstemevoked response audiometry (BERA) 1, 2 revealed group differences: In T group, significantly reduced ABR wave V amplitude together with significantly prolonged interpeak latency (IPL) I–V (Figure 1F, H, J; Table S3) and reduced