A Citation-Based Main Path Analysis of Tinnitus Research (1984–2025): Knowledge Evolution, Thematic Clusters, and Emerging Research Directions

Over the past four decades, tinnitus research has grown into a highly interdisciplinary field spanning auditory science, neuroscience, psychology, and clinical medicine. Yet how knowledge across subfields has been inherited, diversified, and integrated over time still lacks traceable structural evidence. To address this gap and move beyond frequency-oriented reviews and bibliometric studies that mainly report “hot topics” and prolific contributors, the present study reconstructs the intellectual evolution of tinnitus research (1984–2025) using citation-network-based main path analysis (MPA). From the Web of Science Core Collection, 6584 records were initially retrieved, of which 6354 formed a mutually linked core citation network (96.5%), indicating high coverage and analyzability. SPLC (Search Path Link Count)–weighted MPA was applied to extract global and key-route main paths capturing dominant knowledge trajectories and major branches. Cluster and co-word analyses were then integrated to delineate seven evolutionary stages and five major thematic clusters. This framework identifies bridging works and turning points and reveals how emerging lines—neuromodulation, implant-related treatments, and digital/telehealth CBT—branch from and later converge with established neurobiological and psychological pathways rather than appearing in isolation. Overall, the field has progressed from early psychoacoustics and spontaneous otoacoustic emissions through cochlear-injury plasticity, central gain, and limbic–auditory network models, and most recently toward mechanism-oriented diagnostics, individualized assessment, and targeted interventions.