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11 Conclusion The convergence of tinnitus and neurodegenerative diseases on shared pathological mechanisms, including chronic neuroinflammation, synaptic dysfunction, and excitotoxicity, has prompted a conceptual shift in understanding tinnitus not merely as a symptom but as a disorder of neural plasticity and resilience

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Further, controlled clinical studies simulating NSW provide causal evidence that melatonin secretion diminishes rapidly upon night work exposure and remains suppressed with continued circadian disruption 183

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