It is estimated that 5% of the population suffer from chronic tinnitus with 17% of those suffering emotional distress. The authors attempted to study the neural correlates of tinnitus-related distress using functional magnetic resonance imaging (fMRI) during an Emotional Stroop Task (EST) which used neutral words and tinnitus related words as stimuli. The EST is a known template for examining selective attention and emotional processing. The authors also conducted a random effects analysis as well as correlational analyses between blood oxygen level dependent response and tinnitus distress, loudness, depression, anxiety, vocabulary and hypersensitivity to sounds. The study found that the distress network was activated in highly distressed tinnitus patients by tinnitus related words while low distressed tinnitus patients seemed to avoid tinnitus related stimuli actively. During the study, the roles played by the insula and the orbitofrontal cortex were confirmed by a task-driven fMRI. The distress network and the depression network were found to partially overlap in right insula activation. The study corroborates earlier studies that demonstrated the role of the insula and the orbitofrontal cortex in tinnitus distress.