Tinnitus and Cognition: Linked?

ABSTRACT Objective: To study whether a group of idiopathic subjective tinnitus (IST) has abnormal changes in auditory P300 and to compare these results with normal subjects. Design: AuditoryP300 was done to thirty two patients with idiopathic subjective tinnitus and they were compared to normal. The elicited auditory P300 event-related potentials (ERPs) were analyzed in terms of peak amplitude and latency of the P300 waveforms. Basic audiological assessments that include pure tone audiometry and immittancemetry were done to the whole study group. Results: The results showed that while P300 peak amplitudes were overall reduced for idiopathic subjective tinnitus but it was varied individually and the P300 peak latencies were statistically of non-significant values between the study group and normal subjects. Discussion and Conclusion: Reduced waveform amplitudes were observed in IST than normal subjects. Possible mechanisms include that the processing of selective attention and its response to auditory tone burst stimuli associated with IST differ than that of the normal. The findings of our study are consistent with the hypothesis that IST patients differ in their response to auditory stimulus measured by P300 mainly auditory cortical area than normal subjects.

Indian Journal of Otolaryngology and Head & Neck Surgery, 2019

Tinnitus is defined as phantom auditory perception without corresponding acoustic or mechanical correlates in cochlea. Existing evidence on its physiological basis is wide ranging, but its origin is still under exploration. To objectify this subjective phenomenon, Auditory Brainstem response test is used. The primary purpose of our study was to ascertain any significant difference in auditory electrophysiological response parameters in sensorineural hearing loss with tinnitus group when compared to controls (normal hearing subjects). Secondary aim was to find correlation of these parameters with degree of hearing loss and severity of tinnitus. This was a case control study conducted in the department of Otorhinolaryngology in tertiary care hospital, New Delhi over a period of one and half years. The study comprised of one hundred and sixty patients out of which, fifty-five patients were sensorineural hearing loss with tinnitus and fifty-one patients were normal hearing subjects. General medical and audiological assessment was done. Significant increase in latency of wave I, III, V and increase in inter peak latency of I-III, III-V, I-V was observed in tinnitus with sensorineural hearing loss group when compared to controls. It was reported that on increasing degree of hearing loss, there was increase in latency of wave I, III, V and increase in inter peak latency of wave I-III, I-V in the former group.

2010

SummaryLong latency auditory evoked potentials (LLAEP) alterations in individuals with tinnitus are suggestive of dysfunction in the central auditory pathways at a cortical level.Aimto characterize the LLAEP in individuals with and without tinnitus exposed to occupational noise.MethodCross-sectional contemporary cohort, prospective study. Sixty subjects exposed to occupational noise, ranging in age from 29 to 50 years underwent LLAEP assessment; 30 of them had tinnitus complaint and 30 did not have tinnitus.Resultswe observed significant statistical difference regarding the mean values of latencies of waves N1 (p<0.001), P2 (p=0.002) and P300 (p=0.039) when we compared individuals with and without tinnitus. In individuals with tinnitus we also noticed a greater number of altered results concerning components N1 (60%) and P2 (66.7%), although only component P2 presented significant statistical difference (p=0.010). For the LLAEP, the latency increase was the only type of alteratio...

International Journal of Otorhinolaryngology and Head and Neck Surgery

Background: Aiming to evaluate the recent theoretical postulates on tinnitus underscoring the role of thalamocortical neural tracts, the present study: explores middle latency response (MLR) as a possible physiological measure of tinnitus: thus investigates the predicted exaggeration of Pa-Na, Na-Pb interpeak amplitudes in tinnitus patients and; explores middle latency response (MLR) as a prognostic indicator of tinnitus retraining therapy (TRT), thus evaluates possible decrease in Pa-Na and Na-Pb amplitude after 2 weeks exposure to tinnitus retraining therapy.Methods: An experimental group was constructed by randomly assigning 30 patients with mean age 38.5 years and complaining of debilitating tinnitus but with normal hearing for the study. MLR was administered on patients with normal auditory brainstem response (ABR) and otoacoustic emission (OAE) both pre- and post-tinnitus retraining therapy. Results: Results demonstrated no significant effect on Pa, Na and Nb absolute and int...

Introduction: Chronic subjective tinnitus is associated with cognitive disruptions affecting perception, thinking, language, reasoning, problem solving, memory, visual tasks (reading) and attention. Objective: To evaluate existence of any association between tinnitus parameters and neuropsychological performance to explain cognitive processing. Materials and Methods: Study design was prospective, consisting 25 patients with idiopathic chronic subjective tinnitus and gave informed consent before planning their treatment. Neuropsychological profile included (i) performance on verbal information, comprehension, arithmetic and digit span; (ii) non-verbal performance for visual pattern completion analogies; (iii) memory performance for long-term, recent, delayed-recall, immediate-recall, verbal-retention, visualretention, visual recognition; (iv) reception, interpretation and execution for visual motor gestalt. Correlation between tinnitus onset duration/ loudness perception with neuropsychological profile was assessed by calculating Spearman's coefficient. Results: Findings suggest that tinnitus may interfere with cognitive processing especially performance on digit span, verbal comprehension, mental balance, attention & concentration, immediate recall, visual recognition and visual-motor gestalt subtests. Negative correlation between neurocognitive tasks with tinnitus loudness and onset duration indicated their association. Positive correlation between tinnitus and visual-motor gestalt performance indicated the brain dysfunction. Conclusion: Tinnitus association with non-auditory processing of verbal, visual and visuo-spatial information suggested neuroplastic changes that need to be targeted in cognitive rehabilitation.

The International Tinnitus Journal, 2014

Tinnitus is the perception of a sound without an external source. It can affect auditory perception abilities in individuals with normal hearing sensitivity. Purpose: The aim of the study was to determine the effect of tinnitus on psychoacoustic abilities in individuals with normal hearing sensitivity. Materials and Methods: The study was conducted on twenty subjects with tinnitus and twenty subjects without tinnitus. Tinnitus group was again divided into mild and moderate tinnitus based on the tinnitus handicap inventory. Data Collection and Analysis: Differential limen of intensity, differential limen of frequency, gap detection test, modulation detection thresholds were done through the mlp toolbox in Matlab and speech in noise test was done with the help of Quick SIN in Kannada. Results: Results of the study showed that the clinical group performed poorly in all the tests except for differential limen of intensity. Conclusions: Tinnitus affects aspects of auditory perception like temporal resolution, speech perception in noise and frequency discrimination in individuals with normal hearing. This could be due to subtle changes in the central auditory system which is not reflected in the pure tone audiogram.

Journal of Korean medical science, 2004

To investigate the cognitive characteristics that affect the emotional and functional distress caused by tinnitus and to decide and test the model to explain their relations, 167 patients with tinnitus, who visited Samsung Medical Center, Seoul, Korea between March 2001 and May 2002 were recruited. To examine their features related to tinnitus, the following scales were administered; Tinnitus-related basic questionnaire including dysfunctional beliefs, Tinnitus Handicap Inventory, State-Trait Anxiety Inventory, Anxious Thought and Tendencies, Self-Consciousness Scale, and modified 'catastrophic thought' from Coping Strategies Questionnaire. The results showed that the duration of experiencing tinnitus was 4.7 +/-7.1 yr, those who complained of hearing one sound were the most common (45.5%), and hearing sounds similarly described to whistling were the most common (22.5%). Also, there were significant correlations among tinnitus features, cognitive characteristics, and distres...

Tinnitus is thought to be an auditory phenomenon resulting from spontaneous neuronal activity somewhere along the auditory pathways either in the peripheral or central nervous system. The neuronal abnormalities underlying tinnitus are largely unknown. This study analysis the auditory brainstem responses in normal hearing patients with tinnitus. This study consisted of 100 patients divided into two groups. Group 1(control)-50 normal hearing patients without tinnitus. Group 2 (study)-50 normal hearing patients complaining of tinnitus. Both groups were subjected to full audiological history taking, otological examination, basic audiological evaluation and Auditory Brainstem Responses (ABR) followed by calculation of absolute latencies of wave I, III and V and interpeak latencies between waves I-III, III-V and I-V. In the study group, 18 patients (36%) showed abnormal results in atleast one of the 6 parameters evaluated. The results of absolute latencies of wave I, III and V showed significant prolongation when compared with the control group. Furthermore, the interpeak I-III, III-V and I-V latencies were not significantly prolonged when compared with the control group.

Although a peripheral auditory (bottom-up) deficit is an essential prerequisite for the generation of tinnitus, central cognitive (top-down) impairment has also been shown to be an inherent neuropatho-logical mechanism. Using an auditory oddball paradigm (for top-down analyses) and a passive listening paradigm (for bottom-up analyses) while recording electroencephalograms (EEGs), we investigated whether top-down or bottom-up components were more critical in the neuropathology of tinnitus, independent of peripheral hearing loss. We observed significantly reduced P300 amplitudes (reflecting fundamental cognitive processes such as attention) and evoked theta power (reflecting top-down regulation in memory systems) for target stimuli at the tinnitus frequency of patients with tinnitus but without hearing loss. The contingent negative variation (reflecting top-down expectation of a subsequent event prior to stimulation) and N100 (reflecting auditory bottom-up selective attention) were different between the healthy and patient groups. Interestingly, when tinnitus patients were divided into two subgroups based on their P300 amplitudes, their P170 and N200 components, and annoyance and distress indices to their tinnitus sound were different. EEG theta-band power and its Granger causal neurodynamic results consistently support a double dissociation of these two groups in both top-down and bottom-up tasks. Directed cortical connectivity corroborates that the tinnitus network involves the anterior cingulate and the parahippocampal areas, where higher-order top-down control is generated. Together, our observations provide neurophysiological and neurodynamic evidence revealing a differential engagement of top-down impairment along with deficits in bottom-up processing in patients with tinnitus but without hearing loss.

Auris Nasus Larynx, 2011

Objectives: Tinnitus can be accompanied by depression, anxiety, insomnia, problems with auditory perception and poor general and mental health. This work was designed to evaluate the cognitive and psychological status in tinnitus patients using different subjective and objective measures. Methods: This work included 40 patients complaining of tinnitus without any vestibular complaints. Those patients were compared with 40 healthy age and sex matched controls. All subjects were evaluated through: basic audiologic evaluation, electrophysiological test (P300), oculomotor tests (smooth-pursuit, optokinetic, gaze and saccadic eye movements) and psychological evaluation (Hamilton depression and anxiety scales, Mini Mental Status Examination and Trail making tests). Results: Patients with tinnitus showed abnormalities at both electrophysiological and psychological levels when compared with normal subjects. Conclusion: This study provides evidences that different pathological mechanisms are involved in tinnitus generation which are more extensive than we thought.