The Effect of Citalopram Versus a Placebo on Central Auditory Processing in the Elderly

Antidepressants and risk of sudden sensorineural hearing loss: a population-based cohort study

BACKGROUND

Increasing numbers of animal studies have found that sudden sensorineural hearing loss (SSNHL) is related to the mechanism of serotonergic modulation. However, the relationship between antidepressants and SSNHL is unclear in humans. Therefore, this study aimed to evaluate the association between antidepressant use and risk of SSNHL.

METHODS

Data from 218 466 antidepressant users and 1 116 518 nonusers were obtained from the Taiwan Longitudinal Health Insurance Database. We used propensity-score matching (PSM) and inverse-probability treatment weighting (IPTW) to eliminate any bias. Each patient was tracked for 5 years to ascertain whether or not they were diagnosed with SSNHL. Cox proportional-hazard regression analyses were performed to calculate the SSNHL risk.

RESULTS

The adjusted hazard ratio (aHR) of SSNHL for antidepressant users was 1.36 compared with nonusers in the full cohort study. The aHR for antidepressant users was 1.44 and 1.49 compared with the nonusers in the IPTW and PSM cohorts, respectively. All classes of antidepressants consistently increased the SSNHL risk. Additionally, patients receiving four classes of antidepressants were associated with a much higher SSNHL risk (aHR, 2.05) and those receiving one or two classes of antidepressants had a relatively lower SSNHL risk.

CONCLUSION

Antidepressants increased SSNHL risk, regardless of their class. Furthermore, patients who took a higher number of antidepressant classes showed an increased risk of developing SSNHL than those who took a lower number of antidepressant classes. Therefore, physicians should estimate the risks and benefits of antidepressant use and avoid prescribing antidepressants concurrently.

Age-related altering temporal processing and binaural interaction functions in normal hearing individuals: Observational and cross-sectional study

OBJECTIVE

This study aimed to investigate the temporal processing and binaural interaction functions of central auditory processing tests according to the anatomical localizations of young and elderly individuals. It also sought to evaluate the relationships between the same individuals' central auditory processing tests.

METHODS

This observational and cross-sectional study included individuals with normal hearing between 18 and 30 and 60-75 years of age, who were referred to as the young group and the elderly group, respectively. The evaluation of the central auditory processing tests was completed using the frequency pattern test, duration pattern test, masking level difference test, and random gap detection test. Furthermore, speech discrimination and speech in noise scores were analyzed for both groups.

RESULTS

Statistically significant differences were identified between the groups' scores for the speech in noise test, masking level difference test, random gap detection test, frequency pattern test, and duration pattern test (p < 0.05). A statistically significant relationship was observed between the age and the results of the central auditory processing tests (p < 0.05).

CONCLUSION

When compared to younger individuals, elderly individuals presented with declined temporal sequences, temporal resolutions, and binaural interaction skills.

Silence, Solitude, and Serotonin: Neural Mechanisms Linking Hearing Loss and Social Isolation

For social animals that communicate acoustically, hearing loss and social isolation are factors that independently influence social behavior. In human subjects, hearing loss may also contribute to objective and subjective measures of social isolation. Although the behavioral relationship between hearing loss and social isolation is evident, there is little understanding of their interdependence at the level of neural systems. Separate lines of research have shown that social isolation and hearing loss independently target the serotonergic system in the rodent brain. These two factors affect both presynaptic and postsynaptic measures of serotonergic anatomy and function, highlighting the sensitivity of serotonergic pathways to both types of insult. The effects of deficits in both acoustic and social inputs are seen not only within the auditory system, but also in other brain regions, suggesting relatively extensive effects of these deficits on serotonergic regulatory systems. Serotonin plays a much-studied role in depression and anxiety, and may also influence several aspects of auditory cognition, including auditory attention and understanding speech in challenging listening conditions. These commonalities suggest that serotonergic pathways are worthy of further exploration as potential intervening mechanisms between the related conditions of hearing loss and social isolation, and the affective and cognitive dysfunctions that follow.

Hearing loss and psychiatric disorders: a review

Hearing loss is one of the most common yet unrecognized impairments experienced by adults, especially as they age. Mental health investigators and practitioners require better understanding of hearing loss, its association with psychiatric disorders, and the treatment of these disorders in the presence of hearing loss as well as the treatment of hearing loss itself. In this review, the authors briefly explore the global burden of hearing loss. Next we provide an overview of the extant literature on hearing loss associated with cognitive impairment, depression, anxiety disorders, psychoses, and quality of life with attention focused on the strength of the association, possible mechanisms explaining the association, data on treatment options specific to these disorders, and future research opportunities for these disorders. Current approaches to the treatment of hearing loss are presented, including hearing aids, rehabilitation including psychotherapies, surgical procedures (specifically cochlear implants), and induction loops connected to telecoils. Finally, cutting edge research into the pathophysiology and potential biological treatments of hearing loss is described.