Association between subjective tinnitus and cognitive performance: protocol for systematic review and meta-analysis

Tinnitus-associated cognitive and psychological impairments: a comprehensive review meta-analysis

Background

Tinnitus is strongly associated with an increased risk of cognitive disabilities. The findings of this research will provide valuable support for future investigations aimed at determining the correlation between tinnitus and the risk of cognitive impairments.

Objectives

We investigated the potential correlation between tinnitus and the risk of various cognitive impairments, such as dementia, compromised learning attention, anxiety, depression, and insomnia. The study examined this relationship collectively and by categorizing the data based on different age groups.

Methods

We compiled data from case-control studies and cohort studies obtained from reputable databases such as PubMed, Cochrane Library, and Embase. To minimize potential bias, two reviewers independently assessed the selected articles. After extracting the data, we calculated the pooled odds ratios (ORs) using a random-effects model.

Results

Seventeen relevant studies, comprising an adult population, were included in this analysis. Pooled estimated outcomes revealed a strong association between tinnitus and an elevated risk of dementia-compromised learning, auditory attention, anxiety, depression, and poor sleep quality (P<0.05). Furthermore, the pooled analysis stratified by age demonstrated that patients aged above 60 years, in comparison to those aged 18 to 60 years, exhibited more significant outcomes in relation to the progression of cognitive impairments.

Conclusion

Tinnitus has the potential to increase the risk of cognitive impairments. Moreover, geriatric patients aged above 60 shows a higher susceptibility to developing cognitive disabilities compared to their younger counterparts.

The Impact of Sleep Quality on Cognitive Function in Patients with Chronic Subjective Tinnitus

BACKGROUND

The aim of this study was to explore the impact of sleep quality on cognitive function in patients with chronic subjective tinnitus.

METHODS

The Pittsburgh Sleep Quality Index (PSQI) and the Montreal Cognitive Assessment Scale (MoCA) were used to assess sleep quality and cognitive function in patients with chronic subjective tinnitus, sleep disorder patients (SD), and normal controls (NC). The tinnitus evaluation questionnaire (TEQ) and tinnitus loudness were used to assess the severity in patients with chronic subjective tinnitus. Tinnitus patients were divided into two groups based on PSQI results: "tinnitus with sleep disorder (TwSD)" and "tinnitus without sleep disorder (TnSD)." The MoCA scores in TwSD and TnSD groups were compared with those in SD and NC groups, and the correlation between PSQI, TEQ, tinnitus loudness, and MoCA scores in subjective tinnitus patients were analyzed.

RESULTS

Whether TwSD group or TnSD group, the MoCA score was significantly lower than those in the NC group and SD group. Meanwhile, there was no significant difference between TwSD and TnSD groups in MoCA score, and PSQI, TEQ, and tinnitus loudness were not significantly correlated with MoCA.

CONCLUSION

Subjective tinnitus may be an independent risk factor for cognitive impairment. The underlying neural mechanisms between subjective tinnitus, sleep disorders, and cognitive impairment need to be further explored and clarified.

The Association Between Effectiveness of Tinnitus Intervention and Cognitive Function-A Systematic Review

Tinnitus refers to the perception of sound in the absence of an external stimulus. This can be problematic and can lead to health problems in some sufferers, including effects on cognitive functions such as attention and memory. Although several studies have examined the effectiveness of tinnitus interventions, e.g., cognitive behavioral therapy and sound therapy, it is still unclear as to the overall quality and limitations of these studies and whether their results could be generalized. Clarification is also needed as to whether poor cognitive function will lead to a less favorable intervention outcome in tinnitus patients. The present systematic review was therefore designed to critically appraise and synthesize findings from randomized controlled trials (RCTs) of tinnitus intervention and its effects on cognition. The methodology followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA). Medline (PubMed), Embase, and PsycINFO were searched. Only RCTs that compared the effectiveness of a tinnitus intervention and a measure of cognitive function in adult participants with tinnitus were included. A total of 8 studies involving 610 participants tested using 11 cognitive function assessment tools (e.g., Stroop Color and Word Test and Visual Continuous Performance Task) and 5 tinnitus intervention outcome measurements (e.g., Tinnitus Handicap Inventory and Tinnitus Questionnaire) were included and analyzed. The outcomes of the review suggest that tinnitus intervention not only facilitates tinnitus management but also improves cognitive functions. It is likely that cognition and emotion play an important role in a patient's adjustment to tinnitus. Whether cognition can predict treatment outcomes is unclear due to insufficient evidence. Future research is needed using a standardized assessment protocol focusing on the effect of sound-based interventions on tinnitus severity and cognitive functions. Studies on whether cognitive function measurement can be used as a predictor for the effectiveness of tinnitus therapy are also needed.

Clinical characteristics of subjective idiopathic tinnitus and preliminarily analyses for the effect of tinnitus multielement integration sound therapy

OBJECTIVE

To study the psychoacoustic and audiological characteristics of patients with chronic subjective tinnitus and provide basis for the personalized diagnosis and treatment of tinnitus through a single tinnitus multielement integration sound therapy (T-MIST) and analysis of efficacy preliminarily.

METHODS

145 patients with tinnitus were assessed by systematic medical history collection, professional examination of otolaryngology, audiology examination, full precision test (FPT), residual inhibition test (RIT), tinnitus handicap inventory (THI) and visual analog scale (VAS) annoyance. The correlation among factors was performed.

RESULTS

The frequency of tinnitus was correlated with the frequency of maximum hearing loss (P < 0.05). The loudness of tinnitus was correlated with the loudness of maximum hearing loss (P < 0.05). In this study, T-MIST was used to treat tinnitus. After treatment, tinnitus alleviated VAS annoyance (P < 0.05). The results of RIT were correlated with the effect of T-MIST (P < 0.05).

CONCLUSION

There was a correlation between tinnitus and hearing loss. The RIT may indicate the effectiveness of acoustic therapy in patients. The FPT can find the hidden hearing loss without display on routine pure tone audiometry, so as to provide a clinical reference for the detection of early hearing loss in tinnitus patients.

Associations Between Subjective Tinnitus and Cognitive Performance: Systematic Review and Meta-Analyses

Tinnitus is the perception of sound in the absence of a corresponding external sound source, and bothersome tinnitus has been linked to poorer cognitive performance. This review comprehensively quantifies the association between tinnitus and different domains of cognitive performance. The review protocol was preregistered and published in a peer-reviewed journal. The review and analyses were reported according to Preferred Reporting Items for Systematic Review and Meta-analysis guidelines. Peer-reviewed literature was searched using electronic databases to find studies featuring participants with tinnitus who had undertaken measures of cognitive performance. Studies were assessed for quality and categorized according to an established cognitive framework. Random-effects meta-analyses were performed on various cognitive domains with potential moderator variables assessed where possible. Thirty-eight records were included in the analysis from a total of 1,863 participants. Analyses showed that tinnitus is associated with poorer executive function, processing speed, general short-term memory, and general learning and retrieval. Narrow cognitive domains of Inhibition and Shifting (within executive function) and learning and retrieval (within general learning and retrieval) were also associated with tinnitus.

Clinical efficacy of cognitive behavioral therapy for chronic subjective tinnitus

BACKGROUND

Although cognitive behavioral therapy (CBT) has been known with a theoretical basis for tinnitus patients, there still were lack of clinical evidence.

OBJECTIVE

To evaluate the clinical efficacy of cognitive behavioral therapy (CBT) for treatment of chronic subjective tinnitus.

METHODS

One hundred patients with chronic subjective tinnitus patients were randomly divided into control (50 cases) and intervention (50 cases) groups, which received the masking therapy and sound treatment and masking therapy and sound treatment plus CBT. The treatment efficacy was evaluated.

RESULTS

The total effective rate in intervention group was significantly higher than control group (P < 0.01). After treatment, compared with control group, in intervention group the psychotic somatization, interpersonal sensitivity, depression, anxiety, hostility, terror, and phobic anxiety scores in Symptom Checklist-90 and Tinnitus Handicap Inventory score were significantly decreased (P < 0.05), the serum cortisol level was significantly decreased (P < 0.05), and the serum interleukin-2 level was significantly increased (P < 0.05).

CONCLUSION

Based on the elimination the mood disorders and reduce the stress, CBT can significantly relieve the symptoms of chronic subjective tinnitus.