1
|
Devolder P, Keppler H, Keshishzadeh S, Taghon B, Dhooge I, Verhulst S. The role of hidden hearing loss in tinnitus: Insights from early markers of peripheral hearing damage. Hear Res 2024; 450:109050. [PMID: 38852534 DOI: 10.1016/j.heares.2024.109050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Revised: 05/24/2024] [Accepted: 05/28/2024] [Indexed: 06/11/2024]
Abstract
Since the presence of tinnitus is not always associated with audiometric hearing loss, it has been hypothesized that hidden hearing loss may act as a potential trigger for increased central gain along the neural pathway leading to tinnitus perception. In recent years, the study of hidden hearing loss has improved with the discovery of cochlear synaptopathy and several objective diagnostic markers. This study investigated three potential markers of peripheral hidden hearing loss in subjects with tinnitus: extended high-frequency audiometric thresholds, the auditory brainstem response, and the envelope following response. In addition, speech intelligibility was measured as a functional outcome measurement of hidden hearing loss. To account for age-related hidden hearing loss, participants were grouped according to age, presence of tinnitus, and audiometric thresholds. Group comparisons were conducted to differentiate between age- and tinnitus-related effects of hidden hearing loss. All three markers revealed age-related differences, whereas no differences were observed between the tinnitus and non-tinnitus groups. However, the older tinnitus group showed improved performance on low-pass filtered speech in noise tests compared to the older non-tinnitus group. These low-pass speech in noise scores were significantly correlated with tinnitus distress, as indicated using questionnaires, and could be related to the presence of hyperacusis. Based on our observations, cochlear synaptopathy does not appear to be the underlying cause of tinnitus. The improvement in low-pass speech-in-noise could be explained by enhanced temporal fine structure encoding or hyperacusis. Therefore, we recommend that future tinnitus research takes into account age-related factors, explores low-frequency encoding, and thoroughly assesses hyperacusis.
Collapse
Affiliation(s)
- Pauline Devolder
- Hearing Technology @ WAVES, Department of Information Technology, Ghent University, Zwijnaarde, Belgium; Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium.
| | - Hannah Keppler
- Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium; Department of Ear, Nose and Throat, Ghent University Hospital, Ghent, Belgium
| | - Sarineh Keshishzadeh
- Hearing Technology @ WAVES, Department of Information Technology, Ghent University, Zwijnaarde, Belgium
| | - Baziel Taghon
- Hearing Technology @ WAVES, Department of Information Technology, Ghent University, Zwijnaarde, Belgium
| | - Ingeborg Dhooge
- Department of Ear, Nose and Throat, Ghent University Hospital, Ghent, Belgium; Department of Head and Skin, Ghent University, Ghent, Belgium
| | - Sarah Verhulst
- Hearing Technology @ WAVES, Department of Information Technology, Ghent University, Zwijnaarde, Belgium
| |
Collapse
|
2
|
Clifford RE, Maihofer AX, Chatzinakos C, Coleman JRI, Daskalakis NP, Gasperi M, Hogan K, Mikita EA, Stein MB, Tcheandjieu C, Telese F, Zuo Y, Ryan AF, Nievergelt CM. Genetic architecture distinguishes tinnitus from hearing loss. Nat Commun 2024; 15:614. [PMID: 38242899 PMCID: PMC10799010 DOI: 10.1038/s41467-024-44842-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Accepted: 01/04/2024] [Indexed: 01/21/2024] Open
Abstract
Tinnitus is a heritable, highly prevalent auditory disorder treated by multiple medical specialties. Previous GWAS indicated high genetic correlations between tinnitus and hearing loss, with little indication of differentiating signals. We present a GWAS meta-analysis, triple previous sample sizes, and expand to non-European ancestries. GWAS in 596,905 Million Veteran Program subjects identified 39 tinnitus loci, and identified genes related to neuronal synapses and cochlear structural support. Applying state-of-the-art analytic tools, we confirm a large number of shared variants, but also a distinct genetic architecture of tinnitus, with higher polygenicity and large proportion of variants not shared with hearing difficulty. Tissue-expression analysis for tinnitus infers broad enrichment across most brain tissues, in contrast to hearing difficulty. Finally, tinnitus is not only correlated with hearing loss, but also with a spectrum of psychiatric disorders, providing potential new avenues for treatment. This study establishes tinnitus as a distinct disorder separate from hearing difficulties.
Collapse
Affiliation(s)
- Royce E Clifford
- Veterans Affairs San Diego Healthcare System, Research Service, San Diego, CA, USA.
- University of California San Diego, Division of Otolaryngology - Head and Neck Surgery, La Jolla, CA, USA.
| | - Adam X Maihofer
- Veterans Affairs San Diego Healthcare System, Research Service, San Diego, CA, USA
- University of California San Diego, Department of Psychiatry, La Jolla, CA, USA
| | - Chris Chatzinakos
- Harvard Medical School, Department of Psychiatry, Boston, MA, USA
- McLean Hospital, Center of Excellence in Depression and Anxiety Disorders, Belmont, MA, USA
| | - Jonathan R I Coleman
- King's College London, NIHR Maudsley BRC, London, UK
- King's College London, Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, London, UK
| | - Nikolaos P Daskalakis
- Harvard Medical School, Department of Psychiatry, Boston, MA, USA
- McLean Hospital, Center of Excellence in Depression and Anxiety Disorders, Belmont, MA, USA
| | - Marianna Gasperi
- Veterans Affairs San Diego Healthcare System, Research Service, San Diego, CA, USA
- University of California San Diego, Department of Psychiatry, La Jolla, CA, USA
| | - Kelleigh Hogan
- Veterans Affairs San Diego Healthcare System, Research Service, San Diego, CA, USA
- University of California San Diego, Department of Psychiatry, La Jolla, CA, USA
| | - Elizabeth A Mikita
- Veterans Affairs San Diego Healthcare System, Research Service, San Diego, CA, USA
- University of California San Diego, Department of Psychiatry, La Jolla, CA, USA
| | - Murray B Stein
- University of California San Diego, Department of Psychiatry, La Jolla, CA, USA
- Veterans Affairs San Diego Healthcare System, Psychiatry Service, San Diego, CA, USA
- University of California San Diego, School of Public Health, La Jolla, CA, USA
| | | | - Francesca Telese
- University of California San Diego, Department of Psychiatry, La Jolla, CA, USA
| | - Yanning Zuo
- University of California San Diego, Department of Psychiatry, La Jolla, CA, USA
| | - Allen F Ryan
- Veterans Affairs San Diego Healthcare System, Research Service, San Diego, CA, USA
- University of California San Diego, Division of Otolaryngology - Head and Neck Surgery, La Jolla, CA, USA
| | - Caroline M Nievergelt
- Veterans Affairs San Diego Healthcare System, Research Service, San Diego, CA, USA.
- University of California San Diego, Department of Psychiatry, La Jolla, CA, USA.
| |
Collapse
|
3
|
Bramhall NF, McMillan GP. Perceptual Consequences of Cochlear Deafferentation in Humans. Trends Hear 2024; 28:23312165241239541. [PMID: 38738337 DOI: 10.1177/23312165241239541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/14/2024] Open
Abstract
Cochlear synaptopathy, a form of cochlear deafferentation, has been demonstrated in a number of animal species, including non-human primates. Both age and noise exposure contribute to synaptopathy in animal models, indicating that it may be a common type of auditory dysfunction in humans. Temporal bone and auditory physiological data suggest that age and occupational/military noise exposure also lead to synaptopathy in humans. The predicted perceptual consequences of synaptopathy include tinnitus, hyperacusis, and difficulty with speech-in-noise perception. However, confirming the perceptual impacts of this form of cochlear deafferentation presents a particular challenge because synaptopathy can only be confirmed through post-mortem temporal bone analysis and auditory perception is difficult to evaluate in animals. Animal data suggest that deafferentation leads to increased central gain, signs of tinnitus and abnormal loudness perception, and deficits in temporal processing and signal-in-noise detection. If equivalent changes occur in humans following deafferentation, this would be expected to increase the likelihood of developing tinnitus, hyperacusis, and difficulty with speech-in-noise perception. Physiological data from humans is consistent with the hypothesis that deafferentation is associated with increased central gain and a greater likelihood of tinnitus perception, while human data on the relationship between deafferentation and hyperacusis is extremely limited. Many human studies have investigated the relationship between physiological correlates of deafferentation and difficulty with speech-in-noise perception, with mixed findings. A non-linear relationship between deafferentation and speech perception may have contributed to the mixed results. When differences in sample characteristics and study measurements are considered, the findings may be more consistent.
Collapse
Affiliation(s)
- Naomi F Bramhall
- VA National Center for Rehabilitative Auditory Research, Veterans Affairs Portland Health Care System, Portland, OR, USA
- Department of Otolaryngology/Head & Neck Surgery, Oregon Health & Science University, Portland, OR, USA
| | - Garnett P McMillan
- VA National Center for Rehabilitative Auditory Research, Veterans Affairs Portland Health Care System, Portland, OR, USA
| |
Collapse
|