Clin Exp Otorhinolaryngol.  2024 Feb;17(1):15-25. 10.21053/ceo.2023.00808.

Cognitive Screening and Hearing Assessment in Patients With Chronic Tinnitus

• Bernal-Robledano A
• Perez-Carpena P
• Kikidis D
• Mazurek B
• Schoisswohl S
• Staudinger S
• Langguth B
• Schlee W
• Lopez-Escamez JA

• KMID: 2553052
• DOI: http://doi.org/10.21053/ceo.2023.00808

Abstract

Objectives
. The study aimed to assess the relationship of tinnitus with hyperacusis with cognitive impairment as indicated by the Montreal Cognitive Assessment (MoCA) tool.
Methods
. This multicenter cross-sectional study included individuals with chronic tinnitus from the “Unification of Treatments and Interventions for Tinnitus Patients” (UNITI) database. Participants were recruited from four different tertiary clinical centers located in Athens and Granada (Mediterranean group), as well as Berlin and Regensburg (German group). In total, 380 individuals with a diagnosis of non-pulsatile chronic tinnitus (permanent and constant tinnitus lasting more than 6 months) and no evidence of severe cognitive impairment (MoCA score >22) were enrolled. The evaluation utilized the following tools: MoCA, Tinnitus Handicap Inventory (THI), Hyperacusis Questionnaire (GÜF), Patient Health Questionnaire (PHQ-9), and the European School for Interdisciplinary Tinnitus Research Screening Questionnaire.
Results
. MoCA scores differed between German and Mediterranean individuals (P<0.01), necessitating separate analyses for each group. In both cohorts, MoCA scores were significantly associated with education level, age, hearing threshold at 8 kHz, and THI. Furthermore, a significant correlation was observed between PHQ-9 scores and both THI and GÜF (P<0.01 for both Germans and those from the Mediterranean).
Conclusion
. Our data suggest an association between tinnitus handicap, high-frequency hearing loss, and mild cognitive impairment. Additionally, PHQ-9 scores were associated with tinnitus and hyperacusis scores, independent of hearing loss thresholds.

Keyword

Tinnitus; Hearing Loss; Cognition; Neuropsychological Tests; Cognitive Dysfunction; Depression

Figure

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  Fig. 1. Cognitive screening in individuals with chronic tinnitus. (A) Frequency histogram of the Montreal Cognitive Assessment (MoCA) scores from each site. (B) Boxplots of MoCA score differences according to hearing threshold in German and Mediterranean individuals. No differences are discernible. SNHL, sensorineural hearing loss.

• 

  Fig. 2. Visualization of the relationship between Montreal Cognitive Assessment (MoCA) scores, Tinnitus Handicap Inventory (THI) scores, and average 8-kHz frequency values (high-frequency hearing loss). Variables in the German (A) and Mediterranean (B) groups in a three-dimensional scatterplot.

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