An Exploratory Study of the Effect of Tinnitus on Listening Effort Using EEG and Pupillometry

Abstract

ObjectivePrevious behavioral studies on listening effort in tinnitus patients did not consider extended high‐frequency hearing thresholds and had conflicting results. This inconsistency may be related that listening effort is not evaluated by the central nervous system (CNS) and autonomic nervous system (ANS), which are directly related to tinnitus pathophysiology. This study matches hearing thresholds at all frequencies, including the extended high‐frequency and reduces hearing loss to objectively evaluate listening effort over the CNS and ANS simultaneously in tinnitus patients.Study DesignCase‐control study.SettingUniversity hospital.MethodsSixteen chronic tinnitus patients and 23 matched healthy controls having normal pure‐tone averages with symmetrical hearing thresholds were included. Subjects were evaluated with 0.125 to 20 kHz pure‐tone audiometry, Montreal Cognitive Assessment Test (MoCA), Tinnitus Handicap Inventory (THI), Visual Analog Scale (VAS), electroencephalography (EEG), and pupillometry.ResultsPupil dilation and EEG alpha band in the “coding” phase of the sentence presented in tinnitus patients was less than in the control group (p < .05). VAS score was higher in the tinnitus group (p < .01). Also, there was no statistically significant relationship between EEG and pupillometry components and THI or MoCA (p > .05).ConclusionThis study suggests that tinnitus patients may need to make an extra effort to listen. Also, pupillometry may not be sufficiently reliable to assess listening effort in ANS‐related pathologies. Considering the possible listening difficulties in tinnitus patients, reducing the listening difficulties, especially in noisy environments, can be added to the goals of tinnitus therapy protocols.

Investigation of the behavior of tinnitus patients under varying listening conditions with simultaneous electroencephalography and pupillometry

“…( 2017 ) (using dual‐task paradigm) and Sendesen et al. ( 2023 ) (using EEG and pupillometry) hypothesis's of a potential listening effort in tinnitus patients. If this difference was due to fatigue, the brain's general inhibition mechanism would dominate, and the EEG alpha band power would increase since more neural resources would not be needed (Hunter, 2022 ).…”

“…In the literature, electroencephalography (EEG) and pupillometry are widely recommended for physiologic assessment of listening effort (Fiedler et al., 2021 ; Haro et al., 2022 ; Miles et al., 2017 ; Sendesen et al., 2023 ). Pupillometry is closely related to the autonomic nervous system (ANS) response that develops as the processing load increases (Sirois & Brisson, 2014 ).…”

“…There are studies on potential listening efforts in tinnitus patients (Degeest et al., 2022 ; Huang et al., 2022 ; Juul Jensen et al., 2018 ; Gürses et al, 2018 ; Sendesen & Turkyilmaz, 2024 ; Sendesen et al., 2023 ). Only a few of these studies used objective assessment methods (Juul Jensen et al., 2018 ; Sendesen & Turkyilmaz, 2024 ; Sendesen et al., 2023 ).…”

“…There are studies on potential listening efforts in tinnitus patients (Degeest et al., 2022 ; Huang et al., 2022 ; Juul Jensen et al., 2018 ; Gürses et al, 2018 ; Sendesen & Turkyilmaz, 2024 ; Sendesen et al., 2023 ). Only a few of these studies used objective assessment methods (Juul Jensen et al., 2018 ; Sendesen & Turkyilmaz, 2024 ; Sendesen et al., 2023 ). Furthermore, some of the studies evaluating listening effort in tinnitus patients did not assess tinnitus patients’ extended high frequencies (EHFs) (8−20 kHz) (Degeest et al., 2022 ; Huang et al., 2022 ; Juul Jensen et al., 2018 ).…”

“…Sendesen et al. ( 2023 ) addressed this in an attempt to define the listening difficulty in tinnitus patients. This study has once again confirmed the listening difficulty in tinnitus patients.…”