Association of Chronic Subjective Tinnitus with Neuro-Cognitive Performance

Abstract

Introduction: Chronic subjective tinnitus is associated with cognitive disruptions affecting perception, thinking, language, reasoning, problem solving, memory, visual tasks (reading) and attention. Objective: To evaluate existence of any association between tinnitus parameters and neuropsychological performance to explain cognitive processing. Materials and Methods: Study design was prospective, consisting 25 patients with idiopathic chronic subjective tinnitus and gave informed consent before planning their treatment. Neuropsychological profile included (i) performance on verbal information, comprehension, arithmetic and digit span; (ii) non-verbal performance for visual pattern completion analogies; (iii) memory performance for long-term, recent, delayed-recall, immediate-recall, verbal-retention, visualretention, visual recognition; (iv) reception, interpretation and execution for visual motor gestalt. Correlation between tinnitus onset duration/ loudness perception with neuropsychological profile was assessed by calculating Spearman's coefficient. Results: Findings suggest that tinnitus may interfere with cognitive processing especially performance on digit span, verbal comprehension, mental balance, attention & concentration, immediate recall, visual recognition and visual-motor gestalt subtests. Negative correlation between neurocognitive tasks with tinnitus loudness and onset duration indicated their association. Positive correlation between tinnitus and visual-motor gestalt performance indicated the brain dysfunction. Conclusion: Tinnitus association with non-auditory processing of verbal, visual and visuo-spatial information suggested neuroplastic changes that need to be targeted in cognitive rehabilitation.

Neurocognition of Aged Patients With Chronic Tinnitus: Focus on Mild Cognitive Impairment

“…As shown previously, the more severe the tinnitus, the more likely the deterioration of cognitive processing is, suggesting that cognitive processing speed is an independent predictor of tinnitus severity [12]. Furthermore, a neuropsychological study reported a significant negative correlation between tinnitus loudness and duration, and performance on neurocognitive tasks [15]. In this regard, the increase in tinnitus severity may negatively affect attentional orientation and executive control, reducing cognitive processing speed [6].…”

“…Several previous studies have indicated the presence of cognitive impairments, including attention deficit, instant memory disorder, and inefficient learning in patients with chronic tinnitus [6,15]. Despite inconsistent results on the association of tinnitus with certain types of cognitive functions, tinnitus has been shown to have negative effects on executive or selective attention and working memory [6].…”

“…However, the exact pathophysiology behind the development of tinnitus-associated cognitive deficits has not been yet elucidated. A neuropsychological study investigating cognitive processing in chronic tinnitus patients revealed that tinnitus disrupts non-auditory processing of verbal, visual, and visual-spatial information, suggesting the development of neuroplastic changes [15]. Furthermore, a neuroimaging study employing EEG with source analysis recently reported the nature of the cognitive deficits in tinnitus patients [13].…”

“…Third, the present study did not adopt an objective approach such as neuroimaging or electrophysiology in the examination of the nature of these cognitive deficits. Neurobiological modelling studies have reported that brain areas like the limbic system, autonomic nervous system, and sensory cortex may contribute to the association between tinnitus and cognitive deficits [15,32]. Therefore, neurobiological and neuroimaging approaches should be implemented to aid with the identification of the cognitive impairment etiology in chronic tinnitus patients.…”

“…Despite the existence of putative evidence between tinnitus and cognitive deficits, only a few published studies have yet explored the cognitive function of chronic tinnitus patients [11,12,14,15]. Notably, there was no study that suggested the possible association between chronic tinnitus and mild cognitive impairment (MCI).…”