Natural history of tinnitus in adults: a cross-sectional and longitudinal analysis

Abstract

ObjectiveTo assess incidence and changes in tinnitus and bothersome tinnitus as well as associated risk factors in a large sample of UK adults.DesignProspective cohort study.SettingUK.ParticipantsFor cross-sectional analysis, a group of 168 348 participants aged between 40 and 69 years with hearing and tinnitus data from the UK Biobank resource. Longitudinal analysis included a subset of 4746 people who attended a 4-year retest assessment.Main outcome measuresPresence and bothersomeness of tinnitus.Results17.7% and 5.8% of participants reported tinnitus or bothersome tinnitus, respectively. The 4-year incidence of tinnitus was 8.7%. Multivariate logistic regression models suggested that age, hearing difficulties, work noise exposure, ototoxic medication and neuroticism were all positively associated with both tinnitus and bothersome tinnitus. Reduced odds of tinnitus, but not bothersome tinnitus, was seen in alcohol drinkers versus non-drinkers. Male gender was associated with increased odds of tinnitus, while female gender was associated with increased odds of bothersome tinnitus. At follow-up, of those originally reporting tinnitus, 18.3% reported no tinnitus. Of those still reporting tinnitus, 9% reported improvement and 9% reported tinnitus becoming more bothersome, with the rest unchanged. Male gender and alcohol consumption were associated with tinnitus being reported less bothersome, and hearing difficulties were associated with the odds of tinnitus being reported as more bothersome.ConclusionsThis study is one of the few to provide data on the natural history of tinnitus in a non-clinical population, suggesting that resolution is relatively uncommon, with improvement and worsening of symptoms equally likely. There was limited evidence for any modifiable lifestyle factors being associated with changes in tinnitus symptoms. In view of the largely persistent nature of tinnitus, public health strategies should focus on: (1) primary prevention and (2) managing symptoms in people that have tinnitus and monitoring changes in bothersomeness.

Different bimodal neuromodulation settings reduce tinnitus symptoms in a large randomized trial

“…Bimodal stimulation did not result in any noticeable differences in rate of increased tinnitus AEs compared to the sound-only condition (first row of data in Table 3), suggesting that this type of AE is associated with the sound component rather than the tongue component. In a recent large-scale study characterizing the natural history of tinnitus in adults, 9% of participants (94 out of 1039) reported a worsening of their tinnitus 24 ; thus, a proportion of these increased tinnitus AEs are likely due to natural variation in tinnitus symptoms over time. Increase in tinnitus was self-reported by participants during compliance calls or directly to the investigation team either at a clinic visit or in between clinic visits if participants experienced that their tinnitus was louder or more bothersome.…”

“…Relating to the inclusion and exclusion criteria, participants can be enrolled if they have a THI score of 38-100 at the screening visit, which includes moderate (38-56), severe (58-76), and catastrophic (78-100) groups. Participants are excluded if they are in the no/slight handicap (0-16) or mild (18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36) group; thus, those who are less likely to seek Lenire treatment in the real-world clinical setting. There were 62.3%, 30.4%, and 7.3% in the moderate, severe, and catastrophic group, respectively (out of 191 enrolled participants).…”

Factors Associated With the Development of Tinnitus and With the Degree of Annoyance Caused by Newly Developed Tinnitus

“…Factors associated with tinnitus have mainly been studied cross-sectionally. Tinnitus is associated with hearing loss, noise exposure, ototoxic medication, head and neck trauma, a variety of illnesses and lifestyle factors such as smoking, and reduced emotional well-being and especially depression and anxiety (Nondahl et al 2002(Nondahl et al , 2011Shargorodsky et al 2010;Kim et al 2015;Trevis et al 2018;Dawes et al 2020). Hereditary predisposition has also been described (Hendrickx et al 2007) as a risk factor.…”

“…Only a few studies exist that report on risk factors for developing tinnitus. Pre-existing risk factors shown to be associated with the development of tinnitus are hearing loss, temporomandibular joint disorders, dizziness, middle ear infections, history of head and neck injury, history of migraines, otosclerosis, history of smoking, high cholesterol, chronic kidney disease, arthritis, no/low caffeine intake, chemotherapeutic agents (cisplatin and carboplatin), alcohol consumption (protective), and obesity in men (Table 1; Nondahl et al 2002Nondahl et al , 2010Dille et al 2010;Gopinath et al 2010;Bernhardt et al 2011;Glicksman et al 2014;Lee et al 2016;Shih et al 2017;Hwang et al 2018;Dawes et al 2020).…”

Barriers to Adoption of Digital Therapeutics (DTx) into Audiology Clinical Practice: Acknowledging the Challenges, Adapting to the Future

“…[6][7][8] Prevalence rates of tinnitus are difficult to determine due to the lack of objective criteria; however, several large population studies suggest prevalence rates of 5 to 20% in adult populations. 9,10 Risk factors include age, noise exposure, and genetics, 8,11,12 and comorbidities include anxiety and depression 7,11,13 as well as hearing loss and hyperacusis. 9,11 The effects of tinnitus on the individual can have far-reaching consequences including impaired communication, poor quality of life, and reduced productivity.…”