The Prevalence of Different Types of Headache in Patients with Subjective Tinnitus and Its Influence on Tinnitus Parameters: A Prospective Clinical Study

Abstract

Both tinnitus and headache are very prevalent conditions in the general population, with bidirectional co-occurrence of them. A number of studies revealed a high prevalence of headache in tinnitus patients; however, most of them used self-reported symptoms, questionnaires, or health databases and were retrospective. The aim of this study was to evaluate the prevalence of different types of headache in a cohort of tinnitus patients and to assess the influence of headache on tinnitus parameters, focusing on appropriate headache and tinnitus diagnosis verified by clinical examination. This prospective study involved 286 patients diagnosed with subjective non-pulsating tinnitus. Patients’ clinical information was thoroughly assessed by the multidisciplinary team, including tinnitus characteristics and severity according to the Tinnitus Handicap Inventory (THI), loudness assessed by the Visual Analogue Scale (VAS), audiometry, type of headache diagnosed according to the third edition of the International Classification of Headache Disorders, severity of headache assessed by the Numeric Rating Scale (NRS), and impact of headache using the Headache Impact Test (HIT). In total, 141 (49.3%) tinnitus patients were diagnosed with headache, most of them with tension-type headache or migraine. They were significantly younger; mostly women; had bilateral tinnitus, vertigo, and depression more frequently; and had hearing loss less frequently as compared with the non-headache group. In total, 82 (58.16%) patients had the same localization of tinnitus and headache. Younger age, female gender, higher tinnitus burden measured by THI, and coexistence of hearing loss were independent variables connected with the occurrence of headache in the tinnitus group. According to our study, headaches impact tinnitus on many different levels and may be an important co-factor for tinnitus subtyping. We recommend screening for headache coexistence in all tinnitus patients.

Arterial Spin Labeling Cerebral Perfusion Changes in Chronic Tinnitus With Tension-Type Headache

“…Furthermore, almost 26-47% of tinnitus patients also accompanied with headache (5). The relationship between tinnitus and headache has been reported in previous studies (5)(6)(7). Thus, headache may be a risk factor that plays a critical role for tinnitus-related impairment.…”

Measures of Subjective Tinnitus: What Does Visual Analog Scale Stand for?

“…Approximately half of tinnitus patients had an accompanying headache, and most of these patients had tension headaches or migraines. 12 Comorbid psychologic disorders such as depression should be confirmed and controlled first to decrease tinnitus loudness. In addition, management of an accompanying headache should be accomplished as soon as possible because it can aggravate tinnitus loudness, and a longer tinnitus duration is associated with increasing loudness of persistent tinnitus.…”

Efficacy of Low-Level Laser Therapy for Tinnitus: A Systematic Review with Meta-Analysis and Trial Sequential Analysis

“…In one of the excluded studies showing a favorable effect of LLLT, patients also suffered from the comorbidity with of temporal-mandibular joint disorder (TMD) [44], which could benefit from LLLT too [45]. As somatosensory diseases like TMD [46][47][48], chronic headache [49], trigeminal neuralgia [50] or cervical spondylosis [51], could lead to tinnitus and the relief of those somatosensory diseases could also lead to improvement of tinnitus, the relationship between comorbidity and effect of LLLT would serve as the potential bias. To avoid the bias, it was worth emphasizing the importance on patient selection.…”