Cognitive Performance in Chronic Tinnitus Patients

Cognitive Performance in Chronic Tinnitus Patients: A Cross-Sectional Study Using the RBANS-H.

Abstract
OBJECTIVE:
Many tinnitus patients report cognitive deficits such as concentration and attention difficulties. The aim of this study was to comprehensively assess cognitive functioning in tinnitus patients using a standardized test battery, the repeatable battery for the assessment of neuropsychological status adjusted for hearing impaired individuals (RBANS-H).

STUDY DESIGN:
Cross-sectional study.

SETTING:
Tertiary referral center.

PARTICIPANTS:
Twenty-eight chronic tinnitus patients and 28 control participants, matched for sex, age, hearing loss, and education level.

INTERVENTION:
Diagnostic.

MAIN OUTCOME MEASURES:
All participants completed the RBANS-H, which includes subtests probing immediate and delayed memory, visuospatial capabilities, language, and attention. The tinnitus patients completed the tinnitus functional index (TFI), a visual analogue scale (VAS) measuring subjective mean tinnitus loudness and the hyperacusis questionnaire (HQ).

RESULTS:
The total RBANS-H scores did not differ between tinnitus patients and controls. However, on the language subscale, mean scores of the tinnitus group (97.6 ± 11.0) were significantly lower than those of controls (104.4 ± 12.0), with correction for sex, age, hearing level, and education level (general linear model: p = 0.034). Post hoc t tests revealed a specific deficit concerning the semantic fluency subtest (tinnitus: 19.5 ± 6.2; control: 23.1 ± 5.9; p = 0.015). VAS scores for tinnitus loudness were negatively correlated to scores on the RBANS-H attention subscale (r = -0.48, p = 0.012).

CONCLUSIONS:
The current study successfully employed the RBANS-H to provide a broader view on cognitive functioning in tinnitus patients. The results showed a specific negative influence of tinnitus on verbal fluency, which could be related to a deficit in executive cognitive control. Moreover, patients experiencing louder tinnitus performed worse on specific subtests concerning attention.

https://journals.lww.com/otology-ne...nitive_Performance_in_Chronic_Tinnitus.5.aspx

 

I've noticed myself a little wonky since I got tinnitus... A bit like being Vegan again... Just not quite as sharp.

 

Assessment of auditory working memory in normal hearing adults with tinnitus

Purpose

Tinnitus is characterized by the perception of sound without an existing external stimulus. The presence of tinnitus might be intolerable for many and can be sufficiently troublesome in hearing, sleep, thought processing, and other functional abilities, all of which can negatively impact the quality of life. Individuals with tinnitus may have decreased cognitive efficiency because tinnitus can adversely affect the other tasks being performed. The present study was taken up to evaluate auditory working memory using digit span tasks in adults with tinnitus.

Methods
The tasks administered included forward, backward, ascending, and descending digit span. Tinnitus Handicap Inventory questionnaire was administered on all the individuals with tinnitus, and also, it was attempted to correlate the scores of auditory working memory with that of tinnitus handicap inventory.

Results
The results indicated poorer scores for backward, ascending and descending digit span task and no significant difference for the forward digit span task. There was no correlation between auditory working memory tasks and overall tinnitus handicap scores along with its sub-scales.

Conclusion
It was concluded that tinnitus disrupts the functioning of auditory working memory and is governed by the annoyance caused by tinnitus.

Keywords
Tinnitus Cognitive processing Auditory working memory Tinnitus handicap

Source: https://link.springer.com/article/10.1007/s00405-019-05658-4

 

Yep... brain damage will slow you down for sure.
I am thinking of doing everything left handed, juggling, anything to keep the brain stimulated and pumped... I need to up my game and get hardcore... this disease is no good for the brain, especially if it’s severe.

 

Beyond Hearing Loss: Does Tinnitus Cause Cognitive Impairment?

 

Cognitive Communicative Abilities in Tinnitus Patients with Normal Hearing

ABSTRACT

Background: Tinnitus is a bothersome complain , some studies show that 13-18 percent of the people suffer from tinnitus, almost 5 percent of which, have chronic or bothersome tinnitus. Chronic tinnitus may be accompanied by anxiety, depression, insomnia, and impairment in cognitive functions such as memory and attention.

The Aim of this Study: To compare the auditory memory and auditory attention between two groups with and without tinnitus all of them have normal hearing.

Methods: This study were performed on 30 tinnitus patients (10 men and 20 women) aged from 20 to 50 years old and 30 healthy volunteers (12 men and 18 women) aged from 21 to 50 years old with normal hearing thresholds. Pure tone audiometry (PTA), auditory continuous performance test (ACPT), Memory for recognition (MR), memory for content (MC) and memory for sequence (MS) were employed for all participants. Tinnitus evaluation and tinnitus handicap inventory questionnaire (THI) was done for the study group only.

Results: Comparing the results of ACPT between study and control groups show no statistically significant difference. While comparing the results of memory battery test between both groups were statistically highly significant.

Conclusion: Tinnitus decreased the memory battery test scores at the study group in comparison with the control group. Auditory continuous performance test (ACPT) results show no difference between study and control group. Duration of tinnitus affect significantly ACPT results. Bilateral tinnitus affects memory for sequence results. While loudness decreased results of memory for recognition.

Full article see attached file.

 

So you're telling me that having a constant noise in your head is distracting??? Thank god for such groundbreaking research or else nobody would've known!

 

Associations Between Subjective Tinnitus and Cognitive Performance: Systematic Review and Meta-Analyses
Nathan A. Clarke, Helen Henshaw, Michael A. Akeroyd,
Bethany Adams, Derek J. Hoare

Analyses showed that tinnitus is associated with poorer executive function, processing speed, general short-term memory, and general learning and retrieval. Narrow cognitive domains of Inhibition and Shifting (within executive function) and learning and retrieval (within general learning and retrieval) were also associated with tinnitus.

 

Correlations between tinnitus and cognitive abilities

Introduction Recent Studies have discussed the association between decompensated tinnitus and cognitive impairment. In a comprehensive multidisciplinary study, we investigated various interactions between tinnitus burden, hearing loss, psychological comorbidities and cognitive performance in executive functions and in an intelligence test.

Methods A total of 140 patients with chronic tinnitus were included in the study. All subjects received audiological and psychometric (TF, THI, TFI, PSQ) diagnostics. To measure cognitive impairment for executive functioning a complex visual motor task (Trail making test, TMT) was applied. Furthermore to examinate crystalline and verbal intelligence we performed the Multiple Choise Word Test (MWT).

Results On average, patients had moderate-grade compensated tinnitus. The average hearing loss was 29.38 ± 8.2 dB on the right side and 29.08 ± 8.31 dB on the left side and correlated slightly negatively with the performance in the graphomotoric test (TMT). Decompensated tinnitus proved to be a significant covariance factor. The regression model revealed a negative impact on intellectual (MWT) and executive (TMT) functioning due to the tinnitus burden (TF, THI, TFI). In interaction with tinnitus distress, hearing loss and stress had a significant impact on cognitive functions.

Conclusion Our study confirmed an association between hearing loss, stress and cognitive impairment. In a complex model it is suggested that the decompensation of tinnitus is associated with a lower crystalline and verbal intelligence and reduced executive functioning. The extent to which accompanying psychological comorbidities play a role in this complex interaction will be further investigated in the study.

https://www.thieme-connect.com/products/ejournals/html/10.1055/s-0040-1711249

 

I'm going to notify these researchers that I have always had completely full reading comprehension with no cognitive interference whatsoever regarding Joyce's "Ulysses", Proust's 7,000 page "Remembrance of Things Past", T.S. Eliot's "Four Quartets", etc. while I had a strong, constant, unremitting high-pitched tea kettle sound in my left ear.

After all, why should such phenomena bother your concentration?

 

It's strange that some studies say that tinnitus plays a role worsening cognitive abilities and other studies say there is not really a big difference. Strange.

Anyway, there are different types of tinnitus and also varying degrees of severity so that should be taken into account.

 

I feel like I take a few seconds to respond to people now... like I have to think about what they say and then respond...

 

There have definitely been changes. I too feel slower, and just less capable somehow.

Unbelievable that there is research showing changes and yet tinnitus is still presented as harmless and just a noise. Obviously there's more going on.

 

I have since recovered from my wonkyness... Tinnitus is improving again now too. Went back into a proper high fat, high fiber ketosis with added potassium and magnesium.

 

That sounds more like a symptom of auditory neuropathy. I posted a research article on that...

 

What causes auditory neuropathy? I would love to read your article.

 

Noise.

 

It's caused by noise, and I think it can be a result of other conditions such as autism. I posted the article on the section "Research News". Search for "auditory neuropathy". It is an interesting read.

 

I definitely feel it affects me. Even if I manage to ignore it, tinnitus will periodically intrude my thoughts and I need a few seconds to get the flow of thought back.

 

The potential interruptive effect of tinnitus-related distress on attention

The mechanism through which tinnitus affects attention is unclear. This study examines whether distress mediates the relationship(s) between tinnitus and sustained, selective and executive attentions as well as response inhibition. Eighteen participants with tinnitus and fifteen controls completed the Counting Stroop, Vigilance and Stop Signal tasks. Tinnitus distress was assessed using the Tinnitus Questionnaire (TQ), severity of depressive mood states examined using the Beck Depression Inventory-II, and general distress assessed using the Hospital Anxiety and Depression Scale. Tinnitus participants had significantly slower reactions during the Vigilance task (F = 4.86, p = .035), and incongruent trials of the Cognitive Counting task (F = 3.45, p = .045) compared to controls. Tinnitus-related distress significantly mediated the effect of tinnitus in incongruent trials (TQ: Sobel test t = 1.73, p = .042) of the Cognitive Counting Task. Complaints of distress and concentration difficulties are common amongst tinnitus patients in clinical settings and these afflictions have been shown to negatively impact an individual’s quality of life. If confirmed in future studies, results suggest that distress may be an important factor in the causal mechanism between tinnitus and attention.

Full article: https://www.nature.com/articles/s41598-020-68664-1

 

A bit frustrating to see funding spent on research like this. It's pretty clear that the tinnitus itself and the distress resulting from it negatively affect attention. Did they really need to conduct a study to inconclusively verify this?

 

Assessment of Stroop Color Word Interference Test-TBAG form performance in subjects with tinnitus
Purpose
To evaluate ordinary behavioral pattern suppression performance of individuals with tinnitus under disruptive effect using Stroop Color Word Interference Test-TBAG Form (SCWT), and to determine the impact of acoustic stimulus on this performance.

Methods
40 individuals with subjective tinnitus at Slight and higher severity according to Tinnitus Handicap Inventory (THI) (16 females, 24 males; mean age: 42.02 ± 10.00) (Study group), and 40 healthy individuals (Control group) (18 females, 22 males; mean age: 38.85 ± 10.25) were included in this study. All individuals were subjected to audiological evaluation. SCWT was applied with and without acoustic stimulus (NB noise), and test completion durations were recorded.

Results
It was determined that the duration for completion of 5 sections of SCWT, both in the presence of and without acoustic stimulus, was longer in the Study group than the control group. In the presence of acoustic stimulus, it took longer for the individuals with tinnitus to complete sections 4 and 5, and the control group to complete sections 3, 4 and 5 in SCWT in comparison with the lack of acoustic stimulus.

Conclusion
It was determined that SCWT performance of the individuals with tinnitus was worse than the individuals without tinnitus, both in the presence of and without acoustic stimulus. It was found that SCWT performances of both groups with acoustic stimulus were better than their test performances without acoustic stimulus.

Source: https://link.springer.com/article/10.1007/s00405-020-06221-2

 

Tinnitus and cognition: Can load theory help us refine our understanding?

Objective: Tinnitus has been shown to be associated with specific cognitive deficits. Contemporary models of tinnitus, based primarily on human behavior, emphasize the influence of the cognitive response to tinnitus in tinnitus manifestation and level of associated annoyance. The models and hypotheses proposed thus far have (a) focused on the cognitive response to the onset of tinnitus, and not necessarily focused on the cognitive consequences of established chronic tinnitus, and (b) failed to dissociate the contributions of cognitive and perceptual load in their theories. Load theory states that we have a limited capacity of neural resources that can be used to process internal and external stimuli. This theory is differentially applied to perceptual load, which refers to the neural resources engaged in the processing of sensory stimuli in our environment, and cognitive load, which refers to the occupation of a more central resource that is involved in higher-level processing, such as stimulus discrimination, decision making, and working memory processing.

Methods: A focused review was conducted on behavioral and brain-imaging studies examining cognitive deficits in tinnitus, in an attempt to reexamine the findings in a load theory framework.

Results: Findings of these studies are discussed in the context of load theory, and a novel model for understanding these findings is proposed.

Conclusion: We believe the incorporation of load theory into models of tinnitus may advance understanding of the cognitive impact of tinnitus and lead to better management of tinnitus.