The Effect of Tinnitus and Related Characteristics on Subcortical Auditory Processing

Abstract

Objectives: The primary aim of this study was to evaluate whether individuals with tinnitus exhibited evidence of reduced inhibition and increased excitation at the subcortical auditory processing level. Based on the proposed mechanism of tinnitus generation, including peripheral auditory insult that triggers reduced inhibition and subcortical hyperactivity, it was hypothesized that a tinnitus group would yield reduced amplitudes for the most peripheral auditory brainstem response (ABR) component (wave I) and larger amplitudes for the most central ABR component (wave V) relative to controls matched on factors of age, sex, and hearing loss. Further, this study assessed the relative influence of tinnitus presence versus other related individual characteristics, including hearing loss, age, noise exposure history, and speech perception in noise on these ABR outcomes. Design: Subcortical processing was examined using click-evoked ABR in an independent groups experimental design. A group of adults who perceived daily unilateral or bilateral tinnitus were matched with a control group counterpart without tinnitus by age, hearing, and sex (in each group n = 18; 10 females, 8 males). Amplitudes for ABR waves I, III, V, and the V/I ratio were compared between groups by independent t-tests. The relative influence of tinnitus (presence/absence), age (in years), noise exposure history (subjective self-report), hearing loss (audiometric thresholds), and speech perception in noise (SNR-50) was determined based on the proportional reduction in error associated with accounting for each variable of interest using multiple regression. Results: Between-group trends were consistent with smaller amplitudes for all ABR components in individuals with tinnitus. Contrary to our hypotheses, however, none of the tinnitus compared with control group differences in ABR outcomes were statistically significant. In the multiple regression models, none of the factors including tinnitus presence, age, noise exposure history, hearing loss, and speech perception in noise significantly predicted ABR V/I ratio outcomes. Conclusions: The presence of reduced inhibition and subcortical hyperactivity in the tinnitus group was not supported in the current study. There were trends in ABR outcomes consistent with reduced peripheral to central brainstem auditory activity in the tinnitus group, but none of the group differences reached significance. It should also be noted that the tinnitus group had poorer extended high-frequency thresholds compared with controls. Regardless, neither tinnitus presence nor any of the proposed related characteristics were found to significantly influence the ABR V/I ratio. These findings suggest that either reduced subcortical inhibition was not a primary underlying mechanism for the tinnitus perceived by these subjects, or that ABR was not a reliable indicator of reduced subcortical inhibition possibly due to characteristics of the sample including a skewed distributions toward young and normal hearing individuals with little tinnitus distress.