Hyperacusis and Tinnitus in Vestibular Migraine Patients

To estimate the prevalence of tinnitus and hyperacusis in patients with vestibular migraine (VM), and to define the association with hearing loss, anxiety, and depression.

A cross-sectional, multicenter study including 51 adult patients with definite or probable VM, defined according to the Barany Society diagnostic criteria. Audiological examinations were performed by pure tones extended to high frequencies to assess hearing thresholds. Psychoacoustic (pitch, masking level, and residual inhibition) and psychometric assessment of tinnitus was performed in all patients that reported tinnitus with the following questionnaires: Tinnitus Handicap Inventory (THI), Hypersensitivity to Sound Questionnaire and Hospital Anxiety Depression Scale. Correlation and regression analyses were used to assess the relationship between THI scores hyperacusis, anxiety, and depression in patients with VM.

Forty-five of 50 VM patients (90%) were females; 38 out of 50 (75%) patients reported tinnitus. In our series, the most common frequency (pitch) for tinnitus was 8000 Hz. Tinnitus was not associated with hearing loss in patients with VM and the hearing thresholds were similar in VM patients with or without tinnitus. Hyperacusis was reported in 35 (60%) individuals, and in patients with tinnitus, the THI scores were associated with higher scores in Hypersensitivity to Sound Questionnaire, and anxiety and depression subscales of Hospital Anxiety Depression Scale. There were differences in the distribution of hearing loss in patients with hyperacusis, however both groups did not exceed the normal hearing threshold (17.18 ± 13.43 patients with hyperacusis and 11.66 ± 5.41, p = 0.023 in patients without hyperacusis).

Tinnitus is a common symptom in patients with VM and it is not related to hearing loss in the standard audiogram. Hyperacusis was associated with tinnitus, anxiety, and depression, but it was not associated with hearing thresholds.