Tinnitus and Cognitive effects (a follow up from my previous post)

[daverussell]

I'm posting the following excerpts as they make some interesting reading about Tinnitus and Cognitive effects including how we respond to tinnitus. So hopefully this is interesting all round and not only about me :).

So... I posted a few weeks ago "Promethazine sleeping tablets following insomnia and increased episodes amnesia" - healthunlocked.com/tinnitus...

I had a follow up Neurologist appointment this week. I'd previously had a CT and MRI scan which did not show any physical damage. I had feared dementia. So he suspects Functional Neurological Disorder (FND) symptoms. In other words, it's not the hardware it's a software issue. So I am awaiting an EEG, to look at activity of my brain. From my reading and understanding, so far, Functional Cognitive Symptoms and Persistent Postural Perceptual Dizziness (PPPD) tick the boxes.

However, I found this study on "The characteristics of cognitive impairment in subjective chronic tinnitus" (from which I've extracted a few excerpts below). I score around 82 on the Tinnitus Handicap Inventory (THI) which is classed as Catastrophic (though I'm possibly high end of severe. So I'm not convinced about FND unless they are one of the same. Well I need to discuss this with my neurologist but I welcome an EEG to be thorough.

I hope some of you may find these excerpts an interesting read.

"Studies have demonstrated that patients experiencing severe tinnitus may suffer serious cognitive deficits which may lead to an obvious decrease in quality of life and work efficiency (Andersson & McKenna, 2006; Bankstahl & Gortelmeyer, 2013; Das, Wineland, Kallogjeri, & Piccirillo, 2012; Hallam et al., 2004; Pierce et al., 2012)....

We classified tinnitus patients into the mild and severe tinnitus groups by level of severity as ranked according to the Tinnitus Handicap Inventory (THI) score developed by Pierce et al. (Newman, Sandridge, & Jacobson, 1998; Pierce et al., 2012).....

Next, we compared cognitive impairment across tinnitus severity class using the Cognitive Abilities Screening Instrument, Chinese Version 2.0 (CASI C‐2.0; Lin, Wang, Liu, & Teng, 2012; Lin et al., 2002) and P300 event‐related potential (P300 ERPs)....

The CASI C‐2.0 can be divided into nine subdomains, including:

- long‐term memory (LTM),

- short‐term memory (STM),

- attention (Att),

- concentration or mental manipulation (Conc),

- orientation (Ori),

- abstraction and judgment (AJ),

- language abilities (Lang),

- visual construction (VC),

- category fluency (Flu).

Cognitive impairment may have a close relationship with tinnitus, as tinnitus is not only an aberrant auditory sensory perception but also associated with a variety of non-auditory symptoms which include frustration, inability to relax, and difficulty concentrating (Wineland, Burton, & Piccirillo, 2012).....

At the same time, patients with poor cognitive skills may be more likely to harbor misconception about tinnitus, which in turn may lead to clinical symptoms such as fear, anxiety, insomnia, and other harmful psychological reactions. These psychological reactions in turn may deteriorate tinnitus symptoms, forming a cycle of negative outcomes which may interfere with or exacerbate intrinsic cognitive impairments.....

In this study, we analyzed the differences in cognitive deficits between mild tinnitus patients and severe tinnitus patients using a combinatorial subjective (CASI) and objective (P300 ERPs) approach. Further, we studied the correlation between the severity of tinnitus and cognition impairment extent. Our findings demonstrated that severe tinnitus patients possess distinct cognitive deficits compared to mild tinnitus patients, a difference that could not be accounted for by differences in hearing loss. Furthermore, the correlation analysis indicated that severity of tinnitus was positively correlated with the extent of cognitive impairment."

Wang Y, Zhang J‐N, Hu W, et al. The characteristics of cognitive impairment in subjective chronic tinnitus. Brain Behav. 2018;8:e00918

ncbi.nlm.nih.gov/pmc/articl...

[Bellyboo]

once again extremely informative Dave. Your last link also hit the nail on the head

Thank you for taking the time to share

[Agnetha1985]

Very informative and salutary. Currently my T has subsided and I feel notably perkier and can hear just fine without hearing aids. The TV far from being on Number 41 volume is down to 24 . T is very much a distraction usually as I fight not to pay it attention . Surely then it must distract from other cognitive processes and over time, lead to cognitive decline with the sheer effort of trying to maintain engaged with the world.

[daverussell in reply to Agnetha1985]

That must be such a relief. Stay strong. We won't let it beat us.

[Sonnybee]

Hi Dave. Very interesting posting. I think you may be on to something there, regarding recent problems. I bought a book around 6 months ago called living well with tinnitus, a cbt self help guide. Theres a questionnaire at the very beginning asking various questions about your T and relating anxiety, behaviour etc. I too, scored extremely poorly. After extensively working through the book, completing various tasks, I had a light bulb moment, suddenly realising how important I had made my tinnitus, elevating it to such a height, that it was ruling everything in my life. The research you've shown here also shows how that can affect other brain functions. Thanks for the info and take care.

[daverussell in reply to Sonnybee]

The study does show some good correlation, but as with most studies subjects (namely ourselves) have so many comorbidities.

We must remain critically open-minded, but some form of answers are essential for our coping mechanism whether scientifically accurate or not. Sometimes it's just nice to be able to make some sense of it (having eliminated anything more serious of course).

[EnidABlyton]

I found your post very interesting, thank you. I haven’t heard of the THI, how is tinnitus measured on this scale? Is it self reporting or can it actually be measured in some way on a scale?