Auditory attention in individuals with tinnitus

Lima, Daviany Oliveira; Araújo, Aline Menezes Guedes Dias de; Branco-Barreiro, Fátima Cristina Alves; Carneiro, Cláudia da Silva; Almeida, Larissa Nadjara Alves; Rosa, Marine Raquel Diniz da

doi:10.1016/j.bjorl.2019.01.011

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Brazilian Journal of Otorhinolaryngology

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Original articles • Braz. j. otorhinolaryngol. 86 (4) • Jul-Aug 2020 • https://doi.org/10.1016/j.bjorl.2019.01.011 copy

Auditory attention in individuals with tinnitus^☆ ☆ Please cite this article as: Lima DO, Araújo AM, Branco-Barreiro FC, Carneiro CS, Almeida LN, Rosa MR. Auditory attention in individuals with tinnitus. Braz J Otorhinolaryngol. 2020;86:461–7.

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Abstract

Introduction

Tinnitus is characterized by the presence of a sound in the absence of external sound stimulus. In individuals with normal audiometry, it may be associated with auditory attention difficulty, especially in those who report high tinnitus annoyance.

Objective

To investigate auditory attention ability in individuals with tinnitus complaint.

Methods

Cross-sectional analytical observational study. We evaluated 30 volunteers with normal hearing (up to 25 dBHL): 15 with tinnitus (test group) and 15 with no complaints (control group), aged between 18-40 years. The volunteers answered the tinnitus handicap inventory questionnaire and a visual analogue scale. Subsequently, a basic audiological evaluation (meatoscopy, tonal and vocal audiometry, and imittanciometry) and psychoacoustic measures of tinnitus (loudness and pitch) were performed. To evaluate auditory attention, the following tests were performed: auditory cognitive evoked potential (P300), central auditory processing tests (dichotic digits test and speech-in-noise test) and sustained auditory attention ability test.

Results

In the tinnitus handicap inventory, individuals with tinnitus had a mean score of 37.78 (±27.05), characterized as moderate degree. In the dichotic digits test (binaural separation), a difference was observed between the groups in both ears. Moreover, there was a difference in the speech-in-noise test in both ears (RE: p = 0.044; LE: p = 0.019), in P300 (p = 0.049) and in total sustained auditory attention ability test (p = 0.032). Also, there is a negative correlation between sustained auditory attention ability test, decrease in attentiveness and binaural integration (RE: p = 0.044; LE: p = 0.048).

Conclusions

Individuals with tinnitus had a poorer performance compared to the control group regarding auditory attention ability. Therefore, it is inferred that tinnitus is associated with poor performance in selective and sustained auditory attention in the assessed volunteers. These aspects should be considered for the management of patients with tinnitus.

Keywords
Hearing; Auditory perception; Tinnitus; Auditory attention

Intelligent Hearing System^® equipment	SmartEP module
Electrodes: M1, M2, Fpz and Cz	Electrode impedance ≤3 kohms
Intensity 75 dB Pe	Stimulation type: binaural
Number of stimuli: 300 (80% frequent and 20% rare)	Channels: AB
Velocity: 0.8 pps	Duration: 2.0 ms
Phase	Alternate
Stimulus utilized	1 kHz (frequent) 4 kHz (rare)
Transducer type	Insert earphones
Stimulus duration	50,000 µs
Envelope	Trapezoid
Individual status	Alert

Variable	Study group
Variable	n	%
Location
RE	4	26.7
LE	5	33.3
R = L	3	20.0
R > L	3	20.0
R < L	0	0.0
Head	0	0.0

Type
Single	9	60.0
Multiple	3	20.0
Pulsatile	2	13.3
Single click	1	6.7

Start
Progressive	6	40.0
Sudden	9	60.0

Perception
Constant	11	73.3
Intermittent	4	26.7

Description of the sound
Whistling	9	60.0
Wheezing	4	26.7
Pulsatile	2	13.3

Acuphenometry stimulus RE
Continuous	9	60.0
Modulated frequency	0	0.0
NB	2	13.3
Did not report tinnitus in the RE	4	26.7

Acuphenometry stimulus LE
Continuous	10	66.7
Modulated frequency	1	6.7
NB	0	0.0
Did not report tinnitus in the LE	4	26.7

Variables	Study group
Variables	Mean	SD
Time of tinnitus	5.04	6.20
VAS	6.21	1.84
THI: Functional	17.85	12.97
THI: Emotional	13.35	10.62
THI: Catastrophic	9.14	6.16
Total THI	37.78	27.05
Psychoacoustic measure: frequency RE	3000	2576.45
Psychoacoustic measurement: intensity RE	13	11.96
Psychoacoustic measure: frequency LE	3000	3057.29
Psychoacoustic measure: intensity LE	13	15.00

Variable	Study group		Control group		p-Value
Variable	Mean	SD	Mean	SD	p-Value
Dichotic Digits Test
Binaural integration RE	95.89	6.91	97.66	2.90	0.087
Binaural integration LE	98.00	4.83	95.40	5.07	0.508
Binaural separation RE	96.50	8.18	100.00	0.000	0.009^a a Student's t-test - independent samples; p < 0.05.
Binaural separation LE	94.60	7.29	97.66	3.33	0.001^a a Student's t-test - independent samples; p < 0.05.

Speech-in-Noise Test
PSRI RE	95.60	5.25	96.13	3.41	0.262
PSRI LE	96.26	3.53	94.00	3.46	0.563
SN RE	82.93	13.13	86.93	9.25	0.044^a a Student's t-test - independent samples; p < 0.05.
SN LE	81.33	11.17	85.60	7.97	0.019^a a Student's t-test - independent samples; p < 0.05.
P300	305.86	37.68	301.40	23.28	0.049^a a Student's t-test - independent samples; p < 0.05.
Total SAAAT	3.26	5.86	1.00	1.30	0.032^a a Student's t-test - independent samples; p < 0.05.
SAAAT decrease	0.86	1.18	0.46	0.74	0.152

Variable	Test statistics	p-Value^a a Pearson's Correlation Test; p < 0.05.
Total THI × VAS	0.563	0.036
Total THI × SAAAT	0.482	0.041
SAAAT AD × binaural integration RE	-0.546	0.044
SAAAT AD × binaural integration LE	-0.454	0.048

Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Sede da Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico Facial, Av. Indianópolia, 1287, 04063-002 São Paulo/SP Brasil, Tel.: (0xx11) 5053-7500, Fax: (0xx11) 5053-7512 - São Paulo - SP - Brazil
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[1] * Corresponding author. mrdrosa@yahoo.com.br

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Auditory attention in individuals with tinnitus☆ ☆ Please cite this article as: Lima DO, Araújo AM, Branco-Barreiro FC, Carneiro CS, Almeida LN, Rosa MR. Auditory attention in individuals with tinnitus. Braz J Otorhinolaryngol. 2020;86:461–7.

Abstract

Introduction

Objective

Methods

Results

Conclusions

Auditory attention in individuals with tinnitus^☆ ☆ Please cite this article as: Lima DO, Araújo AM, Branco-Barreiro FC, Carneiro CS, Almeida LN, Rosa MR. Auditory attention in individuals with tinnitus. Braz J Otorhinolaryngol. 2020;86:461–7.