Subclinical Cochlear Dysfunctions in Migraine Patients Assessed by Otoacoustic Emissions
Keywords:
Cochlear dysfunction, DPOAE , Migraine , Subclinical hearing impairment , TEOAEAbstract
Background: Migraine is a common neurovascular condition that is increasingly recognized to affect the auditory system, even in the presence of normal hearing thresholds. Subclinical cochlear dysfunction, particularly affecting outer hair cells, has been hypothesized but not well understood. Objective: To investigate cochlear function in migraine patients utilizing transient-evoked and distortion product otoacoustic emissions and to evaluate their relationship with migraine clinical characteristics and sex. Methods: This case-control study involved 120 participants (60 migraine patients and 60 age/sex-matched healthy controls) aged 18–45 years. All individuals had normal otoscopy, a type A tympanogram, and normal hearing thresholds on pure tone audiometry. Cochlear function is evaluated by transient-evoked and distortion product otoacoustic emissions (TEOAE, DPOAE). Migraine severity and disability were assessed using the Visual Analog Scale (VAS) and Migraine Disability Assessment (MIDAS). Results: Migraine patients had a significantly higher proportion of abnormal TEOAE responses (50.8%) than controls (0%) (p<0.05). DPOAE amplitudes were decreased significantly in migraine patients at all frequencies (2000-8000 Hz) while lower frequencies (1000-1500 Hz) remained unaffected. Signal-to-noise ratio values were significantly lower in migraine patients at most frequencies. Migraine patients with aura, longer illness duration, higher severity, and disability score had more cochlear damage. Conclusions: Migraine is associated with frequency-dependent subclinical cochlear impairment, primarily affecting higher frequencies. This dysfunction correlates with disease severity and clinical burden, suggesting that otoacoustic emissions are a sensitive technique for evaluating and monitoring migraine-induced auditory impairment.
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