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偏头痛患者的异常主观和听力学听觉功能。

Abnormal Subjective and Audiometric Auditory Function in Migraine.

机构信息

Department of Otolaryngology-Head and Neck Surgery, Stanford University School of Medicine, Stanford, California, USA.

出版信息

Otolaryngol Head Neck Surg. 2023 Jun;168(6):1362-1370. doi: 10.1002/ohn.201. Epub 2023 Jan 29.

DOI:10.1002/ohn.201
PMID:36939529
Abstract

OBJECTIVE

To identify if migraine is associated with auditory deficits and if the auditory profile of migraine is distinct from other pain syndromes, such as chronic pain.

STUDY DESIGN

Cross-sectional, retrospective.

SETTING

A total of 5273 respondents of the 1999 to 2004 National Health and Nutrition Examination Survey.

METHODS

Regression analyses assessed the association between migraine (n = 1245) and chronic pain (n = 430) status with subjectively endorsed hearing loss, tinnitus, pure-tone average (PTA) at 500, 1000, 2000, and 4000 Hz, and subjective-audiometric hearing mismatch (endorsed hearing loss but with a PTA ≤ 25 dB), correcting for confounding factors.

RESULTS

Migraine was associated with increased tinnitus (adjusted odds ratio [aOR] = 1.77, 95% confidence interval [CI]: 1.47-2.13, p < .001) and subjective hearing loss (aOR = 1.58, 95% CI: 1.29-1.94, p < .001). Migraine was associated with higher PTA (β = .89, p = .023). Migraine decreased the PTA threshold at which individuals endorsed subjective hearing loss (β = -1.94, p = .013) and was associated with a more subjective-audiometric hearing mismatch (aOR = 1.50, 95% CI: 1.18-1.89, p < .001). Chronic pain was not associated with tinnitus (aOR = 1.26, 95% CI: 0.97-1.63, p = 0.079), subjective hearing loss (aOR = 0.94, 95% CI: 0.71-1.23, p = .64), changes in PTA (β = -.22, p = .69), altered PTA threshold for endorsing hearing loss (β = 1.40, p = .19), or subjective-audiometric hearing mismatch (aOR = 0.98, 95% CI: 0.70-1.34, p = .88).

CONCLUSION

Migraine is associated with both worse pure-tone audiometry and higher sensitivity to changes in hearing ability, suggesting both peripheral and central auditory function abnormalities. In contrast, patients with chronic pain did not demonstrate these abnormalities. The etiology of abnormal auditory processing in migraine may be different from that of other pain syndromes.

摘要

目的

确定偏头痛是否与听觉缺陷有关,以及偏头痛的听觉特征是否与其他疼痛综合征(如慢性疼痛)不同。

研究设计

横断面、回顾性。

地点

1999 年至 2004 年全国健康与营养调查的 5273 名受访者。

方法

回归分析评估了偏头痛(n=1245)和慢性疼痛(n=430)状态与主观听力损失、耳鸣、500、1000、2000 和 4000 Hz 的纯音平均(PTA)以及主观听力失配(报告听力损失但 PTA≤25dB)之间的关联,同时校正了混杂因素。

结果

偏头痛与耳鸣增加有关(调整后的优势比[aOR] = 1.77,95%置信区间[CI]:1.47-2.13,p<0.001)和主观听力损失(aOR = 1.58,95% CI:1.29-1.94,p<0.001)。偏头痛与较高的 PTA 相关(β=0.89,p=0.023)。偏头痛降低了个体报告主观听力损失的 PTA 阈值(β=-1.94,p=0.013),并与更主观的听力失配相关(aOR=1.50,95% CI:1.18-1.89,p<0.001)。慢性疼痛与耳鸣(aOR=1.26,95% CI:0.97-1.63,p=0.079)、主观听力损失(aOR=0.94,95% CI:0.71-1.23,p=0.64)、PTA 变化(β=-0.22,p=0.69)、听力损失的 PTA 阈值改变(β=1.40,p=0.19)或主观听力失配(aOR=0.98,95% CI:0.70-1.34,p=0.88)无关。

结论

偏头痛与纯音听力测试结果较差和对听力变化的敏感性增加有关,提示存在外周和中枢听觉功能异常。相比之下,慢性疼痛患者没有表现出这些异常。偏头痛患者听觉处理异常的病因可能与其他疼痛综合征不同。

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