Niemczak Christopher, Skoe Erika, Leigh Samantha, Zhang Linda, Dotzenrod Megan, Kieley Annalise, Stone Simon, Parsonnet Jeffrey, Martin Christina, Ealer Christin, Clavier Odile, Gui Jiang, Waszkiewicz Angela, Roth Robert, Buckey Jay
Department of Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, USA.
Geisel School of Medicine at Dartmouth, Hanover, USA.
Sci Rep. 2025 Mar 18;15(1):9387. doi: 10.1038/s41598-025-93664-4.
The Post-acute Sequela of SARS-CoV-2 (PASC) syndrome, also known as Long-COVID, often presents with subjective symptoms such as brain fog and cognitive fatigue. Increased tinnitus, and decreased hearing in noise ability also occur with PASC, yet whether auditory manifestations of PASC are linked with the cognitive symptoms is not known. Electrophysiology, specifically the Auditory Brainstem Response (ABR), provides objective measures of auditory processing. We hypothesized that ABR findings would be linked to PASC and with subjective feelings of cognitive fatigue. Eighty-two individuals, 37 with PASC (mean age: 47.5, Female: 83%) and 45 healthy controls (mean age: 38.5, Female: 76%), were studied with an auditory test battery that included audiometry and ABR measures. Peripheral hearing thresholds did not differ between groups. The PASC group had a higher prevalence of tinnitus, anxiety, depression, and hearing handicap in addition to increased subjective cognitive fatigue. ABR latency findings showed a significantly greater increase in the wave V latency for PASC subjects when a fast (61.1 clicks/sec) compared to a slow click (21.1 clicks/sec) was used. The increase in latency correlated with cognitive fatigue scores and predicted PASC status. The ABR V/I amplitude ratio was examined as a measure of central gain. Although these ratios were not significantly elevated in the full PASC group, to minimize the cofounding effect of age, the cohort was median split on age. Elevated V/I amplitude ratios were significant predictors of both predicted PASC group classification and cognitive fatigue scores in the younger PASC subjects compared to age-matched controls providing evidence of elevated central gain in younger individuals with PASC. More frequent tinnitus also significantly predicted higher subjective cognitive fatigue scores. Our findings suggest that PASC may alter the central auditory pathway and lead to slower conduction and elevated auditory neurophysiology responses at the midbrain, a pattern associated with the typical aging process. This study marks a significant stride toward establishing an objective measure of subjective cognitive fatigue through assessment of the central auditory system.
新型冠状病毒2型（SARS-CoV-2）感染后的急性后遗症（PASC）综合征，也称为长期新冠，常伴有如脑雾和认知疲劳等主观症状。PASC还会出现耳鸣加重以及噪声环境下听力下降的情况，然而PASC的听觉表现是否与认知症状有关尚不清楚。电生理学，特别是听觉脑干反应（ABR），可提供听觉处理的客观测量指标。我们假设ABR结果将与PASC以及认知疲劳的主观感受相关。对82名个体进行了研究，其中37名患有PASC（平均年龄：47.5岁，女性：83%），45名健康对照者（平均年龄：38.5岁，女性：76%），使用了包括听力测定和ABR测量的听觉测试组合。两组之间的外周听力阈值没有差异。除了主观认知疲劳增加外，PASC组耳鸣、焦虑、抑郁和听力障碍的患病率更高。ABR潜伏期结果显示，与慢点击（21.1次/秒）相比，使用快点击（61.1次/秒）时，PASC受试者的V波潜伏期显著增加。潜伏期的增加与认知疲劳评分相关，并可预测PASC状态。对ABR的V/I振幅比进行了检测，作为中枢增益的一项指标。虽然在整个PASC组中这些比值没有显著升高，但为了尽量减少年龄的混杂效应，按年龄对队列进行了中位数分割。与年龄匹配的对照组相比，年轻PASC受试者中升高的V/I振幅比是预测PASC组分类和认知疲劳评分的重要指标，这为年轻PASC个体中枢增益升高提供了证据。更频繁的耳鸣也显著预测了更高的主观认知疲劳评分。我们的研究结果表明，PASC可能会改变中枢听觉通路，导致中脑传导减慢和听觉神经生理反应升高，这是一种与典型衰老过程相关的模式。这项研究朝着通过评估中枢听觉系统建立主观认知疲劳的客观测量指标迈出了重要一步。
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