Tinnitus and Cochlear Synaptopathy: Exploring Listening Effort, Speech Perception in Noise and Auditory Brainstem Response in Normal Hearing Adults

Background : Tinnitus, a common auditory condition, frequently disrupts speech perception in noisy environments and heightens listening effort in individuals with normal hearing, possibly due to hidden hearing loss indicated by diminished auditory brainstem response (ABR) wave I amplitude. The current study aimed to evaluate speech perception in noise, listening effort, and amplitude of ABR wave I in individuals with tinnitus and normal hearing Method : The study included 34 adults with tinnitus and normal hearing sensitivity, and 34 age-matched controls with normal hearing. A speech-in-noise test at +5, 0 and -5 dB signal-to-noise ratios (SNR), subjective listening effort rating, and ABR testing was done for all the participants Results : Individuals with tinnitus exhibited poorer speech perception at 0 dB and -5 dB SNR (p < 0.05) and reported greater listening effort (p < 0.01) compared to controls. Correlation between Speech in noise at 0, -5dB SNR with listening effort was observed in tinnitus group. Reduced ABR wave I amplitude in the tinnitus group (p < 0.05) correlated with lower speech-in-noise scores (r = 0.62, p < 0.01) Conclusions : These findings highlight significant auditory challenges in normal-hearing individuals with tinnitus, including impaired speech perception in noise and heightened listening effort. The association between reduced ABR wave I amplitude and speech-in-noise deficits supports its potential as a biomarker for cochlear synaptopathy.