Brainstem evoked auditory potentials in tinnitus: A best-evidence synthesis and meta-analysis

Laura Jacxsens; Joke De Pauw; Emilie Cardon; Annemarie van der Wal; Laure Jacquemin; Annick Gilles; Sarah Michiels; Vincent Van Rompaey; Marc J W Lammers; Willem De Hertogh

doi:10.3389/fneur.2022.941876

Brainstem evoked auditory potentials in tinnitus: A best-evidence synthesis and meta-analysis

Front Neurol. 2022 Aug 22:13:941876. doi: 10.3389/fneur.2022.941876. eCollection 2022.

Authors

Laura Jacxsens^{1

2}, Joke De Pauw¹, Emilie Cardon^{2

3}, Annemarie van der Wal^{1

4}, Laure Jacquemin^{2

3}, Annick Gilles^{2

3

5}, Sarah Michiels^{2

6}, Vincent Van Rompaey^{2

3}, Marc J W Lammers^{2

3}, Willem De Hertogh¹

Affiliations

¹ Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium.
² Department of Otorhinolaryngology, Head and Neck Surgery, Antwerp University Hospital (UZA), Edegem, Belgium.
³ Department of Translational Neurosciences, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium.
⁴ Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam, Amsterdam, Netherlands.
⁵ Department of Education, Health and Social Work, University College Ghent, Ghent, Belgium.
⁶ Faculty of Rehabilitation Sciences, REVAL, University of Hasselt, Hasselt, Belgium.

Abstract

Introduction: Accumulating evidence suggests a role of the brainstem in tinnitus generation and modulation. Several studies in chronic tinnitus patients have reported latency and amplitude changes of the different peaks of the auditory brainstem response, possibly reflecting neural changes or altered activity. The aim of the systematic review was to assess if alterations within the brainstem of chronic tinnitus patients are reflected in short- and middle-latency auditory evoked potentials (AEPs).

Methods: A systematic review was performed and reported according to the PRISMA guidelines. Studies evaluating short- and middle-latency AEPs in tinnitus patients and controls were included. Two independent reviewers conducted the study selection, data extraction, and risk of bias assessment. Meta-analysis was performed using a multivariate meta-analytic model.

Results: Twenty-seven cross-sectional studies were included. Multivariate meta-analysis revealed that in tinnitus patients with normal hearing, significantly longer latencies of auditory brainstem response (ABR) waves I (SMD = 0.66 ms, p < 0.001), III (SMD = 0.43 ms, p < 0.001), and V (SMD = 0.47 ms, p < 0.01) are present. The results regarding possible changes in middle-latency responses (MLRs) and frequency-following responses (FFRs) were inconclusive.

Discussion: The discovered changes in short-latency AEPs reflect alterations at brainstem level in tinnitus patients. More specifically, the prolonged ABR latencies could possibly be explained by high frequency sensorineural hearing loss, or other modulating factors such as cochlear synaptopathy or somatosensory tinnitus generators. The question whether middle-latency AEP changes, representing subcortical level of the auditory pathway, are present in tinnitus still remains unanswered. Future studies should identify and correctly deal with confounding factors, such as age, gender and the presence of somatosensory tinnitus components.

Systematic review registration: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021243687, PROSPERO [CRD42021243687].

Keywords: auditory brainstem responses (ABRs); auditory evoked potentials; brainstem; frequency-following responses (FFRs); middle-latency responses (MLRs); systematic review; tinnitus.

Publication types

Systematic Review