Association of Poorer Hearing With Longitudinal Change in Cerebral White Matter Microstructure

Abstract

IMPORTANCE There is a dearth of studies that examine the association between poorer hearing and change in cerebral white matter (WM) microstructure.OBJECTIVE To examine the association of poorer hearing with baseline and change in WM microstructure among older adults. DESIGN, SETTING, AND PARTICIPANTSThis was a prospective cohort study that evaluated speech-in-noise, pure-tone audiometry, and WM microstructure, as measured by mean diffusivity (MD) and fractional anisotropy (FA), both of which were evaluated by diffusion tensor imaging (DTI) in 17 WM regions. Data were collected between October 2012 and December 2018 and analyzed between March 2019 and August 2019 with a mean follow-up time of 1.7 years. The study evaluated responses to the Baltimore Longitudinal Study of Aging among 356 cognitively normal adults who had at least 1 hearing assessment and DTI session. Excluded were those with baseline cognitive impairment, stroke, head injuries, Parkinson disease, and/or bipolar disorder.EXPOSURES Peripheral auditory function was measured by pure-tone average in the better-hearing ear. Central auditory function was measured by signal-to-noise ratio score from a speech-in-noise task and adjusted by pure-tone average. MAIN OUTCOMES AND MEASURESLinear mixed-effects models with random intercepts and slopes were used to examine the association of poorer peripheral and central auditory function with baseline and longitudinal DTI metrics in 17 WM regions, adjusting for baseline characteristics (age, sex, race, hypertension, elevated total cholesterol, and obesity). RESULTSOf 356 cognitively normal adults included in the study, the mean (SD) age was 73.5 (8.8) years, and 204 (57.3%) were women. There were no baseline associations between hearing and DTI measures. Longitudinally, poorer peripheral hearing was associated with increases in MD in the inferior fronto-occipital fasciculus (β = 0.025; 95% CI, 0.008-0.042) and the body (β = 0.050; 95% CI, 0.015-0.085) of the corpus callosum, but there were no associations of peripheral hearing with FA changes in these tracts. Poorer central auditory function was associated with longitudinal MD increases (β = 0.031; 95% CI, 0.010-0.052) and FA declines (β = −1.624; 95% CI, −2.511 to −0.738) in the uncinate fasciculus.CONCLUSIONS AND RELEVANCE Findings of this cohort study suggest that poorer hearing is related to change in integrity of specific WM regions involved with auditory processing.

Aging Brain and Hearing: A Mini-Review

“…There is growing evidence of a link between structural brain findings and hearing loss with aging ( Lin et al, 2014 ; Qian et al, 2017 ; Rigters et al, 2017 , 2018 ; Uchida et al, 2018 ; Armstrong et al, 2019 , 2020a , b ; Xu et al, 2019 ; Ha et al, 2020 ; Isler et al, 2021 ). Various studies have reported results using different assessments of brain structure and auditory function; the heterogeneity of study designs makes it difficult to discuss them in a unified manner ( Jafari et al, 2021 ).…”

“…From a longitudinal analysis of the BLSA, an association between hearing and changes in WM microstructure has also been published ( Armstrong et al, 2020b ). Three hundred and fifty-six cognitively normal adults (age range: 55–99, mean age: 73.5 ± 8.8 years) who had at least one hearing assessment and serial MRI session with DTI were evaluated with a mean follow-up time of 1.7 years.…”

“…Poor central auditory function, measured by signal-to-noise ratio score from a speech-in-noise task, was associated with changes in the uncinate fasciculus. Armstrong et al (2020b) interpreted that poor hearing was related to changes in the integrity of specific WM regions involved in auditory processing.…”

“…The association between the degrees of auditory speech processing performance (normal, insufficient, and poor) and brain volumes was examined cross-sectionally after pure-tone average adjustment, the degrees of auditory performance were not associated with brain volumes. been published (Armstrong et al, 2020b). Three hundred and fifty-six cognitively normal adults (age range: 55-99, mean age: 73.5 ± 8.8 years) who had at least one hearing assessment and serial MRI session with DTI were evaluated with a mean follow-up time of 1.7 years.…”

The Laterality of Age-Related Hearing Loss and Depression

“…These subtle asymmetries in HL provide variability that allows laterality-based studies (19,20). Neuroimaging studies have demonstrated that HL is associated with lateralized changes in the right and left brain hemispheres (17,(21)(22)(23). Indeed, other studies have shown that left and right ears demonstrate asymmetric input to the ascending auditory pathways, which likely reflects the hemispheric asymmetry of the central nervous system and possibly its processing of different types of stimuli (e.g., speech vs. tones) (24)(25)(26).…”