Does Tinnitus Distress Depend on Age of Onset?

Winfried Schlee,Gerhard Goebel,Berthold Langguth,Tobias Kleinjung,Wolfgang Hiller,Iris-Tatjana Kolassa

doi:10.1371/journal.pone.0027379

Abstract

ObjectivesTinnitus is the perception of a sound in the absence of any physical source of it. About 5–15% of the population report hearing such a tinnitus and about 1–2% suffer from their tinnitus leading to anxiety, sleep disorders or depression. It is currently not completely understood why some people feel distressed by their tinnitus, while others don't. Several studies indicate that the amount of tinnitus distress is associated with many factors including comorbid anxiety, comorbid depression, personality, the psychosocial situation, the amount of the related hearing loss and the loudness of the tinnitus. Furthermore, theoretical considerations suggest an impact of the age at tinnitus onset influencing tinnitus distress.MethodsBased on a sample of 755 normal hearing tinnitus patients we tested this assumption. All participants answered a questionnaire on the amount of tinnitus distress together with a large variety of clinical and demographic data.ResultsPatients with an earlier onset of tinnitus suffer significantly less than patients with an onset later in life. Furthermore, patients with a later onset of tinnitus describe their course of tinnitus distress as more abrupt and distressing right from the beginning.ConclusionWe argue that a decline of compensatory brain plasticity in older age accounts for this age-dependent tinnitus decompensation.

Highlights

Tinnitus is the perception of sound in the absence of an auditory stimulus
Age at tinnitus onset influences tinnitus distress In the investigation of the relationship between tinnitus onset and tinnitus severity, hearing loss is an important confounding factor, which interacts in a complex way with age and tinnitus severity
First the prevalence of hearing loss increases with age, second hearing loss increases the risk for developing tinnitus [10], and third the amount of tinnitus distress is influenced by the distress the participant experiences because of the hearing loss accompanying the tinnitus

Summary

Introduction

Tinnitus is the perception of sound in the absence of an auditory stimulus. Averaged over all age groups 5–15% of the western population experience some form of tinnitus. Many people can cope with chronic tinnitus, but about 1–2% of the population experience significant impairments in their quality of life due to their tinnitus. The prevalence of chronic tinnitus increases with increasing age, peaking at 14.3% in people between 60 and 69 years of age [1]. Imaging studies reveal that neuroplastic changes in the central auditory system are generating the tinnitus percept [5] and that coactivation of nonauditory structures in the frontal cortex and the limbic system are involved in tinnitus related distress [6,7]

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