Tinnitus – a manifestation of neurodegenerative diseases

Abstract

Background
Tinnitus is a widespread hearing impairment that can be characterized by the perception of sound, such as tone or noise, in the absence of an appropriate external sound source. The cause of tinnitus and mechanism are unclear. The prevalence of tinnitus is higher in people over 60 years of age. Tinnitus is usually a manifestation of а hearing impairment. Symptoms can be acute or chronic. In most cases, tinnitus manifests as an idiopathic condition. In the clinical practice, common factors that affect the psychological and emotional well-being of people with tinnitus are: fear, stress, anxiety and depression, which in turn can cause insomnia, impaired concentration and cognitive dysfunction. Tinnitus is a heterogeneous disorder in terms of its etiology and clinic. Tinnitus is associated with hearing loss, as both symptoms often occur together, though in many clinical cases, people with hearing loss do not develop tinnitus.
Methods
We present а clinical case of a patient diagnosed with a posturographic system, along with a full otoneurological and hearing examinations. Methods of videonystagmography, video head impulse test, subjective visual vertical, audiometry, tympanometry, otoacoustic emissions test, automated auditory brainstem response were used. We provided a dental check-up and an occlusion analysis. Patient filled out questionnaires and signed a written informed consent. The aim of the team was to analyze the manifestation of tinnitus as a precursor of a neurodegenerative disease.
Results and discussion
From the literature review done chronic tinnitus is associated with anatomical brain abnormalities, including decreased cortical gray matter and decreased white matter integrity. There is also a high prevalence of cognitive impairment reported among patients with tinnitus from a clinical point of view. Tinnitus is an independent risk factor for subsequent neurodegenerative disease. There are a number of neurological conditions that can be encountered in the otorhinolaryngological and dental practice. It is important for the dentist to enrich own knowledge of the underlying neurological conditions, as they may affect the provision of dental treatment. Our findings from the examinations executed are consistent with previous studies, which show that diabetes and head injuries can be risk factors for AD and neurodegeneration.
Conclusions
Further research is needed to re-confirm the conclusions of our research and to investigate the pathophysiology of the relationship between tinnitus and the Alzheimer’s disease and tinnitus and the Parkinson’s disease in more depth.