Distinct changes in the morphology of cortical and subcortical grey matter associated with age-related hearing loss and tinnitus in the UK Biobank participants

Prevalence of both hearing loss and tinnitus increases with age. However, neuroimaging studies of both conditions report inconsistent changes in brain morphology likely due to small sample size and variable methodology. Structural and functional neuroimaging studies in hearing loss and tinnitus have revealed distinct neural correlates, and further replication is needed to confirm these findings. This study aims to investigate the effects of hearing loss and tinnitus on the brain morphology in a well-powered sample. We utilized self-reported hearing difficulty and tinnitus in participants with magnetic resonance imaging (MRI) in the UK Biobank cohort. Control participants without hearing difficulty and tinnitus were age and sex matched leading to total sample sizes of 13 074 and 6242 for self-reported hearing difficulty and tinnitus, respectively. We utilized the rich UK Biobank dataset (i) to reveal these brain changes in a well-powered large study of hearing loss and tinnitus, (ii) to document the effect of confounding factors on these associations, (iii) to discriminate the effects of tinnitus versus hearing difficulty on the brain and (iv) to estimate the brain-age gap in hearing difficulty and tinnitus subjects compared with controls. Hearing difficulty is significantly associated with smaller grey matter volumes exclusively in the bilateral transverse temporal regions, whereas tinnitus is associated with larger volumes of bilateral hippocampi and thalami when compared with the control group. Furthermore, correcting for confounders (i.e. diabetes, cardiovascular disease, age, sex, smoking, alcohol consumption and Townsend deprivation index) during statistical analysis helped to better delineate the impact of hearing status on brain structural changes. The brain-age gap analysis showed that participants with tinnitus appeared to have significantly younger brains than controls, whereas participants with hearing difficulty did not differ significantly from the control group. Altogether, our results confirmed previous findings and suggest the enlargement of bilateral thalami as the main effect in people with tinnitus. We also established that there are independent and distinct brain pathologies between hearing difficulty and tinnitus. Therefore, the self-reported measure is a reasonable approach to assess the hearing loss and tinnitus pathologies.