Subjective and objective central auditory assessment in patients with multiple sclerosis: a case-control study

Abstract Background Multiple sclerosis (MS) is a chronic autoimmune demyelinating disease of the central nervous system. Although peripheral hearing thresholds may remain normal, demyelination can disturb timing-dependent auditory pathways and produce listening problems that are not detected by routine audiometry. Objective Assessment of central auditory processing in adults with relapsing-remitting MS using complementary subjective behavioral and objective electrophysiological measures. Methods This case-control study included 30 Egyptian adults with clinically stable relapsing-remitting MS and 30 healthy adults with no audiological or neurological complaints. All participants had normal peripheral hearing sensitivity. The assessment battery included otological examination, immittancemetry, pure-tone audiometry, speech discrimination, speech-in-noise test (SPIN), dichotic digit test (DDT), gap-in-noise test (GIN), auditory memory measures, auditory brainstem response (ABR), and long-latency auditory evoked potentials including P300. Results Compared with controls, the MS group showed significantly profound decline in speech-in-noise perception, dichotic listening integration, temporal resolution capacity, recognition memory, memory for content, and memory for sequence. ABR showed delayed central conduction, especially at wave “V” and expansion of central peak intervals “III-V” and “I-V”. P300 evaluation demonstrated significant latency abnormalities and reduced amplitudes, indicating altered cortical auditory processing and reduced neural synchrony. Conclusion Adults with MS may present with measurable central auditory dysfunction despite normal pure-tone thresholds. A combined behavioral and electrophysiological auditory test battery can help identify brainstem and cortical pathway involvement and may support more targeted clinical management of listening complaints in MS.