History of Migraine Linked to Development of Tinnitus, Other Cochlear Disorders

Having a history of migraines may play a role in the development of cochlear disorders, according to new research published in JAMA Otolaryngology-Head & Neck Surgery. Observing 5000 participants, researchers determined that migraine was associated with an increased risk of developing a cochlear disorder, such as tinnitus, sensorineural hearing impairment, or sudden deafness.

While headache is the most commonly associated symptom of migraine, those who suffer from migraine often report abnormal sensory perception, including hearing. However, a direct correlation between the 2 had yet to be assessed prior to this study.

Noting the lack of prior evidence, the researchers wrote, “It is still unclear whether migraines might increase the risk of other cochlear disorders, including tinnitus, and/or sensorineural hearing impairment, even though migraines do not occur concurrently with cochlear disorders."

The study recruited 1056 patients recently diagnosed with migraine and 4224 controls between January 1, 1996, and December 31, 2012. Participants were identified using claims data from the Taiwan Longitudinal Health Insurance Database and were followed from the index date until the first diagnosis of a cochlear disorder, death, or the end of 2012.

The migraine cohort was followed for 6.39 years, and the controls were followed for 6.52 years. Compared with the controls, those with migraine were nearly 3 times more likely (hazard ratio, 2.83; 95% CI, 2.01-3.99) to develop a cochlear disorder. By the end of follow-up, the incidence rate of cochlear disorders was 81.4 per 1 million person-years of follow-up for those with migraine, compared with 29.4 per 1 million person-years of follow-up for controls.

According to Kaplan-Meier estimates, the cumulative incidence in the migraine cohort was 12.2%, whereas the cumulative incidence in the control cohort was 5.5%.

When stratified by cochlear disorder, tinnitus was the most commonly associated with migraine. Those with a history of migraine were more than 3 times more likely than controls to develop the disorder.

The authors noted that the correlation between migraine and cochlear disorders might be explained by shared pathophysiologic characteristics. As sleep disorders, trigeminovascular theory, neuroinflammation, and/or cortical hypersensitivity have been associated with migraine, patients with tinnitus have vagal withdrawal and/or sympathetic overactivity.

“Sleep disorders, neural inflammation, and/or damage from oxidative stress could increase the risk of tinnitus and age-related hearing impairment,” wrote the researchers. “That is, these cochleovestibular disorders might result from sleep disorders, migraine-associated vasospasm, cortical hyperexcitability, neural inflammation and/or damage from oxidative stress, or enhanced activation of the sympathetic nervous system in the limbic and autonomous brain regions.”

Reference

Hwang J, Tsai S, Liu T, et al. Association of tinnitus and other cochlear disorders with a history of migraines [published online July 12, 2018]. JAMA Otolaryngol Head Neck Surg. doi: 10.1001/jamaoto.2018.0939.