Authors
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Xiangli Zeng
Department of Otolaryngology, Third Affiliated Hospital of Sun Yat-sen University, China
Author
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Cheng Zhong
Department of Otolaryngology, Third Affiliated Hospital of Sun Yat-sen University, China
Author
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Lihua Wang
Department of Otolaryngology, Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
Author
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Haopeng Zhang
Department of Otolaryngology, Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
Author
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Lin Ji
Department of Otolaryngology, Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
Author
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Xiaohui Liu
Department of Otolaryngology, Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
Author
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Yu Guo
Department of Otolaryngology, Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
Author
Keywords:
Chronic Idiopathic Tinnitus, Clinical Features, Risk Factors
Abstract
Background: Hearing loss is recognized as the single largest modifiable risk factor for Alzheimer’s disease (AD), yet the cognitive implications of chronic tinnitus—a frequent auditory phantom percept—remain largely unexplored. This study aims to identify whether risk factors for tinnitus overlap with those for AD, and whether decompensated tinnitus reflects a heightened neuropsychiatric burden relevant to brain aging.
Methods: A two-sample Mendelian randomization (MR) design using IEU OpenGWAS and FinnGen R12 was employed to evaluate causal associations between AD-related exposures and tinnitus. Clinical validation was conducted in 262 patients with chronic idiopathic tinnitus (compensated, n=150; decompensated, n=112, defined by Tinnitus Handicap Inventory [THI] ≥38), focusing on sleep quality (PSQI) and anxiety/depression (HADS). Logistic regression identified independent risk factors for decompensation.
Results: MR revealed significant causal associations with tinnitus: poor overall health (OR=1.605), frequent fatigue (OR=1.929), high anxiety (OR=2.818), and smoking history (OR=2.688). Clinically, decompensated patients exhibited significantly higher rates of sleep disorders (63.39% vs. 34.67%, P<0.001) and a higher proportion of disease duration ≥4 years (40.18% vs. 26.00%, P=0.043). Logistic regression identified Kidney Deficiency TCM syndrome (OR=13.428), HADS-A score (OR=1.174), PSQI score (OR=1.163), and VAS loudness (OR=3.293) as independent risk factors for decompensation. Notably, anxiety and sleep disturbances independently affected tinnitus severity without significant interaction (P=0.876), mirroring independent neuropsychiatric pathways implicated in AD prodrome.
Conclusion: Chronic tinnitus, particularly in its decompensated state, clusters with major AD-modifiable risk factors including anxiety, sleep disruption, fatigue, and smoking. These findings suggest that clinical screening for decompensated tinnitus may offer a peripheral window into central neuropsychiatric vulnerability, warranting longitudinal cognitive follow-up in this population.
Author Biographies
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Xiangli Zeng, Department of Otolaryngology, Third Affiliated Hospital of Sun Yat-sen University, China
Xiangli Zeng, Department of Otolaryngology, Third Affiliated Hospital of Sun Yat-sen University, China.
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Cheng Zhong, Department of Otolaryngology, Third Affiliated Hospital of Sun Yat-sen University, China
Cheng Zhong, Department of Otolaryngology, Third Affiliated Hospital of Sun Yat-sen University, China.
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Lihua Wang, Department of Otolaryngology, Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
Lihua Wang, Department of Otolaryngology, Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China.
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Haopeng Zhang, Department of Otolaryngology, Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
Haopeng Zhang, Department of Otolaryngology, Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China.
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Lin Ji, Department of Otolaryngology, Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
Lin Ji, Department of Otolaryngology, Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China.
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Xiaohui Liu, Department of Otolaryngology, Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
Xiaohui Liu, Department of Otolaryngology, Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
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Yu Guo, Department of Otolaryngology, Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
Yu Guo, Department of Otolaryngology, Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China.
