Abnormal Subjective and Audiometric Auditory Function in Migraine

Abstract Objective To identify if migraine is associated with auditory deficits and if the auditory profile of migraine is distinct from other pain syndromes, such as chronic pain. Study Design Cross‐sectional, retrospective. Setting A total of 5273 respondents of the 1999 to 2004 National Health and Nutrition Examination Survey. Methods Regression analyses assessed the association between migraine (n = 1245) and chronic pain (n = 430) status with subjectively endorsed hearing loss, tinnitus, pure‐tone average (PTA) at 500, 1000, 2000, and 4000 Hz, and subjective‐audiometric hearing mismatch (endorsed hearing loss but with a PTA ≤ 25 dB), correcting for confounding factors. Results Migraine was associated with increased tinnitus (adjusted odds ratio [aOR] = 1.77, 95% confidence interval [CI]: 1.47‐2.13, p < .001) and subjective hearing loss (aOR = 1.58, 95% CI: 1.29‐1.94, p < .001). Migraine was associated with higher PTA ( β = .89, p = .023). Migraine decreased the PTA threshold at which individuals endorsed subjective hearing loss ( β = −1.94, p = .013) and was associated with a more subjective‐audiometric hearing mismatch (aOR = 1.50, 95% CI: 1.18‐1.89, p < .001). Chronic pain was not associated with tinnitus (aOR = 1.26, 95% CI: 0.97‐1.63, p = 0.079), subjective hearing loss (aOR = 0.94, 95% CI: 0.71‐1.23, p = .64), changes in PTA ( β = −.22, p = .69), altered PTA threshold for endorsing hearing loss ( β = 1.40, p = .19), or subjective‐audiometric hearing mismatch (aOR = 0.98, 95% CI: 0.70‐1.34, p = .88). Conclusion Migraine is associated with both worse pure‐tone audiometry and higher sensitivity to changes in hearing ability, suggesting both peripheral and central auditory function abnormalities. In contrast, patients with chronic pain did not demonstrate these abnormalities. The etiology of abnormal auditory processing in migraine may be different from that of other pain syndromes.