Mapping the Brain Effects of Hearing Loss: The Matter of White Matter

“Described as the “greatest global challenge for health and social care in the 21st century,” dementia is a debilitating disease that affects about 50 million individuals worldwide, a number projected to triple by 2050. Given the limited efficacy of current dementia treatments, society stands to benefit tremendously from public health prevention strategies. Hearing loss (HL) has been recently shown to be a treatable risk factor for dementia.

[..] Clinicians may be tempted to use the known independent association between HL and cognition to justify HL treatment (eg, hearing aids) to prevent age-related cognitive deficits. While appropriate management of HL is certainly recommended, a clear causal linkage between HL and cognition has yet to be found. In the meantime, the low risk and growing theoretical benefit of HL treatment warrant improved efforts to broadly test and treat. This article [a manuscript identifying an association between poorer hearing with longitudinal change in white matter microstructure] supports ongoing public health and legislative efforts to improve hearing health care.

Randomized clinical trials are the criterion standard for studying causal relationships; however, they may be impractical or even unethical to perform. For example, ensuring continuous wear of hearing aids throughout a clinical trial may be difficult because adherence is low, and prolonged withholding of hearing aids from an individual with HL may be unethical. Nonetheless, future prospective studies should be performed to further elucidate longitudinal relationships between HL and WM [brain white matter] microstructure. In particular, replication of these findings by other investigators using more diverse populations and various DTI [diffusion tensor imaging] approaches over a longer follow-up will be necessary to substantiate these findings.”

Full article, Chern A, Irace AL, and Golub JS. JAMA Otolaryngology – Head & Neck Surgery 2020.9.3