Association between TBI-related hearing impairment and cognition: a TRACK-TBI study

J Head Trauma Rehabil, 2022 · DOI: 10.1097/HTR.0000000000000735 · Published: September 1, 2022

Simple Explanation

This study investigated the connection between hearing problems and cognitive abilities after a traumatic brain injury (TBI). It looked at how hearing impairment soon after a TBI might affect a person's thinking and memory skills later on. The study found that individuals with hearing impairment after a TBI had some difficulties with executive functioning (planning and decision-making). However, their cognitive processing speed (how quickly they process information) was not significantly affected. These findings suggest that hearing loss after a brain injury might contribute to cognitive problems, possibly because the brain receives less auditory information or has to work harder to process sounds.

Study Duration

February 2014 to June 2018

Participants

1,267 participants with TBI (216 with hearing impairment, 1,051 without)

Evidence Level

Prospective, observational cohort study

Key Findings

1
TBI-related hearing impairment was significantly associated with worse executive functioning, as measured by the Trail Making Test (TMT) B/A ratio.
2
No significant association was found between TBI-related hearing impairment and cognitive processing speed, as measured by the WAIS-IV PSI scores.
3
The association between TBI-related hearing impairment and executive functioning was significant only among participants who reported bilateral hearing impairment.

Research Summary

This study examined the relationship between TBI-related hearing impairment and cognitive function in a large cohort of patients from Level I trauma centers. The results indicated a small but significant association between hearing impairment at 2 weeks post-TBI and worse executive functioning at 6 months post-TBI. The study suggests that TBI-related hearing impairment may contribute to cognitive dysfunction, particularly in individuals with bilateral hearing impairment and those with intracranial pathology.

Practical Implications

Clinical Assessment

Routine hearing assessment should be considered for TBI patients, particularly those with intracranial findings.

Rehabilitation Strategies

Cognitive rehabilitation programs for TBI patients should address potential auditory processing deficits.

Further Research

Future studies should investigate the underlying mechanisms of the hearing-cognition relationship in TBI and the long-term impact of hearing impairment on cognitive outcomes.

Study Limitations

1
Possible misclassification of hearing impairment status due to the use of self-reported hearing impairment.
2
Lack of sample size among those with moderate-to-severe TBI to adequately power studies of the association between TBI-related hearing impairment and cognition in this subgroup.
3
The TRACK-TBI study enrolled only participants seen at academic Level I trauma centers across the United States who received head CT scans.

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