Speech perception in tinnitus is related to individual distress level - A neurophysiological study

The analysis of behavioural and audiometric data showed indications of mild to moderate symptoms of tinnitus distress when peripheral hearing loss was not in evidence. Nevertheless, tinnitus distress was negatively related to speech in noise performance which may be indicative of a lack of inhibitory competence. We further observed an effect of tinnitus distress on phoneme discrimination. More precisely, higher tinnitus distress was associated with higher accuracy and longer reaction times, while the effect on reaction times was mediated by the individual N2 ERP peak amplitudes. Our results suggest that tinnitus clearly interacts with the central auditory system in that responsiveness to salient input changes as a function of tinnitus-related distress, irrespective of peripheral hearing loss. Akin to individuals with higher psychological stress, persons with increased tinnitus-related distress demonstrate higher sensitivity during auditory processing. Taken together, we interpret our findings in light of a Bayesian approach (Sedley et al., 2016). According to this view, tinnitus distress-related factors (e.g., attention, stress) influence the excitability of the central auditory system and this, in turn, affects the sensory precision of inflowing auditory input, including spoken language.