Auditory outcome following aneurysmal subarachnoid haemorrhage

Auditory deficits are increasingly recognised following aneurysmal subarachnoid haemorrhage (aSAH) and are thought to be of central rather than peripheral origin. Central hearing impairment, also known as auditory processing disorder (APD), often coexists with cognitive deficits and it is thought that APD has both auditory and cognitive elements. The aim of this study was to assess auditory outcome following aSAH and its relationship with cognition. A retrospective case-controlled study design was employed with aSAH cases and matched controls identified from the UK Biobank. Auditory and cognitive outcomes were assessed using the digit triplet test (DTT) and a test of psychomotor reaction time, respectively. Best DTT score was compared between cases and controls using the t-test. A regression-based mediation analysis was performed to assess whether cognition mediated auditory outcome. 270 aSAH patients with auditory outcomes were identified with an average follow-up of 106 months. A matched control cohort of 1080 individuals was also identified. The aSAH cohort had significantly impaired best DTT scores compared to matched controls (p = 0.002). Cognition significantly mediated auditory outcome following aSAH, accounting for 9.8% of the hearing impairment after aSAH. In conclusion significant hearing impairment follows aSAH. The deficit is bilateral and non-progressive. There is a link with cognitive deficit, pointing to a central rather than peripheral source, in keeping with an auditory processing disorder. All aSAH patients should be asked about hearing difficulty at follow-up and when present it should be investigated with peripheral and central auditory assessments, as well as cognitive tests.

Keywords: Health care; Hearing loss; Outcome assessment; Stroke; Subarachnoid haemorrhage.

Health care, Hearing loss, Outcome assessment, Stroke, Subarachnoid haemorrhage

10.1016/j.jns.2021.120125

0022-510X

120-125

Gaastra, Benjamin

c7b7f371-706b-4d59-9150-94e8f254e205

Ashokumar, Monica

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Bulters, Diederik

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Campbell, Nicole

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Galea, Ian

66209a2f-f7e6-4d63-afe4-e9299f156f0b

15 March 2022

Gaastra, Benjamin

c7b7f371-706b-4d59-9150-94e8f254e205

Ashokumar, Monica

501cf358-f2e4-43b4-941c-bd68688d39a0

Bulters, Diederik

d6f9644a-a32f-45d8-b5ed-be54486ec21d

Campbell, Nicole

fde07dcf-4874-4bab-ab3a-c3bc3c0015da

Galea, Ian

66209a2f-f7e6-4d63-afe4-e9299f156f0b

Gaastra, Benjamin, Ashokumar, Monica, Bulters, Diederik, Campbell, Nicole and Galea, Ian (2022) Auditory outcome following aneurysmal subarachnoid haemorrhage. Journal of the Neurological Sciences, 434, 120-125, [120125]. (doi:10.1016/j.jns.2021.120125).

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Accepted/In Press date: 24 December 2021

e-pub ahead of print date: 30 December 2021

Published date: 15 March 2022

Additional Information: Funding Information: BG is funded by is funded by the Royal College of Surgeons, Society of British Neurological Surgeons and Barrow Foundation in addition to the Institute for Life Sciences, University of Southampton. Funding Information: Thanks to Professor Carl Verschuur (Auditory Implant Service, University of Southampton) for support. The authors acknowledge the use of the IRIDIS High Performance Computing Facility, and associated support services at the University of Southampton, in the completion of this work. The data that support the findings of this study are available from the UK Biobank (https://www.ukbiobank.ac.uk) by application. IG and NC conceived the study. All authors contributed to the study design. The first draft of the manuscript was written by BG, IG and NC, all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript. The study was performed under National Research Ethics Committee Approval 16/NW/0274 and institutional approval (ERGO 49253). Informed consent was obtained from all individual participants included in the study. Not applicable. BG is funded by is funded by the Royal College of Surgeons, Society of British Neurological Surgeons and Barrow Foundation in addition to the Institute for Life Sciences, University of Southampton. Not applicable. Publisher Copyright: © 2021 Elsevier B.V.

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