Investigating tinnitus subgroups based on hearing-related difficulties

Purpose: Meaningfully grouping individuals with tinnitus who share the common characteristics (i.e., subgrouping, phenotyping) may help tailor interventions to certain tinnitus subgroups and hence reduce outcome variability. The purpose of this study was to test if the presence of tinnitus subgroups are discernible based on hearing-related comorbidities, and to identify predictors of tinnitus severity for each subgroup identified.

Methods: An exploratory cross-sectional study was used. The study was nested within an online survey distributed worldwide to investigate tinnitus experiences during the COVID-19 pandemic. The main outcome measure was the tinnitus Handicap Inventory- Screening Version.

Results: From the 3400 respondents, 2,980 were eligible adults with tinnitus with an average age of 58 years (SD= 14.7) with 50% (n= 1,457) being female. A three-cluster solution identified distinct subgroups, namely, those with tinnitus but no hearing loss (n = 1,306; 44%), those presenting with tinnitus and hyperacusis and/or misophonia (n = 795; 27%), and those with tinnitus and hearing loss (n = 879; 29%). Those with tinnitus and hyperacusis reported the highest tinnitus severity (M= 20.3; SD= 10.5) and those with tinnitus and no hearing loss had the lowest tinnitus severity (M= 15.7; SD= 10.4). Younger age and the presence of mental health problems predicted greater tinnitus severity for all groups (β≤ -.1, p≤ .016).

Conclusion: Further exploration of these potential subtypes are needed in both further research and clinical practice by initially triaging tinnitus patients prior to their clinical appointments based on the presence of hearing-related comorbidities. Unique management pathways and interventions could be tailored for each tinnitus subgroup.