Auditory Impairments in Multiple Sclerosis

Multiple sclerosis (MS) is chiefly known for its impact on motor and visual pathways, but auditory function is increasingly recognised as vulnerable to demyelinating and inflammatory processes. Patients may experience sudden sensorineural hearing loss, often unilateral but occasionally bilateral, linked to acute inflammatory lesions within the brainstem or auditory nerve. More commonly, subtle deficits of central auditory processing manifest as difficulty understanding speech in noisy environments, impaired temporal resolution and disrupted auditory pattern recognition, despite normal pure tone thresholds. Pathophysiological mechanisms include focal demyelination in the auditory brainstem, aberrant neuroinflammatory signalling via fluid exchange between cerebrospinal fluid and the inner ear, and subsequent damage to inner hair cells or central projection pathways. Electrophysiological assessments—such as auditory brainstem response recordings and distortion product otoacoustic emissions—reveal delayed conduction and reduced cochlear amplification in a substantial subset of MS patients. Recognition of these impairments is essential for holistic management, rehabilitation strategies and the design of hearing aids or assistive listening devices tailored to the unique central and peripheral deficits encountered in MS.

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Auditory Impairments in Multiple Sclerosis publication trend

The graph below shows the total number of articles in auditory impairments in multiple sclerosis across all publications each year (not limited to Nature Index journals).

Technical terms

Sensorineural hearing loss: Impairment arising from damage to the cochlea or auditory nerve pathways.

Auditory Brainstem Response (ABR): Electrophysiological assay measuring neural conduction times along the auditory pathway.

Distortion Product Otoacoustic Emissions (DPOAE): Sounds generated by outer hair cells in response to tonal stimuli, used to assess cochlear health.

Temporal resolution: Ability of the auditory system to detect brief gaps or changes in sound over time.

Central auditory processing: Neural operations involved in decoding, integrating and interpreting complex acoustic signals.

References

1. Management of Sudden Sensorineural Hearing Loss in Multiple Sclerosis: A Comprehensive Case Report of a Patient with Bilateral Loss and Literature Review. Life (2024).
2. Neuroinflammatory disorders of the brain and inner ear: a systematic review of auditory function in patients with migraine, multiple sclerosis, and neurodegeneration to support the idea of an innovative ‘window of discovery’. Frontiers in Neurology (2023).
3. Central auditory processing and word discrimination in patients with multiple sclerosis. European Archives of Oto-Rhino-Laryngology (2013).
4. Alterations in early auditory evoked potentials in multiple sclerosis patients. Brazilian Journal of Otorhinolaryngology (2009).