Multiple sclerosis and related disorders · 2026
Down-sloping high-frequency audiometric findings in ENT-MS-12 auditory screen-positive patients with relapsing-remitting multiple sclerosis: A pilot case series.
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Di Stadio Arianna, Francavilla Beatrice, Ralli Massimo, Koohi Nehzat, Kaski Diego, Turchetta Rosaria, Indovina Iole, Dipietro Laura, Altieri Marta
Аннотация
BACKGROUND: Audio-vestibular symptoms, including hearing loss and tinnitus, are increasingly reported in people with multiple sclerosis (pwMS), yet their clinical significance and underlying mechanisms remain unclear. Both central demyelination and peripheral involvement along the brain-cochlea axis have been proposed as potential contributors.This study aims to explore and describe pure-tone audiometry (PTA) findings in pwMS who screened positive for auditory complaints on the ENT-MS-12 questionnaire, and to summarize associated clinical and magnetic resonance imaging (MRI) features during follow-up.
METHODS: In this prospective pilot study, 40 pwMS with relapsing-remitting MS were screened using the ENT-MS-12 questionnaire. Patients reporting auditory complaints and meeting predefined exclusion criteria were invited to undergo pure-tone audiometry (125-8000 Hz). Clinical data and MRI findings obtained within three months of audiometric testing were reviewed and compared with imaging from the previous year.
RESULTS: Twenty-seven patients (67.5%) reported auditory symptoms. Eleven met the inclusion criteria and five consented to audiometric testing. All five patients showed a down-sloping audiometric configuration with elevated high-frequency thresholds, particularly at 6000-8000 Hz. Mean high-frequency thresholds were higher than age-matched reference values reported in the literature. During follow-up, four of five patients experienced clinical relapses; one of these also showed disease progression, auditory brainstem response abnormalities, and a temporal lobe lesion on MRI.
CONCLUSIONS: In this pilot study, pwMS who reported hearing concerns and underwent audiometry presented subtle high-frequency auditory threshold elevations with a down-sloping audiometric pattern. These preliminary, descriptive findings suggest that incorporating auditory assessment may provide complementary clinical information in pwMS. Larger, controlled studies with electrophysiological testing and advanced neuroimaging are warranted to clarify the relevance and mechanisms of auditory involvement in multiple sclerosis, including potential central and peripheral contributions.
METHODS: In this prospective pilot study, 40 pwMS with relapsing-remitting MS were screened using the ENT-MS-12 questionnaire. Patients reporting auditory complaints and meeting predefined exclusion criteria were invited to undergo pure-tone audiometry (125-8000 Hz). Clinical data and MRI findings obtained within three months of audiometric testing were reviewed and compared with imaging from the previous year.
RESULTS: Twenty-seven patients (67.5%) reported auditory symptoms. Eleven met the inclusion criteria and five consented to audiometric testing. All five patients showed a down-sloping audiometric configuration with elevated high-frequency thresholds, particularly at 6000-8000 Hz. Mean high-frequency thresholds were higher than age-matched reference values reported in the literature. During follow-up, four of five patients experienced clinical relapses; one of these also showed disease progression, auditory brainstem response abnormalities, and a temporal lobe lesion on MRI.
CONCLUSIONS: In this pilot study, pwMS who reported hearing concerns and underwent audiometry presented subtle high-frequency auditory threshold elevations with a down-sloping audiometric pattern. These preliminary, descriptive findings suggest that incorporating auditory assessment may provide complementary clinical information in pwMS. Larger, controlled studies with electrophysiological testing and advanced neuroimaging are warranted to clarify the relevance and mechanisms of auditory involvement in multiple sclerosis, including potential central and peripheral contributions.