Effects of Hearing and Vestibular Function on Balance and Spatial Cognition

Abstract

Introduction: The hearing and vestibular system have been associated with balance and spatial cognition independently, however, few studies have accounted for both sensory components in the study of balance and spatial cognitive domains. Aims: The primary aim of this pilot study was to determine if people with combined bilateral vestibular and hearing loss will perceive greater handicap in hearing and balance, report greater complaints in spatial cognition, and perceive greater spatial and balance benefit from the use of hearing devices than those with either sensory loss alone. Additional investigations on spatial and balance hearing device benefit in people with balance disorders will also provide some insight into how these devices can impact postural benefit. Methods: Data was collected from 41 participants, including 7 participants with bilateral vestibulopathy (BVP), 11 participants with bilateral hearing loss (HL), 7 participants with BVP and HL (BVPHL), 6 participants with other auditory and vestibular pathologies (OV), and 10 healthy controls. Hearing and vestibular loss were confirmed with vestibular and auditory testing. Perceived handicap and difficulties were assessed through hearing handicap inventory (HHI), dizziness handicap inventory (DHI), neuropsychological vertigo inventory (NVI), and a set of customised questionnaires probing spatial cognition and hearing device benefit. Results: Participants with combined sensory loss had significantly greater scores on HHI, but not DHI, NVI, nor report greater cognitive complaints than participants with either sensory loss alone. Participants with combined sensory loss reported greater hearing device benefit than participants with hearing loss alone, however this was not specific to BVP. Participants identified postural benefits from increased access to spatial auditory cues or reduced cognitive load. Hearing devices were also noted to be less beneficial for postural control in complex auditory environments. Conclusions: Findings of this study support the idea of increased hearing handicap in participants with combined vestibular and hearing loss compared to those with either loss alone. The present study failed to identify differences in balance and spatial cognitive domains between groups. However, findings provide some insight into the use of auditory rehabilitation to alleviate issues associated with imbalance, and potential confounders to control for in future studies.