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Migraine impairs the auditory protective mechanism: a potential biomarker.

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Τίτλος: Migraine impairs the auditory protective mechanism: a potential biomarker.
Συγγραφείς: Huang M; Department of Otorhinolaryngology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, People's Republic of China.; Institute of Otorhinolaryngology, Sun Yat-sen University, Guangzhou, 510080, People's Republic of China., Xiong G; Department of Otorhinolaryngology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, People's Republic of China. xguanx@mail.sysu.edu.cn.; Institute of Otorhinolaryngology, Sun Yat-sen University, Guangzhou, 510080, People's Republic of China. xguanx@mail.sysu.edu.cn., Wang X; Department of Otorhinolaryngology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, People's Republic of China. wangxren@mail.sysu.edu.cn.; Institute of Otorhinolaryngology, Sun Yat-sen University, Guangzhou, 510080, People's Republic of China. wangxren@mail.sysu.edu.cn.
Πηγή: The journal of headache and pain [J Headache Pain] 2026 Jun 05; Vol. 27 (1). Date of Electronic Publication: 2026 Jun 05.
Τύπος έκδοσης: Journal Article
Γλώσσα: English
Στοιχεία περιοδικού: Publisher: BioMed Central Country of Publication: England NLM ID: 100940562 Publication Model: Electronic Cited Medium: Internet ISSN: 1129-2377 (Electronic) Linking ISSN: 11292369 NLM ISO Abbreviation: J Headache Pain Subsets: MEDLINE
Imprint Name(s): Publication: [2018]- : [London, United Kingdom] : BioMed Central
Original Publication: Milano : Springer Verlag Italia, c2000-c2017.
Ιατρικοί όροι (MeSH): Migraine Disorders*/physiopathology , Migraine Disorders*/complications , Migraine Disorders*/diagnosis , Tinnitus*/physiopathology , Tinnitus*/epidemiology , Reflex, Acoustic*/physiology , Auditory Pathways*/physiopathology, Otoacoustic Emissions, Spontaneous/physiology ; Auditory Threshold/physiology ; Cochlea/physiopathology ; Humans ; Female ; Male ; Cross-Sectional Studies ; Adult ; Biomarkers ; Middle Aged ; Young Adult
Περίληψη: Background: Migraine is a prevalent neurological disorder frequently accompanied by auditory symptoms such as tinnitus and hyperacusis. While their associations suggest shared neural mechanisms, objective evidence regarding the specific involvement of brainstem-mediated auditory efferent pathways in migraine remains limited. The medial olivocochlear reflex (MOCR) and the middle ear muscle reflex (MEMR) are two key auditory protective mechanisms, yet their integrity in migraine patients remains to be investigated. This study aimed to evaluate the functional integrity of the MOCR and MEMR pathways in migraine patients with and without comorbid tinnitus.
Methods: In this cross-sectional study, 143 participants were classified into four groups based on strict diagnostic criteria: healthy controls (HC, n = 44), tinnitus-only (T, n = 49), migraine-only (M, n = 25), and migraine with tinnitus (TM, n = 25). Groups were matched for age, sex, and hearing thresholds. All participants underwent comprehensive audiological assessments, including pure-tone audiometry, ipsilateral and contralateral acoustic reflex threshold (ART) testing to assess MEMR function, and distortion-product otoacoustic emissions (DPOAE) with contralateral suppression evaluation to assess MOCR function.
Results: The migraine group (M) demonstrated significantly elevated contralateral ART (indicating MEMR impairment) at 500 Hz and 1000 Hz (p < 0.001) and globally reduced DPOAE suppression (reflecting MOCR dysfunction) (p < 0.001) compared to healthy controls. The TM group exhibited a similar pattern of MOCR and MEMR dysfunction to the M group, with no significant additive effect from tinnitus comorbidity. A clear gradient of contralateral ART impairment was observed across groups: HC < T < (M ≈ TM). Ipsilateral ART results showed less consistent abnormalities.
Conclusion: Migraine may be associated with specific dysfunction of brainstem auditory efferent pathways, particularly affecting both MOCR and MEMR systems, independent of peripheral hearing status. The convergent abnormalities in migraine patients with and without tinnitus indicate that auditory efferent disruption may be an intrinsic component of migraine pathophysiology. These findings support the potential of contralateral ART as an objective biomarker of migraine-related auditory pathway involvement, highlighting the clinical value of auditory assessment in migraine management and providing insights for the development of targeted therapeutic strategies.
(© 2026. The Author(s).)
Competing Interests: Declarations. Ethical approval: The ethics committee of the First Affiliated Hospital of Sun Yat-sen University (No. [2020]062) reviewed and approved this study. In accordance with the Declaration of Helsinki, all participants provided written informed consent before data collection. Requests for reprints: Xianren Wang at the Department of Otolaryngology, the first affiliated hospital of Sun Yat-sen University, Guangzhou 510080, China. E-mail: wangxren@mail.sysu.edu.cn. Competing interests: The authors declare no competing interests.
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JAMA Otolaryngol Head Neck Surg. 2018 Aug 1;144(8):712-717. (PMID: 30003226)
J Neurosci. 2018 Dec 5;38(49):10479-10488. (PMID: 30341182)
Laryngoscope. 2010 Aug;120(8):1632-6. (PMID: 20641078)
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Grant Information: 2024A1515010755 Natural Science Foundation of Guangdong Province
Contributed Indexing: Keywords: Acoustic reflex; CGRP; Migraine; Tinnitus
Substance Nomenclature: 0 (Biomarkers)
Entry Date(s): Date Created: 20260605 Date Completed: 20260813 Latest Revision: 20260906
Update Code: 20260906
PubMed Central ID: PMC13471409
DOI: 10.1186/s10194-026-02414-y
PMID: 42249307
Βάση Δεδομένων: MEDLINE
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  Data: Migraine impairs the auditory protective mechanism: a potential biomarker.
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  Data: &lt;searchLink fieldCode=&quot;AU&quot; term=&quot;%22Huang+M%22&quot;&gt;Huang M&lt;/searchLink&gt;; Department of Otorhinolaryngology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, People&#39;s Republic of China.; Institute of Otorhinolaryngology, Sun Yat-sen University, Guangzhou, 510080, People&#39;s Republic of China.&lt;br /&gt;&lt;searchLink fieldCode=&quot;AU&quot; term=&quot;%22Xiong+G%22&quot;&gt;Xiong G&lt;/searchLink&gt;; Department of Otorhinolaryngology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, People&#39;s Republic of China. xguanx@mail.sysu.edu.cn.; Institute of Otorhinolaryngology, Sun Yat-sen University, Guangzhou, 510080, People&#39;s Republic of China. xguanx@mail.sysu.edu.cn.&lt;br /&gt;&lt;searchLink fieldCode=&quot;AU&quot; term=&quot;%22Wang+X%22&quot;&gt;Wang X&lt;/searchLink&gt;; Department of Otorhinolaryngology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, People&#39;s Republic of China. wangxren@mail.sysu.edu.cn.; Institute of Otorhinolaryngology, Sun Yat-sen University, Guangzhou, 510080, People&#39;s Republic of China. wangxren@mail.sysu.edu.cn.
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  Data: &lt;searchLink fieldCode=&quot;JN&quot; term=&quot;%22100940562%22&quot;&gt;The journal of headache and pain&lt;/searchLink&gt; [J Headache Pain] 2026 Jun 05; Vol. 27 (1). &lt;i&gt;Date of Electronic Publication: &lt;/i&gt;2026 Jun 05.
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– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: Background: Migraine is a prevalent neurological disorder frequently accompanied by auditory symptoms such as tinnitus and hyperacusis. While their associations suggest shared neural mechanisms, objective evidence regarding the specific involvement of brainstem-mediated auditory efferent pathways in migraine remains limited. The medial olivocochlear reflex (MOCR) and the middle ear muscle reflex (MEMR) are two key auditory protective mechanisms, yet their integrity in migraine patients remains to be investigated. This study aimed to evaluate the functional integrity of the MOCR and MEMR pathways in migraine patients with and without comorbid tinnitus.&lt;br /&gt;Methods: In this cross-sectional study, 143 participants were classified into four groups based on strict diagnostic criteria: healthy controls (HC, n = 44), tinnitus-only (T, n = 49), migraine-only (M, n = 25), and migraine with tinnitus (TM, n = 25). Groups were matched for age, sex, and hearing thresholds. All participants underwent comprehensive audiological assessments, including pure-tone audiometry, ipsilateral and contralateral acoustic reflex threshold (ART) testing to assess MEMR function, and distortion-product otoacoustic emissions (DPOAE) with contralateral suppression evaluation to assess MOCR function.&lt;br /&gt;Results: The migraine group (M) demonstrated significantly elevated contralateral ART (indicating MEMR impairment) at 500&#160;Hz and 1000&#160;Hz (p &amp;lt; 0.001) and globally reduced DPOAE suppression (reflecting MOCR dysfunction) (p &amp;lt; 0.001) compared to healthy controls. The TM group exhibited a similar pattern of MOCR and MEMR dysfunction to the M group, with no significant additive effect from tinnitus comorbidity. A clear gradient of contralateral ART impairment was observed across groups: HC &amp;lt; T &amp;lt; (M ≈ TM). Ipsilateral ART results showed less consistent abnormalities.&lt;br /&gt;Conclusion: Migraine may be associated with specific dysfunction of brainstem auditory efferent pathways, particularly affecting both MOCR and MEMR systems, independent of peripheral hearing status. The convergent abnormalities in migraine patients with and without tinnitus indicate that auditory efferent disruption may be an intrinsic component of migraine pathophysiology. These findings support the potential of contralateral ART as an objective biomarker of migraine-related auditory pathway involvement, highlighting the clinical value of auditory assessment in migraine management and providing insights for the development of targeted therapeutic strategies.&lt;br /&gt; (&#169; 2026. The Author(s).)
– Name: Abstract
  Label: Competing Interests
  Group: Ab
  Data: Declarations. Ethical approval: The ethics committee of the First Affiliated Hospital of Sun Yat-sen University (No. [2020]062) reviewed and approved this study. In accordance with the Declaration of Helsinki, all participants provided written informed consent before data collection. Requests for reprints: Xianren Wang at the Department of Otolaryngology, the first affiliated hospital of Sun Yat-sen University, Guangzhou 510080, China. E-mail: wangxren@mail.sysu.edu.cn. Competing interests: The authors declare no competing interests.
– Name: Ref
  Label: References
  Group: RefInfo
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– Name: GrantInfo
  Label: Grant Information
  Group: Grant
  Data: 2024A1515010755 Natural Science Foundation of Guangdong Province
– Name: SubjectMinor
  Label: Contributed Indexing
  Group:
  Data: &lt;i&gt;Keywords: &lt;/i&gt;Acoustic reflex; CGRP; Migraine; Tinnitus
– Name: NumberCAS
  Label: Substance Nomenclature
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  Data: 0 (Biomarkers)
– Name: DateEntry
  Label: Entry Date(s)
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  Data: &lt;i&gt;Date Created: &lt;/i&gt;20260605 &lt;i&gt;Date Completed: &lt;/i&gt;20260813 &lt;i&gt;Latest Revision: &lt;/i&gt;20260906
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  Label: Update Code
  Group: Date
  Data: 20260906
– Name: PubmedCentralID
  Label: PubMed Central ID
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  Data: PMC13471409
– Name: DOI
  Label: DOI
  Group: ID
  Data: 10.1186/s10194-026-02414-y
– Name: AN
  Label: PMID
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  Data: 42249307
PLink https://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=cmedm&AN=42249307
RecordInfo BibRecord:
  BibEntity:
    Identifiers:
      – Type: doi
        Value: 10.1186/s10194-026-02414-y
    Languages:
      – Code: eng
        Text: English
    Subjects:
      – SubjectFull: Otoacoustic Emissions, Spontaneous physiology
        Type: general
      – SubjectFull: Auditory Threshold physiology
        Type: general
      – SubjectFull: Cochlea physiopathology
        Type: general
      – SubjectFull: Humans
        Type: general
      – SubjectFull: Female
        Type: general
      – SubjectFull: Male
        Type: general
      – SubjectFull: Cross-Sectional Studies
        Type: general
      – SubjectFull: Adult
        Type: general
      – SubjectFull: Biomarkers
        Type: general
      – SubjectFull: Middle Aged
        Type: general
      – SubjectFull: Young Adult
        Type: general
      – SubjectFull: Migraine Disorders physiopathology
        Type: general
      – SubjectFull: Migraine Disorders complications
        Type: general
      – SubjectFull: Migraine Disorders diagnosis
        Type: general
      – SubjectFull: Tinnitus physiopathology
        Type: general
      – SubjectFull: Tinnitus epidemiology
        Type: general
      – SubjectFull: Reflex, Acoustic physiology
        Type: general
      – SubjectFull: Auditory Pathways physiopathology
        Type: general
    Titles:
      – TitleFull: Migraine impairs the auditory protective mechanism: a potential biomarker.
        Type: main
  BibRelationships:
    HasContributorRelationships:
      – PersonEntity:
          Name:
            NameFull: Huang M
      – PersonEntity:
          Name:
            NameFull: Xiong G
      – PersonEntity:
          Name:
            NameFull: Wang X
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          Dates:
            – D: 05
              M: 06
              Text: 2026 Jun 05
              Type: published
              Y: 2026
          Identifiers:
            – Type: issn-electronic
              Value: 1129-2377
          Numbering:
            – Type: volume
              Value: 27
            – Type: issue
              Value: 1
          Titles:
            – TitleFull: The journal of headache and pain
              Type: main
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