An Exploratory Investigation of Pupillometry As a Measure of Tinnitus Intrusiveness on a Test of Auditory Short-Term Memory

Ear Hear. 2022 Sep-Oct;43(5):1540-1548. doi: 10.1097/AUD.0000000000001214. Epub 2022 Feb 23.


Objectives: The purpose of the current study was to investigate the potential of pupillometry to provide an objective measure of competition between tinnitus and external sounds during a test of auditory short-term memory.

Design: Twelve participants with chronic tinnitus and twelve control participants without tinnitus took part in the study. Pretest sessions used an adaptive method to estimate listeners' frequency discrimination threshold on a test of delayed pitch discrimination for pure tones. Target and probe tones were presented at 72 dB SPL and centered on 750 Hz±2 semitones with an additional jitter of 5 to 20 Hz. Test sessions recorded baseline pupil diameter and task-related pupillary responses (TEPRs) during three blocks of delayed pitch discrimination trials. The difference between target and probe tones was set to the individual's frequency detection threshold for 80% response-accuracy. Listeners with tinnitus also completed the Tinnitus Handicap Inventory (THI). Linear mixed effects procedures were applied to examine changes in baseline pupil diameter and TEPRs associated with group (tinnitus versus control), block (1 to 3) and their interaction. The association between THI scores and maximum TEPRs was assessed using simple linear regression.

Results: Patterns of baseline pupil dilation across trials diverged in listeners with tinnitus and controls. For controls, baseline pupil dilation remained constant across blocks. For listeners with tinnitus, baseline pupil dilation increased on blocks 2 and 3 compared with block 1. TEPR amplitudes were also larger in listeners with tinnitus than controls. Linear mixed effects models yielded a significant group by block interaction for baseline pupil diameter and a significant main effect of group on maximum TEPR amplitudes. Regression analyses yielded a significant association between THI scores and TEPR amplitude in listeners with tinnitus.

Conclusions: Our data indicate measures of baseline pupil diameter, and TEPRs are sensitive to competition between tinnitus and external sounds during a test of auditory short-term memory. This result suggests pupillometry can provide an objective measure of intrusion in tinnitus. Future research will be required to establish whether our findings generalize to listeners across a full range of tinnitus severity.

MeSH terms

  • Auditory Perception / physiology
  • Humans
  • Memory, Short-Term
  • Pitch Discrimination / physiology
  • Pupil / physiology
  • Tinnitus*