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Migraine impairs the auditory protective mechanism: a potential biomarker

Huang M, Xiong G, Wang X

The journal of headache and pain, 2026

143 participants

Abstract

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…

How strong is the evidence?

Evidence Hub reads this as a cross-sectional, done in people. Its evidence level is 4 of 5 (Low · observational). Observational designs can show an association but not prove cause. Reported size: 143 participants or records.

How the five levels of evidence work. The level is assigned automatically from the abstract and can be wrong, so check the paper.

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