Migraine Links to Hearing Disorders and Tinnitus

Migraine affects over one billion people globally and is a leading cause of disability for adults under 50. A review by researchers Pola Kobryń, Igor Nowiński, and Dawid Ocicki consolidates modern evidence, framing migraine as a complex neurological disorder of sensory processing with significant implications for public health and hearing-related conditions.

From Vascular Theory to Network Dysfunction

For decades, migraine was mischaracterized as primarily a vascular disorder. The review by Kobryń and colleagues clarifies that current evidence presents it as a “complex disorder of sensory processing and neural network dysfunction.” Key mechanisms include activation of the trigeminovascular system, altered cortical and brainstem excitability, and the role of calcitonin gene-related peptide (CGRP) signaling. In migraine with aura, a wave of altered brain activity called cortical spreading depression is a critical process. This neurological framework explains why migraineurs often experience heightened sensitivity to light, sound, and smell, and why it frequently coexists with conditions like misophonia and hyperacusis.

Diagnosis and the Spectrum of Comorbidities

Migraine diagnosis remains clinical, based on criteria from the International Classification of Headache Disorders. The authors stress that identifying comorbidities is a vital part of the assessment. Migraine has strong links to psychiatric conditions like depression and anxiety, sleep disorders, vestibular problems, and cardiovascular issues. Of particular relevance to hearing health are the overlaps with tinnitus and hyperacusis. The shared pathways of central sensitization—where the nervous system becomes hyper-reactive—may explain why these conditions often cluster. This connection is explored in our article on Migraine and Hearing Disorders Explained.

A Multi-Pronged Treatment Strategy

Kobryń, Nowiński, and Ocicki outline a treatment approach that moves beyond simple pain relief. Acute pharmacotherapy, including triptans and NSAIDs, targets attacks. Preventive strategies are critical for reducing frequency and include traditional drugs (beta-blockers, antidepressants), the newer anti-CGRP monoclonal antibodies, and neuromodulation devices. Non-pharmacological support is equally important: patient education, lifestyle modification, regular physical activity, and sleep regulation form the foundation of care. This comprehensive model aligns with approaches for related sensory processing conditions, such as the combined use of CBT and sound therapy for tinnitus.

Practical Implications for Patients and Clinicians

The review concludes that migraine must be understood as both a neurological disease and a public health challenge. Effective care is inherently individualized and multidisciplinary. For patients experiencing migraine alongside sound sensitivity or tinnitus, this means treatment should address both the headache disorder and the auditory symptoms. Clinicians are encouraged to screen for hearing-related sensitivities in migraine patients. Management of comorbid psychiatric and sleep conditions can also improve overall prognosis. The paper advocates for long-term patient education to empower individuals in managing their condition.

Conclusion

The evidence summarized by Kobryń, Nowiński, and Ocicki marks a significant shift in how migraine is perceived and treated. Recognizing its basis in sensory processing and network dysfunction opens doors to more targeted therapies and explains its high comorbidity with auditory conditions. Successful management depends on integrating pharmacological advances with holistic, patient-centered support.

Source: Kobryń, P., Nowiński, I., & Ocicki, D. (2026). Contemporary perspectives on migraine: from pathophysiology to multidisciplinary management. Journal of Education, Health and Sport, 94, 72978.