{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T15:48:09Z","timestamp":1785167289290,"version":"3.55.0"},"reference-count":41,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,9,1]],"date-time":"2025-09-01T00:00:00Z","timestamp":1756684800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Aging Neurosci."],"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To analyze the dual improvement effects of transcranial direct current stimulation (tDCS)-assisted auditory rehabilitation training on cognitive function and auditory ability of elderly patients with hearing impairment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>100 cases of elderly patients with hearing impairment admitted to our hospital between January 2020 and January 2025 were prospectively selected as study subjects. The patients were divided into sham tDCS group (<jats:italic>N<\/jats:italic>\u202f=\u202f50) and tDCS group (<jats:italic>N<\/jats:italic>\u202f=\u202f50) according to the randomized numeric table method. All patients received conventional auditory rehabilitation training, and were intervened for 1\u202fmonth, 3 times\/week, 1\u202fh each time. tDCS was given to patients in both groups before conventional auditory rehabilitation training, patients in the tDCS group underwent dual-site sequential high-definition tDCS stimulation, and patients in the sham tDCS group used sham dual-site sequential high definition tDCS stimulation. The main clinical assessments included hearing thresholds, Hearing Handicap Inventory for the Elderly-Screening (HHIE-S), Montreal Cognitive Assessment Scale (MoCA) and Mini-Mental State Examination (MMSE), Communication Performance Assessment (CPA), Personal Report of Communication Apprehension (PRCA-24), and 36-item Short-Form Health Survey (SF-36) scores of the patients in the two groups before and after the treatment. The correlation between hearing threshold, HHIE-S and MoCA and MMSE scores were analyzed by Pearson correlation coefficient.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>There were no significant differences between the two groups in terms of age, gender, BMI, degree of hearing loss, education level, smoking and drinking habits, laboratory indicators [FBG, ALP, ALT, AST, TC, TG, HDL-C, LDL-C], comorbidities, and family history of hearing loss (all <jats:italic>p<\/jats:italic>\u202f&amp;gt;\u202f0.05). The hearing thresholds and HHIE-S scores of patients in both groups after treatment were significantly lower than those before treatment (both <jats:italic>p<\/jats:italic>\u202f=\u202f0.001), and the hearing thresholds and HHIE-S scores of patients in the tDCS group after treatment were significantly lower than those in the sham tDCS group (<jats:italic>p<\/jats:italic>\u202f&amp;lt;\u202f0.001 and <jats:italic>p<\/jats:italic>\u202f=\u202f0.002, respectively). The MoCA and MMSE scores of patients in both groups were significantly higher than those before treatment (both <jats:italic>p<\/jats:italic>\u202f&amp;lt;\u202f0.001), and the MoCA and MMSE scores of patients in the tDCS group were significantly higher than those in the sham tDCS group after treatment (<jats:italic>p<\/jats:italic>\u202f=\u202f0.048 and <jats:italic>p<\/jats:italic>\u202f=\u202f0.038, respectively). Hearing thresholds and HHIE-S were negatively correlated with MoCA and MMSE scores in elderly patients with hearing impairment (all <jats:italic>p<\/jats:italic>\u202f&amp;lt;\u202f0.05). Bootstrap mediation analysis suggests that changes in hearing impairment may partially mediate improvements in cognitive function. After treatment, the total CPA and SF-36 scores of all patients were higher than before treatment, and the total PRCA-24 score was lower than before treatment (<jats:italic>p<\/jats:italic>\u202f&amp;lt;\u202f0.05). The CPA and SF-36 total scores of the patients in the tDCS group were higher than those in the sham tDCS group after treatment (<jats:italic>p<\/jats:italic>\u202f=\u202f0.012 and <jats:italic>p<\/jats:italic>\u202f=\u202f0.007, respectively), and the differences in the PRCA-24 total scores of the two groups were not statistically significant when compared with each other after treatment (<jats:italic>p<\/jats:italic>\u202f=\u202f0.248).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Transcranial direct current stimulation-assisted auditory rehabilitation training may improve the cognitive and auditory functions of elderly patients with hearing impairment and enhance the quality of life of patients.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fnagi.2025.1591496","type":"journal-article","created":{"date-parts":[[2025,9,1]],"date-time":"2025-09-01T05:31:59Z","timestamp":1756704719000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Dual improvement of cognitive function and auditory ability in elderly patients with hearing impairment by transcranial direct current stimulation-assisted auditory rehabilitation training"],"prefix":"10.3389","volume":"17","author":[{"given":"Ying","family":"Zhou","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haolun","family":"Han","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoli","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yiyan","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenbo","family":"Duan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liyun","family":"Su","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Baowei","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhezhe","family":"Sun","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lei","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gang","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,9,1]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"862","DOI":"10.1044\/2016_JSLHR-H-15-0170","article-title":"Task- and talker-specific gains in auditory training","volume":"59","author":"Barcroft","year":"2016","journal-title":"J. Speech Lang. Hear. Res."},{"key":"ref2","doi-asserted-by":"publisher","first-page":"151","DOI":"10.1016\/j.bpsc.2022.09.014","article-title":"Combined cognitive training and transcranial direct current stimulation in neuropsychiatric disorders: a systematic review and Meta-analysis","volume":"8","author":"Burton","year":"2023","journal-title":"Biol. Psychiatry Cogn. Neurosci. Neuroimaging"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"170","DOI":"10.1097\/WAD.0000000000000304","article-title":"Transcranial direct current stimulation improves cognitive function in mild to moderate Alzheimer disease: a Meta-analysis","volume":"33","author":"Cai","year":"2019","journal-title":"Alzheimer Dis. Assoc. Disord."},{"key":"ref4","doi-asserted-by":"publisher","first-page":"4222","DOI":"10.1093\/brain\/awac263","article-title":"Dual-site transcranial direct current stimulation to treat tinnitus: a randomized controlled trial","volume":"145","author":"Cardon","year":"2022","journal-title":"Brain"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"397","DOI":"10.1038\/s41380-019-0499-9","article-title":"Transcranial direct current stimulation: a roadmap for research, from mechanism of action to clinical implementation","volume":"25","author":"Chase","year":"2020","journal-title":"Mol. Psychiatry"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"12638","DOI":"10.1038\/s41598-021-91977-8","article-title":"Effects of transcranial direct current stimulation combined with listening to preferred music on memory in older adults","volume":"11","author":"Chow","year":"2021","journal-title":"Sci. Rep."},{"key":"ref7","doi-asserted-by":"publisher","first-page":"165","DOI":"10.1007\/s00106-019-0617-7","article-title":"Hearing interventions to prevent dementia","volume":"67","author":"Dawes","year":"2019","journal-title":"HNO"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"104339","DOI":"10.1016\/j.amjoto.2024.104339","article-title":"Current practices and opinions on auditory training in adult cochlear implant recipients","volume":"45","author":"Dornhoffer","year":"2024","journal-title":"Am. J. Otolaryngol."},{"key":"ref9","doi-asserted-by":"publisher","first-page":"256","DOI":"10.1093\/ijnp\/pyaa051","article-title":"Evidence-based guidelines and secondary meta-analysis for the use of transcranial direct current stimulation in neurological and psychiatric disorders","volume":"24","author":"Fregni","year":"2021","journal-title":"Int. J. Neuropsychopharmacol."},{"key":"ref10","doi-asserted-by":"publisher","first-page":"409","DOI":"10.1093\/geronb\/gbac148","article-title":"Age-Related hearing Loss, cognitive performance, and metabolic risk in healthy adults: a seven-year longitudinal study","volume":"78","author":"Ghisletta","year":"2023","journal-title":"J. Gerontol. B Psychol. Sci. Soc. Sci."},{"key":"ref11","doi-asserted-by":"publisher","first-page":"e0166208","DOI":"10.1371\/journal.pone.0166208","article-title":"The effects of compensatory auditory stimulation and high-definition transcranial direct current stimulation (HD-tDCS) on tinnitus perception - a randomized pilot study","volume":"11","author":"Henin","year":"2016","journal-title":"PLoS One"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"137","DOI":"10.1016\/bs.pbr.2020.09.001","article-title":"High definition transcranial direct current stimulation (HD-tDCS) for chronic tinnitus: outcomes from a prospective longitudinal large cohort study","volume":"263","author":"Jacquemin","year":"2021","journal-title":"Prog. Brain Res."},{"key":"ref13","doi-asserted-by":"publisher","first-page":"714","DOI":"10.1177\/1545968318787916","article-title":"Effects of electrical stimulation in tinnitus patients: conventional versus high-definition tDCS","volume":"32","author":"Jacquemin","year":"2018","journal-title":"Neurorehabil. Neural Repair"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"100963","DOI":"10.1016\/j.arr.2019.100963","article-title":"Age-related hearing loss and tinnitus, dementia risk, and auditory amplification outcomes","volume":"56","author":"Jafari","year":"2019","journal-title":"Ageing Res. Rev."},{"key":"ref15","doi-asserted-by":"publisher","first-page":"391","DOI":"10.1093\/brain\/awaa429","article-title":"Hearing and dementia: from ears to brain","volume":"144","author":"Johnson","year":"2021","journal-title":"Brain"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"53","DOI":"10.1016\/j.chc.2018.07.008","article-title":"Transcranial direct current stimulation: mechanisms and psychiatric applications","volume":"28","author":"Kenney-Jung","year":"2019","journal-title":"Child Adolesc. Psychiatr. Clin. N. Am."},{"key":"ref17","doi-asserted-by":"publisher","first-page":"e25399","DOI":"10.1371\/journal.pone.0025399","article-title":"Polarity-dependent transcranial direct current stimulation effects on central auditory processing","volume":"6","author":"Ladeira","year":"2011","journal-title":"PLoS One"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"811","DOI":"10.3917\/spub.187.0811","article-title":"D\u00e9terminants de la qualit\u00e9 de vie des sujets \u00e2g\u00e9s pr\u00e9sentant Une d\u00e9ficience auditive [determinants of the quality of life of the hearing-impaired elderly]","volume":"30","author":"Lazzarotto","year":"2018","journal-title":"Sante Publique"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"136","DOI":"10.1016\/j.neurom.2024.06.001","article-title":"Perceptual and cognitive effects of focal transcranial direct current stimulation of auditory cortex in tinnitus","volume":"28","author":"Leaver","year":"2025","journal-title":"Neuromodulation"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"95","DOI":"10.1056\/NEJMc2406363","article-title":"Age-Related hearing Loss","volume":"391","author":"Lin","year":"2024","journal-title":"N. Engl. J. Med."},{"key":"ref21","doi-asserted-by":"publisher","first-page":"369","DOI":"10.1001\/archinternmed.2011.728","article-title":"Hearing loss and falls among older adults in the United States","volume":"172","author":"Lin","year":"2012","journal-title":"Arch. Intern. Med."},{"key":"ref22","doi-asserted-by":"publisher","first-page":"413","DOI":"10.1016\/S0140-6736(20)30367-6","article-title":"Dementia prevention, intervention, and care: 2020 report of the lancet commission","volume":"396","author":"Livingston","year":"2020","journal-title":"Lancet"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"115","DOI":"10.1001\/jamaoto.2017.2513","article-title":"Association of Age-Related Hearing Loss with Cognitive Function, cognitive impairment, and dementia: a systematic review and Meta-analysis","volume":"144","author":"Loughrey","year":"2018","journal-title":"JAMA Otolaryngol. Head Neck Surg."},{"key":"ref24","doi-asserted-by":"publisher","first-page":"760","DOI":"10.1177\/0300060516630843","article-title":"Anodal transcranial direct current stimulation over the auditory cortex improved hearing impairment in a patient with brainstem encephalitis","volume":"44","author":"Mori","year":"2016","journal-title":"J. Int. Med. Res."},{"key":"ref25","doi-asserted-by":"publisher","first-page":"166","DOI":"10.4103\/nah.nah_5_22","article-title":"Influence of auditory training on acceptable noise level scores in elderly persons with hearing impairment","volume":"24","author":"Nakshathri","year":"2022","journal-title":"Noise Health"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"633","DOI":"10.1111\/j.1469-7793.2000.t01-1-00633.x","article-title":"Excitability changes induced in the human motor cortex by weak transcranial direct current stimulation","volume":"527","author":"Nitsche","year":"2000","journal-title":"J. Physiol."},{"key":"ref27","doi-asserted-by":"publisher","first-page":"1416","DOI":"10.1097\/AUD.0000000000001205","article-title":"Hearing Loss and cognitive function: baseline findings from the Brazilian longitudinal study of adult health: ELSA-Brasil","volume":"43","author":"Samelli","year":"2022","journal-title":"Ear Hear."},{"key":"ref28","doi-asserted-by":"publisher","first-page":"835","DOI":"10.6061\/clinics\/2014(12)08","article-title":"Effects of auditory training in individuals with high-frequency hearing loss","volume":"69","author":"Santos","year":"2014","journal-title":"Clinics (Sao Paulo)"},{"key":"ref29","doi-asserted-by":"publisher","first-page":"10","DOI":"10.1055\/s-0041-1725997","article-title":"Age-Related hearing Loss and the development of cognitive impairment and late-life depression: a scoping overview","volume":"42","author":"Sharma","year":"2021","journal-title":"Semin. Hear."},{"key":"ref30","doi-asserted-by":"publisher","first-page":"410","DOI":"10.1177\/1545968313508655","article-title":"Randomized trial of transcranial direct current stimulation and hearing aids for tinnitus management","volume":"28","author":"Shekhawat","year":"2014","journal-title":"Neurorehabil. Neural Repair"},{"key":"ref31","doi-asserted-by":"publisher","first-page":"164","DOI":"10.1177\/1545968312459908","article-title":"Transcranial direct current stimulation intensity and duration effects on tinnitus suppression","volume":"27","author":"Shekhawat","year":"2013","journal-title":"Neurorehabil. Neural Repair"},{"key":"ref32","doi-asserted-by":"publisher","first-page":"8311","DOI":"10.1038\/s41598-018-26665-1","article-title":"Optimization of transcranial direct current stimulation of dorsolateral prefrontal cortex for tinnitus: a non-linear dose-response effect","volume":"8","author":"Shekhawat","year":"2018","journal-title":"Sci. Rep."},{"key":"ref33","doi-asserted-by":"publisher","first-page":"810","DOI":"10.1016\/j.tins.2020.07.005","article-title":"The effects of age-related hearing loss on the brain and cognitive function","volume":"43","author":"Slade","year":"2020","journal-title":"Trends Neurosci."},{"key":"ref34","doi-asserted-by":"publisher","first-page":"351","DOI":"10.1159\/000275062","article-title":"Current trends in treating hearing loss in elderly people: a review of the technology and treatment options\u2013a mini-review","volume":"56","author":"Sprinzl","year":"2010","journal-title":"Gerontology"},{"key":"ref35","doi-asserted-by":"publisher","first-page":"697","DOI":"10.1097\/AUD.0000000000000806","article-title":"Auditory training supports auditory rehabilitation: a state-of-the-art review","volume":"41","author":"Stropahl","year":"2020","journal-title":"Ear Hear."},{"key":"ref36","doi-asserted-by":"publisher","first-page":"S1","DOI":"10.1002\/ohn.750","article-title":"Clinical practice guideline: age-related hearing loss","volume":"170","author":"Tsai Do","year":"2024","journal-title":"Otolaryngol. Head Neck Surg."},{"key":"ref37","doi-asserted-by":"publisher","first-page":"947.e1","DOI":"10.1016\/j.jvoice.2018.07.004","article-title":"The influence of auditory feedback and vocal rehabilitation on Prelingual hearing-impaired individuals post Cochlear implant","volume":"33","author":"Ubrig","year":"2019","journal-title":"J. Voice"},{"key":"ref38","doi-asserted-by":"publisher","first-page":"531","DOI":"10.3390\/brainsci10080531","article-title":"Effects of transcranial electrical stimulation on human auditory processing and behavior-a review","volume":"10","author":"Wang","year":"2020","journal-title":"Brain Sci."},{"key":"ref39","doi-asserted-by":"publisher","first-page":"115183","DOI":"10.1016\/j.psychres.2023.115183","article-title":"Effect of HD-tDCS on white matter integrity and associated cognitive function in chronic schizophrenia: a double-blind, sham-controlled randomized trial","volume":"324","author":"Xu","year":"2023","journal-title":"Psychiatry Res."},{"key":"ref40","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.joto.2016.03.004","article-title":"Safety and outcomes of cochlear implantation in the elderly: a review of recent literature","volume":"11","author":"Yang","year":"2016","journal-title":"J. Otol."},{"key":"ref41","doi-asserted-by":"publisher","first-page":"2137","DOI":"10.1038\/s41598-018-20496-w","article-title":"The risk of cognitive impairment associated with hearing function in older adults: a pooled analysis of data from eleven studies","volume":"8","author":"Yuan","year":"2018","journal-title":"Sci. Rep."}],"container-title":["Frontiers in Aging Neuroscience"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fnagi.2025.1591496\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,1]],"date-time":"2025-09-01T05:31:59Z","timestamp":1756704719000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fnagi.2025.1591496\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,1]]},"references-count":41,"alternative-id":["10.3389\/fnagi.2025.1591496"],"URL":"https:\/\/doi.org\/10.3389\/fnagi.2025.1591496","relation":{},"ISSN":["1663-4365"],"issn-type":[{"value":"1663-4365","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9,1]]},"article-number":"1591496"}}