-
Frontiers in Neuroscience 2023Clinical observations of hundreds of patients who exhibited decreased tolerance to sound showed that many of them could not be diagnosed as having hyperacusis when... (Review)
Review
Clinical observations of hundreds of patients who exhibited decreased tolerance to sound showed that many of them could not be diagnosed as having hyperacusis when negative reactions to a sound depend only on its physical characteristics. In the majority of these patients, the physical characteristics of bothersome sounds were secondary, and patients were able to tolerate other sounds with levels higher than sounds bothersome for them. The dominant feature determining the presence and strength of negative reactions are specific to a given patient's patterns and meaning of bothersome sounds. Moreover, negative reactions frequently depend on the situation in which the offensive sound is presented or by whom it is produced. Importantly, physiological and emotional reactions to bothersome sounds are very similar (even identical) for both hyperacusis and misophonia, so reactions cannot be used to diagnose and differentiate them. To label this non-reported phenomenon, we coined the term misophonia in 2001. Incorporating clinical observations into the framework of knowledge of brain functions allowed us to propose a neurophysiological model for misophonia. The observation that the physical characterization of misophonic trigger was secondary and frequently irrelevant suggested that the auditory pathways are working in identical manner in people with as in without misophonia. Descriptions of negative reactions indicated that the limbic and sympathetic parts of the autonomic nervous systems are involved but without manifestations of general malfunction of these systems. Patients with misophonia could not control internal emotional reactions (even when fully realizing that these reactions are disproportionate to benign sounds evoking them) suggesting that subconscious, conditioned reflexes linking the auditory system with other systems in the brain are the core mechanisms of misophonia. Consequently, the strength of functional connections between various systems in the brain plays a dominant role in misophonia, and the functional properties of the individual systems may be perfectly within the norms. Based on the postulated model, we proposed a treatment for misophonia, focused on the extinction of conditioned reflexes linking the auditory system with other systems in the brain. Treatment consists of specific counseling and sound therapy. It has been used for over 20 years with a published success rate of 83%.
PubMed: 37034168
DOI: 10.3389/fnins.2023.895574 -
Journal of Clinical Medicine May 2024Migraine is a prevalent episodic brain disorder known for recurrent attacks of unilateral headaches, accompanied by complaints of photophobia, phonophobia, nausea, and... (Review)
Review
Migraine is a prevalent episodic brain disorder known for recurrent attacks of unilateral headaches, accompanied by complaints of photophobia, phonophobia, nausea, and vomiting. Two main categories of migraine are migraine with aura (MA) and migraine without aura (MO). Early twin and population studies have shown a genetic basis for these disorders, and efforts have been invested since to discern the genes involved. Many techniques, including candidate-gene association studies, loci linkage studies, genome-wide association, and transcription studies, have been used for this goal. As a result, several genes were pinned with concurrent and conflicting data among studies. It is important to understand the evolution of techniques and their findings. This review provides a chronological understanding of the different techniques used from the dawn of migraine genetic investigations and the genes linked with the migraine subtypes.
PubMed: 38731230
DOI: 10.3390/jcm13092701 -
Life (Basel, Switzerland) Jan 2021(1) Background: Decreased sound tolerance is a significant problem in tinnitus sufferers. The aim of the study was to evaluate the relationship between tinnitus and...
(1) Background: Decreased sound tolerance is a significant problem in tinnitus sufferers. The aim of the study was to evaluate the relationship between tinnitus and decreased sound tolerance (hyperacusis and misophonia). (2) Methods: The study sample consisted of 74 patients with tinnitus and decreased sound tolerance. The procedure comprised patient interviews, pure tone audiometry, impedance audiometry, measurement of uncomfortable loudness levels, and administration of the Hyperacusis Questionnaire, Tinnitus Handicap Inventory, and Visual Analogue Scales. (3) Results: The majority (69%) of the patients reported that noise aggravated their tinnitus. The correlation between tinnitus and hyperacusis was found to be statistically significant and positive: = 0.44; < 0.01. The higher the tinnitus severity, the greater the hyperacusis. There was no correlation between misophonia and hyperacusis ( = 0.18; > 0.05), or between misophonia and tinnitus ( = 0.06; > 0.05). (4) Conclusions: For tinnitus patients the more significant problem was hyperacusis rather than misophonia. The diagnosis and treatment of decreased sound tolerance should take into account not only audiological, but also psychological problems of the patients.
PubMed: 33530474
DOI: 10.3390/life11020087 -
Ugeskrift For Laeger Jan 2021Superior semicircular canal dehiscence syndrome (SCDS) is caused by a bony defect of the superior semicircular canal. The bony defect allows low-frequency acoustic... (Review)
Review
Superior semicircular canal dehiscence syndrome (SCDS) is caused by a bony defect of the superior semicircular canal. The bony defect allows low-frequency acoustic stimuli of high intensity to travel to the vestibular organ. This can be induced by sound stimuli or pressure stimuli leading to vertigo, torsional nystagmus, pulsatile tinnitus, hyperacusis, hearing loss and autophony. SCDS is diagnosed with provocative testing, audiometry, CT-scan, vestibular evoked myogenic potentials and electrocochleography. Treatment is conservative, however, surgery with occlusion of the defect can be necessary for debilitating symptoms, as argued in this review.
Topics: Humans; Nystagmus, Pathologic; Semicircular Canal Dehiscence; Semicircular Canals; Vertigo; Vestibular Evoked Myogenic Potentials
PubMed: 33491628
DOI: No ID Found -
Journal of the American Academy of... Sep 2020Hyperacusis is a prevalent auditory disorder that causes significant distress and negatively affects quality of life for many patients. Patients with hyperacusis often...
BACKGROUND
Hyperacusis is a prevalent auditory disorder that causes significant distress and negatively affects quality of life for many patients. Patients with hyperacusis often have different complaints about the sounds and situations that they experience. Audiologists may have few patients with hyperacusis, and a limited understanding of the sounds and situations that are reported to be challenging by their patients.
PURPOSE
To investigate the common complaints reported by hyperacusis patients.
RESEARCH DESIGN
A qualitative study was conducted with 11 hyperacusis patients who participated in a group session.
RESULTS
All 11 hyperacusis patients experienced negative reactions to specific sounds. In addition, many patients reported physical symptoms such as headaches, balance problems, dysosmia (strong smell problems), and light sensitivity. Sounds that induced discomfort were wide ranging and included low-frequency sounds, high-frequency sounds, wide-band noise, and sudden, high-intensity sounds. Most patients (9/11, 81.8%) reported negative reactions to music in loud rock concerts. Patients reported that stress/tension (90.9%) worsened their hyperacusis, while removing themselves from noise (90.9%) relieved their hyperacusis.
CONCLUSION
Loudness is only one of the many factors related to the discomfort of patients with hyperacusis. Across patients, we observed that there were different complaints about the sounds and situations that produced difficulty due to hyperacusis. Physical symptoms following sound exposure were also reported by the patients, suggesting that hyperacusis is a complex disorder and requires intervention that often involves multiple members of the medical team.
Topics: Hearing Disorders; Humans; Hyperacusis; Noise; Quality of Life; Sound
PubMed: 32340056
DOI: 10.1055/s-0040-1709447 -
Journal of Clinical Medicine Jul 2020Many individuals with tinnitus report experiencing hyperacusis (enhanced sensitivity to sounds). However, estimates of the association between hyperacusis and tinnitus...
Many individuals with tinnitus report experiencing hyperacusis (enhanced sensitivity to sounds). However, estimates of the association between hyperacusis and tinnitus is lacking. Here, we investigate this relationship in a Swedish study. A total of 3645 participants (1984 with tinnitus and 1661 without tinnitus) were enrolled via LifeGene, a study from the general Swedish population, aged 18-90 years, and provided information on socio-demographic characteristics, as well as presence of hyperacusis and its severity. Tinnitus presence and severity were self-reported or assessed using the Tinnitus Handicap Inventory (THI). Phenotypes of tinnitus with ( = 1388) or without ( = 1044) hyperacusis were also compared. Of 1661 participants without tinnitus, 1098 (66.1%) were women and 563 were men (33.9%), and the mean (SD) age was 45.1 (12.9). Of 1984 participants with tinnitus, 1034 (52.1%) were women and 950 (47.9%) were men, and the mean (SD) age was 47.7 (14.0) years. Hyperacusis was associated with any tinnitus [Odds ratio (OR) 3.51, 95% confidence interval (CI) 2.99-4.13], self-reported severe tinnitus (OR 7.43, 95% CI 5.06-10.9), and THI ≥ 58 (OR 12.1, 95% CI 7.06-20.6). The association with THI ≥ 58 was greater with increasing severity of hyperacusis, the ORs being 8.15 (95% CI 4.68-14.2) for moderate and 77.4 (95% CI 35.0-171.3) for severe hyperacusis. No difference between sexes was observed in the association between hyperacusis and tinnitus. The occurrence of hyperacusis in severe tinnitus is as high as 80%, showing a very tight relationship. Discriminating the pathophysiological mechanisms between the two conditions in cases of severe tinnitus will be challenging, and optimized study designs are necessary to better understand the mechanisms behind the strong relationship between hyperacusis and tinnitus.
PubMed: 32731492
DOI: 10.3390/jcm9082412 -
Revue Neurologique Sep 2021Migraine is characterized by symptoms related to cortical hyperexcitability such as photophobia, phonophobia, osmophobia and allodynia. One-third of migraineurs... (Review)
Review
Migraine is characterized by symptoms related to cortical hyperexcitability such as photophobia, phonophobia, osmophobia and allodynia. One-third of migraineurs experience aura, whose neurophysiological substrate is thought to be cortical spreading depression (CSD). Functional magnetic resonance imaging (MRI) has shown the migraine aura to be characterized by cerebral hyperactivity/hyperperfusion followed by hypometabolism/hypoperfusion spreading along the occipital cortex with the same spatiotemporal organization as the experimentally triggered CSD. The link between migraine aura and headache remains undetermined. Neuroimaging studies have failed to show a leakage of the blood-brain barrier, which was suspected to occur during CSD and to cause the stimulation of trigeminal nociceptive receptors. However, recent studies have highlighted the involvement of neuroglial inflammation and other studies have suggested that a common central network plays a role in the link between CSD and migraine pain. Finally, MRI has made it possible to study the contribution of metabolites such as glutamic acid, γ-amino-butyric acid and sodium in the pathophysiology of hyperexcitability in migraine.
Topics: Cortical Spreading Depression; Headache; Humans; Magnetic Resonance Imaging; Migraine Disorders; Migraine with Aura
PubMed: 34332777
DOI: 10.1016/j.neurol.2021.07.008 -
International Journal of Audiology Oct 2022To determine if a positive test for COVID-19 is associated with self-reported audio-vestibular symptoms.
OBJECTIVE
To determine if a positive test for COVID-19 is associated with self-reported audio-vestibular symptoms.
DESIGN
Self-reported changes in hearing, tinnitus, hyperacusis, and dizziness/rotatory vertigo were assessed in hospitalised and non-hospitalised COVID-19 patients and the acute phase of the disease and compared to non-COVID controls.
STUDY SAMPLE
There were 150 severe cases of COVID-19 requiring hospital admission and 150 mild cases that were managed at home. Controls were 267 adults, 32 of whom had been hospitalised for a non-COVID-19 condition, and a further 85 who worked in hospital settings.
RESULTS
Deterioration in hearing and/or tinnitus was reported in 8% of the COVID-19 cases (tinnitus had resolved in 2% after the acute phase), with no significant difference between severe and mild cases. Deterioration in hearing or tinnitus was not significantly different from controls. However, rotatory vertigo was reported by 5% in the COVID-19 groups and 1.1% in the controls, and this difference was statistically significant.
CONCLUSIONS
There is no evidence that COVID-19 results in deterioration in hearing or tinnitus during the acute phase or after recovery in mild or severe cases. However, rotatory vertigo, which could be vestibular in origin, may be a clinical manifestation of COVID-19.
Topics: Adult; COVID-19; Dizziness; Humans; Self Report; Tinnitus; Vertigo
PubMed: 34370603
DOI: 10.1080/14992027.2021.1957161 -
Noise & Health 2022One of the most common hearing disorders is hyperacusis, characterized by decreased sound tolerance or noise sensitivity.
BACKGROUND
One of the most common hearing disorders is hyperacusis, characterized by decreased sound tolerance or noise sensitivity.
OBJECTIVE
The present paper aimed to evaluate the validity of the Persian version of the hyperacusis questionnaire.
METHODS
The sample was comprised of 434 students evaluated at the Kashan University of Medical Science, Isfahan, between July 2019 and February 2020. After translation and retranslation of questionnaire, the content validity was assessed by 15 occupational health experts using content validity index (CVI) and ratio (CVR). Validity and reliability of the scale were examined by using confirmatory factor analysis, the Cronbach alpha, composite reliability (CR), and the average variance extracted (AVE) tests.
RESULTS
: In the exploratory analysis of the Persian version of Khalfa hyperacusis questionnaire, 14 items were created based on three subscales) attentional, social, and emotional dimensions) which explained 46.5% of the total variances. Content validity of 14 questions was approved with CVR > 0.49 and CVI > 0.7. The Cronbach alpha, AVE, and CR indexes were calculated 0.811, 0.761, and 0.901, respectively, which showed that reliability of the scale was adequate.
CONCLUSIONS
: It was concluded that this Persian version of the hyperacusis questionnaire has relatively acceptable validity and reliability in Iran. Given that the tool has a small number of questions, it is easily used in different studies.
Topics: Humans; Hyperacusis; Psychometrics; Reproducibility of Results; Surveys and Questionnaires; Translations
PubMed: 36124529
DOI: 10.4103/nah.nah_16_22 -
Scientific Reports May 2021Misophonia is a condition where a strong arousal response is triggered when hearing specific human generated sounds, like chewing, and/or repetitive tapping noises, like...
Misophonia is a condition where a strong arousal response is triggered when hearing specific human generated sounds, like chewing, and/or repetitive tapping noises, like pen clicking. It is diagnosed with clinical interviews and questionnaires since no psychoacoustic tools exist to assess its presence. The present study was aimed at developing and testing a new assessment tool for misophonia. The method was inspired by an approach we have recently developed for hyperacusis. It consisted of presenting subjects (n = 253) with misophonic, pleasant, and unpleasant sounds in an online experiment. The task was to rate them on a pleasant to unpleasant visual analog scale. Subjects were labeled as misophonics (n = 78) or controls (n = 55) by using self-report questions and a misophonia questionnaire, the MisoQuest. There was a significant difference between controls and misophonics in the median global rating of misophonic sounds. On the other hand, median global rating of unpleasant, and pleasant sounds did not differ significantly. We selected a subset of the misophonic sounds to form the core discriminant sounds of misophonia (CDS). A metric: the CDS score, was used to quantitatively measure misophonia, both with a global score and with subscores. The latter could specifically quantify aversion towards different sound sources/events, i.e., mouth, breathing/nose, throat, and repetitive sounds. A receiver operating characteristic analysis showed that the method accurately classified subjects with and without misophonia (accuracy = 91%). The present study suggests that the psychoacoustic test we have developed can be used to assess misophonia reliably and quickly.
Topics: Adult; Affective Symptoms; Arousal; Emotions; Female; Humans; Hyperacusis; Male; Psychoacoustics; Self Report; Surveys and Questionnaires
PubMed: 34040061
DOI: 10.1038/s41598-021-90355-8