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The European Journal of Neuroscience Mar 2021Phonophobia in migraineurs may be due to lower hearing threshold (HT) and higher brainstem neuronal excitability. We report the correlation of phonophobia in migraineurs...
Phonophobia in migraineurs may be due to lower hearing threshold (HT) and higher brainstem neuronal excitability. We report the correlation of phonophobia in migraineurs with HT, brain stem auditory evoked potential (BAEP) findings, and auditory triggers. Sixty-one migraineurs and 101 controls were included for HT, of whom 59 migraineurs and 31 controls had BAEP studies. Clinical details, migraine triggers, and headache frequency were noted. Hearing threshold was measured, and amplitudes of waves I to V of BAEP studies were measured. Migraineurs had lower HT compared with controls (41.61 ± 5.25 versus 45.39 ± 6.26 dB; p < 0.001) especially in chronic migraine (40.24 ± 4.81; p < 0.001). Hearing threshold correlated with headache frequency (p < 0.05) and auditory, visual, and tactile (p < 0.05) triggers. Hearing threshold was lower during headache (p < 0.001). Wave II, III, and IV amplitudes of BAEP were higher in migraineurs than the controls. Wave II (p < 0.05) and III (p < 0.05) amplitudes correlated with HT. Migraineurs have lower HT, especially in those having chronic migraine, ictal HT recording, and multiple sensory triggers. Higher amplitudes of BAEP waves in migraineurs and their relationship with the frequency of headache and HT suggest the sensitization of brainstem auditory neurons.
Topics: Brain Stem; Evoked Potentials, Auditory, Brain Stem; Humans; Hyperacusis; Migraine Disorders
PubMed: 33305448
DOI: 10.1111/ejn.15078 -
American Journal of Audiology Sep 2022For some people, exposure to everyday sounds presents a significant problem. The purpose of this tutorial was to define and differentiate between the various sound... (Review)
Review
UNLABELLED
For some people, exposure to everyday sounds presents a significant problem. The purpose of this tutorial was to define and differentiate between the various sound tolerance conditions and to review some options for their clinical management.
METHOD
We informally reviewed the literature regarding sound tolerance conditions. The terminology and definitions provided are mostly consistent with how these terms are defined. However, many inconsistencies are noted. Methods of assessment and treatment also differ, and different methodologies are briefly described.
RESULTS
describes physical discomfort or pain when any sound reaches a certain level of loudness that would be tolerable for most people. refers to intense emotional reactions to certain sounds (often body sounds such as chewing and sniffing) that are not influenced by the perceived loudness of those sounds. refers to increased reactivity to sounds that may include general discomfort (annoyance or feeling overwhelmed) due to a perceived noisy environment, regardless of its loudness. as addressed in the audiology profession, describes anticipatory fear of sound. Phonophobia is an emotional response such as anxiety and avoidance of sound due to the "fear" that sound(s) may occur that will cause a comorbid condition to get worse (e.g., tinnitus) or the sound itself will result in discomfort or pain. (Note that is a term used by neurologists to describe "migraineur phonophobia"-a different condition not addressed herein.) Conclusions: The literature addresses sound tolerance conditions but reveals many inconsistencies, indicating lack of consensus in the field. When doing an assessment for decreased sound tolerance, it is important to define any terms used so that the patient and all health care professionals involved in the care of the patient are aligned with the goals of the treatment plan. Treatment generally involves gradual and systematic sound desensitization and counseling.
SUPPLEMENTAL MATERIAL
https://doi.org/10.23641/asha.20164130.
Topics: Anxiety; Humans; Hyperacusis; Pain; Sound; Tinnitus
PubMed: 35858241
DOI: 10.1044/2022_AJA-22-00035 -
Acta Oto-laryngologica Jul 2020Epidemiological studies have shown different association between migraine and Meniere's disease (MD). Few studies investigated the frequency of phonophobia in MD. This...
Epidemiological studies have shown different association between migraine and Meniere's disease (MD). Few studies investigated the frequency of phonophobia in MD. This study aimed to determine the frequency of phonophobia and other features of migraine in definite MD. Patients with definite MD and a group of healthy (non-MD, non-vertiginous) control subjects participated. Demographic data and other clinical features of the two diseases recorded. Data analyzed in SPSS software version 20, by qi square and independent T test and logistic regression model. 69 MD patients (average age: 48.87 ± 12.15 years) and 60 control subjects (average age: 47.58 ± 12.05 years) enrolled. The frequency of migraine headache in MD cases was 16% (45% with aura) compared with 5% in control group (three cases; 2 without and 1 with aura) ( < .001). Family history of migraine was the only determinant of the presence of migraine in MD ( = .001, OR = 15.625, 95%CI: 2.94-88.33). The frequency of phonophobia in MD was very high (88.4%: 54.5% in migraine subgroup and 89.6% in non-migraine cases) and without significant relation to existence of migraine, in contrast to photophobia and osmophobia ( = .064). The frequency of migraine in MD is higher than normal subjects. Phonophobia may be an independent symptom in MD.
Topics: Adult; Aged; Case-Control Studies; Female; Humans; Hyperacusis; Iran; Logistic Models; Male; Meniere Disease; Middle Aged; Migraine Disorders
PubMed: 32281461
DOI: 10.1080/00016489.2020.1749299 -
Cephalalgia : An International Journal... Nov 2022Past studies do not account for avoidance behaviour in migraine as a potential confounder of phonophobia.
BACKGROUND
Past studies do not account for avoidance behaviour in migraine as a potential confounder of phonophobia.
OBJECTIVE
To analyse whether phonophobia is partially driven by avoidance behaviour when using the classic methodology (method of limits).
METHODS
This is a case-control study where we tested phonophobia in a cohort of high-frequency/chronic migraine patients (15.5 ± 0.74 headache days/month) and non-headache controls. Auditory stimuli, delivered in both ears, were presented using three different paradigms: the method of limits, the method of constant stimuli, and the adaptive method. Participants were asked to report how bothersome each tone was until a sound aversion threshold was estimated for each method.
RESULTS
In this study, we successfully replicate previously reported reduction in sound aversion threshold using three different methods in a group of 35 patients and 25 controls (p < 0.0001). Avoidance behaviour in migraine reduced sound aversion threshold in the method of limits (p = 0.0002) and the adaptive method (p < 0.0001) when compared to the method of constant stimuli. While thresholds in controls remained the same across methods (method of limits, p = 0.9877 and adaptive method, p = 1).
CONCLUSION
Avoidance behaviour can exacerbate phonophobia. The current methodology to measure phonophobia needs to be revised.
Topics: Humans; Hyperacusis; Case-Control Studies; Avoidance Learning; Migraine Disorders
PubMed: 35815637
DOI: 10.1177/03331024221111772 -
HNO Dec 2003Hypersensitivity to sound is a common description of distinct nosological phenomena of peripheral and central hearing disorders, which are characterized by intense... (Review)
Review
Hypersensitivity to sound is a common description of distinct nosological phenomena of peripheral and central hearing disorders, which are characterized by intense suffering from the acoustic environment. One can distinguish between recruitment accompanying inner ear hearing loss, hyperacusis with a general hypersensitivity to sound of any frequency, and phonophobia as an anxious sensitivity towards specific sound largely independent of its volume. While recruitment can be described as a peripheral reaction caused by a lack of outer hair cell moderation, hyperacusis and phonophobia represent disturbances of central auditory processing without peripheral pathology, often combined with psychosomatic reactions. Due to insufficient efferent inhibition, hyperacusis often follows psychovegetative exhaustion. In cases of phonophobia, peripheral and efferent hearing functions are usually intact, but certain learning (conditioning) processes lead to development of specific reactions and avoidance patterns to certain content-related acoustic stimuli. This article describes those different phenomena with regard to their clinical appearance, diagnostics, and possibilities for therapy.
Topics: Anxiety; Auditory Pathways; Depression; Diagnosis, Differential; Hearing Disorders; Humans; Hyperacusis; Life Change Events; Patient Care Team; Recruitment Detection, Audiologic
PubMed: 14647932
DOI: 10.1007/s00106-003-0967-y -
Journal of the American Academy of... Mar 2018
Topics: Humans; Hyperacusis; Self-Injurious Behavior; Suicidal Ideation; Tinnitus
PubMed: 29488869
DOI: 10.3766/jaaa.29.3.1 -
Journal of the Royal Society of Medicine Dec 2003
Review
Topics: Disabled Persons; Humans; Hyperacusis; Psychotherapy; Tinnitus
PubMed: 14645606
DOI: 10.1177/014107680309601203 -
Journal of Neurology, Neurosurgery, and... Nov 2010To determine whether phonophobia and dynamic mechanical (brush) allodynia are associated in episodic migraine (EM).
OBJECTIVE
To determine whether phonophobia and dynamic mechanical (brush) allodynia are associated in episodic migraine (EM).
METHODS
Adult patients with EM were prospectively recruited. A structured questionnaire was used to obtain demographic and migraine related data. Phonophobia was tested quantitatively using a real time sound processor and psychoacoustic software. Sound stimuli were pure tones at frequencies of 1000 Hz, 4000 Hz and 8000 Hz, delivered to both ears at increasing intensities, until an aversive level was reached. Allodynia was assessed by brushing the patient's skin with a gauze pad at different areas. Patients were tested both between and during acute attacks. Sound aversion thresholds (SATs) in allodynic and non-allodynic patients were compared.
RESULTS
Between attacks, SATs were lower in allodynic compared with non-allodynic patients, with an average difference of -5.7 dB (p=0.04). During acute attacks, the corresponding average SAT difference (allodynic-non-allodynic) was -15.7 dB (p=0.0008). There was a significant negative correlation between allodynia scores and SATs, both within and between attacks.
CONCLUSIONS
The results support an association between phonophobia and cutaneous allodynia in migraine.
Topics: Acoustic Stimulation; Acute Disease; Adolescent; Adult; Auditory Threshold; Female; Humans; Hyperacusis; Hyperalgesia; Male; Middle Aged; Migraine with Aura; Migraine without Aura; Physical Stimulation; Psychoacoustics; Surveys and Questionnaires; Young Adult
PubMed: 20562466
DOI: 10.1136/jnnp.2009.198481 -
Lin Chuang Er Bi Yan Hou Tou Jing Wai... Jun 2021Hyperacusis refers to the experience of the sound environment being perceived as overwhelmingly loud or painful, and this can severely affect the patient's quality of... (Review)
Review
Hyperacusis refers to the experience of the sound environment being perceived as overwhelmingly loud or painful, and this can severely affect the patient's quality of life. In China little attention has been paid to hyperacusis, and there has been little research undertaken on the topic. Therefore, this article summarizes the recent research on hyperacusis regarding definition, epidemiology, etiology, mechanism, evaluation and treatment to give directions for future research.
Topics: China; Humans; Hyperacusis; Quality of Life; Sound; Tinnitus
PubMed: 34304521
DOI: 10.13201/j.issn.2096-7993.2021.06.018 -
Neuroscience May 2019Many, or most, tinnitus models rely on increased central gain in the auditory pathway as all or part of the explanation, in that central auditory neurones deprived of... (Review)
Review
Many, or most, tinnitus models rely on increased central gain in the auditory pathway as all or part of the explanation, in that central auditory neurones deprived of their usual sensory input maintain homeostasis by increasing the rate at which they fire in response to any given strength of input, including amplifying spontaneous firing which forms the basis of tinnitus. However, dramatic gain changes occur in response to damage to the auditory periphery, irrespective of whether tinnitus occurs. This article considers gain in its broadest sense, summarizes its contributory processes, neural manifestations, behavioral effects, techniques for its measurement, pitfalls in attributing gain changes to tinnitus, a discussion of the minimum evidential requirements to implicate gain as a necessary and/or sufficient basis to explain tinnitus, and the extent of existing evidence in this regard. Overall there is compelling evidence that peripheral auditory insults induce changes in neuronal firing rates, synchrony and neurochemistry and thus increase gain, but specific attribution of these changes to tinnitus is generally hampered by the absence of hearing-matched human control groups or insult-exposed non-tinnitus animals. A few studies show changes specifically attributable to tinnitus at group level, but the limited attempts so far to classify individual subjects based on gain metrics have not proven successful. If gain turns out to be unnecessary or insufficient to cause tinnitus, candidate additional mechanisms include focused attention, resetting of sensory predictions, failure of sensory gating, altered sensory predictions, formation of pervasive memory traces and/or entry into global perceptual networks. This article is part of a Special Issue entitled: Hearing Loss, Tinnitus, Hyperacusis, Central Gain.
Topics: Acoustic Stimulation; Animals; Auditory Pathways; Cochlea; Hearing; Humans; Hyperacusis; Tinnitus
PubMed: 30690137
DOI: 10.1016/j.neuroscience.2019.01.027