Hyperacusis in children: a preliminary study on the effects of hypersensitivity to sound on speech and language

There is a growing awareness that children may experience hyperacusis, a condition that is often associated with behavioral and developmental disorders. This preliminary study was aimed to investigate the effects of hyperacusis alone on various components of speech and language in children without developmental disorders. This study was conducted on 109 children aged between 4 and 7 years attending kindergarten and primary school. Hyperacusis was assessed through behavioral observation of children and questionnaires for parents. Different components of speech and language were assessed through specific tests. Hyperacusis was diagnosed in fifteen children (13.8%); ten (66.7%) were attending primary school and five (33.3%) kindergarten. A significant difference between children with and without hyperacusis was found for tests evaluating the average number of words in a sentence and phonemic fluency; older children appeared to have more difficulties. Several differences in education profiles were found: parents of children with hyperacusis spent less time with their children compared to parents of children without hyperacusis. Our preliminary results suggest some difficulties in lexical access and the use of shorter sentences by children with hypersensitivity to sound; however, the small size of our sample and the largely unknown interactions between hyperacusis and developmental disorders suggest caution when interpreting these results. Further studies on larger samples are necessary to gain additional knowledge on the effects of hyperacusis on speech and language in children without developmental disorders

Characteristics of somatic tinnitus patients with and without hyperacusis

Objective: Determine if somatic tinnitus patients with hyperacusis have different characteristics from those without hyperacusis. Patients and methods: 172 somatic tinnitus patients with (n = 82) and without (n = 90) hyperacusis referred to the Tinnitus Unit of Sapienza University of Rome between June 2012 and June 2016 were compared for demographic characteristics, tinnitus features, self-administered questionnaire scores, nature of somatic modulation and history. Results: Compared to those without hyperacusis, patients with somatic tinnitus and hyperacusis: (a) were older (43.38 vs 39.12 years, p = 0.05), (b) were more likely to have bilateral tinnitus (67.08% vs 55.56%, p = 0.04), (c) had a higher prevalence of somatic modulation of tinnitus (53.65% vs 36.66%, p = 0.02) and (d) scored significantly worse on tinnitus annoyance (39.34 vs 22.81, p<0.001) and subjective hearing level (8.04 vs 1.83, p<0.001). Conclusion: Our study shows significantly higher tinnitus modulation and worse self-rating of tinnitus and hearing ability in somatic tinnitus patients with hyperacusis versus somatic tinnitus patients without hyperacusis. These differences could prove useful in developing a better understanding of the pathophysiology and establishing a course of treatment for these two groups of patients

Efficacy of Multi-Modal Migraine Prophylaxis Therapy on Hyperacusis Patients.

ObjectivesTo evaluate the efficacy of a multi-modal migraine prophylaxis therapy for patients with hyperacusis.MethodsIn a prospective cohort, patients with hyperacusis were treated with a multi-modal step-wise migraine prophylactic regimen (nortriptyline, verapamil, topiramate, or a combination thereof) as well as lifestyle and dietary modifications. Pre- and post-treatment average loudness discomfort level (LDL), hyperacusis discomfort level measured by a visual analogue scale (VAS), and scores on the modified Khalfa questionnaire for severity of hyperacusis were compared.ResultsTwenty-two of the 25 patients (88%) reported subjective resolution of their symptoms following treatment. Post-treatment audiograms showed significant improvement in average LDL from 81.3 ± 3.2 dB to 86.4 ± 2.6 dB (P < .001), indicating increased sound tolerability. The VAS discomfort level also showed significant improvement from a pre-treatment average of 7.7 ± 1.1 to 3.7 ± 1.6 post-treatment (P < .001). There was also significant improvement in the average total score on modified Khalfa questionnaire (32.2 ± 3.6 vs 22.0 ± 5.7, P < .001).ConclusionsThe majority of patients with hyperacusis demonstrated symptomatic improvement from migraine prophylaxis therapy, as indicated by self-reported and audiometric measures. Our findings indicate that, for some patients, hyperacusis may share a pathophysiologic basis with migraine disorder and may be successfully managed with multimodal migraine prophylaxis therapy

New frontiers in tinnitus, hearing loss and hyperacusis

Although considerable progresses have been made in the recent years, there are still wide-open pathways for research in tinnitus, hearing loss and hyperacusis. Among them, I’d like to put particular focus on basic and clinical research on the predisposing elements to ac- quired hearing loss to favour understanding in prevention and treatment, on the exploration of the pathophysiological basis of tinnitus necessary for future possible treatments, and on the correlation between tinnitus and hyperacusis, an interesting direction that could rise questions and give answers to identify target mechanisms able to help in therapeutic strategies

Hearing loss, tinnitus, hyperacusis, and diplacusis in professional musicians: a systematic review

Professional musicians (PMs) are at high risk of developing hearing loss (HL) and other audiological symptoms such as tinnitus, hyperacusis, and diplacusis. The aim of this systematic review is to (A) assess the risk of developing HL and audiological symptoms in PMs and (B) evaluate if different music genres (Pop/Rock Music-PR; Classical Music-CL) expose PMs to different levels of risk of developing such conditions. Forty-one articles including 4618 PMs were included in the study. HL was found in 38.6% PMs; prevalence was significantly higher among PR (63.5%) than CL (32.8%) PMs; HL mainly affected the high frequencies in the 3000-6000 Hz range and was symmetric in 68% PR PMs and in 44.5% CL PMs. Tinnitus was the most common audiological symptom, followed by hyperacusis and diplacusis. Tinnitus was almost equally distributed between PR and CL PMs; diplacusis was more common in CL than in PR PMs, while prevalence of hyperacusis was higher among PR PMs. Our review showed that PR musicians have a higher risk of developing HL compared to CL PMs; exposure to sounds of high frequency and intensity and absence of ear protection may justify these results. Difference in HL symmetry could be explained by the type of instruments used and consequent single-sided exposure

Somatic tinnitus

Modulation of tinnitus characteristics such as pitch and loudness has been extensively described following movements of the head, neck and limbs, vertical or horizontal eye gaze, pressure on myofascial trigger points, cutaneous stimulation of the hands, electrical stimulation of the median nerve, and transcranial direct current stimulation. Modulation of tinnitus follows complex interactions between auditory and somatosensory afferents and can be favored by underlying somatic disorders. When tinnitus appears to be preceded or strictly linked to a somatic disorder, and therefore related to problems of the musculoskeletal system rather than of the ear, it is defined somatic tinnitus. A correct diagnosis and treatment of somatic disorders underlying tinnitus play a central role for a correct management of somatic tinnitus. However, the identification of somatic tinnitus may be complex in some cases. In this paper, after a general review of the current evidences for somatic tinnitus available in the literature, we present and discuss some cases of patients in which somatic modulation of tinnitus played a role - although different from case to case - in their tinnitus, describing the diagnostic and therapeutic approaches followed in each individual case and the results obtained, also highlighting unexpected findings and pitfalls that may be encountered when approaching somatic tinnitus patients

Gender and Ethnic Differences in Sound Tolerance

Gender and Ethnic Differences in Sound Tolerance Nicole Concepcion, Depts. of Psychology, Social Work, and Human Resource Management, and Rachel Wallace, M.S., Dept. of Psychology Graduate Student, with Dr. Scott Vrana, Dept. of Psychology Misophonia, hyperacusis, and tinnitus are related to decreased sound tolerance (DST). Misophonia is characterized as strong aversive reactions to specific sounds. Hyperacusis is a heightened sensitivity to certain sounds below the loudness sensitivity levels. Tinnitus is a condition that includes continuous ringing or buzzing in the ears. Current research has shown that misophonia symptoms have many commonalities with psychiatric diagnoses and these symptoms result in substantial functional disability and lower quality of life. In the growing literature, there are some questions that need to be answered. The questions sought to be answered in this study are: what is the prevalence of the DST conditions? Are there any significant ethnic and gender differences for those who endorse misophonia, hyperacusis, or tinnitus? Can these differences be corroborated by current health items, like anxiety? To answer these questions, a large scale survey (n= 1,200) was examined by conducting chi-square, independent samples t-test, and ANOVA analyses. The findings indicate there were significant gender and racial differences among hyperacusis and misophonia. Women reported more negative responses towards misophonia and hyperacusis. This is consistent with the past findings that women report higher anxiety. White participants endorsed all DST conditions more than any other group. These findings promote further research.https://scholarscompass.vcu.edu/uresposters/1349/thumbnail.jp

Counseling for Patients with Hyperacusis

Hyperacusis is the phenomenon of experiencing moderately loud sounds as overly loud and/or intensely annoying. Hyperacusis can also cause fear or pain in response to sound. There is no one known cause of hyperacusis, and because of the variety of ways it presents itself, the approximate prevalence is difficult to determine. Despite the ambiguity of hyperacusis, the audiologist is an important part of diagnosing and educating clients with hyperacusis. During this project we aimed to discover the challenges individuals with hyperacusis face. These include anxiety, depression and avoidance behavior, and sometimes co-occurring tinnitus and hearing loss. Another aim was to evaluate effective counseling techniques for hyperacusis, and furthermore, how effective individuals perceive these techniques to be. We found that meditation and progressive relaxation techniques, and sound therapy are most effective for managing hyperacusis symptoms. Participants reported that the educational counseling materials developed during this project were very useful. Counseling materials were adapted for hyperacusis from the Tinnitus Activities Treatment developed by Richard Tyler and covered the definition and types of hyperacusis, effects of hyperacusis on life, and management strategies. We hope the development of these materials and the results of interviewing individuals with hyperacusis can aid audiologists in educating and counseling clients with hyperacusis symptoms

Somatic modulation of tinnitus: a review and some open questions

Tinnitus modulation by movements of the temporomandibular joint, head and neck musculoskeletal structures and the eye, can be found in one to two thirds of tinnitus sufferers; unfortunately this condition is often overlooked by otolaryngologists. Although somatic modulation has been initially hypothesized as a fundamental characteristic of tinnitus, there is increasing evidence of a tight connection with disorders of non-auditory regions. The structure that mostly modulates tinnitus is the temporomandibular joint, which mainly causes an increase in tinnitus loudness, followed by head and neck movements that may result in an increase or decrease of loudness and eye movements (gaze-evoked tinnitus). Besides loudness, somatic movements can also modulate tinnitus pitch and localization. Somatosensory tinnitus is a relatively new nding that leaves several open questions: are there individual predisposing factors to somatic modulation? How strong is the association between the capability to somatically modulate tinnitus and an underlying non-auditory disorder? Changes that occur after somatic maneuvers are only transitory? Why patients that have concomitant hyperacusis also have higher chances of tinnitus modulation? Further basic science and clinical research is required to address these and many other questions about somatosensory tinnitus