In a retrospective study analyzing case notes of 61 children with hyperacusis, it was found that 28 of the children, or 46% of the sample, had a concomitant neurodevelopmental condition, with the most common diagnosis being autism spectrum disorder. These diagnoses include a high number of psychiatric conditions such as post-traumatic stress disorder (PTSD), depression, and exhaustion syndrome as well as migraines, tinnitus, hearing loss, attention deficit hyperactivity disorder (ADHD), and autism spectrum disorder (ASD). It has been found that hyperacusis often accompanies other medical conditions. These findings have ranged from reports of 3.2% up to 17.1%. Prevalence of Hyperacusis and Concomitant DiagnosesĪ number of studies have analyzed the prevalence of hyperacusis in the general population. Interestingly, among children and adolescents seeking help for tinnitus and/or hyperacusis from an audiology clinic, the mean value of ULLmin was 64 dB HL (SD = 15, n = 34). With this ULLmin criterion, 95% of adult patients diagnosed as having hyperacusis were found also to meet the criterion of a cut-off score on the Hyperacusis Questionnaire (HQ) of 22 or more. They suggested that a value of ULLmin equal to or below 77 dB HL should be taken as indicating the presence of hyperacusis. īased on results obtained with adults, Aazh and Moore proposed diagnostic criteria for hyperacusis based on the average ULL across 0.25, 0.5, 1, 2, 4 and 8 kHz for the ear with the lower average ULL, which is denoted ULLmin. The average ULL for patients with normal hearing and without hyperacusis is around 100 dB hearing level (HL), and reports of ULLs for patients with hyperacusis have been reported to be around 60 to 85 dB HL. In patients with hyperacusis, ULLs will typically be lower than the average person with normal hearing and without hyperacusis. Generally, ULL provides the level above which tones become uncomfortably loud for a patient. However, due to limitations in obtaining accurate levels of loudness discomfort or sometimes hearing thresholds, particularly in severe cases of ASD, clinicians rely on behavioral observation strategies and case history. Īssessment of hyperacusis typically will involve extensive case history taking, pure tone audiometry, measurement of uncomfortable loudness levels (ULLs), and self-report questionnaires such as the hyperacusis questionnaire (HQ). Other theories propose the role of central gain enhancement in hyperacusis and the possibility of hyperacusis to be an indication of problems with the limbic system or auditory pathway. Utilizing Magnetic Resonance Imaging (MRI), scientists have seen elevated auditory activity in the auditory midbrain, thalamus and cortex, as well as enlarged subcortical and cortical responses to sound in subjects with hyperacusis. Theories include the idea that hyperacusis is the result of increased neural synchrony and reorganization of the tonotopic structure of the auditory cortex as well as the possibility that neurons that would typically respond to loud sounds start to respond to lower intensity sounds. The precise cause of hyperacusis still remains unknown. It can impact one’s emotional wellbeing, sleep, concentration, and can cause anxiety. Hyperacusis can affect an individual at various degrees depending on the severity. These reactions are in response to general sounds, rather than specific sounds (such as chewing and sniffling), as would be the case with misophonia. Hyperacusis is a class of decreased sound tolerance disorders in which a negative or incongruous reaction is triggered from exposure to sounds that are not described as threatening or uncomfortable by a neurotypical individual. The most common types of DSTD are hyperacusis and misophonia. Decreased Sound Tolerance Disorders (DSTD) are routinely observed in autism spectrum disorder (ASD).
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