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Audiometric characteristics of hyperacusis patients
Jacqueline Sheldrake1, Peter U Diehl2, Roland Schaette3
1The Tinnitus and Hyperacusis Centre , London , UK.
Frontiers in Neurology
|June 2, 2015
Summary
Hyperacusis, a disorder causing sounds to be perceived as painfully loud, may stem from a generalized increase in auditory gain. This contrasts with tinnitus, which is often linked to hearing loss.
Area of Science:
- Audiology
- Neuroscience
- Otolaryngology
Background:
- Hyperacusis involves abnormal loudness perception, often co-occurring with tinnitus.
- Previous loudness discomfort level (LDL) studies covered limited frequency ranges.
- Understanding hyperacusis mechanisms requires full-range LDL measurements.
Purpose of the Study:
- To measure LDLs across the full audiometric range (0.125–8 kHz) in hyperacusis patients.
- To investigate the relationship between hearing thresholds (HTs) and LDLs in hyperacusis.
- To explore potential mechanisms underlying hyperacusis.
Main Methods:
- Audiograms and LDLs were measured in 381 hyperacusis patients.
- Data were compared to a normal-hearing reference group.
- Receiver operating characteristic (ROC) analysis assessed LDL test utility.
Main Results:
- Hyperacusis patients showed decreased LDLs (average ~85 dB HL) across all frequencies.
- Over a third of patients had normal hearing thresholds.
- LDLs were neither sensitive nor specific enough for a standalone hyperacusis diagnosis.
- A moderate positive correlation between HTs and LDLs was observed.
- Decreased LDLs across all frequencies suggest a generalized auditory gain increase.
Conclusions:
- Hyperacusis may result from a generalized increase in auditory gain, not solely hearing loss.
- The mechanisms of hyperacusis and tinnitus may differ, with tinnitus linked to localized neuroplastic changes.
- Full-range LDL measurements are crucial for understanding hyperacusis.
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