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When we hear a sound, our nervous system is detecting sound waves—pressure waves of mechanical energy traveling through a medium. The frequency of the wave is perceived as pitch, while the amplitude is perceived as loudness.
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Validating and refining a psychoacoustic test to diagnose hyperacusis.

Philippe Fournier1, Pierre H Bourez2, Anne-Sophie Côté2

  • 1School of Rehabilitation Sciences, Université Laval, QC, Canada; Centre Interdisciplinaire de Recherche en Réadaptation et en Intégration Sociale (CIRRIS), Centre Intégré Universitaire de Santé et de Services Sociaux de La Capitale-Nationale (CIUSSS-CN), QC, Canada; Laboratory for Brain, Music and Sound Research (BRAMS) & Centre for Research on Brain, Language and Music (CRBLM), Montreal, Quebec, Canada; Institut Pasteur, AP-HP, INSERM, Fondation Pour l'Audition, IHU reConnect, Paris, France.

Hearing Research
|November 30, 2025
PubMed
Summary
This summary is machine-generated.

A new tablet test effectively diagnoses hyperacusis, a condition causing distress from everyday sounds. This objective tool uses Core Discriminant Sounds (CDS) to assess sound pleasantness and loudness, improving diagnosis for decreased sound tolerance.

Keywords:
AssessmentHyperacusisLoudnessMisophoniaNatural soundsPleasantnessUnpleasantness

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Area of Science:

  • Audiology and Hearing Science
  • Neuroscience of Sensory Perception
  • Clinical Diagnostics

Background:

  • Decreased sound tolerance, including hyperacusis and misophonia, significantly impairs quality of life.
  • Current hyperacusis diagnosis relies on subjective measures lacking reliability and ecological validity.
  • Objective diagnostic tools are needed to accurately identify individuals with hyperacusis.

Purpose of the Study:

  • To validate a novel tablet-based Core Discriminant Sounds (CDS) test for prospective hyperacusis diagnosis.
  • To assess the efficacy of CDShyper sounds in differentiating hyperacusis patients from controls.
  • To evaluate the diagnostic accuracy of pleasantness and loudness ratings using the CDS test.

Main Methods:

  • A tablet-based test presenting Core Discriminant Sounds (CDShyper and CDSmiso) at varying decibel levels (dBA).
  • Participants (20 hyperacusis, 29 controls) rated sound pleasantness and loudness using visual analog scales.
  • Hyperacusis diagnosis was confirmed by clinical evaluation, Hyperacusis Questionnaire scores, and loudness discomfort levels (LDLs).

Main Results:

  • Individuals with hyperacusis rated CDShyper sounds as significantly less pleasant and louder compared to controls.
  • No significant group differences were observed for misophonia trigger sounds (CDSmiso).
  • The CDShyper pleasantness and loudness scores achieved 90% sensitivity and 69% specificity for hyperacusis detection.

Conclusions:

  • The tablet-based CDS test is a validated, efficient, and ecologically sound tool for diagnosing hyperacusis.
  • This objective measure offers improved diagnostic capabilities for decreased sound tolerance conditions.
  • Further research may refine CDS testing for broader clinical application in audiology.