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Structural and functional brain alterations in patients with hyperacusis: MRI systematic review.
Rania Alkahtani1, Reem Elbeltagy1, Zuhal Y Hamd2
1Department of Health Communication Sciences, College of Health and Rehabilitation Sciences, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia.
Frontiers in Human Neuroscience
|April 23, 2026
Summary
This review reveals brain changes in hyperacusis patients, including heightened auditory processing and altered connectivity. These findings suggest a complex neurological basis for sound sensitivity, impacting auditory and emotional networks.
Area of Science:
- Neuroscience
- Audiology
- Radiology
Background:
- Hyperacusis involves heightened sound sensitivity, causing distress and social withdrawal.
- The neural underpinnings of hyperacusis are not well understood.
- Magnetic resonance imaging (MRI) offers insights into brain structure and function.
Purpose of the Study:
- To systematically review MRI-based studies on brain alterations in hyperacusis.
- To investigate structural, functional, and connectivity changes using MRI techniques.
Main Methods:
- Systematic review of 11 studies utilizing structural MRI (sMRI), functional MRI (fMRI), and diffusion tensor imaging (DTI).
- Analysis of neural activity, grey matter volume, and white matter tract integrity.
Main Results:
- fMRI showed increased activity in auditory regions (e.g., Heschl's gyrus) indicating exaggerated processing (SMD >5.0).
- sMRI revealed reduced grey matter in the right supplementary motor area (SMD=2.10), suggesting impaired sound modulation.
- DTI indicated altered auditory pathway integrity (e.g., medial geniculate nucleus), supporting disrupted connectivity.
Conclusions:
- Hyperacusis involves complex alterations in auditory and emotional processing networks.
- Findings support integrated diagnostic and multidisciplinary therapeutic approaches for hyperacusis.
