Definition and Description of Hyperacusis

[Frédéric]

Well, it is a shame that hyperacusis sufferers were not allowed to take part in this survey.

A Delphi survey to determine a definition and description of hyperacusis by clinician consensus

Objective
There is currently no singularly accepted definition of hyperacusis. The aim of this study was to determine a definition and description of hyperacusis by clinician consensus.

Design
A three-round Delphi survey involving hearing healthcare professionals built towards clinical consensus on a definition of hyperacusis. Round 1 involved three open-ended questions about hyperacusis. Seventy-nine statements were generated on descriptions, impact, sounds, and potential features of hyperacusis. Agreement on the relevance of each statement to defining or describing hyperacusis was then measured in Rounds 2 and 3. General consensus was defined a priori as ≥70% agreement, or ≥90 for clinical decision making.

Study sample
Forty-five hearing healthcare professionals were recruited to take part in this study. Forty-one completed Round 1, 36 completed Round 2, and 33 completed Round 3.

Results
Consensus was reached on 42/79 statements. From these a consensus definition includes "A reduced tolerance to sound(s) that are perceived as normal to the majority of the population or were perceived as normal to the person before their onset of hyperacusis". A consensus description of hyperacusis was also determined.

Conclusions
This consensus definition of hyperacusis will help to determine the scope of clinical practice guidelines and influence needed research on hyperacusis.

 

[Juan]

Consensus was reached on 42/79 statements. From these a consensus definition includes "A reduced tolerance to sound(s) that are perceived as normal to the majority of the population or were perceived as normal to the person before their onset of hyperacusis". A consensus description of hyperacusis was also determined.

It is accurate as the partial description of one of the several symptoms of hyperacusis. However, it leaves out common symptoms like pressure, aural fullness, stabbing pain, etc etc.

 

[Frédéric]

I posted this publication here as it provides information to defining hyperacusis.

COMPARISON OF LOUDNESS AND PAIN HYPERACUSIS

Purpose
Hyperacusis is a complex and poorly understood auditory disorder characterized by decreased tolerance to sound at levels that would not trouble most individuals. Recently, it has been suggested that individuals who experience otalgia in response to everyday sounds (termed "pain hyperacusis") may differ clinically from those whose primary symptom is the perception of everyday sounds as excessively loud (termed "loudness hyperacusis"). Despite this theoretical distinction, there have been no empirical studies directly comparing these two populations of hyperacusis patients.

Method
Using data from a multinational patient registry (the Coordination of Rare Diseases at Sanford [CoRDS] Registry), we examined self-reported demographics, symptoms, comorbidity, and response to treatment in a sample of 243 adults with hyperacusis, 152 of whom were classified as having pain hyperacusis based on reported symptoms. Bayesian statistical tests were used to investigate both the presence and absence of group differences between patients with loudness and pain hyperacusis.

Results
Individuals with pain hyperacusis presented with a more severe clinical phenotype, reporting a higher frequency of temporary symptom exacerbations (i.e., "setbacks"), less perceived symptom improvement over time, more severe comorbid headache disorders, and reduced benefit from sound therapy. However, the two hypothesized hyperacusis subtypes exhibited more similarities than differences, with the majority of symptoms and comorbidities being equally prevalent across groups. Multiple comorbidities were commonly observed, including tinnitus, primary headache disorders, psychiatric disorders, and functional somatic syndromes. Intolerance of sensory stimuli in other modalities was also frequently reported.

Conclusion
Although this study provides little evidence that loudness and pain hyperacusis are pathophysiologically distinct conditions, our findings indicate that a pain-predominant phenotype may be a meaningful prognostic marker in patients with hyperacusis.

Full article: see attached file.

 

[serendipity1996]

I posted this publication here as it provides information to defining hyperacusis.

COMPARISON OF LOUDNESS AND PAIN HYPERACUSIS

Purpose
Hyperacusis is a complex and poorly understood auditory disorder characterized by decreased tolerance to sound at levels that would not trouble most individuals. Recently, it has been suggested that individuals who experience otalgia in response to everyday sounds (termed "pain hyperacusis") may differ clinically from those whose primary symptom is the perception of everyday sounds as excessively loud (termed "loudness hyperacusis"). Despite this theoretical distinction, there have been no empirical studies directly comparing these two populations of hyperacusis patients.

Method
Using data from a multinational patient registry (the Coordination of Rare Diseases at Sanford [CoRDS] Registry), we examined self-reported demographics, symptoms, comorbidity, and response to treatment in a sample of 243 adults with hyperacusis, 152 of whom were classified as having pain hyperacusis based on reported symptoms. Bayesian statistical tests were used to investigate both the presence and absence of group differences between patients with loudness and pain hyperacusis.

Results
Individuals with pain hyperacusis presented with a more severe clinical phenotype, reporting a higher frequency of temporary symptom exacerbations (i.e., "setbacks"), less perceived symptom improvement over time, more severe comorbid headache disorders, and reduced benefit from sound therapy. However, the two hypothesized hyperacusis subtypes exhibited more similarities than differences, with the majority of symptoms and comorbidities being equally prevalent across groups. Multiple comorbidities were commonly observed, including tinnitus, primary headache disorders, psychiatric disorders, and functional somatic syndromes. Intolerance of sensory stimuli in other modalities was also frequently reported.

Conclusion
Although this study provides little evidence that loudness and pain hyperacusis are pathophysiologically distinct conditions, our findings indicate that a pain-predominant phenotype may be a meaningful prognostic marker in patients with hyperacusis.

Full article: see attached file.

Amazing find - thank you for posting this!

 

[Aaron91]

I posted this publication here as it provides information to defining hyperacusis.

COMPARISON OF LOUDNESS AND PAIN HYPERACUSIS

Purpose
Hyperacusis is a complex and poorly understood auditory disorder characterized by decreased tolerance to sound at levels that would not trouble most individuals. Recently, it has been suggested that individuals who experience otalgia in response to everyday sounds (termed "pain hyperacusis") may differ clinically from those whose primary symptom is the perception of everyday sounds as excessively loud (termed "loudness hyperacusis"). Despite this theoretical distinction, there have been no empirical studies directly comparing these two populations of hyperacusis patients.

Method
Using data from a multinational patient registry (the Coordination of Rare Diseases at Sanford [CoRDS] Registry), we examined self-reported demographics, symptoms, comorbidity, and response to treatment in a sample of 243 adults with hyperacusis, 152 of whom were classified as having pain hyperacusis based on reported symptoms. Bayesian statistical tests were used to investigate both the presence and absence of group differences between patients with loudness and pain hyperacusis.

Results
Individuals with pain hyperacusis presented with a more severe clinical phenotype, reporting a higher frequency of temporary symptom exacerbations (i.e., "setbacks"), less perceived symptom improvement over time, more severe comorbid headache disorders, and reduced benefit from sound therapy. However, the two hypothesized hyperacusis subtypes exhibited more similarities than differences, with the majority of symptoms and comorbidities being equally prevalent across groups. Multiple comorbidities were commonly observed, including tinnitus, primary headache disorders, psychiatric disorders, and functional somatic syndromes. Intolerance of sensory stimuli in other modalities was also frequently reported.

Conclusion
Although this study provides little evidence that loudness and pain hyperacusis are pathophysiologically distinct conditions, our findings indicate that a pain-predominant phenotype may be a meaningful prognostic marker in patients with hyperacusis.

Full article: see attached file.

This is an amazing find @Frédéric. I've been drafting a post recently about why I think hyperacusis should be regarded as a spectrum of pain and how "loudness" and "pain" subtypes have muddied the waters. The conclusion of this paper seems to tie everything together. Will be posting more on this soon.

@FGG