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Richard Salvi - One of the best experts on this subject based on the ideXlab platform.
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functional magnetic resonance imaging of enhanced central auditory gain and electrophysiological correlates in a behavioral model of Hyperacusis
Hearing Research, 2020Co-Authors: Eddie Wong, Xiaopeng Liu, Richard Salvi, Benjamin D. Auerbach, Kelly Radziwon, Guangdi Chen, Francis A M Manno, Sinai Hc Manno, Condon LauAbstract:Abstract Hyperacusis is a debilitating hearing condition in which normal everyday sounds are perceived as exceedingly loud, annoying, aversive or even painful. The prevalence of Hyperacusis approaches 10%, making it an important, but understudied medical condition. To noninvasively identify the neural correlates of Hyperacusis in an animal model, we used sound-evoked functional magnetic resonance imaging (fMRI) to locate regions of abnormal activity in the central nervous system of rats with behavioral evidence of Hyperacusis induced with an ototoxic drug (sodium salicylate, 250 mg/kg, i.p.). Reaction time-intensity measures of loudness-growth revealed behavioral evidence of salicylate-induced Hyperacusis at high intensities. fMRI revealed significantly enhanced sound-evoked responses in the auditory cortex (AC) to 80 dB SPL tone bursts presented at 8 and 16 kHz. Sound-evoked responses in the inferior colliculus (IC) were also enhanced, but to a lesser extent. To confirm the main results, electrophysiological recordings of spike discharges from multi-unit clusters were obtained from the central auditory pathway. Salicylate significantly enhanced tone-evoked spike-discharges from multi-unit clusters in the AC from 4 to 30 kHz at intensities ≥60 dB SPL; less enhancement occurred in the medial geniculate body (MGB), and even less in the IC. Our results demonstrate for the first time that non-invasive sound-evoked fMRI can be used to identify regions of neural hyperactivity throughout the brain in an animal model of Hyperacusis.
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a review of auditory gain low level noise and sound therapy for tinnitus and Hyperacusis
International Journal of Audiology, 2020Co-Authors: Adam Sheppard, Massimo Ralli, Christina Stocking, Richard SalviAbstract:Objective: This article reviews: (1) the evidence related to enhanced central gain as a potential mechanism for the generation of tinnitus and Hyperacusis, (2) the neuroplastic changes induced by prolonged, low-level sound stimulation and (3) the clinical effectiveness of various sound therapies and amplification for the treatment of tinnitus and Hyperacusis.Design: General literature review.Study sample: Peer-reviewed articles related to auditory neural gain, prolonged low-level noise exposure and effectiveness of sound therapy.Results: A large body of literature exists supporting the enhanced neural gain model of tinnitus and Hyperacusis. Neuroplastic changes associated with prolonged low-level noise show evidence of reversing enhanced neural gain, which should theoretically reduce percepts of tinnitus and/or Hyperacusis. However, the available clinical evidence assessing the efficacy of sound therapy to reduce tinnitus or Hyperacusis lacks controlled clinical trials to accurately assess the effectiveness of sound therapy.Conclusions: The available literature from basic science studies supports the neural gain model of tinnitus and Hyperacusis, which conceivably should be effectively managed with sound therapy. However, well-controlled clinical trials are needed before conclusions can be made on the effectiveness of sound therapy for tinnitus and Hyperacusis.
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preclinical animal behavioral models of Hyperacusis and loudness recruitment
2020Co-Authors: Kelly E Radziwo, Guangdi Che, Enjami D Auerbach, Xiaopeng Liu, Senthilvela Manoha, Richard SalviAbstract:Hyperacusis is a loudness intolerance disorder in which everyday sounds are perceived as intolerably loud, annoying, fearful, or even painful. While Hyperacusis is often considered exclusively as a hearing problem, it is associated with a broad spectrum of auditory (tinnitus), vestibular, and other neurological disorders such as autism, Williams syndrome, fibromyalgia, migraine, and a host of other sensory hypersensitivity disorders. The underlying mechanisms and biological basis of Hyperacusis in its different manifestations are poorly understood largely due to the lack of valid behavioral models. In this review, we discuss recent advances in the development of behavioral models that have been used to measure various forms of Hyperacusis and the genetic models and experimental conditions that have been employed to induce Hyperacusis in animals.
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noise induced loudness recruitment and Hyperacusis insufficient central gain in auditory cortex and amygdala
Neuroscience, 2019Co-Authors: Kelly E Radziwo, Guangdi Che, Enjami D Auerbach, Dalia Ding, Xiaopeng Liu, Richard SalviAbstract:Abstract Noise-induced hearing loss generally induces loudness recruitment, but sometimes gives rise to Hyperacusis, a debilitating condition in which moderate intensity sounds are perceived abnormally loud. In an attempt to develop an animal model of loudness Hyperacusis, we exposed rats to a 16–20 kHz noise at 104 dB SPL for 12 weeks. Behavioral reaction time-intensity functions were used to assess loudness growth functions before, during and 2-months post-exposure. During the exposure, loudness recruitment (R) was present in the region of hearing loss, but subtle evidence of Hyperacusis (H) started to emerge at the border of the hearing loss. Unexpectedly, robust evidence of Hyperacusis appeared below and near the edge of the hearing loss 2-months post-exposure. To identify the neural correlates of Hyperacusis and test the central gain model of Hyperacusis, we recorded population neural responses from the cochlea, auditory cortex and lateral amygdala 2-months post-exposure. Compared to controls, the neural output of the cochlea was greatly reduced in the noise group. Consistent with central gain models, the gross neural responses from the auditory cortex and amygdala were proportionately much larger than those from the cochlea. However, despite central amplification, the population responses in the auditory cortex and amygdala were still below the level needed to fully account for Hyperacusis and/or recruitment. Having developed procedures that can consistently induce Hyperacusis in rats, our results set the stage for future studies that seek to identify the neurobiological events that give rise to Hyperacusis and to develop new therapies to treat this debilitating condition.
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Testing the Central Gain Model: Loudness Growth Correlates with Central Auditory Gain Enhancement in a Rodent Model of Hyperacusis.
Neuroscience, 2018Co-Authors: Benjamin D. Auerbach, Kelly E. Radziwon, Richard SalviAbstract:Abstract The central gain model of Hyperacusis proposes that loss of auditory input can result in maladaptive neuronal gain increases in the central auditory system, leading to the over-amplification of sound-evoked activity and excessive loudness perception. Despite the attractiveness of this model, and supporting evidence for it, a critical test of the central gain theory requires that changes in sound-evoked activity be explicitly linked to perceptual alterations of loudness. Here we combined an operant conditioning task that uses a subject’s reaction time to auditory stimuli to produce reliable measures of loudness growth with chronic electrophysiological recordings from the auditory cortex and inferior colliculus of awake, behaviorally-phenotyped animals. In this manner, we could directly correlate daily assessments of loudness perception with neurophysiological measures of sound encoding within the same animal. We validated this novel psychophysical-electrophysiological paradigm with a salicylate-induced model of hearing loss and Hyperacusis, as high doses of sodium salicylate reliably induce temporary hearing loss, neural hyperactivity, and auditory perceptual disruptions like tinnitus and Hyperacusis. Salicylate induced parallel changes to loudness growth and evoked response-intensity functions consistent with temporary hearing loss and Hyperacusis. Most importantly, we found that salicylate-mediated changes in loudness growth and sound-evoked activity were correlated within individual animals. These results provide strong support for the central gain model of Hyperacusis and demonstrate the utility of using an experimental design that allows for within-subject comparison of behavioral and electrophysiological measures, thereby making inter-subject variability a strength rather than a limitation.
David M. Baguley - One of the best experts on this subject based on the ideXlab platform.
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prevalence of Hyperacusis and its relation to health the busselton healthy ageing study
Laryngoscope, 2021Co-Authors: Adriana L Smit, David M. Baguley, Inge Stegeman, Robert H Eikelboom, Rebecca J Bennett, Susan Teggquinn, Romola S Bucks, Robert J Stokroos, Michael HunterAbstract:Importance The prevalence of Hyperacusis and its relationship with mental and general health is unknown in a nonclinical sample. Therefore, we aimed to determine the prevalence of Hyperacusis and its relation with hearing, general and mental health in a population-based study. Study Design Prospective population-based study. Material and Methods This study uses data from the Busselton Healthy Ageing Study (BHAS). A sample of 5,107 eligible inhabitants aged 45 to 70 years completed a detailed questionnaire and a clinical assessment. A positive answer to “Do you consider yourself sensitive or intolerant to everyday sounds” was used to indicate Hyperacusis. Logistic regression was used to examine the association between hearing, mental and general health factors, and Hyperacusis. Results Of 5,107 participants, 775 (15.2%) reported Hyperacusis. The majority of participants with Hyperacusis reported an occasional effect on daily life (72.0%). Being female, older in age, having a lower income, physical or mental health difficulties, more severe hearing loss, and tinnitus were all associated with the presence of Hyperacusis. Individuals who experience hearing impairment, poorer general or mental health have a higher possibility of Hyperacusis having an effect on their daily life. Conclusions In this community population-based cohort study, we found a prevalence of Hyperacusis of 15.2%. Individuals with hearing loss, mental health problems, and lower physical health have a higher possibility of experiencing effects on their daily life associated with their Hyperacusis. Unravelling the relationship between Hyperacusis hearing, general and mental health can be of major importance for a better understanding of the condition and its consequences. Level of Evidence II-2 Laryngoscope, 2021
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association between Hyperacusis and tinnitus
Journal of Clinical Medicine, 2020Co-Authors: Christopher R Cederroth, David M. Baguley, Alessandra Lugo, Niklas K Edvall, Andra Lazar, Jose A Lopezescamez, Jan Bulla, Inger Uhlen, Darek J HoareAbstract:Many individuals with tinnitus report experiencing Hyperacusis (enhanced sensitivity to sounds). However, estimates of the association between Hyperacusis and tinnitus is lacking. Here, we investigate this relationship in a Swedish study. A total of 3645 participants (1984 with tinnitus and 1661 without tinnitus) were enrolled via LifeGene, a study from the general Swedish population, aged 18-90 years, and provided information on socio-demographic characteristics, as well as presence of Hyperacusis and its severity. Tinnitus presence and severity were self-reported or assessed using the Tinnitus Handicap Inventory (THI). Phenotypes of tinnitus with (n = 1388) or without (n = 1044) Hyperacusis were also compared. Of 1661 participants without tinnitus, 1098 (66.1%) were women and 563 were men (33.9%), and the mean (SD) age was 45.1 (12.9). Of 1984 participants with tinnitus, 1034 (52.1%) were women and 950 (47.9%) were men, and the mean (SD) age was 47.7 (14.0) years. Hyperacusis was associated with any tinnitus [Odds ratio (OR) 3.51, 95% confidence interval (CI) 2.99-4.13], self-reported severe tinnitus (OR 7.43, 95% CI 5.06-10.9), and THI ≥ 58 (OR 12.1, 95% CI 7.06-20.6). The association with THI ≥ 58 was greater with increasing severity of Hyperacusis, the ORs being 8.15 (95% CI 4.68-14.2) for moderate and 77.4 (95% CI 35.0-171.3) for severe Hyperacusis. No difference between sexes was observed in the association between Hyperacusis and tinnitus. The occurrence of Hyperacusis in severe tinnitus is as high as 80%, showing a very tight relationship. Discriminating the pathophysiological mechanisms between the two conditions in cases of severe tinnitus will be challenging, and optimized study designs are necessary to better understand the mechanisms behind the strong relationship between Hyperacusis and tinnitus.
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a cross sectional study of the prevalence and factors associated with tinnitus and or Hyperacusis in children
Ear and Hearing, 2020Co-Authors: Susanne Nemholt, Jesper Hvass Schmidt, Niels Wedderkopp, David M. BaguleyAbstract:OBJECTIVES The aim of this study was to determine the prevalence of tinnitus and/or Hyperacusis in Danish children aged 10 to 16 years, and to assess associations between tinnitus or Hyperacusis and other relevant factors. DESIGN A cross-sectional study based on a previously established child cohort. A total of 501 children were enrolled in the project. The study was performed in eight mainstream schools and data were collected during an 8-week period from October 27, 2014 to December 16, 2014. RESULTS Using broad tinnitus research questions, the prevalence of any tinnitus was 66.9%; of noise-induced tinnitus (NIT) was 35.7%; and of spontaneous tinnitus (ST) was 53.7%. Bothersome tinnitus was reported by 34.6% of the children with any tinnitus, 23.2% of the whole population. Few children were severely bothered (2.4%, 1.6%, respectively). It was significantly more common for children with NIT to report tinnitus episodes lasting for minutes or longer than for children with ST (p = 0.01). Girls were more likely than boys to be bothered by tinnitus [Odds ratio (OR) = 2.96; 95% confidence interval (CI) 1.34 to 6.51; p = 0.01]. 14.6% of the children reported Hyperacusis, and 72.6% of those reporting Hyperacusis were bothered by it, 10.6% of the whole population. The odds of having Hyperacusis were 4.73 (1.57, 14.21) times higher among those with ST compared with those without ST. Furthermore, Hyperacusis was associated with sound avoidance behaviors such as experience of sound-induced pain in the ear (OR = 2.95, 95% CI 1.65 to 5.27; p < 0.001), withdrawal from places or activities (OR = 3.33; 95% CI 1.44 to 7.69; p = 0.01), or concerns about sound could damage the hearing (OR = 1.85, 95% CI 1.06 to 3.31; p = 0.03). CONCLUSIONS Tinnitus and Hyperacusis are common in children but prevalence is dependent on tinnitus definitions. Only a few children are severely bothered by tinnitus. In the case of Hyperacusis, children may exhibit sound avoidance behavior.
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factors related to insomnia in adult patients with tinnitus and or Hyperacusis an exploratory analysis
Journal of The American Academy of Audiology, 2019Co-Authors: Hashir Aazh, David M. Baguley, Brian C J MooreAbstract:People with tinnitus and/or Hyperacusis often experience insomnia. However, it is unclear what factors are most strongly associated with insomnia. To explore factors related to insomnia in patients with tinnitus and/or Hyperacusis. This was a retrospective study using multiple-regression analysis. Data were assessed for 444 consecutive patients who sought help concerning their tinnitus and/or Hyperacusis from a specialist audiology center in the UK National Health Service. The average age of the patients was 54 years (standard deviation = 15 years). The results of audiological tests and self-report questionnaires were gathered retrospectively from the records of the patients. Multiple-regression analysis was used to assess the relationship between insomnia and other variables. Sixty-nine percent of patients with tinnitus experienced some form of insomnia as measured via the Insomnia Severity Index (ISI). A multiple-regression model showed that ISI scores were significantly associated with depression scores measured via the depression subscale of the Hospital Anxiety and Depression Scale (HADS) (regression coefficient [b] = 0.44, p The prevalence of insomnia in patients with tinnitus is high. Both tinnitus-related factors and psychological factors are related to the severity of insomnia. Hyperacusis is not significantly associated with insomnia.
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Hyperacusis major research questions
Hno, 2018Co-Authors: David M. Baguley, Derek J HoareAbstract:Hyperacusis is a troublesome symptom that can have a marked negative impact on quality of life. To identify major research questions in Hyperacusis. Review of gaps in knowledge regarding Hyperacusis, and where opportunities may lie to address these. Eight major research questions were identified as priorities for future research. These were: What is the prevalence of Hyperacusis in adults and children? What are the risk factors associated with Hyperacusis? What is the natural history of Hyperacusis? How is ‘pain Hyperacusis’ perceived? What mechanisms are involved in Hyperacusis? What is the relationship between Hyperacusis and tinnitus? Can a questionnaire be developed that accurately measures the impact of Hyperacusis and can be used as a treatment outcome measure? What treatments, alone or in combination, are effective for Hyperacusis? This clinical/researcher-led project identified major research questions in Hyperacusis. A further development to identify patient-prioritized research will follow.
Brian C J Moore - One of the best experts on this subject based on the ideXlab platform.
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internal consistency and convergent validity of the inventory of Hyperacusis symptoms
Ear and Hearing, 2021Co-Authors: Hashir Aazh, Ali A Danesh, Brian C J MooreAbstract:Objectives The aim was to assess the internal consistency and convergent and discriminant validity of a new questionnaire for Hyperacusis, the Inventory of Hyperacusis Symptoms (IHS; Greenberg & Carlos 2018), using a clinical population. Design This was a retrospective study. Data were gathered from the records of 100 consecutive patients who sought help for tinnitus and/or Hyperacusis from an audiology clinic in the United Kingdom. The average age of the patients was 55 years (SD = 13 years). Audiological measures were the pure-tone average threshold (PTA) and uncomfortable loudness levels (ULL). Questionnaires administered were: IHS, Tinnitus Handicap Inventory (THI), Hyperacusis Questionnaire (HQ), Insomnia Severity Index, Generalized Anxiety Disorder, and Patient Health Questionnaire-9. Results Cronbach's alpha for the 25-item IHS questionnaire was 0.96. Neither the total IHS score nor scores for any of its five subscales were correlated with the PTA of the better or worse ear. This supports the discriminant validity of the IHS, as Hyperacusis is thought to be independent of the PTA. There were moderately strong correlations between IHS total scores and scores for the HQ, Tinnitus Handicap Inventory, Generalized Anxiety Disorder, and Patient Health Questionnaire-9, with r = 0.58, 0.58, 0.61, 0.54, respectively. Thus, although IHS scores may reflect Hyperacusis itself, they may also reflect the coexistence of tinnitus, anxiety, and depression. The total score on the IHS was significantly different between patients with and without Hyperacusis (as diagnosed based on ULLs or HQ scores). Using the HQ score as a reference, the area under the receiver operating characteristic for the IHS was 0.80 (95% confidence interval = 0.71 to 0.89) and the cutoff point of the IHS with highest overall accuracy was 56/100. The corresponding sensitivity and specificity were 74% and 82%. Conclusions The IHS has good internal consistency and reasonably high convergent validity, as indicated by the relationship of IHS scores to HQ scores and ULLs, but IHS scores may also partly reflect the co-occurrence of tinnitus, anxiety, and depression. We propose an IHS cutoff score of 56 instead of 69 for diagnosing Hyperacusis.
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patients perspectives about the acceptability and effectiveness of audiologist delivered cognitive behavioral therapy for tinnitus and or Hyperacusis rehabilitation
American Journal of Audiology, 2019Co-Authors: Hashir Aazh, Christina Bryant, Brian C J MooreAbstract:Objective The aim of this study was to evaluate the views of patients who completed audiologist-delivered cognitive behavioral therapy (CBT) about (a) the effectiveness of the treatment, (b) the acceptability of receiving CBT from audiologists, and (c) the most effective treatment components. Design This was a service evaluation survey with a cross-sectional design. Study Sample The study population comprised 40 consecutive adult patients who received a full course of audiologist-delivered CBT for tinnitus and/or Hyperacusis management at a Tinnitus and Hyperacusis Therapy Specialist Clinic in the United Kingdom over a 1-year period. Thirty-one of 40 patients who attended their final session as planned completed the survey questionnaire. Data Collection and Analysis As a part of their routine care, all patients completed a wide range of questionnaires before and after receiving audiologist-delivered CBT. These comprised Tinnitus Handicap Inventory (Newman, Sandridge, & Bolek, 2008); Hyperacusis Questionnaire (Khalfa et al., 2002); Insomnia Severity Index (Bastien, Vallieres, & Morin, 2001); Visual Analogue Scale (Maxwell, 1978) for tinnitus loudness, tinnitus annoyance, and effect of tinnitus on life; Generalized Anxiety Disorder (Spitzer, Kroenke, Williams, & Lowe, 2006) questionnaire; and Patient Health Questionnaire (Kroenke, Spitzer, & Williams, 2001). In addition, patients were asked to complete the survey questionnaire at their final session to provide feedback with regard to their therapy. Results The majority of patients reported that it was very acceptable to them to receive CBT focused on tinnitus and Hyperacusis from a specialist audiologist; the median response was 10/10. The majority of patients felt that the CBT was very effective (median response 8/10) and that they were able to manage their tinnitus and/or Hyperacusis well (median response 9/10). The effect sizes of treatment based on pre- and postintervention comparison of scores for the Tinnitus Handicap Inventory, Visual Analogue Scale of tinnitus annoyance and effect on life, Hyperacusis Questionnaire, Insomnia Severity Index, Generalized Anxiety Disorder, and Patient Health Questionnaire were large. Conclusions Audiologist-delivered CBT is acceptable to patients and is effective in the management of tinnitus and/or Hyperacusis from the patients' perspectives.
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parental mental health in childhood as a risk factor for anxiety and depression among people seeking help for tinnitus and Hyperacusis
Journal of The American Academy of Audiology, 2019Co-Authors: Hashir Aazh, Ali A Danesh, Brian C J MooreAbstract:Background Parental mental illness is a risk factor for mental health disorders in the offspring. However, the relationship between parental illness in childhood and mental health disorders in adulthood among patients with tinnitus and/or Hyperacusis is not known. Purpose The aim was to explore the relationship between parental mental health in childhood and anxiety and depression for patients experiencing tinnitus and/or Hyperacusis. Research design This was a retrospective cross-sectional study with a correlational design. Study sample Two hundred eighty-seven consecutive patients who attended a Tinnitus and Hyperacusis Therapy Specialist Clinic in the United Kingdom were included. Their average age was 52.5 years. Data collection and analysis The association was explored between anxiety and depression measured via the Generalized Anxiety Disorder questionnaire (GAD-7) and the Patient Health questionnaire (PHQ-9) and responses to the question "While you were growing up during the first 18 years of life did your parent(s) have depression or mental illness?" Results Thirty-nine percent of patients (111/287) responded "yes" to the question about their parents' mental health, which is about double the incidence in the general population. Regression analysis showed that parental mental illness significantly increased the risk of anxiety and depression, with unadjusted odds ratios (ORs) of 2.7 (95% confidence interval [CI]: 1.5-4.9, p = 0.001) for the PHQ-9 and 2.6 (95% CI: 1.4-4.8, p = 0.002) for the GAD-7. However, when the models were adjusted for the effects of age, gender, tinnitus handicap as measured via the Tinnitus Handicap Inventory, Hyperacusis handicap as measured via the Hyperacusis questionnaire, uncomfortable loudness levels, GAD-7 scores (for the depression model only), and PHQ-9 scores (for the anxiety model only), parental mental health was only significantly associated with depression, with an OR of 2.7 (95% CI: 1.08-6.7, p = 0.033). Conclusions Audiologists offering tinnitus and Hyperacusis rehabilitation should screen patients for parental mental illness in childhood, especially for those with comorbid depression, and make onward referral to appropriate mental health services when needed. Future research should analyze the breadth and type of adverse childhood experiences among patients with tinnitus and Hyperacusis and their relationship with mental problems and treatment efficacy.
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factors related to insomnia in adult patients with tinnitus and or Hyperacusis an exploratory analysis
Journal of The American Academy of Audiology, 2019Co-Authors: Hashir Aazh, David M. Baguley, Brian C J MooreAbstract:People with tinnitus and/or Hyperacusis often experience insomnia. However, it is unclear what factors are most strongly associated with insomnia. To explore factors related to insomnia in patients with tinnitus and/or Hyperacusis. This was a retrospective study using multiple-regression analysis. Data were assessed for 444 consecutive patients who sought help concerning their tinnitus and/or Hyperacusis from a specialist audiology center in the UK National Health Service. The average age of the patients was 54 years (standard deviation = 15 years). The results of audiological tests and self-report questionnaires were gathered retrospectively from the records of the patients. Multiple-regression analysis was used to assess the relationship between insomnia and other variables. Sixty-nine percent of patients with tinnitus experienced some form of insomnia as measured via the Insomnia Severity Index (ISI). A multiple-regression model showed that ISI scores were significantly associated with depression scores measured via the depression subscale of the Hospital Anxiety and Depression Scale (HADS) (regression coefficient [b] = 0.44, p The prevalence of insomnia in patients with tinnitus is high. Both tinnitus-related factors and psychological factors are related to the severity of insomnia. Hyperacusis is not significantly associated with insomnia.
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parental separation and parental mental health in childhood and risk of insomnia in adulthood among patients with tinnitus
Journal of The American Academy of Audiology, 2019Co-Authors: Hashir Aazh, Basant K Puri, Brian C J MooreAbstract:BACKGROUND Many patients seeking help for tinnitus also suffer from insomnia. Adverse childhood experiences may affect the likelihood of insomnia in later life for such patients. PURPOSE To explore whether parental separation and parental mental health during childhood are related to the severity of insomnia among patients with tinnitus and/or Hyperacusis seen in an Audiology clinic. RESEARCH DESIGN This was a retrospective cross-sectional study. STUDY SAMPLE One hundred seventy-four consecutive patients who attended a tinnitus/Hyperacusis clinic in the United Kingdom were included. DATA COLLECTION Data were based on responses to questionnaires for people seeking help for tinnitus. RESULTS Sixteen percent of patients (27/174) reported that during the first 18 years of life, their parents were separated or divorced and 41% (72/174) reported that their parent(s) suffered from a mental illness. The mean score for the insomnia severity index (ISI) was not significantly affected by parental separation or divorce. However, the mean ISI score was significantly worse for patients whose parents had a mental illness. A multinomial logistic regression model, adjusted for the presence of Hyperacusis, hearing loss, age, and gender, indicated that for individuals experiencing tinnitus, a history of parental mental illness during their childhood increased the chance of severe insomnia by a factor of 3.4 (95% confidence interval: 1.1 to 10.8, p = 0.04). The risk of having severe insomnia was 3.8 times greater for patients with Hyperacusis than for those without. CONCLUSIONS Among patients seeking help for tinnitus/Hyperacusis, poor parental mental health was associated with severe insomnia.
Sylvie Hebert - One of the best experts on this subject based on the ideXlab platform.
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modulation of Hyperacusis and tinnitus loudness in tinnitus patients with and without hearing loss following 3 weeks of acoustic stimulation a proof of concept study
Progress in Brain Research, 2021Co-Authors: Philippe Fournier, Arnaud Norena, Charlotte Bigras, Alexandre Lehmann, Sylvie HebertAbstract:Abstract Tinnitus and Hyperacusis are two debilitating conditions that are highly comorbid. It has been postulated that they may originate from similar pathophysiological mechanisms such as an increase in central gain. Interestingly, sound stimulation has been shown to reduce central gain and is currently used for the treatment of both conditions. This study investigates the effect of sound stimulation on both tinnitus and Hyperacusis in the same patients. Two distinct series of tinnitus participants were tested: one with normal or near-normal hearing (n = 16) and one with hearing loss (n = 14). A broadband noise shaped to cover most of the tinnitus frequency spectrum was delivered through hearing aids using the noise generator feature (no amplification) and verified through real-ear measurements. Participants received sound stimulation for 3 weeks and were tested before (at baseline), then after 1 week and at the end of the 3 weeks of sound stimulation. There was also a 1-month follow-up after the end of the stimulation protocol. The measurements included self-reported measures of tinnitus and Hyperacusis (VAS), validated questionnaires (THI, HQ) and psychoacoustic measurements (tinnitus battery and loudness functions). On both self-assessment (VAS of sound tolerance and tinnitus loudness) and psychoacoustic measures (loudness function and tinnitus loudness in dB), about 50% of tinnitus participants had a synchronous (either a decrease or an increase) modulation of Hyperacusis and tinnitus loudness after 1 week and 3 weeks of acoustic stimulation and up to about 70% of participants at 1-M follow-up. The decrease of Hyperacusis and tinnitus loudness was more prevalent in normal-hearing participants. There was a significant increase in tinnitus loudness during and following the stimulation in the group with hearing loss. Hyperacusis improvement as assessed by loudness function was significantly correlated with the intensity level of the acoustic stimulation (dB level of the noise produced by the noise generator) in tinnitus participants with normal/near-normal hearing thresholds. Our study partly supports the central gain hypothesis by showing synchronous modulation of Hyperacusis and tinnitus loudness. It also shows beneficial effects of acoustic stimulation in some tinnitus individuals, in particular those with normal or near-normal hearing, while highlighting the importance of a careful fitting of sound generators to prevent increase. Since the amplification feature was not turned on in our study, future work should determine whether amplification alone, or in addition to acoustic stimulation (sound generators), would benefit to those with hearing loss.
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sensitivity to sounds in sport related concussed athletes a new clinical presentation of Hyperacusis
Scientific Reports, 2018Co-Authors: Hussein A Assi, Davis R Moore, Dave Ellemberg, Sylvie HebertAbstract:Sensitivity to sounds is one frequent symptom of a sport-related concussion, but its assessment rarely goes beyond a single question. Here we examined sensitivity to sounds using psychoacoustic and psychometric outcomes in athletes beyond the acute phase of injury. Fifty-eight college athletes with normal hearing who either had incurred one or more sport-related concussions (N = 28) or who had never suffered head injury (N = 30) participated. Results indicated that the Concussed group scored higher on the Hyperacusis questionnaire and displayed greater sensitivity to sounds in psychoacoustic tasks compared to the Control group. However, further analyses that separated the Concussed group in subgroups with Sound sensitivity symptom (N = 14) and Without sound sensitivity symptom (N = 14) revealed that athletes with the sound complaint were the ones responsible for the effect: Concussed athletes with self-reported sound sensitivity had lower Loudness Discomfort Thresholds (LDLs), higher Depression and Hyperacusis scores, and shifted loudness growth functions compared to the other subgroup. A simple mediation model disclosed that LDLs exert their influence both directly on Hyperacusis scores as well as indirectly via depressive symptoms. We thus report a new clinical presentation of Hyperacusis and discuss possible mechanisms by which it could arise from concussion.
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the auditory sensitivity is increased in tinnitus ears
The Journal of Neuroscience, 2013Co-Authors: Sylvie Hebert, Philippe Fournier, Arnaud NorenaAbstract:Increased auditory sensitivity, also called Hyperacusis, is a pervasive complaint of people with tinnitus. The high prevalence of Hyperacusis in tinnitus subjects suggests that both symptoms have a common origin. It has been suggested that they may result from a maladjusted increase of central gain attributable to sensory deafferentation. More specifically, tinnitus and Hyperacusis could result from an increase of spontaneous and stimulus-induced activity, respectively. One prediction of this hypothesis is that auditory sensitivity should be increased in tinnitus compared with non-tinnitus subjects. The purpose of this study was to test this prediction by examining the loudness functions in tinnitus ears (n = 124) compared with non-tinnitus human ears (n = 106). Because tinnitus is often accompanied by hearing loss and that hearing loss makes it difficult to disentangle hypersensitivity (Hyperacusis) to loudness recruitment, tinnitus and non-tinnitus ears were carefully matched for hearing loss. Our results show that auditory sensitivity is enhanced in tinnitus subjects compared with non-tinnitus subjects, including subjects with normal audiograms. We interpreted these findings as compatible with a maladaptive central gain in tinnitus.
Elouise A Koops - One of the best experts on this subject based on the ideXlab platform.
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Hyperacusis in tinnitus patients relates to enlarged subcortical and cortical responses to sound except at the tinnitus frequency
Hearing Research, 2021Co-Authors: Elouise A Koops, P Van DijkAbstract:Hyperacusis, a hypersensitivity to sounds of mild to moderate intensity, has been related to increased neural gain along the auditory pathway. To date, there is still uncertainty on the neural correlates of Hyperacusis. Since Hyperacusis often co-occurs with hearing loss and tinnitus, the effects of the three conditions on cortical and subcortical structures are often hard to separate. In this fMRI study, two groups of hearing loss and tinnitus participants, with and without Hyperacusis, were compared to specifically investigate the effect of the latter in a group that often reports Hyperacusis. In 35 participants with hearing loss and tinnitus, with and without Hyperacusis as indicated by a cut-off score of 22 on the Hyperacusis Questionnaire (HQ), subcortical and cortical responses to sound stimulation were investigated. In addition, the frequency tuning of cortical voxels was investigated in the primary auditory cortex. In cortical and subcortical auditory structures, sound-evoked activity was higher in the group with Hyperacusis. This effect was not restricted to frequencies affected by hearing loss but extended to intact frequencies. The higher subcortical and cortical activity in response to sound thus appears to be a marker of Hyperacusis. In contrast, the response to the tinnitus frequency was reduced in the group with Hyperacusis. This increase in subcortical and cortical activity in Hyperacusis can be related to an increase in neural gain along the auditory pathway, and the reduced response to the tinnitus frequency to differences in attentional resources allocated to the tinnitus sound.