Materiały źródłowe

• #1 Hyperacusis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK557713/

  Hyperacusis is a rare hearing disorder characterized by a decreased tolerance to sound where patients report excessive loudness or pain, often leading to sound avoidant behavior. […] Hyperacusis is a rare disorder of loudness perception, where sounds that are ordinarily considered innocuous become intolerable. Patients may perceive this sensation as painful, frightening, unpleasant, or excessively loud. […] The most common cause of hyperacusis is high noise exposure. The association between hyperacusis and hearing loss is complicated. Occupational and recreational noise exposure and noise-induced hearing loss are commonly cited as major risk factors. […] In patients with hyperacusis, LDL is decreased by 1618 dB compared to the general population, in whom the average LDL is around 100 dB. Regardless of the degree of hearing loss, LDL in hyperacusis is decreased across the whole frequency spectrum, suggesting an increase in auditory gain as the underlying mechanism.

• #1 Hyperacusis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK557713/

  The central auditory gain model proposes that a reduction in auditory input can lead to a dysfunctional increase in neuronal gain, leading to over-amplification of sound and the symptoms of hyperacusis. […] Hyperacusis can also result due to dysfunction of the auditory cortex as a result of increased neural synchrony and reorganization of the tonotopic map. Hyperacusis occurring in autistic spectrum disorder is thought to be associated with subtle cochlear dysfunction and reduced effectiveness of the efferent system.

• #1

  https://journals.lww.com/otology-neurotology/Fulltext/2001/05000/Hyperacusis__Review_and_Clinical_Guidelines.9.aspx?generateEpub=Article%7Cotology-neurotology:2001:05000:00009%7C%7C

  To review the current known causes of hyperacusis and the different hypotheses concerning its etiology, and to suggest clinical guidelines. […] Hyperacusis was shown to be caused by pathologic conditions of the peripheral auditory system, diseases of the central nervous system diseases, and hormonal and infectious diseases. In some cases there was no known cause. The pathophysiology of hyperacusis probably involves a central mechanism rather than a peripheral one. Suggested clinical guidelines and treatment are discussed.

• #1 Physiological mechanisms of hyperacusis: an update | ENT & Audiology News

  https://www.entandaudiologynews.com/features/audiology-features/post/physiological-mechanisms-of-hyperacusis-an-update

  Hyperacusis is a heterogeneous and complex clinical entity, and proposals about physiological mechanisms should reflect these issues. […] Advancing diagnosis and treatment of hyperacusis requires a better understanding of its underlying neural mechanisms. […] This update will discuss recent efforts to model distinct forms of hyperacusis in animals to help elucidate potential mechanisms underlying this diverse disorder. […] Loudness hyperacusis, where moderately intense sounds are judged to be excessively loud, is the best characterised form of the disorder. Evidence points to excessive central gain enhancement as a major mechanism underlying loudness hyperacusis. […] Neuronal gain changes along the central auditory pathway are a likely mechanism underlying loudness hyperacusis. […] While there is strong support for the central gain model, less is known about how these neuronal gain changes are implemented at the cellular and molecular level. […] Hearing loss is likely to evoke a homeostatic increase in neural activity in attempts to compensate for decreased auditory input.

• #1 A window into the brain mechanisms associated with noise sensitivity | Scientific Reports

  https://www.nature.com/articles/srep39236

  Noise sensitive individuals are more likely to experience negative emotions from unwanted sounds and they show greater susceptibility to adverse effects of noise on health. […] Noise sensitivity does not originate from dysfunctions of the peripheral auditory system, and it is thus far unknown whether and how it relates to abnormalities of auditory processing in the central nervous system. […] Our results show that high noise sensitivity is associated with altered sound feature encoding and attenuated discrimination of sound noisiness in the auditory cortex. […] The current understanding is that hyperacusis results from the malfunction of the central auditory pathways and their connections within the central nervous system rather than the dysfunction at the peripheral level, whereas the mechanisms underlying NS are less well-understood.

• #1 A window into the brain mechanisms associated with noise sensitivity | Scientific Reports

  https://www.nature.com/articles/srep39236

  This suggests that NS may relate to functional changes in the central nervous system. […] Our results showed that NS is associated with functional alternation of auditory stimulus encoding and discrimination of noisy sounds. […] First, we observed a diminished P1 component of the ERP in subjects with high NS as compared to subjects with low NS. […] Second, noise sensitive subjects had generally smaller MMN amplitude than non-sensitive subjects. […] Furthermore, we found evidence for specific attenuation of MMN and MMNm to the noise feature, out of all other features, in subjects with high NS as compared to the low NS group. […] These findings suggest that central mechanisms of auditory processing and discrimination are involved and, specifically, affected in NS. […] Our results, furthermore, suggest that NS may be related to the altered mechanism of filtering of auditory input in the brain. […] Attenuation of both obligatory P1 response and MMN suggests that there are several steps of pre-attentive central auditory processing that are associated with NS. […] The neuronal mechanisms of sound processing may be the key to understanding the origin of NS.

• #1 Hyperacusis

  https://pmc.ncbi.nlm.nih.gov/articles/PMC539655/

  Another potential mechanism is auditory efferent dysfunction. An auditory efferent system is common to all mammals, and in humans consists of both a lateral and a medial system. In the medial system they begin medially with the superior olivary complex and terminate on the base of outer hair cells, and functions of the system appear to include modulation of auditory gain and the behavioural response to sound. Medial auditory dysfunction might contribute to both hyperacusis and tinnitus; thus, disturbance of the ability to modulate central gain might result in persistent sensitivity despite exposure to noise of moderate to high intensity. […] For patients, hypersensitivity of hearing may evoke anxiety and even fear. This can be true for specific sounds or for sound in general. The links between the central auditory system and areas of the brain implicated in anxiety and fear are now under close scrutiny. Specifically, anatomical and functional links between the central auditory system and the amygdalae have been identified (the amygdalae being an essential element of fear conditioning). Such processes have been described as integral to the development of tinnitus-related distress, and also to the fear and anxiety component of hyperacusis. […] Jastreboff and Hazell discussed this as a potential mechanism for hyperacusis. The experience of hyperacusis in patients with no apparent dysfunction or involvement of the peripheral auditory apparatus is circumstantial evidence in favour of this mechanism.

• #1 Effect of noise sensitivity on psychophysiological response through monoscopic 360 video and stereoscopic sound environment experience: a randomized control trial | Scientific Reports

  https://www.nature.com/articles/s41598-022-08374-y

  Noise sensitivity is a crucial factor affecting subjective psychophysiological responses to the acoustic environment of various indoor and outdoor spaces. […] Noise sensitivity did not have considerable effect on psychophysiological recovery in the natural environment, but had a significant effect on emotional response in the urban environment. […] These individual characteristics related to noise sensitivity can be explained by hyperacusis, commonly defined as a disorder that makes it hard to deal with everyday sounds that others generally do not find uncomfortable. […] Hyperacusis indicates a hypersensitivity to loudness levels where abnormally strong auditory cues occur in most frequency bands. […] Hyperacusis is a disease that can be explained by integrating multifactorial causes and hypotheses as abnormal auditory gain.

• #1 Hyperacusis

  https://pmc.ncbi.nlm.nih.gov/articles/PMC539655/

  Disorders of loudness perception, for long a clinical enigma, can represent a serious challenge to the patient. In this paper I review what is known of hyperacusis the mechanisms and approaches to treatment. […] Hyperacusis has several potential mechanisms which are not mutually exclusive; as with tinnitus, the patient population is likely to be heterogeneous. The high prevalence of hyperacusis in Williams syndrome led Marriage and Barnes to consider the mechanism in that condition and the extent to which it might be generalized to other individuals. Their suggestion that 5-HT might be implicated was based partly on the clinical observation that hyperacusis tends to occur in other conditions where 5-HT function is thought to be disturbed namely, migraine, depression and post-traumatic stress disorder. 5-HT does appear to have a role in modulating auditory gain and the determination of significance of sound.

• #1 Hyperacusis – Article 1223

  https://www.audiologyonline.com/articles/hyperacusis-1223

  Interestingly, the presence of asymmetric hyperacusis might support a peripheral based etiology, as central mechanisms would likely impact both sides. […] Some medical conditions can be linked to the central processing of signals, and modification of the level of neuromodulators as a factor inducing or enhancing hyperacusis. […] Moreover, serotonin was indicated as involved in hyperacusis, and a recent case report indicated that serotonin reuptake inhibitors might be helpful for hyperacusis. […] Decreased sound tolerance, including hyperacusis, misophonia, and phonophobia, is a challenging topic to study and a challenging symptom to treat. Many questions are unanswered; etiology is not clear, neural mechanisms are speculative and treatments are not yet proven.

• #1 Effect of noise sensitivity on psychophysiological response through monoscopic 360 video and stereoscopic sound environment experience: a randomized control trial | Scientific Reports

  https://www.nature.com/articles/s41598-022-08374-y

  Hyperacusis mostly indicates decreased sound tolerance and sometimes the decline of the hearing threshold, that is, abnormally excellent hearing. […] The group with relatively high noise sensitivity may have slowed down the emotional recovery due to more neural excitement than recovery due to the natural environment stimuli. […] Changes in afferent neural plasticity, neurotransmitter, hormones, and olivocochlear efferent control disorder have been studied as the pathological mechanisms of the central auditory system related to hyperacusis, leading to an abnormal increase in auditory gain. […] The emotional difference due to noise sensitivity may have been more apparent in the urban than the natural environment that is relatively fixed since the city has various noise sources.

• #1

  https://journals.lww.com/ear-hearing/fulltext/2022/07000/the_impact_of_occupational_noise_exposure_on.26.aspx

  Interestingly, studies suggest that cochlear type-II neurons may act as pain receptors reacting to noise-induced tissue damage, possibly explaining pain hyperacusis. […] The general population prevalence of self-reported hyperacusis has been reported at 8% to 9% among Swedish adults, whereas a Polish study reported a 15% prevalence. […] One possible explanation to the increased risk in preschool personnel is occupational noise exposure. […] While previous studies indicate that sudden intense sounds may be particularly harmful and may lead to hyperacusis, there is a lack of studies on the effects of long-term occupational noise exposure, of dose-response relationships and of causal effects. […] This study indicates increased risk of hyperacusis already below the permissible occupational noise exposure limit in Sweden (85 dB LAeq,8h) among female workers in general, and in particular among preschool teachers.

• #1 Hyperacusis – Wikipedia

  https://en.wikipedia.org/wiki/Hyperacusis

  Hyperacusis is an increased sensitivity to sound and a low tolerance for environmental noise. […] Proposed mechanisms in the literature involve dysfunction in the brain, inner ear, or middle ear. […] As one possible mechanism, adaptation processes in the auditory brain that influence the dynamic range of neural responses are assumed to be distorted by irregular input from the inner ear. This is mainly caused by hearing loss related damage in the inner ear. […] The mechanism behind hyperacusis is not currently known, but it is suspected to be caused by damage to the inner ear and cochlea. […] Type II afferent fibers of the cochlear nerve are not responsible for hearing like the type I afferent fibers. They are thought to be cochlear pain neurons. Gain of function of these type II afferent fibers may be caused by a flood of ATP after hair cell damage.

• #1 Hyperacusis – Wikipedia

  https://en.wikipedia.org/wiki/Hyperacusis

  Norea et al. (2018) propose a model that may account for sound-induced pain and a constellation of other symptoms often experienced after an acoustic shock, acoustic trauma, and potentially other mechanisms of auditory damage. Symptoms may include a sense of fullness in the ear, tinnitus, and dizziness. […] The model details how symptoms may be initiated by tensor tympani muscle damage or overload due to acoustic shock or trauma. Hypercontraction or hyperactivity of the muscle may cause an „ATP energy crisis.” […] Pain from sound sometimes radiates to the face, scalp, and neck. This may be due to the trigeminocervical complex in the brainstem, which integrates input from and output to various regions of the head and neck, including the middle ear.

• #1 Hyperacusis – Article 1223

  https://www.audiologyonline.com/articles/hyperacusis-1223

  Hyperacusis has recently attracted professional attention. […] Epidemiologic studies and prevalence rates are not well described, mechanisms are speculative and anatomic sites and etiology are, unfortunately, not well documented. […] In the majority of cases the etiology of hyperacusis is unknown. Hyperacusis has been linked to sound exposure (particularly short, impulse noise), head injury, stress, and medications. The lack of strong epidemiological data, and the lack of an animal model for hyperacusis prevents us from proving the validity of any theory of potential mechanism responsible for hyperacusis. […] At the peripheral level it is possible to speculate that the abnormal enhancement of vibratory signals within the cochlea by the outer hair cells (OHC) might result in overstimulation of inner hair cells (IHC) and subsequently result in hyperacusis.

• #1 Physiological mechanisms of hyperacusis: an update | ENT & Audiology News

  https://www.entandaudiologynews.com/features/audiology-features/post/physiological-mechanisms-of-hyperacusis-an-update

  Pain hyperacusis is the least understood form of hyperacusis and, until recently, the concept of noise-induced pain was a mystery to researchers and clinicians. […] Interestingly, several recent studies have implicated a novel pathway from the ear to the brain in signalling noxious or painful auditory stimuli, termed noxacusis or auditory nociception. […] A fundamental question that remains for hyperacusis research is whether different forms of hyperacusis are mechanistically distinct disorders with overlapping presentation, or if they converge on a common pathophysiological mechanism. Current evidence suggests that different forms of hyperacusis may be mediated by distinct mechanisms. […] With continued research, the field is positioned to make great insights into the pathophysiological mechanism of hyperacusis and, most importantly, develop novel therapies for this often devastating disorder.

• #1 Hyperacusis – Balance & Dizziness Canada

  https://balanceanddizziness.org/symptoms/hyperacusis/

  Other theories for why hyperacusis occurs include: malfunction of the ear’s protective hearing mechanisms, damage to a portion of the auditory nerve, a malfunction of the facial nerve. […] More than 80% of patients with hyperacusis also have tinnitus (ringing in the ears). Hyperacusis can develop before, at the same time as, or after the onset of tinnitus. The frequent combination of hyperacusis and tinnitus suggests they may be caused by a similar mechanism. […] The noise of an MRI scan may trigger or worsen hyperacusis. Scanning sequences for the internal auditory canal (IAC) are especially noisy. Hearing protection should be available, and equipment can be set up to reduce noise exposure. […] In some cases, hyperacusis appears without connection to any event or condition (idiopathic).

• #1 Hyperacusis: Hearing Sensitivity Causes and Treatment

  https://my.clevelandclinic.org/health/diseases/24320-hyperacusis

  Still, there isnt a single cause that explains all cases of hyperacusis. Instead, its associated with multiple possible contributing factors and conditions. […] Hyperacusis often accompanies conditions like tinnitus (up to 86% of people) and Williams syndrome (as many as 90% of people). Nearly half of the people diagnosed with hyperacusis also have a behavioral health condition, like anxiety. […] There isnt a standard treatment for hyperacusis. Instead, treatments usually involve reducing physical symptoms and teaching coping strategies to handle the mental stress of hyperacusis. […] The goal is to gradually (and safely) expose you to progressively louder sounds until the sound experience becomes more manageable. […] CBT teaches how to deal with the stress and negative feelings associated with loud sounds. It reduces the fear and anxiety associated with hyperacusis. […] There isnt a cure for hyperacusis, but depending on whats causing it, your symptoms may improve in time.

• #1 Tinnitus and Hyperacusis: #1 Expert Guide | NeuroMed Tinnitus Clinic

  https://neuromedcare.com/tinnitus-and-hyperacusis/

  We believe that an atypical migraine reaction in the brain drives hyperacusis. Drawing from the central sensitization model, we have found that hyperacusis is initiated by an inflammatory condition in the brain (i.e., migraine). […] Considering that: the migraine reaction initiates and drives the dynamic changes in hyperacusis and tinnitus, and the migraine reaction stimulates the brain wiring changes described in the central gain model; we must conclude that without managing the underlying migraine process, sound-based treatment for hyperacusis alone is likely to fail. […] Overall, the natural history of hyperacusis is highly individualized. However, when we see hyperacusis combined with tinnitus, it is often a red flag that both conditions will escalate. The good news is that treatment is possible, and people are recovering from hyperacusis and tinnitus under my care every day.

• #1 Desensitization tools for hyperacusis and sound sensitivity

  https://www.healthyhearing.com/report/53529-Hyperacusis-tinnitus-and-sound-tolerance-finding-relief-from-noise

  Sound sensitivity and hyperacusis are caused by a variety of different health conditions and factors, many of which are treatable. But even if you are never able to identify or treat what caused your sound sensitivity, you can still desensitize to sound and restore your quality of life. […] The most effective strategy is to use much quieter volume levels for than you would for tinnitus sound therapy, simply as a way to keep the auditory system activated at all times. […] Its important to remember that hyperacusis desensitization takes time, even with the best available techniques. All of the strategies mentioned here require repetition and time to increase your sound tolerance.

• #1 Hyperacusis – Types, Causes, Symptoms, Treatment & Prevention

  https://www.medindia.net/health/conditions/hyperacusis.htm

  Hyperacusis (or hyperacousis) is a rare hearing disorder characterized by an abnormal sensitivity to noises or high-pitched sound. […] Cochlear hyperacusis is the most common type and it damages the sound sensing organ (cochlea). […] There is also some evidence that suggests that chemical imbalances of neurotransmitters in the brain can cause this condition. […] If the condition is left untreated, it may lead to increased stress levels, anxiety and phonophobia (psychological fear of sound). […] The most common treatment for hyperacusis is retraining therapy, which uses broadband noise. […] Tinnitus Retraining Therapy (TRT): TRT is habituation-oriented therapy. The goal of this therapy is to reduce the patient’s reactions to hyperacusis. […] Counseling session involves an in-depth discussion of the tests, anatomy and physiology of the hearing mechanism and how it relates to hyperacusis.

• #1 Why Are My Ears so Sensitive to Noise? Hyperacusis Explained – Regain Hearing

  https://www.regainhearing.co.uk/blog/why-are-my-ears-so-sensitive-to-noise-hyperacusis-explained/

  The distress and confusion is the primary issue for patients, and knowledge is enough to help them make simple changes to impact their lifestyle in a positive way. […] If there is a known factor involved in your noise sensitivity, like an injury or a medical condition, treatment of this factor will be the first way caregivers look to help reduce the symptoms of hyperacusis. […] If no external factors are known to cause your hearing sensitivity, sound therapy is the primary method of treatment. […] Sensitive hearing is a very unique and distressing condition, but you do have options for support.

• #1 Tensor Tympani Syndrome | The Hyperacusis Network

  https://hyperacusis.net/tensor-tympani-syndrome/

  The aim of hyperacusis/phonophobia management therapy is to provide information, counseling and a desensitization program, based on Tinnitus Retraining Therapy principles, to increase tolerance to everyday sound. […] Once the mechanism of hyperacusis has been understood, practical self-management strategies to assist desensitization and reduce auditory hypervigilance, personalized to suit each persons individual coping style, can be developed.

• #1

  https://journals.lww.com/ear-hearing/fulltext/2022/07000/the_impact_of_occupational_noise_exposure_on.26.aspx

  The significant results were confirmed in an exposure sensitivity analysis with a strict division of preschool workers and non-preschool workers. […] The substantial risk among preschool personnel is argued, based on earlier studies, to be explained by infrequent use of hearing protection, frequent exposure to screaming in the ears, and possibly also simultaneous exposure to stressful working conditions. […] The results of increased risk of hyperacusis in relation to occupational noise exposure below the permissible exposure limit should have implications for occupational health care, occupational medicine, and audiological management of occupational disability claims relating to hyperacusis cases, particularly among women working in preschool.

• #2 4 Types of Sound Sensitivity | The Hyperacusis Network

  https://hyperacusis.net/what-is-hyperacusis/4-types-of-sound-sensitivity/

  These individuals have a collapsed tolerance to normal environmental sound. The term commonly used to describe this condition is hyperacusis. Hyperacusis can come on gradually or occur suddenly where the patient finds themself in a state of crisis. Patients who have a collapsed tolerance to sound need to have their Loudness Discomfort Levels (LDLs) established by a hearing healthcare professional. Normal LDLs are in the 85-90+ decibel range. Patients with hyperacusis would have LDLs well below that level. The common treatment for hyperacusis is listening to broadband pink noise though sound generators (special hearing aids) which must be ordered through a specially trained doctor or audiologist who administers Hyperacusis (Tinnitus) Retraining Therapy. The therapy often costs $3000-$4000 (depending on the clinician) and typically is not covered by insurance.

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