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Makani P, Thioux M, Koops EA, Pyott SJ, van Dijk P. Hyperacusis in Tinnitus Individuals Is Associated with Smaller Gray Matter Volumes in the Supplementary Motor Area Regardless of Hearing Levels. Brain Sci 2024; 14:726. [PMID: 39061466 PMCID: PMC11275185 DOI: 10.3390/brainsci14070726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2024] [Revised: 07/11/2024] [Accepted: 07/12/2024] [Indexed: 07/28/2024] Open
Abstract
Recent evidence suggests a connection between hyperacusis and the motor system of the brain. For instance, our recent study reported that hyperacusis in participants with tinnitus and hearing loss is associated with smaller gray matter volumes in the supplementary motor area (SMA). Given that hearing loss can affect gray matter changes in tinnitus, this study aimed to determine if the changes reported in our previous findings of smaller SMA gray matter volumes in hyperacusis persist in the absence of hearing loss. Data for this study were gathered from four prior studies conducted between 2004 and 2019 at the University Medical Centre Groningen (UMCG). A total of 101 participants with tinnitus and either clinically normal hearing (normal hearing with tinnitus or NHT, n = 35) or bilateral sensorineural hearing loss (hearing loss with tinnitus or HLT, n = 66) were included across four studies. Hyperacusis was determined by a score of ≥22 on the Hyperacusis Questionnaire (HQ). In the NHT group, 22 (63%) participants scored ≥22 on the HQ (NHT with hyperacusis: mean age 44.1 years, 12 females), while in the HLT group, 25 (38%) participants scored ≥22 on the HQ (HLT with hyperacusis: mean age 59.5 years, 10 females). The 2 × 2 between-group ANOVAs revealed that hyperacusis is associated with smaller SMA gray matter volumes, regardless of hearing levels. Notably, the smaller SMA gray matter volumes in hyperacusis were primarily influenced by the attentional subscales of the HQ. The association between hyperacusis and the motor system may indicate a constant alertness to sounds and a readiness for motor action.
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Affiliation(s)
- Punitkumar Makani
- Department of Otorhinolaryngology—Head and Neck Surgery, University of Groningen, University Medical Center Groningen, 9700 RB Groningen, The Netherlands; (P.M.); (E.A.K.); (S.J.P.); (P.v.D.)
- Graduate School of Medical Sciences (Research School of Behavioral and Cognitive Neurosciences), University of Groningen, 9713 AV Groningen, The Netherlands
| | - Marc Thioux
- Department of Otorhinolaryngology—Head and Neck Surgery, University of Groningen, University Medical Center Groningen, 9700 RB Groningen, The Netherlands; (P.M.); (E.A.K.); (S.J.P.); (P.v.D.)
- Graduate School of Medical Sciences (Research School of Behavioral and Cognitive Neurosciences), University of Groningen, 9713 AV Groningen, The Netherlands
| | - Elouise A. Koops
- Department of Otorhinolaryngology—Head and Neck Surgery, University of Groningen, University Medical Center Groningen, 9700 RB Groningen, The Netherlands; (P.M.); (E.A.K.); (S.J.P.); (P.v.D.)
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA
| | - Sonja J. Pyott
- Department of Otorhinolaryngology—Head and Neck Surgery, University of Groningen, University Medical Center Groningen, 9700 RB Groningen, The Netherlands; (P.M.); (E.A.K.); (S.J.P.); (P.v.D.)
- Graduate School of Medical Sciences (Research School of Behavioral and Cognitive Neurosciences), University of Groningen, 9713 AV Groningen, The Netherlands
| | - Pim van Dijk
- Department of Otorhinolaryngology—Head and Neck Surgery, University of Groningen, University Medical Center Groningen, 9700 RB Groningen, The Netherlands; (P.M.); (E.A.K.); (S.J.P.); (P.v.D.)
- Graduate School of Medical Sciences (Research School of Behavioral and Cognitive Neurosciences), University of Groningen, 9713 AV Groningen, The Netherlands
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Aazh H, Najjari A, Moore BCJ. A Preliminary Analysis of the Clinical Effectiveness of Audiologist-Delivered Cognitive Behavioral Therapy Delivered via Video Calls for Rehabilitation of Misophonia, Hyperacusis, and Tinnitus. Am J Audiol 2024; 33:559-574. [PMID: 38651993 DOI: 10.1044/2024_aja-23-00254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/25/2024] Open
Abstract
PURPOSE Cognitive behavioral therapy (CBT) is a key intervention for management of misophonia, hyperacusis, and tinnitus. The aim of this study was to perform a preliminary analysis comparing the scores for self-report questionnaires before and after audiologist-delivered CBT via video calls for adults with misophonia, hyperacusis, or tinnitus or a combination of these. METHOD This was a retrospective cross-sectional study. The data for 37 consecutive patients who received CBT for misophonia, hyperacusis, or tinnitus from a private institute in the United Kingdom were analyzed. Self-report questionnaires taken as part of routine care were as follows: 4C Questionnaires for tinnitus, hyperacusis, and misophonia (4C-T, 4C-H, and 4C-M, respectively), Tinnitus Impact Questionnaire (TIQ), Hyperacusis Impact Questionnaire (HIQ), Misophonia Impact Questionnaire (MIQ), Sound Sensitivity Symptoms Questionnaire (SSSQ), and Screening for Anxiety and Depression in Tinnitus (SAD-T). Responses were also obtained to other questionnaires related to tinnitus, hyperacusis, insomnia, and anxiety and mood disorders. A linear mixed-model method was used to assess the changes in response to the questionnaires pretreatment and posttreatment. RESULTS Pretreatment-posttreatment comparisons showed that scores for the 4C-T, 4C-H, 4C-M, TIQ, HIQ, MIQ, SSSQ, and SAD-T improved, with effect sizes of 1.4, 1.2, 1.3, 2.6, 0.9, 0.7, 0.9, and 1.4, respectively (all p < .05). CONCLUSIONS This preliminary analysis suggests that CBT via video calls may be effective in reducing the impact of misophonia, hyperacusis, and tinnitus. However, this study did not have a control group, so its results need to be interpreted with caution.
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Affiliation(s)
- Hashir Aazh
- Hashir International Specialist Clinics & Research Institute for Misophonia, Tinnitus and Hyperacusis, London, United Kingdom
- Faculty of Engineering and Physical Sciences, University of Surrey, United Kingdom
| | - Anahita Najjari
- Hashir International Specialist Clinics & Research Institute for Misophonia, Tinnitus and Hyperacusis, London, United Kingdom
| | - Brian C J Moore
- Hashir International Specialist Clinics & Research Institute for Misophonia, Tinnitus and Hyperacusis, London, United Kingdom
- Cambridge Hearing Group, Department of Psychology, University of Cambridge, United Kingdom
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Aazh H, Moore BCJ, Erfanian M. Confirmatory factor analysis of the Tinnitus Impact Questionnaire using data from patients seeking help for tinnitus alone or tinnitus combined with hyperacusis. PLoS One 2024; 19:e0302837. [PMID: 38718050 PMCID: PMC11078403 DOI: 10.1371/journal.pone.0302837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Accepted: 04/12/2024] [Indexed: 05/12/2024] Open
Abstract
A confirmatory factor analysis (CFA) of the Tinnitus Impact Questionnaire (TIQ) was performed. In contrast to commonly used tinnitus questionnaires, the TIQ is intended solely to assess the impact of tinnitus by not including items related to hearing loss or tinnitus loudness. This was a psychometric study based on a retrospective cross-sectional analysis of clinical data. Data were available for 155 new patients who had attended a tinnitus and hyperacusis clinic in the UK within a five-month period and had completed the TIQ. The mean age was 54 years (standard deviation = 14 years). The TIQ demonstrated good internal consistency, with Cronbach's α = 0.84 and McDonald's ω = 0.89. CFA showed that two items of the TIQ had low factor loadings for both one-factor and two-factor models and their scores showed low correlations with scores for other items. Bi-factor analysis gave a better fit, indicated by a relative chi-square (χ2) of 18.5, a Root-Mean Square Error of Approximation (RMSEA) of 0.103, a Comparative Fit Index (CFI) of 0.97, a Tucker Lewis Index (TLI) of 0.92, and a Standardized Root-Mean Residual (SPMR) of 0.038. Total TIQ scores were moderately correlated with scores for the Visual Analogue Scale of effect of tinnitus on life and the Screening for Anxiety and Depression-Tinnitus questionnaire, supporting the convergent validity of the TIQ. The TIQ score was not correlated with the pure-tone average hearing threshold, indicating discriminant validity. A multiple-causes multiple-indicator (MIMIC) model showed no influences of age, gender or hearing status on TIQ item scores. The TIQ is an internally consistent tool. CFA suggests a bi-factor model with sufficient unidimensionality to support the use of the overall TIQ score for assessing the impact of tinnitus. TIQ scores are distinct from the impact of hearing impairment among patients who have tinnitus combined with hearing loss.
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Affiliation(s)
- Hashir Aazh
- Hashir International Specialist Clinics & Research Institute for Misophonia, Tinnitus and Hyperacusis Ltd, London, United Kingdom
- Audiology Department, Royal Surrey NHS Foundation Trust, Guildford, United Kingdom
| | - Brian C. J. Moore
- Hashir International Specialist Clinics & Research Institute for Misophonia, Tinnitus and Hyperacusis Ltd, London, United Kingdom
- Cambridge Hearing Group, Department of Psychology, University of Cambridge, Cambridge, United Kingdom
| | - Mercede Erfanian
- Hashir International Specialist Clinics & Research Institute for Misophonia, Tinnitus and Hyperacusis Ltd, London, United Kingdom
- Institute for Environmental Design and Engineering, The Bartlett, University College London, London, United Kingdom
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Aazh H, McFerran D, Danesh AA, Louw C, Moore BCJ. A comparison of interaural asymmetry, audiogram slope, and psychometric measures of tinnitus, hyperacusis, anxiety and depression for patients with unilateral and bilateral tinnitus. Int J Audiol 2024; 63:373-380. [PMID: 36688600 DOI: 10.1080/14992027.2022.2160383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2022] [Revised: 12/06/2022] [Accepted: 12/11/2022] [Indexed: 01/24/2023]
Abstract
OBJECTIVE To evaluate differences in tinnitus impact, hyperacusis and hearing threshold level (HTL) between patients with unilateral and bilateral tinnitus. For patients with unilateral tinnitus, to compare audiological variables for the tinnitus ear and the non-tinnitus ear. To assess whether the presence of unilateral tinnitus increases the likelihood of interaural hearing asymmetry (relative to bilateral tinnitus) that warrants referral for an MRI scan. DESIGN Retrospective cross-sectional. STUDY SAMPLE Data regarding HTLs and responses to self-report questionnaires were collected from the records of 311 patients attending a tinnitus clinic. RESULTS 38.5% had unilateral tinnitus and the ears with tinnitus had higher HTLs and greater HTL slopes than the ears without tinnitus. There was no significant difference in tinnitus impact and hyperacusis between patients with unilateral and bilateral tinnitus. 40% of patients with unilateral tinnitus and 13% of patients with bilateral tinnitus had a between-ear difference in HTL ≥15 dB at two adjacent frequencies (2AF15 asymmetry). Unilateral tinnitus increased the risk of 2AF15 asymmetry by a factor of 4.4. CONCLUSIONS Unilateral tinnitus increases the risk of having interaural asymmetry in HTLs that warrants referral for an MRI scan.
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Affiliation(s)
- Hashir Aazh
- Audiology Department, Royal Surrey NHS Foundation Trust, Guildford, UK
- Department of Communication Sciences & Disorders, Florida Atlantic University, Boca Raton, FL, USA
- Hashir International Specialist Clinics & Research Institute for Misophonia, Tinnitus and Hyperacusis, London, UK
| | | | - Ali A Danesh
- Department of Communication Sciences & Disorders, Florida Atlantic University, Boca Raton, FL, USA
| | - Christine Louw
- Department of Speech-Language Pathology and Audiology, University of Pretoria, Pretoria, South Africa
| | - Brian C J Moore
- Cambridge Hearing Group, Department of Psychology, University of Cambridge, Cambridge, UK
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Bernal-Robledano A, Perez-Carpena P, Kikidis D, Mazurek B, Schoisswohl S, Staudinger S, Langguth B, Schlee W, Lopez-Escamez JA. Cognitive Screening and Hearing Assessment in Patients With Chronic Tinnitus. Clin Exp Otorhinolaryngol 2024; 17:15-25. [PMID: 37974057 PMCID: PMC10933812 DOI: 10.21053/ceo.2023.00808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 09/27/2023] [Accepted: 11/12/2023] [Indexed: 11/19/2023] Open
Abstract
OBJECTIVES The study aimed to assess the relationship of tinnitus with hyperacusis with cognitive impairment as indicated by the Montreal Cognitive Assessment (MoCA) tool. METHODS This multicenter cross-sectional study included individuals with chronic tinnitus from the "Unification of Treatments and Interventions for Tinnitus Patients" (UNITI) database. Participants were recruited from four different tertiary clinical centers located in Athens and Granada (Mediterranean group), as well as Berlin and Regensburg (German group). In total, 380 individuals with a diagnosis of non-pulsatile chronic tinnitus (permanent and constant tinnitus lasting more than 6 months) and no evidence of severe cognitive impairment (MoCA score >22) were enrolled. The evaluation utilized the following tools: MoCA, Tinnitus Handicap Inventory (THI), Hyperacusis Questionnaire (GÜF), Patient Health Questionnaire (PHQ-9), and the European School for Interdisciplinary Tinnitus Research Screening Questionnaire. RESULTS MoCA scores differed between German and Mediterranean individuals (P<0.01), necessitating separate analyses for each group. In both cohorts, MoCA scores were significantly associated with education level, age, hearing threshold at 8 kHz, and THI. Furthermore, a significant correlation was observed between PHQ-9 scores and both THI and GÜF (P<0.01 for both Germans and those from the Mediterranean). CONCLUSION Our data suggest an association between tinnitus handicap, high-frequency hearing loss, and mild cognitive impairment. Additionally, PHQ-9 scores were associated with tinnitus and hyperacusis scores, independent of hearing loss thresholds.
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Affiliation(s)
- Alberto Bernal-Robledano
- Otology and Neurotology Group CTS495, Instituto de Investigación Biosanitaria, ibs. Granada, Universidad de Granada, Granada, Spain
- Division of Otolaryngology, Department of Surgery, University of Granada, Granada, Spain
- Sensorineural Pathology Programme, Centro de Investigación Biomédica en Red en Enfermedades Raras, CIBERER, Madrid, Spain
| | - Patricia Perez-Carpena
- Otology and Neurotology Group CTS495, Instituto de Investigación Biosanitaria, ibs. Granada, Universidad de Granada, Granada, Spain
- Division of Otolaryngology, Department of Surgery, University of Granada, Granada, Spain
- Sensorineural Pathology Programme, Centro de Investigación Biomédica en Red en Enfermedades Raras, CIBERER, Madrid, Spain
- Department of Otolaryngology, Hospital Universitario Virgen de las Nieves, Granada, Spain
| | - Dimitris Kikidis
- Department of Otolaryngology-Head and Neck Surgery, Hippocrateion General Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Birgit Mazurek
- Charité‒Universitätsmedizin Berlin, Tinnitus Center, Berlin, Germany
| | - Stefan Schoisswohl
- Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany
- Department of Human Sciences, Institute of Psychology, Universität der Bundeswehr München, Neubiberg, Germany
| | - Susanne Staudinger
- Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany
| | - Berthold Langguth
- Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany
| | - Winfried Schlee
- Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany
- Institute for Information and Process Management, Eastern Switzerland University of Applied Sciences, St. Gallen, Switzerland
| | - Jose Antonio Lopez-Escamez
- Otology and Neurotology Group CTS495, Instituto de Investigación Biosanitaria, ibs. Granada, Universidad de Granada, Granada, Spain
- Division of Otolaryngology, Department of Surgery, University of Granada, Granada, Spain
- Sensorineural Pathology Programme, Centro de Investigación Biomédica en Red en Enfermedades Raras, CIBERER, Madrid, Spain
- Meniere’s Disease Neuroscience Research Program, Faculty of Medicine and Health, School of Medical Sciences, The Kolling Institute, University of Sydney, Sydney, Australia
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Smith SS, Jahn KN, Sugai JA, Hancock KE, Polley DB. The human pupil and face encode sound affect and provide objective signatures of tinnitus and auditory hypersensitivity disorders. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2023.12.22.571929. [PMID: 38187580 PMCID: PMC10769427 DOI: 10.1101/2023.12.22.571929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/09/2024]
Abstract
Sound is jointly processed along acoustic and emotional dimensions. These dimensions can become distorted and entangled in persons with sensory disorders, producing a spectrum of loudness hypersensitivity, phantom percepts, and - in some cases - debilitating sound aversion. Here, we looked for objective signatures of disordered hearing (DH) in the human face. Pupil dilations and micro facial movement amplitudes scaled with sound valence in neurotypical listeners but not DH participants with chronic tinnitus (phantom ringing) and sound sensitivity. In DH participants, emotionally evocative sounds elicited abnormally large pupil dilations but blunted and invariant facial reactions that jointly provided an accurate prediction of individual tinnitus and hyperacusis questionnaire handicap scores. By contrast, EEG measures of central auditory gain identified steeper neural response growth functions but no association with symptom severity. These findings highlight dysregulated affective sound processing in persons with bothersome tinnitus and sound sensitivity disorders and introduce approaches for their objective measurement.
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Affiliation(s)
- Samuel S Smith
- Eaton-Peabody Laboratories, Massachusetts Eye and Ear, Boston MA, 02114 USA
- Department of Otolaryngology - Head and Neck Surgery, Harvard Medical School, Boston MA 02114 USA
- Lead contact
| | - Kelly N Jahn
- Eaton-Peabody Laboratories, Massachusetts Eye and Ear, Boston MA, 02114 USA
- Department of Otolaryngology - Head and Neck Surgery, Harvard Medical School, Boston MA 02114 USA
| | - Jenna A Sugai
- Eaton-Peabody Laboratories, Massachusetts Eye and Ear, Boston MA, 02114 USA
| | - Ken E Hancock
- Eaton-Peabody Laboratories, Massachusetts Eye and Ear, Boston MA, 02114 USA
- Department of Otolaryngology - Head and Neck Surgery, Harvard Medical School, Boston MA 02114 USA
| | - Daniel B Polley
- Eaton-Peabody Laboratories, Massachusetts Eye and Ear, Boston MA, 02114 USA
- Department of Otolaryngology - Head and Neck Surgery, Harvard Medical School, Boston MA 02114 USA
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Aazh H, Kartsonaki C, Moore BCJ. Psychometric evaluation of the 4C tinnitus management questionnaire for patients with tinnitus alone or tinnitus combined with hyperacusis. Int J Audiol 2024; 63:21-29. [PMID: 36426916 DOI: 10.1080/14992027.2022.2143430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Accepted: 10/28/2022] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To assess the psychometric properties of a new questionnaire evaluating patients' confidence in managing their tinnitus, the 4C tinnitus management questionnaire (4C), which was designed to be used in the process of cognitive behavioural therapy. DESIGN Retrospective cross-sectional based on patient records. STUDY SAMPLES 99 consecutive patients who sought help for tinnitus (with or without hyperacusis) from an audiology clinic in the UK. Pure tone average (PTA) hearing thresholds, Uncomfortable Loudness Levels (ULLs), and responses to the 4C questionnaire, Tinnitus Handicap Inventory (THI), Hyperacusis Questionnaire (HQ), and Screening for Anxiety and Depression in Tinnitus (SAD-T) questionnaire were gathered from the records of patients held at the audiology department. RESULTS Cronbach's alpha for the 4C was 0.91, indicating high internal consistency. Exploratory factor analysis suggested a one-factor solution. Discriminant validity was supported by weak correlations between 4C scores and PTA across ears and ULLmin (the across-frequency average ULL for the ear with lower average ULL). Convergent validity was supported by moderate correlations between 4C scores and scores for the THI, HQ, and SAD-T. CONCLUSIONS The 4C is an internally consistent questionnaire with high convergent and discriminant validity, which can be used to assess patients' confidence in managing their tinnitus.
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Affiliation(s)
- Hashir Aazh
- Audiology Department, Royal Surrey NHS Foundation Trust, Guildford, UK
- Department of Communication Sciences & Disorders, Florida Atlantic University, Boca Raton, USA
- Faculty of Engineering and Physical Sciences, University of Surrey, Guildford, UK
| | - Christiana Kartsonaki
- MRC Population Health Research Unit, Clinical Trials Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Brian C J Moore
- Cambridge Hearing Group, Department of Psychology, University of Cambridge, Cambridge, UK
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Sacchetto L, Apa E, Ciorba A, Palma S, Caragli V, Gherpelli C, Monzani D, Genovese E, Nocini R. Psychological Profile and Social Behaviors of Patients with Hyperacusis. J Clin Med 2022; 11:jcm11247317. [PMID: 36555934 PMCID: PMC9784993 DOI: 10.3390/jcm11247317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 12/02/2022] [Accepted: 12/08/2022] [Indexed: 12/13/2022] Open
Abstract
Increased noise sensitivity refers to the abnormal subjective response to external sounds, with a prevalence of between 8% and 15.2% in the adult population as suggested by epidemiological studies. The basic neural mechanism of hyperacusis still remains obscure, so therapies for this often-devastating symptom remain elusive. The aim of this study was to assess psychological profiles in patients with presbycusis without tinnitus in a perspective case-control design. All subjects were initially submitted to audiological evaluation (tympanometry, recordings of the acoustic reflex thresholds, pure tone audiometry) and subsequently were administered the following questionnaires: the hyperacusis questionnaire (HQ), the brief symptom inventory (BSI), and the modified somatic perception questionnaire (MSPQ). Patients with hyperacusis reported a total score and subscales (attentional, social, and emotional) of the HQ significantly higher than controls. They also reported higher scores of the MSPQ and significantly higher mean values with concern to the somatization, obsessive-compulsive, interpersonal sensitivity, depression, and anxiety subscales of the BSI. These results show that psychological distress, as expressed by higher level of somatic attention, somatization, anxiety, and depression, is a significant factor to consider for a complete diagnosis and effective treatment of hyperacusis. For a correct diagnosis of patients seeking help for hyperacusis, their psychological distress should also be assessed, regardless of their hearing abilities. Further studies are required to investigate the pathological mechanisms that are involved in the onset of hyperacusis in patients with normal hearing and those with sensorineural hearing loss.
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Affiliation(s)
- Luca Sacchetto
- Ear Nose and Throat (ENT), Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, University of Verona, 37134 Verona, Italy
| | - Enrico Apa
- Audiology, ENT Department, University of Modena and Reggio Emilia, 41100 Modena, Italy
| | - Andrea Ciorba
- ENT & Audiology Unit, Department of Neurosciences, University Hospital of Ferrara, Via Aldo Moro 8, 44124 Cona, Italy
| | - Silvia Palma
- Audiology, Primary Care Department, Ausl Modena, 41121 Modena, Italy
- Correspondence:
| | - Valeria Caragli
- Audiology, ENT Department, University of Modena and Reggio Emilia, 41100 Modena, Italy
| | - Chiara Gherpelli
- Audiology, ENT Department, University of Modena and Reggio Emilia, 41100 Modena, Italy
| | - Daniele Monzani
- Ear Nose and Throat (ENT), Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, University of Verona, 37134 Verona, Italy
| | - Elisabetta Genovese
- Audiology, ENT Department, University of Modena and Reggio Emilia, 41100 Modena, Italy
| | - Riccardo Nocini
- Ear Nose and Throat (ENT), Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, University of Verona, 37134 Verona, Italy
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What Should Be Considered When Assessing Hyperacusis? A Qualitative Analysis of Problems Reported by Hyperacusis Patients. Brain Sci 2022; 12:brainsci12121615. [PMID: 36552075 PMCID: PMC9775019 DOI: 10.3390/brainsci12121615] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 11/23/2022] [Accepted: 11/24/2022] [Indexed: 11/27/2022] Open
Abstract
Hyperacusis (decreased sound tolerance) is a prevalent complaint. Yet, to date, no research has qualitatively evaluated the types of problems experienced by adults with hyperacusis. Our service evaluation aims to determine the hyperacusis-related problem domains reported by patients and the degree to which these domains were reported together. Retrospective analysis was conducted on an anonymised clinical dataset from 306 patients who attended a UK tinnitus and hyperacusis treatment centre between 1994 and 2017. Conventional content analysis was used to categorise responses to the question 'Why is hyperacusis a problem?' into domains which were then subjected to a cluster analysis. Twenty-five problem domains were identified, of which 12 were further classified into three overarching categories. 'Fear', 'Reduced quality of life' and 'Physical reaction to sound' were most frequently reported problems. Cluster analysis revealed that 'Sleep difficulties' and 'Despondency', were commonly reported together. Adults with hyperacusis face many challenges in their everyday lives. The nature of these problems indicates the need to develop complex interventions and assessments to aid management of hyperacusis. Current hyperacusis questionnaires may be useful in identifying some problem domains, but further assessment thorough patient interviews is required to fully explore all potential problems and make informed decisions about treatment.
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Wang S, Cha X, Li F, Li T, Wang T, Wang W, Zhao Z, Ye X, Liang C, Deng Y, Liu H. Associations between sleep disorders and anxiety in patients with tinnitus: A cross-sectional study. Front Psychol 2022; 13:963148. [PMID: 35992459 PMCID: PMC9389284 DOI: 10.3389/fpsyg.2022.963148] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 07/15/2022] [Indexed: 11/13/2022] Open
Abstract
ObjectiveTo investigate the characteristics of sleep disorders and anxiety in patients with tinnitus, their influencing factors, and the role of sleep disorders as mediators.MethodsThe general conditions and disease characteristics of 393 patients with tinnitus presented to the Changzheng Hospital of the Naval Medical University from 2018 to 2021 were collected. All patients accepted questionnaires such as Tinnitus Handicap Inventory (THI), Pittsburgh Sleep Quality Index (PSQI) and Self-rating Anxiety Scale (SAS), and then the characteristics and the influencing factors of sleep disorders and anxiety were analyzed.ResultsAmong the 393 tinnitus patients, 213 cases (54.19%) were diagnosed with sleep disorders, and 78 cases (19.85%) were diagnosed with anxiety, including 25 men (32.1%) and 53 women (67.9%). Binary regression showed that gender, hearing loss, tinnitus severity, and sleep disorders severity were positively associated with anxiety. Multiple logistic regression analysis showed that female gender (OR = 2.526, P = 0.008), hearing loss (OR = 2.901, P = 0.003, tinnitus severity (OR = 1.863, P = 0.003) and sleep disorders (OR = 2.510, P = 0.001) were the independent risk factors of anxiety. The mediating effect of sleep disorders between tinnitus severity and anxiety accounted for 27.88% of the total effect size.ConclusionFemales patients with hearing loss, moderate to severe tinnitus, and sleep disorders were at greater risk for anxiety, with sleep disorders partially mediating the anxiety associated with tinnitus.
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Affiliation(s)
- Shenglei Wang
- Department of Otolaryngology, Changzheng Hospital, Naval Medical University (Second Military Medical University), Shanghai, China
| | - Xudong Cha
- Department of Otolaryngology, Changzheng Hospital, Naval Medical University (Second Military Medical University), Shanghai, China
| | - Fengzhen Li
- Department of Otolaryngology, Changzheng Hospital, Naval Medical University (Second Military Medical University), Shanghai, China
| | - Tengfei Li
- Department of Otolaryngology, Changzheng Hospital, Naval Medical University (Second Military Medical University), Shanghai, China
| | - Tianyu Wang
- Department of Otolaryngology, Changzheng Hospital, Naval Medical University (Second Military Medical University), Shanghai, China
| | - Wenwen Wang
- Department of Neurology, Changzheng Hospital, Naval Medical University (Second Military Medical University), Shanghai, China
| | - Zhengqing Zhao
- Department of Neurology, Changzheng Hospital, Naval Medical University (Second Military Medical University), Shanghai, China
| | - Xiaofei Ye
- Department of Health Statistics, Naval Medical University (Second Military Medical University), Shanghai, China
| | - Caiquan Liang
- Department of Otolaryngology, Changzheng Hospital, Naval Medical University (Second Military Medical University), Shanghai, China
- *Correspondence: Caiquan Liang
| | - Yue Deng
- Department of Otolaryngology, Changzheng Hospital, Naval Medical University (Second Military Medical University), Shanghai, China
- Yue Deng
| | - Huanhai Liu
- Department of Otolaryngology, Changzheng Hospital, Naval Medical University (Second Military Medical University), Shanghai, China
- Huanhai Liu
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11
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Aazh H, Erfanian M, Danesh AA, Moore BCJ. Audiological and Other Factors Predicting the Presence of Misophonia Symptoms Among a Clinical Population Seeking Help for Tinnitus and/or Hyperacusis. Front Neurosci 2022; 16:900065. [PMID: 35864982 PMCID: PMC9294447 DOI: 10.3389/fnins.2022.900065] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2022] [Accepted: 06/07/2022] [Indexed: 11/13/2022] Open
Abstract
This paper evaluates the proportion and the audiological and other characteristics of patients with symptoms of misophonia among a population seeking help for tinnitus and/or hyperacusis at an audiology clinic (n = 257). To assess such symptoms, patients were asked "over the last 2 weeks, how often have you been bothered by any of the following problems? Feeling angry or anxious when hearing certain sounds related to eating noises, lip-smacking, sniffling, breathing, clicking sounds, tapping?". The results of routine audiological tests and self-report questionnaires were gathered retrospectively from the records of the patients. Measures included: pure tone audiometry, uncomfortable loudness levels (ULLs), and responses to the tinnitus impact questionnaire (TIQ), the hyperacusis impact questionnaire (HIQ), and the screening for anxiety and depression in tinnitus (SAD-T) questionnaire. The mean age of the patients was 53 years (SD = 16) (age range 17 to 97 years). Fifty four percent were female. Twenty-three percent of patients were classified as having misophonia. The presence and frequency of reporting misophonia symptoms were not related to audiometric thresholds, except that a steeply sloping audiogram reduced the likelihood of frequent misophonia symptoms. Those with more frequent misophonia symptoms had lower values of ULLmin (the across-frequency average of ULLs for the ear with lower average ULLs) than those with less frequent or no reported symptoms. The reported frequency of experiencing misophonia symptoms increased with increasing impact of tinnitus (TIQ score ≥9), increasing impact of hyperacusis (HIQ score >11), and symptoms of anxiety and depression (SAD-T score ≥4). It is concluded that, when assessing individuals with tinnitus and hyperacusis, it is important to screen for misophonia, particularly when ULLmin is abnormally low or the TIQ, HIQ or SAD-T score is high. This will help clinicians to distinguish patients with misophonia, guiding the choice of therapeutic strategies.
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Affiliation(s)
- Hashir Aazh
- Audiology Department, Royal Surrey NHS Foundation Trust, Guildford, United Kingdom
- Department of Communication Sciences & Disorders, Florida Atlantic University, Boca Raton, FL, United States
- Faculty of Engineering and Physical Sciences (FEPS), University of Surrey, Guildford, United Kingdom
| | - Mercede Erfanian
- UCL Institute for Environmental Design and Engineering, The Bartlett, University College London, London, United Kingdom
| | - Ali A. Danesh
- Department of Communication Sciences & Disorders, Florida Atlantic University, Boca Raton, FL, United States
| | - Brian C. J. Moore
- Cambridge Hearing Group, Department of Psychology, University of Cambridge, Cambridge, United Kingdom
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12
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Aazh H, Taylor L, Danesh AA, Moore BCJ. The Effectiveness of Unguided Internet-Based Cognitive Behavioral Therapy for Tinnitus for Patients with Tinnitus Alone or Combined with Hyperacusis and/or Misophonia: A Preliminary Analysis. J Am Acad Audiol 2022; 33:405-416. [PMID: 37146649 PMCID: PMC11293900 DOI: 10.1055/a-2087-0262] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2022] [Accepted: 01/10/2023] [Indexed: 05/07/2023]
Abstract
BACKGROUND In the United Kingdom, audiologist-delivered cognitive behavioral therapy (CBT) is a key intervention to alleviate the distress caused by tinnitus and its comorbid hyperacusis. However, the availability of face-to-face CBT is limited, and such therapy involves significant costs. CBT provided via the internet provides a potential solution to improve access to CBT for tinnitus. PURPOSE The aim was to perform a preliminary assessment of the effect of a specific program of nonguided internet-based CBT for tinnitus, denoted iCBT(T), in alleviating the problems caused by tinnitus alone or tinnitus combined with hyperacusis. RESEARCH DESIGN This was a retrospective cross-sectional study. STUDY SAMPLE The data for 28 people with tinnitus who completed the iCBT(T) program and answered a series of questions about their tinnitus and hearing status were included in the study. Twelve patients also reported having hyperacusis (including five also with misophonia). DATA COLLECTION AND ANALYSIS The iCBT(T) program has seven self-help modules. Anonymous data were collected retrospectively from patients' answers to the questions in the iCBT(T) initial and final assessment modules. Questionnaires administered within the iCBT(T) program were: 4C Tinnitus Management Questionnaire (4C), Screening for Anxiety and Depression in Tinnitus (SAD-T), and the CBT Effectiveness Questionnaire (CBT-EQ). RESULTS Responses to the 4C showed a significant improvement from pre- to posttreatment, with a medium effect size. The mean improvement was similar for those with and without hyperacusis. Responses to the SAD-T questionnaire also showed a significant improvement from pre- to posttreatment with a medium effect size. The improvement was significantly greater for participants with tinnitus alone than for participants who also had hyperacusis. For both the 4C and the SAD-T, the improvements were not significantly related to age or gender. Participants' views of the effectiveness of the iCBT(T) program were assessed using the CBT-EQ. The mean score was 50 out of a maximum of 80, indicating moderately high effectiveness. CBT-EQ scores did not differ for those with and without hyperacusis. CONCLUSION Based on this preliminary analysis, the iCBT(T) program showed promising results in improving the ability to manage tinnitus and decreasing symptoms of anxiety and depression. Future studies with larger samples and control group(s) are required to further assess various aspects of this program.
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Affiliation(s)
- Hashir Aazh
- Hashir International Specialist Clinics & Research Institute for Misophonia, Tinnitus and Hyperacusis Ltd., London, United Kingdom
- Department of Communication Sciences & Disorders, Florida Atlantic University, Boca Raton, Florida
- Faculty of Engineering and Physical Sciences, University of Surrey, United Kingdom
| | - Lauren Taylor
- Hashir International Specialist Clinics & Research Institute for Misophonia, Tinnitus and Hyperacusis Ltd., London, United Kingdom
- School of Psychology, Faculty of Health and Medical Sciences, University of Surrey, Guildford, Surrey, United Kingdom
| | - Ali A. Danesh
- Department of Communication Sciences & Disorders, Florida Atlantic University, Boca Raton, Florida
| | - Brian C. J. Moore
- Cambridge Hearing Group, Department of Psychology, University of Cambridge, Cambridge, United Kingdom
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Aazh H, Danesh AA, Moore BCJ. Self-Reported Tinnitus Severity Prior to and During the COVID-19 Lockdown in the United Kingdom. J Am Acad Audiol 2022; 32:562-566. [PMID: 35176799 DOI: 10.1055/s-0041-1731733] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
BACKGROUND AND PURPOSE The aim of this study was to assess whether the severity of tinnitus, as measured using ratings of tinnitus loudness, annoyance, and effect on life, was influenced by the lockdown related to the coronavirus disease 2019 (COVID-19) pandemic. RESEARCH DESIGN This was a retrospective study. STUDY SAMPLE The data for 105 consecutive patients who were seen at a tinnitus clinic in an audiology department in the United Kingdom during the COVID-19 lockdown between April and June 2020 and 123 patients seen in the same period of the previous year, prior to the COVID-19 pandemic were included. DATA COLLECTION Demographic data for the patients, results of their pure-tone audiometry, and their score on visual analog scale (VAS) of tinnitus loudness, annoyance, and effect on life were imported from their records held at the audiology department. This was a retrospective survey comparing ratings on the VAS of tinnitus loudness, annoyance, and effect on life for consecutive patients seen during the COVID-19 lockdown and consecutive patients seen in the same period of the previous year, prior to the COVID-19 pandemic. Patients seen prior to lockdown used a pen and paper version of the VAS, while the patients who were assessed during the COVID-19 lockdown used an adapted version of the VAS, via telephone. All patients were seeking help for their tinnitus for the first time. RESULTS The mean scores for tinnitus loudness, annoyance, and effect on life did not differ significantly for the groups seen prior to and during lockdown. CONCLUSION Any changes in psychological well-being or stress produced by the lockdown did not significantly affect ratings of the severity of tinnitus.
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Affiliation(s)
- Hashir Aazh
- Department of Audiology, Royal Surrey County Hospital, Royal Surrey NHS Foundation Trust, Guildford, United Kingdom
| | - Ali A Danesh
- Department of Communication Sciences and Disorders, Florida Atlantic University, Boca Raton, Florida
| | - Brian C J Moore
- Department of Experimental Psychology, University of Cambridge, Cambridge Hearing Group, Cambridge, United Kingdom
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Rademaker MM, Stegeman I, Brabers AEM, de Jong JD, Stokroos RJ, Smit AL. Differences in characteristics between people with tinnitus that seek help and that do not. Sci Rep 2021; 11:22949. [PMID: 34824285 PMCID: PMC8616930 DOI: 10.1038/s41598-021-01632-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Accepted: 10/26/2021] [Indexed: 11/15/2022] Open
Abstract
Knowledge on characteristics of people that seek help for tinnitus is scarce. The primary objective of this study was to describe differences in characteristics between people with tinnitus that seek help compared to those who do not seek help. Next, we described differences in characteristics between those with and without tinnitus. In this cross-sectional study, we sent a questionnaire on characteristics in different domains; demographic, tinnitus-specific, general- and psychological health, auditory and noise- and substance behaviour. We assessed if participants had sought help or planned to seek help for tinnitus. Tinnitus distress was defined with the Tinnitus Functional Index. Differences between groups (help seeking: yes/no, tinnitus: yes/no) were described. 932 people took part in our survey. Two hundred and sixteen participants were defined as having tinnitus (23.2%). Seventy-three of those sought or planned to seek help. A constant tinnitus pattern, a varying tinnitus loudness, and hearing loss, were described more frequently in help seekers. Help seekers reported higher TFI scores. Differences between help seekers and people not seeking help were mainly identified in tinnitus- and audiological characteristics. These outcomes might function as a foundation to explore the heterogeneity in tinnitus patients.
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Affiliation(s)
- M M Rademaker
- Department of Otorhinolaryngology and Head and Neck Surgery, University Medical Center Utrecht, Utrecht, The Netherlands.
- UMC Utrecht Brain Center, Utrecht University, Utrecht, The Netherlands.
| | - I Stegeman
- Department of Otorhinolaryngology and Head and Neck Surgery, University Medical Center Utrecht, Utrecht, The Netherlands
- UMC Utrecht Brain Center, Utrecht University, Utrecht, The Netherlands
- Department of Ophthalmology, University Medical Center Utrecht, Utrecht, The Netherlands
- Epidemiology and Data Science, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands
| | - A E M Brabers
- Nivel (Netherlands Institute for Health Services Research), Utrecht, The Netherlands
| | - J D de Jong
- Nivel (Netherlands Institute for Health Services Research), Utrecht, The Netherlands
- Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands
| | - R J Stokroos
- Department of Otorhinolaryngology and Head and Neck Surgery, University Medical Center Utrecht, Utrecht, The Netherlands
- UMC Utrecht Brain Center, Utrecht University, Utrecht, The Netherlands
| | - A L Smit
- Department of Otorhinolaryngology and Head and Neck Surgery, University Medical Center Utrecht, Utrecht, The Netherlands
- UMC Utrecht Brain Center, Utrecht University, Utrecht, The Netherlands
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15
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Internal Consistency and Convergent Validity of the Inventory of Hyperacusis Symptoms. Ear Hear 2021; 42:917-926. [PMID: 33259445 DOI: 10.1097/aud.0000000000000982] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
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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16
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Sleep disturbance and psychological distress in adult patients with tinnitus. J Formos Med Assoc 2021; 121:995-1002. [PMID: 34366185 DOI: 10.1016/j.jfma.2021.07.022] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2020] [Revised: 04/23/2021] [Accepted: 07/20/2021] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND/PURPOSE Sleep disturbance and psychological distress are among the most prevalent comorbidities of tinnitus. We aimed to clarify the dose-response effects of these phenomena with tinnitus severity. METHODS This study enrolled adult patients with subjective tinnitus for more than 6 months was conducted from January 2017 to December 2018 in one tertiary medical center and one local hospital. Data collected included demographic data and questionnaires, namely Tinnitus Handicap Inventory (THI), Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS), and Hospital Anxiety and Depression Scale (HADS). RESULTS In total, 1610 patients with tinnitus (1105 male, 68.6%) with mean age of 48.3 ± 14.3 years completed all questionnaires. The average THI score was 9.2 ± 19.4, and 82.4% of patients reported to have slight tinnitus (THI ranged 0-16). The mean PSQI score was 8.4 ± 4.3, and 70.8% of participants had sleep difficulty (PSQI > 5). Compared with patients with slight tinnitus, those with catastrophic tinnitus were mostly old women with lower body mass index, and had higher scores in ESS, PSQI, and HADS (all P < 0.05). In 1140 patients with sleep difficulty, independent factors influencing THI were age, ESS, and HADS, and positive correlations were observed between age-adjusted THI and ESS, HADS-A, and HADS-D (all P < 0.001). CONCLUSION Old age, daytime sleepiness, and psychological distress are highly associated with tinnitus severity among patients with sleep difficulty. Management of sleep disturbance and psychological distress is necessary to control tinnitus.
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17
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Aazh H, Stevens J, Moore BCJ. Preliminary Examination of the Incidence of and Factors Related to Hearing Tinnitus in Dreams. J Am Acad Audiol 2020; 32:76-82. [PMID: 33296927 DOI: 10.1055/s-0040-1718929] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
BACKGROUND AND PURPOSE The aim of this study was to assess the incidence of the perception of tinnitus in dreams among patients seeking help for tinnitus and/or hyperacusis and to assess whether this is related to the severity of tinnitus and/or hyperacusis. RESEARCH DESIGN This was a retrospective study. STUDY SAMPLE The data for 148 consecutive adult patients who attended a tinnitus/hyperacusis clinic in the United Kingdom were included. The average age of the patients was 56 years (standard deviation [SD] = 15 years). DATA COLLECTION Data were collected retrospectively from their records held at the audiology department. Audiological measures were pure-tone audiometry and uncomfortable loudness levels. Questionnaires administered were: Tinnitus Handicap Inventory (THI), Hyperacusis Questionnaire, Insomnia Severity Index, Visual Analogue Scale (VAS) of tinnitus loudness, annoyance, and effect on life, Generalized Anxiety Disorder, and Patient Health Questionnaire. Patients were also asked "If you dream have you ever perceived tinnitus in your dreams?" RESULTS Five percent of patients (7/148) reported hearing tinnitus in their dreams. There was a nonsignificant trend for patients who reported hearing tinnitus in their dreams to be younger (mean age = 46 years, SD = 15 years) than those who did not (mean age = 57 years, SD = 15 years). The mean scores for the THI and VAS for effect of tinnitus on life were significantly higher (worse) for patients who reported hearing tinnitus in their dreams than for those who did not. CONCLUSION A small proportion of patients reported hearing tinnitus in their dreams and this was associated with higher tinnitus handicap as measured via the THI and more effect of tinnitus on life as measured via the VAS. These preliminary results may indicate that those who are greatly affected by their tinnitus are more likely to hear it in their dreams or to be woken by it. Future studies should use methods that can be used to reliably assess if and when tinnitus is perceived during the sleep cycle, using more physiological measures and testing a wider population.
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Affiliation(s)
- Hashir Aazh
- Audiology Department, Royal Surrey NHS Foundation Trust, Guildford, United Kingdom
| | - Jennifer Stevens
- Audiology Department, Royal Surrey NHS Foundation Trust, Guildford, United Kingdom
| | - Brian C J Moore
- Department of Psychology, University of Cambridge, Cambridge, United Kingdom
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18
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Mancini PC, Tyler RS, Jun HJ, Wang TC, Ji H, Stocking C, Secor C, Rojas-Roncancio E, Witt S. Reliability of the Minimum Masking Level as Outcome Variable in Tinnitus Clinical Research. Am J Audiol 2020; 29:429-435. [PMID: 32717149 DOI: 10.1044/2020_aja-20-00047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Purpose The minimum masking level (MML) is the minimum intensity of a stimulus required to just totally mask the tinnitus. Treatments aimed at reducing the tinnitus itself should attempt to measure the magnitude of the tinnitus. The objective of this study was to evaluate the reliability of the MML. Method Sample consisted of 59 tinnitus patients who reported stable tinnitus. We obtained MML measures on two visits, separated by about 2-3 weeks. We used two noise types: speech-shaped noise and high-frequency emphasis noise. We also investigated the relationship between the MML and tinnitus loudness estimates and the Tinnitus Handicap Questionnaire (THQ). Results There were differences across the different noise types. The within-session standard deviation averaged across subjects varied between 1.3 and 1.8 dB. Across the two sessions, the Pearson correlation coefficients, range was r = .84. There was a weak relationship between the dB SL MML and loudness, and between the MML and the THQ. A moderate correlation (r = .44) was found between the THQ and loudness estimates. Conclusions We conclude that the dB SL MML can be a reliable estimate of tinnitus magnitude, with expected standard deviations in trained subjects of about 1.5 dB. It appears that the dB SL MML and loudness estimates are not closely related.
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Affiliation(s)
- Patricia C. Mancini
- Department of Otolaryngology—Head and Neck Surgery, The University of Iowa, Iowa City
- Department of Speech-Language Pathology and Audiology, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Richard S. Tyler
- Department of Otolaryngology—Head and Neck Surgery, The University of Iowa, Iowa City
- Department of Communication Sciences and Disorders, The University of Iowa, Iowa City
| | - Hyung Jin Jun
- Department of Otolaryngology—Head and Neck Surgery, The University of Iowa, Iowa City
| | - Tang-Chuan Wang
- Department of Otolaryngology—Head and Neck Surgery, The University of Iowa, Iowa City
| | - Helena Ji
- Department of Otolaryngology—Head and Neck Surgery, The University of Iowa, Iowa City
| | | | - Carrie Secor
- University at Buffalo Speech-Language and Hearing Clinic,NY
| | | | - Shelley Witt
- Department of Otolaryngology—Head and Neck Surgery, The University of Iowa, Iowa City
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Siepsiak M, Sobczak AM, Bohaterewicz B, Cichocki Ł, Dragan WŁ. Prevalence of Misophonia and Correlates of Its Symptoms among Inpatients with Depression. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E5464. [PMID: 32751203 PMCID: PMC7432123 DOI: 10.3390/ijerph17155464] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Revised: 07/09/2020] [Accepted: 07/16/2020] [Indexed: 11/16/2022]
Abstract
Misophonia is an underexplored condition that significantly decreases the quality of life of those who suffer from it. It has neurological and physiological correlates and is associated with a variety of psychiatric symptoms; however, a growing body of data suggests that it is a discrete disorder. While comorbid diagnoses among people with misophonia have been a matter of research interest for many years there is no data on the frequency of misophonia among people with psychiatric disorders. This could be the next step to reveal additional mechanisms underlying misophonia. Until recently, the use of a variety of non-validated questionnaires and the dominance of internet-based studies have been also a major obstacles to a proper definition of misophonia. A total of 94 inpatients diagnosed with depression were assessed for misophonia with face-to-face interviews as well as with MisoQuest-a validated misophonia questionnaire. The prevalence of misophonia among these patients and the congruence of MisoQuest with face-to-face interviews were evaluated. Additionally, the patients filled in a series of questionnaires that measured a variety of psychiatric symptoms and psychological traits. Anxiety, depression, impulsivity, somatic pain, vegetative symptoms, post-traumatic stress disorder (PTSD) symptoms, gender, and age were analyzed in relation to the severity of symptoms of misophonia. Between 8.5 to 12.76% of inpatients with depression were diagnosed with misophonia (depending on measurement and inclusion criteria). MisoQuest accuracy was equal to 92.55%, sensitivity-66.67% and specificity-96.34%. Severity of misophonia symptoms was positively correlated to the greatest extent with anxiety. Moderate positive correlation was also found between severity of misophonia symptoms and depressive symptoms, intrusions, and somatic pain; a weak positive correlation was found between severity of misophonia and non-planning impulsivity, motor impulsivity, avoidance, and vegetative symptoms. There was no relationship between the severity of misophonia symptoms and attentional impulsivity or the age of participants.
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Affiliation(s)
- Marta Siepsiak
- Faculty of Psychology, University of Warsaw, 00-183 Warsaw, Poland;
| | - Anna Maria Sobczak
- Department of Cognitive Neuroscience and Neuroergonomics, Institute of Applied Psychology, Jagiellonian University, 30-348 Cracow, Poland; (A.M.S.); (B.B.)
| | - Bartosz Bohaterewicz
- Department of Cognitive Neuroscience and Neuroergonomics, Institute of Applied Psychology, Jagiellonian University, 30-348 Cracow, Poland; (A.M.S.); (B.B.)
| | - Łukasz Cichocki
- Department of Psychiatry, Andrzej Frycz Modrzewski Cracow Academy, 30-705 Cracow, Poland;
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20
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Ke J, Du Y, Tyler RS, Perreau A, Mancini PC. Complaints of People with Hyperacusis. J Am Acad Audiol 2020; 31:553-558. [DOI: 10.1055/s-0040-1709447] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
Abstract
Background Hyperacusis is a prevalent auditory disorder that causes significant distress and negatively affects quality of life for many patients. Patients with hyperacusis often have different complaints about the sounds and situations that they experience. Audiologists may have few patients with hyperacusis, and a limited understanding of the sounds and situations that are reported to be challenging by their patients.
Purpose To investigate the common complaints reported by hyperacusis patients.
Research design A qualitative study was conducted with 11 hyperacusis patients who participated in a group session.
Results All 11 hyperacusis patients experienced negative reactions to specific sounds. In addition, many patients reported physical symptoms such as headaches, balance problems, dysosmia (strong smell problems), and light sensitivity. Sounds that induced discomfort were wide ranging and included low-frequency sounds, high-frequency sounds, wide-band noise, and sudden, high-intensity sounds. Most patients (9/11, 81.8%) reported negative reactions to music in loud rock concerts. Patients reported that stress/tension (90.9%) worsened their hyperacusis, while removing themselves from noise (90.9%) relieved their hyperacusis.
Conclusion Loudness is only one of the many factors related to the discomfort of patients with hyperacusis. Across patients, we observed that there were different complaints about the sounds and situations that produced difficulty due to hyperacusis. Physical symptoms following sound exposure were also reported by the patients, suggesting that hyperacusis is a complex disorder and requires intervention that often involves multiple members of the medical team.
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Affiliation(s)
- Jia Ke
- Department of Otolaryngology—Head and Neck Surgery, Peking University Third Hospital, Beijing, China
| | - Yali Du
- Department of Otolaryngology—Head and Neck Surgery, Peking University Third Hospital, Beijing, China
| | - Richard S. Tyler
- Department of Otolaryngology—Head and Neck Surgery, University of Iowa, Iowa City, Iowa
- Department of Communication Sciences and Disorders, University of Iowa, Iowa City, Iowa
| | - Ann Perreau
- Department of Otolaryngology—Head and Neck Surgery, University of Iowa, Iowa City, Iowa
- Department of Communication Sciences and Disorders, Augustana College, Rock Island, Illinois
| | - Patricia C. Mancini
- Department of Otolaryngology—Head and Neck Surgery, University of Iowa, Iowa City, Iowa
- Postgraduate Program in Ciencias Fonoaudiologicas, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
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Kim SK, Chong CD, Dumkrieger G, Ross K, Berisha V, Schwedt TJ. Clinical correlates of insomnia in patients with persistent post-traumatic headache compared with migraine. J Headache Pain 2020; 21:33. [PMID: 32295535 PMCID: PMC7161138 DOI: 10.1186/s10194-020-01103-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Accepted: 04/02/2020] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Close associations between insomnia with other clinical factors have been identified in migraine, but there have been few studies investigating associations between insomnia and clinical factors in patients with persistent post-traumatic headache (PPTH). The study objective was to contrast the severity of insomnia symptoms in PPTH, migraine, and healthy controls, and to identify factors associated with insomnia in patients with PPTH vs. migraine. METHODS In this cross-sectional cohort study, 57 individuals with PPTH attributed to mild traumatic brain injury, 39 with migraine, and 39 healthy controls were included. Participants completed a detailed headache characteristics questionnaire, the Migraine Disability Assessment Scale (MIDAS), Insomnia Severity Index (ISI), Hyperacusis Questionnaire (HQ), Allodynia Symptom Checklist, Photosensitivity Assessment Questionnaire, Beck Depression Inventory (BDI), State-Trait Anxiety Inventory, Post-Traumatic Stress Disorder (PTSD) checklist, Ray Auditory Verbal Learning Test, and the Trail Making Test A and B to assess headache characteristics, disability, insomnia symptoms, sensory hypersensitivities, and neuropsychological factors. Fisher's test and one-way ANOVA or Tukey's Honest Significant Difference were used to assess group differences of categorical and continuous data. Stepwise linear regression analyses were conducted to identify clinical variables associated with insomnia symptoms. RESULTS Those with PPTH had significantly higher ISI scores (16.7 ± 6.6) compared to migraine patients (11.3 ± 6.4) and healthy controls (4.1 ± 4.8) (p < 0.001). For those with PPTH, insomnia severity was most strongly correlated with the BDI (Spearman's rho (ρ) = 0.634, p < 0.01), followed by Trait Anxiety (ρ = 0.522, p < 0.01), PTSD (ρ = 0.505, p < 0.01), HQ (ρ = 0.469, p < 0.01), State Anxiety (ρ = 0.437, p < 0.01), and MIDAS scores (ρ = 0.364, p < 0.01). According to linear regression models, BDI, headache intensity, and hyperacusis scores were significantly positively associated with insomnia severity in those with PPTH, while only delayed memory recall was negatively associated with insomnia severity in those with migraine. CONCLUSIONS Insomnia symptoms were more severe in those with PPTH compared to migraine and healthy control cohorts. Depression, headache intensity, and hyperacusis were associated with insomnia in individuals with PPTH. Future studies should determine the bidirectional impact of treating insomnia and its associated symptoms.
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Affiliation(s)
- Soo-Kyoung Kim
- Department of Neurology and Institute of Health Science, Gyeongsang National University College of Medicine, Jinju, South Korea.,Department of Neurology, Mayo Clinic, 5777 East Mayo Boulevard, Phoenix, AZ, 85054, USA
| | - Catherine D Chong
- Department of Neurology, Mayo Clinic, 5777 East Mayo Boulevard, Phoenix, AZ, 85054, USA
| | - Gina Dumkrieger
- Department of Neurology, Mayo Clinic, 5777 East Mayo Boulevard, Phoenix, AZ, 85054, USA
| | | | | | - Todd J Schwedt
- Department of Neurology, Mayo Clinic, 5777 East Mayo Boulevard, Phoenix, AZ, 85054, USA.
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22
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Margol-Gromada M, Sereda M, Baguley DM. Readability assessment of self-report hyperacusis questionnaires. Int J Audiol 2020; 59:506-512. [DOI: 10.1080/14992027.2020.1723033] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Magdalena Margol-Gromada
- Hearing Sciences, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, UK
| | - Magdalena Sereda
- Hearing Sciences, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, UK
- NIHR Nottingham Biomedical Research Centre, Nottingham, UK
| | - David M. Baguley
- Hearing Sciences, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, UK
- NIHR Nottingham Biomedical Research Centre, Nottingham, UK
- Nottingham Audiology Services, Nottingham University NHS Trust, Nottingham, UK
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23
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Pavaci S, Tortorella F, Fioretti AB, Angelone AM, Businco LDR, Lauriello M, Eibenstein A. Analysis of the audiological characteristics and comorbidity in patients with chronic tinnitus. Audiol Res 2019; 9:231. [PMID: 31929867 PMCID: PMC6945072 DOI: 10.4081/audiores.2019.231] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Accepted: 10/31/2019] [Indexed: 11/23/2022] Open
Abstract
Tinnitus is defined as perception of a sound without sound stimulation. This study aims to investigate the correlation between chronic tinnitus and the most significant clinical comorbidities and pharmacological treatments. We recruited 130 consecutive outpatients with a tinnitus for least from three months and 100 subjects without tinnitus. All patients had a full medical and audiological evaluation and all filled in Tinnitus Handicap Inventory questionnaire and Khalfa’s Hyperacusis questionnaire. We also analyzed the qualitative variables: audiometry exam, tinnitus characteristics and psychometric questionnaires. Univariate logistic regression was performed to evaluate the associations between the presence of tinnitus and the presence of comorbidities and drug intake. The statistical analysis provided the following results in the group of patients with tinnitus. We obtained an Odds Ratio statistically significant for the following categories taken into consideration: the presence of anxiety and depression, neurological diseases, headache, temporomandibular joint (TMJ) disorders, intake of levothyroxine and proton-pump inhibitor. In this study, we tried to evaluate the audiological characteristics in the subjects affected by chronic tinnitus in order to find a possible correlation with the comorbidities and any drugs intake. We found a statistically significant correlation between tinnitus and comorbidities like anxiety, depression, TMJ disorders, dysthyroidism, headache and levothyroxine and PPI intake.
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Affiliation(s)
- Silva Pavaci
- Department of Applied Clinical and Biotechnological Sciences, University of l'Aquila, L'Aquila.,Minimally Invasive ENT Surgery Unit, San Carlo di Nancy Hospital, Roma
| | - Federica Tortorella
- Department of Applied Clinical and Biotechnological Sciences, University of l'Aquila, L'Aquila.,Minimally Invasive ENT Surgery Unit, San Carlo di Nancy Hospital, Roma
| | | | - Anna Maria Angelone
- Department of Life, Health and Environmental Sciences, University of l'Aquila, Italy
| | | | - Maria Lauriello
- Department of Applied Clinical and Biotechnological Sciences, University of l'Aquila, L'Aquila
| | - Alberto Eibenstein
- Department of Applied Clinical and Biotechnological Sciences, University of l'Aquila, L'Aquila
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24
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Aazh H, Bryant C, Moore BCJ. Patients' Perspectives About the Acceptability and Effectiveness of Audiologist-Delivered Cognitive Behavioral Therapy for Tinnitus and/or Hyperacusis Rehabilitation. Am J Audiol 2019; 28:973-985. [PMID: 31770010 DOI: 10.1044/2019_aja-19-0045] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
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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Affiliation(s)
- Hashir Aazh
- Audiology Department, Royal Surrey County Hospital NHS Foundation Trust, Guildford, United Kingdom
| | - Christina Bryant
- Melbourne School of Psychological Sciences, University of Melbourne, Victoria, Australia
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25
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Oron Y, Levy O, Avivi-Reich M, Goldfarb A, Handzel O, Shakuf V, Ben-David BM. Tinnitus affects the relative roles of semantics and prosody in the perception of emotions in spoken language. Int J Audiol 2019; 59:195-207. [DOI: 10.1080/14992027.2019.1677952] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Yahav Oron
- Department of Otolaryngology, Head, Neck and Maxillofacial Surgery, Tel-Aviv Sourasky Medical Center, Sackler School of Medicine, Tel Aviv University, Tel-Aviv, Israel
| | - Oren Levy
- Baruch Ivcher School of Psychology, Interdisciplinary Center (IDC), Herzliya, Israel
| | - Meital Avivi-Reich
- Baruch Ivcher School of Psychology, Interdisciplinary Center (IDC), Herzliya, Israel
- Communication Arts, Sciences and Disorders, Brooklyn College, City University of New York, New York, NY, USA
| | - Abraham Goldfarb
- Department of Otolaryngology, Head and Neck Surgery, The Edith Wolfson Medical Center, Sackler School of Medicine, Tel Aviv University, Tel-Aviv, Israel
| | - Ophir Handzel
- Department of Otolaryngology, Head, Neck and Maxillofacial Surgery, Tel-Aviv Sourasky Medical Center, Sackler School of Medicine, Tel Aviv University, Tel-Aviv, Israel
| | - Vered Shakuf
- Baruch Ivcher School of Psychology, Interdisciplinary Center (IDC), Herzliya, Israel
| | - Boaz M. Ben-David
- Baruch Ivcher School of Psychology, Interdisciplinary Center (IDC), Herzliya, Israel
- Department of Speech-Language Pathology, University of Toronto, Toronto, ON, Canada
- Toronto Rehabilitation Institute, University Health Networks (UHN), Toronto, ON, Canada
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26
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Jackson JG. The Cortisol Awakening Response: A Feasibility Study Investigating the Use of the Area Under the Curve With Respect to Increase as an Effective Objective Measure of Tinnitus Distress. Am J Audiol 2019; 28:583-596. [PMID: 31318575 DOI: 10.1044/2019_aja-18-0174] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Purpose Tinnitus is a chronic medical condition that can result in distress, concentration difficulties, and clinical depression. An effective, objective measure of tinnitus distress does not currently exist. Endocrinal studies into the condition have been few, with those investigating the cortisol awakening response limited in scope. It was hypothesized that distressed individuals with tinnitus would awaken and be unable to effectively prepare for the day ahead due to a blunted cortisol response. Method Twenty individuals with varying tinnitus distress were compared with a control group (n = 10) in a pilot study, which measured salivary cortisol concentrations on awakening. Multiple exclusion variables were applied. Results In line with previous studies, total cortisol volume (as measured by area under the curve) was not found to be significantly different in the most distressed individuals with tinnitus, F(2, 26) = 0.254, p = .777ns. However, a separate measure of changing cortisol levels-the area under the curve with respect to increase (or AUCi)-was found to be significantly less robust in those individuals reporting the most severe tinnitus distress, F(2, 26) = 7.671, p = .002. This indicates that fewer resources would be available to cope with the demands of the day ahead. Additionally, the AUCi correlated negatively with tinnitus distress later the same day. Conclusions Relationships between proposed objective and self-reported components of self-reported tinnitus distress are considered, with some aspects of tinnitus distress more closely related to physiological mechanisms than others. It is suggested that, with further research, the cortisol awakening response (AUCi) may be put forward as a credible objective biomarker of tinnitus distress.
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Affiliation(s)
- James George Jackson
- Psychology, Sociology and Criminology Group, School of Social and Health Sciences, Leeds Trinity University, Horsforth, United Kingdom
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27
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Aazh H, Moore BCJ. Tinnitus loudness and the severity of insomnia: a mediation analysis. Int J Audiol 2019; 58:208-212. [DOI: 10.1080/14992027.2018.1537524] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Hashir Aazh
- Audiology Department, Royal Surrey County Hospital NHS Foundation Trust, Guildford, UK
| | - Brian C. J. Moore
- Department of Experimental Psychology, University of Cambridge, Cambridge, UK
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28
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Aazh H, Langguth B, Danesh AA. Parental separation and parental mental health in childhood and tinnitus and hyperacusis disability in adulthood: a retrospective exploratory analysis. Int J Audiol 2018; 57:941-946. [PMID: 30272507 DOI: 10.1080/14992027.2018.1514470] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
OBJECTIVES To explore the relationships between parental separation and parental mental health in childhood with tinnitus and hyperacusis disability in adulthood. DESIGN Retrospective cross-sectional. STUDY SAMPLE The data for consecutive patients who attended a tinnitus and hyperacusis clinic in the UK over a six months period were included (n = 184). RESULTS 14.7% of patients reported that while they were growing up, their parents were separated or divorced. There were no significant differences in Tinnitus Handicap Inventory (THI) and Hyperacusis Questionnaire (HQ) between patients with and without history of parental separation. About 40.2% reported history of mental health disorders in their parents. The scores on THI and HQ were worse in the group that reported mental health disorders in their parents (p < .01). Parental mental health illness did not significantly relate to THI, however, it was significantly related to the risk of hyperacusis (odds ratio [OR], after adjusting for age and gender: 2.05, p = .026). The adjusted OR for a subgroup of patients with a diagnosis of hyperacusis was 6.7 (p = .011), indicating a stronger relationship for this subgroup. CONCLUSIONS Among patients seeking help for their tinnitus and hyperacusis, poor parental mental health was associated with increased hyperacusis disability.
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Affiliation(s)
- Hashir Aazh
- a Audiology Department , Royal Surrey County Hospital NHS Foundation Trust , Guildford , UK
| | - Berthold Langguth
- b Department of Psychiatry and Psychotherapy , The University of Regensburg , Regensburg , Germany
| | - Ali A Danesh
- c Department of Communication Sciences and Disorders , Florida Atlantic University , Boca Raton , FL , USA
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29
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Sensitivity to sounds in sport-related concussed athletes: a new clinical presentation of hyperacusis. Sci Rep 2018; 8:9921. [PMID: 29967340 PMCID: PMC6028444 DOI: 10.1038/s41598-018-28312-1] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2018] [Accepted: 06/20/2018] [Indexed: 11/23/2022] Open
Abstract
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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30
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Aazh H, Knipper M, Danesh AA, Cavanna AE, Andersson L, Paulin J, Schecklmann M, Heinonen-Guzejev M, Moore BC. Insights from the third international conference on hyperacusis: causes, evaluation, diagnosis, and treatment. Noise Health 2018; 20:162-170. [PMID: 30136676 PMCID: PMC6122267 DOI: 10.4103/nah.nah_2_18] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Hyperacusis is intolerance of certain everyday sounds that causes significant distress and impairment in social, occupational, recreational, and other day-to-day activities. OBJECTIVE The aim of this report is to summarize the key findings and conclusions from the Third International Conference on Hyperacusis. TOPICS COVERED The main topics discussed comprise (1) diagnosis of hyperacusis and audiological evaluations, (2) neurobiological aspect of hyperacusis, (3) misophonia, (4) hyperacusis in autism spectrum disorder, (5) noise sensitivity, (6) hyperacusis-related distress and comorbid psychiatric illness, and (7) audiologist-delivered cognitive behavioral therapy for hyperacusis. CONCLUSIONS Implications for research and clinical practice are summarised.
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Affiliation(s)
- Hashir Aazh
- Audiology Department, Royal Surrey County Hospital, Guildford, UK
| | - Marlies Knipper
- Department of Molecular Physiology of Hearing, Hearing Research Institute Tübingen, Tübingen, Germany
| | - Ali A. Danesh
- Department of Communication Sciences and Disorders, Florida Atlantic University, Boca Raton, Florida, USA
| | - Andrea E. Cavanna
- Department of Neuropsychiatry, National Centre for Mental Health, Birmingham, UK
| | | | - Johan Paulin
- Department of Psychology, Umeå University, Umeå, Sweden
| | - Martin Schecklmann
- Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany
| | | | - Brian C.J. Moore
- Department of Experimental Psychology, University of Cambridge, Cambridge, UK
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