Phenotypic Characteristics of Hyperacusis in Tinnitus

[daedalus]

• Martin Schecklmann ,
• Michael Landgrebe,
• Berthold Langguth,
• the TRI Database Study Group

Abstract
Background
Many people with tinnitus also suffer from hyperacusis. Both clinical and basic scientific data indicate an overlap in pathophysiologic mechanisms. In order to further elucidate the interplay between tinnitus and hyperacusis we compared clinical and demographic characteristics of tinnitus patients with and without hyperacusis by analyzing a large sample from an international tinnitus patient database.

Materials
The default dataset import [November 1st, 2012] from the Tinnitus Research Initiative [TRI] Database was used for analyses. Hyperacusis was defined by the question "Do sounds cause you pain or physical discomfort?" of the Tinnitus Sample Case History Questionnaire. Patients who answered this question with "yes" were contrasted with "no"-responders with respect to 41 variables.

Results
935 [55%] out of 1713 patients were characterized as hyperacusis patients. Hyperacusis in tinnitus was associated with younger age, higher tinnitus-related, mental and general distress; and higher rates of pain disorders and vertigo. In relation to objective audiological assessment patients with hyperacusis rated their subjective hearing function worse than those without hyperacusis. Similarly the tinnitus pitch was rated higher by hyperacusis patients in relation to the audiometrically determined tinnitus pitch. Among patients with tinnitus and hyperacusis the tinnitus was more frequently modulated by external noise and somatic maneuvers, i.e., exposure to environmental sounds and head and neck movements change the tinnitus percept.

Conclusions
Our findings suggest that the comorbidity of hyperacusis is a useful criterion for defining a sub-type of tinnitus which is characterized by greater need of treatment. The higher sensitivity to auditory, somatosensory and vestibular input confirms the notion of an overactivation of an unspecific hypervigilance network in tinnitus patients with hyperacusis.

Figures




Citation: Schecklmann M, Landgrebe M, Langguth B, the TRI Database Study Group (2014) Phenotypic Characteristics of Hyperacusis in Tinnitus. PLoS ONE 9(1): e86944. doi:10.1371/journal.pone.0086944

Editor: Joel Snyder, UNLV, United States of America

Received: September 2, 2013; Accepted: December 15, 2013; Published: January 31, 2014

Copyright: © 2014 Schecklmann et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Funding: The study was supported by the Tinnitus Research Initiative (TRI; www.tinnitusresearch.org). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Competing interests: Co-author Berthold Langguth is a PLOS ONE Editorial Board member. This does not alter the authors' adherence to all the PLOS ONE policies on sharing data and materials.

Full paper here: http://www.plosone.org/article/info:doi/10.1371/journal.pone.0086944

 

[Hudson]

Quite cool! Although I find it sad a phenotyping paper of this size took until 2013 to conduct. I mean... phenotyping is literally collecting data and writing down what you see.

 

[Street Spirit]

Quite cool! Although I find it sad a phenotyping paper of this size took until 2013 to conduct. I mean... phenotyping is literally collecting data and writing down what you see.

I'll take it!

 

[Sen]

thanks for posting this. interesting stuff.

 

[II Packy II]

I was thinking about this as I was driving home. I thought to myself: it is highly likely that hyperacusis is a subset of tinnitus that could be the result of the hyperactive and misfiring nerves. Often people with Hyperacusis seem to have distorted sounds or a highly increased perception of that sound. Like my ear has been increasingly responsive to chewing hard candies like Jolly Ranchers or popping my neck. I get a temporary and sharp spike in an already loud and high pitch tinnitus. It only occurs in my right ear where the increase occurs.

I also believe I have minor hyperacusis in my right ear that distorts low pitch sounds but also seems to amplify those low distorted sounds. Air conditioning systems seem thumpy when I hear them in my right ear. It also seems that my ear drum is vibrating significantly hard to those types of stimuli. Simply put, I think there is a definite linkage between the mechanisms that cause both symptoms. I still contend they are both debilitating disorders.