Abstract
Many individuals with tinnitus report experiencing hyperacusis (enhanced sensitivity to sounds). However, estimates of the association between hyperacusis and tinnitus is lacking. Here, we investigate this relationship in a Swedish study. A total of 3645 participants (1984 with tinnitus and 1661 without tinnitus) were enrolled via LifeGene, a study from the general Swedish population, aged 18–90 years, and provided information on socio-demographic characteristics, as well as presence of hyperacusis and its severity. Tinnitus presence and severity were self-reported or assessed using the Tinnitus Handicap Inventory (THI). Phenotypes of tinnitus with (n = 1388) or without (n = 1044) hyperacusis were also compared. Of 1661 participants without tinnitus, 1098 (66.1%) were women and 563 were men (33.9%), and the mean (SD) age was 45.1 (12.9). Of 1984 participants with tinnitus, 1034 (52.1%) were women and 950 (47.9%) were men, and the mean (SD) age was 47.7 (14.0) years. Hyperacusis was associated with any tinnitus [Odds ratio (OR) 3.51, 95% confidence interval (CI) 2.99–4.13], self-reported severe tinnitus (OR 7.43, 95% CI 5.06–10.9), and THI ≥ 58 (OR 12.1, 95% CI 7.06–20.6). The association with THI ≥ 58 was greater with increasing severity of hyperacusis, the ORs being 8.15 (95% CI 4.68–14.2) for moderate and 77.4 (95% CI 35.0–171.3) for severe hyperacusis. No difference between sexes was observed in the association between hyperacusis and tinnitus. The occurrence of hyperacusis in severe tinnitus is as high as 80%, showing a very tight relationship. Discriminating the pathophysiological mechanisms between the two conditions in cases of severe tinnitus will be challenging, and optimized study designs are necessary to better understand the mechanisms behind the strong relationship between hyperacusis and tinnitus.
Highlights
2% of the population is extremely bothered by tinnitus [1], showing an increased risk in suicide attempts [2,3] and seeking medical support
Our findings reveal a strong association between tinnitus and hyperacusis
This association peaked when both tinnitus and hyperacusis were perceived as severe, reaching an Odds ratio (OR) of 77.4 in a fully adjusted model. This tight relationship was confirmed by the high prevalence of hyperacusis in participants with severe tinnitus (80%)
Summary
2% of the population is extremely bothered by tinnitus [1], showing an increased risk in suicide attempts [2,3] and seeking medical support. Recent studies suggest that tinnitus could emerge as a failure to adapt to missing sensory information from the ear [20] This loss of sensory input leads to an enhancement of the auditory stimuli in the auditory central system, known as central neural gain. This condition is characterized by altered tuning bandwidths, increased spontaneous and synchronous neural activity, which may contribute to tinnitus, and to hyperacusis [21]. It has, been very difficult to distinguish the neural correlates of tinnitus from those of hyperacusis, in both animal and human studies. We investigate the association between tinnitus and hyperacusis using data from the Swedish Tinnitus Outreach Project and further analyze the phenotypic traits related to tinnitus with accompanying hyperacusis
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