Characteristics of somatic tinnitus patients with and without hyperacusis.

Berthold Langguth,Massimo Ralli,Rosaria Turchetta,Antonio Greco,Richard J Salvi,Giancarlo Altissimi,Marco De Vincentiis,Giancarlo Cianfrone,Armando De Virgilio,Giuseppe Attanasio

doi:10.1371/journal.pone.0188255

Berthold Langguth, Massimo Ralli + Show 8 more

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https://doi.org/10.1371/journal.pone.0188255

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Abstract

ObjectiveDetermine if somatic tinnitus patients with hyperacusis have different characteristics from those without hyperacusis.Patients and methods172 somatic tinnitus patients with (n = 82) and without (n = 90) hyperacusis referred to the Tinnitus Unit of Sapienza University of Rome between June 2012 and June 2016 were compared for demographic characteristics, tinnitus features, self-administered questionnaire scores, nature of somatic modulation and history.ResultsCompared to those without hyperacusis, patients with somatic tinnitus and hyperacusis: (a) were older (43.38 vs 39.12 years, p = 0.05), (b) were more likely to have bilateral tinnitus (67.08% vs 55.56%, p = 0.04), (c) had a higher prevalence of somatic modulation of tinnitus (53.65% vs 36.66%, p = 0.02) and (d) scored significantly worse on tinnitus annoyance (39.34 vs 22.81, p<0.001) and subjective hearing level (8.04 vs 1.83, p<0.001).ConclusionOur study shows significantly higher tinnitus modulation and worse self-rating of tinnitus and hearing ability in somatic tinnitus patients with hyperacusis versus somatic tinnitus patients without hyperacusis. These differences could prove useful in developing a better understanding of the pathophysiology and establishing a course of treatment for these two groups of patients.

Highlights

Hyperacusis is a term used to describe intolerance to certain everyday sounds that causes significant distress and impairment in social, occupational, recreational, and other day-to-day activities [1]
Our study shows significantly higher tinnitus modulation and worse self-rating of tinnitus and hearing ability in somatic tinnitus patients with hyperacusis versus somatic tinnitus patients without hyperacusis
These differences could prove useful in developing a better understanding of the pathophysiology and establishing a course of treatment for these two groups of patients

Summary

Introduction

Hyperacusis is a term used to describe intolerance to certain everyday sounds that causes significant distress and impairment in social, occupational, recreational, and other day-to-day activities [1]. While the neural mechanisms underlying hyperacusis are still unclear [3], there is growing awareness that hyperacusis may be related to increased neural gain at many different levels of the central auditory system and areas outside the classical auditory pathway involved in arousal, emotional response to sound, anxiety, stress and motor control [7,8,9]. Recent brainimaging studies have identified neural hyperexcitability of certain areas of the brain both within and outside the classically defined auditory pathway [9,10,11,12]. Hyperacusis is sometimes associated with disordered perceptions involving the visual and somatosensory domains such as heightened sensitivity to light, migraine and lowered pain thresholds in individuals with chronic pain [13,14]. While hyperacusis and tinnitus are often associated with hearing loss [18,19,20], some individuals with hyperacusis and/or tinnitus have clinically normal audiograms [15,21]

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