Unit:
Κατεύθυνση Ακοολογία–ΝευροωτολογίαLibrary of the School of Health Sciences
Author:
Antoniadis Alexandros
Supervisors info:
Μπίμπας Αθανάσιος, Αναπληρωτής Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Κυροδήμος Ευθύμιος, Επίκουρος Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Παστιάδης Κωνσταντίνος, Αναπληρωτής Καθηγητής, Τμήμα Μουσικών Σπουδών, ΑΠΘ
Original Title:
Υπερακουσία : ανασκόπηση των παθοφυσιολογικών μηχανισμών
Translated title:
Hyperacusis : review of pathophysiological mechanisms
Summary:
Introduction : Dysregulation of loudness perception can represent a serious clinical problem for both the Otologist-Audiologist and the patient. Among several definitions, hyperacusis can be defined as “intolerance to ordinary environmental sounds”, although even basic terminology and definitions that are used present important variation in this research area, which mainly the last few decades attracts more research interest. Hyperacusis can take place as the only complaint, but more frequently it co-exists with tinnitus and other non otological symptoms. Hyperacusis has several potential mechanisms which are not mutually exclusive; Hyperacusis can probably be associated with both peripheral and central mechanisms, which is similar to tinnitus and hearing loss. In this review we try to summarise what is known of hyperacusis pathophysiology, as related to specific medical conditions or as a sole presenting symptom.
Methods: Studies will be selected according to the following criteria:
Studies focused on the mechanisms of hyperacusis in patients complaining for hyperacusis only or hyperacusis as the primary complaint or as a symptom of a non otological syndrome. Animal studies trying to identify a potential mechanism of hyperacusis were included as well.
Medline and Google Scholar will be searched for eligible studies. In addition, to include as many relevant studies as possible, manual searches of any relevant article which had hyperacusis and a possible mechanism/cause in the title was performed.
All type of studies with full-text availability will be included in the research process. There will be restriction concerning the year of publication, including publications of the last 10 years (for Medline and Google Scholar) . Only studies published in English will be included.
Outcomes: Updated data regarding the terminology, assessment, and management of hyperacusis will be presented . Recent knowledge for the anatomy and physiology of the inner ear and the process of loudness neural encoding will be briefly reviewed. Peripheral and central mechanisms leading to the generation of hyperacusis and specific causes of hyperacusis related to pathophysiology is analysed.
Discussion: Current evidence suggests that different forms of hyperacusis may be mediated by distinct mechanisms. In most patients with hyperacusis, no specific medical cause can be diagnosed. In patients with hyperacusis as part of a symptoms set, possible causes of hyperacusis can be divided into three different groups: a) peripheral auditory system disorders b) central nervous system disorders c) other groups of causes. Changes to auditory input due to hearing loss (including hidden hearing loss) can lead to mechanisms of enhancement of central gain which is described as an important mechanism for loudness hyperacusis. Conclusion: The understanding of pathophysiological basis of hyperacusis, although complex, will facilitate researchers to categorise patients in distinct homogeneous groups with different characteristics ,and thus will help the development of novel therapies for this often devastating disorder.
Main subject category:
Health Sciences
Keywords:
Hyperacusis, Mechanisms, Pathophysiology
