Loudness tolerance levels and misophonia
Reviewed by Yovina Khiroya-Morjaria

Misophonia is a prevalent condition, yet its assessment and management remain underrecognised by many audiologists. Current literature highlights the frequent co-occurrence of misophonia with tinnitus and hyperacusis. Hence, the link between loudness intolerance problems and misophonia has been hypothesised by several authors. A questionnaire utilising the Amsterdam Misophonia Scale was emailed to all students from a university. Of the respondents, 47 were invited to take part in the study. Thirty participants were brought forward for further assessment and 15 participants with no misophonia were also invited into the study. All participants underwent assessment including case history, otoscopy, tympanometry, pure tone audiometry (including extended high frequency) and loudness discomfort level testing. Statistical analysis revealed no significant difference in pure tone audiometry and extended high-frequency results between the two groups. However, there was a significant decrease in loudness discomfort levels in those with misophonia, particularly in the low frequencies. The authors concluded that loudness tolerance is a significant concern in those with misophonia and loudness discomfort testing should be included in a standard test battery for misophonia patients.

Loudness tolerance level among individuals with misophonia: A psychoacoustic assessment.
Aryal S, Prabhu P.
HEAR BALANCE COMMUN
2024;22(4):115–21.