Evidence suggests that the incidence of sound sensitivity and general noise intolerance is increasing. Studies have suggested that the incidence of hyperacusis is between 8% and 15.2% of the adult population. There is a correlation between the prevalence of hyperacusis with advancing age and in females with higher educational attainment. The association between sound sensitivity in adults with autism spectrum disorder is widely known. Incidences of hyperacusis and misophonia in this patient group are significantly higher than the general adult population, with some studies citing incidence rates of between 18% and 86%. Diagnosing hyperacusis, misophonia, phonophobia and loudness recruitment can be challenging, relying on patient symptoms and a carefully defined set of screening questions. Currently these conditions are generally treated with a combination of information, psychological therapy/counselling and sound therapy (for hyperacusis only). The Editors’ Choice this month is an exploratory data-driven analysis which identified neural-connectivity-based markers of misophonia among cortical and subcortical networks in the brain using resting-state fMRI data. The findings of this analysis demonstrate a refined neurobiological dissociation between misophonia and hyperacusis. These results have important implications for both diagnosis and treatment. Identification of distinct and overlapping neural markers of misophonia and hyperacusis can support more precise phenotyping of sound sensitivity, leading to more targeted research and development of treatment strategies. Thank you as always to our wonderful reviewers for their contributions.
Nazia and Gaynor
Sound sensitivity is a term used to describe an adverse reaction to an auditory input, whether emotional and/or physiological, and it is increasingly understood that this umbrella term is multifaceted. It may refer to loudness recruitment, hyperacusis, misophonia, phonophobia, or may be linked to a sensory overload response. In practice, this has clear consequences for treatment, and appropriate identification is key. Fortunately, over the last 5–10 years, the research base in this area has begun to grow. This paper explores differences in the neural networks involved in hyperacusis and misophonia, focusing on the implication that these differences support appropriate separation in diagnostics. This type of research encourages greater awareness and understanding and, hopefully, can lead to more tailored and effective treatment plans. In clinical practice, the two conditions may still present together, but a greater understanding of the neurological differences underlying types of sound sensitivity can aid diagnosis and inform future treatment research and clinical considerations.
