Sound hypersensitivity phenotypes and sound hypersensitivity disorder

This paper proposes an overarching definition for sound hypersensitivity, a common symptom frequently observed in patients with hearing loss, tinnitus and other neurological and psychiatric disorders. This multifaceted condition includes several phenotypes, which may exist in isolation or combination in the same individual: loudness hypersensitivity (hyperacusis), noxacusis, misophonia, phonophobia and noise-induced cognitive symptoms. Some individuals with sound hypersensitivity may develop a resultant sound hypersensitivity disorder, a clinically heterogeneous syndrome defined by recurrent episodes of sound-induced symptoms that are associated with a negative emotional response and/or avoidance behavior leading to suffering and/or limitation of social, leisure or occupational activities. We have assembled an international, multidisciplinary working group to develop this theoretical foundation and propose objective operational diagnostic criteria for sound hypersensitivity and sound hypersensitivity disorder. Given the large co-occurrence between tinnitus and sound hypersensitivity phenotypes, it is essential to establish a common ground to differentiate sound hypersensitivity as a symptom from sound hypersensitivity disorder and distinguish between phenotypes. The distinction will facilitate pathophysiological, translational and clinical research differentiating various forms of sound hypersensitivity and separating them from tinnitus, and represent a paradigm shift in auditory and behavioral sciences. Adopting a global and multidisciplinary lens, we aim to spark a debate fostering collaboration and innovation in addressing this pervasive yet underappreciated condition involving auditory, behavioral and cognitive neurosciences.