Auditory cortical functioning in individuals with misophonia: an electrophysiological investigation.

PURPOSE: Misophonia is characterized by a reduced tolerance for specific sound triggers. This aspect has been relatively underexplored in audiology, with limited research from the audiological angle. Our primary objective is to compare the auditory late latency response (ALLR) findings between individuals with misophonia and those without it. METHODS: A study compared individuals with significant misophonia to a healthy control group. Thirty misophonia participants were categorized into mild and moderate-to-severe groups based on their Amsterdam Misophonia Scale scores. The latency and amplitude of auditory response peaks were analyzed across the groups using the ALLR. Statistical tests included Shapiro-Wilk for data normality, one-way ANOVA for group differences, and Bonferroni post hoc analysis for detailed variation sources. RESULTS: The result showed a significant difference in latency of P1 and N1 peaks (p < 0.05) of ALLR between the groups in both ears. This suggests a deficit in auditory processing at the cortical level in individuals with misophonia. CONCLUSION: Our study substantiates the potential utility of the ALLR as a valuable instrument for evaluating misophonia, particularly from the audiological standpoint.

Indicators for cochlear implantation in children with auditory neuropathy spectrum disorder: A systematic review.

PURPOSE: ANSD refers to a group of auditory diseases demonstrating intact outer hair cells and desynchronized neural firings of the auditory nerve. A cochlear implant is a promising intervention strategy for severe to profound sensorineural hearing loss (SNHL). However, due to its variable outcomes in children with ANSD, a consensus has yet to be reached on its performance. This study aimed to review the literature to determine the efficacy of cochlear implants in children with ANSD and to determine prognostic indicators. The study identifies the pre-operative and post-operative predictors of success for CI in children with ANSD. METHOD: The review was carried out using PRISMA guidelines. This resulted in 9630 topic-related articles. Among these, 17 articles met the inclusion and exclusion criteria that were included for the study. The quality and potential risks associated with each article were evaluated using the quality impact assessment protocol (QUIPS) tool. RESULTS: A review of 17 articles was conducted to highlight these predictors. Most selected studies included case reports, case series, cohorts, and comparisons between children with ANSD and SNHL. Assessment of study quality reported an overall low risk of bias. The overall result showed cochlear implant would be an effective option for children with ANSD. However, there are specific prognostic indicators about which clinician needs to be aware before recommending CI for children with ANSD. Our review study identified a set of pre-operative and post-operative indicators that predicted speech and auditory performance and gave some insight into the lesion site in ANSD individuals. CONCLUSION: This review concludes CI is an effective option for children with ANSD. However, before recommending CI, a detailed assessment is required from different perspectives, which could serve as predictors of postoperative outcomes. This review highlights the need to include more precise tools, such as genetic testing to describe the lesion site to choose the most appropriate management strategy for children with ANSD. Knowledge about the prognostic indicators and the effective assessment protocols would help clinicians for the better candidacy selection.

Auditory brainstem functioning in individuals with misophonia.

Purpose: Misophonia is not investigated much from an audiological perspective. Our study aims to examine the processing of the auditory retro-cochlear pathways in individuals with misophonia. Methods: A cross-sectional study was conducted among university students who had misophonia. The revised Amsterdam Misophonia Scale was used to determine the severity of misophonia. Participants were divided into mild and moderate-severe misophonia and compared with the healthy control group. Auditory Brainstem Response testing was recorded from all the individuals with misophonia. The absolute latency, amplitude, inter-peak latency difference, and inter-rate latency difference were compared between the groups. Results: One-way ANOVA result showed no significant difference in all the parameters of auditory brainstem response between the groups. These results are suggestive of normal brainstem processing in individuals with misophonia. Conclusions: The study concludes that the auditory pathway up to brainstem areas is intact in individuals with misophonia. Further studies are essential on a larger population for generalizing the results.

Binaural Processing and Auditory Working Memory in Individuals with Tinnitus Having Normal Hearing Sensitivity.

BACKGROUND: Tinnitus is a sound perceived in the ears or head without any external or internal sound source. It can be hypothesized that the auditory processing at the different levels of the auditory pathway and working memory may get affected due to the additional sound contributed by tinnitus. The objective of our study is to evaluate binaural processes and working memory capacity in individual with tinnitus having normal hearing sensitivity. METHODS: The binaural interaction process was evaluated using the interaural time difference and interaural level difference. Similarly, the binaural integration process was assessed using the dichotic consonant-vowel test, and the working memory was assessed using the audio descending span test and Audio 2N-Back span test. Mann-Whitney U test was done to see the significant difference between the groups. RESULTS: The Mann-Whitney U test showed significantly poorer interaural level difference scores in the tinnitus group. Also, dichotic consonantvowel test scores and auditory working memory test scores were found to be significantly lower in individuals with tinnitus. CONCLUSION: The binaural processes, along with the working memory capacity, are found to be affected in an individual with tinnitus, which in turn may affect the speech perception ability of the individual.

Awareness and perspectives of audiologists on assessment and management of misophonia in India.

Background: The assessment and management of misophonia need a team approach, and audiologists are essential team members. However, the role of an audiologist in this condition is not well understood, and there is a lack of awareness even among professionals about their role in the assessment and management of misophonia. Purpose: The main aim of our study is to document the present level of awareness and knowledge about misophonia assessment and management among audiologists in India. Methods: A descriptive cross-sectional study was carried out among audiologists from all over India. Descriptive statistical procedures were measured based on the type of questions being addressed, and a non-parametric chi-square test was done to see the association among variables. Results: The results show a lack of knowledge about misophonia even among audiologists, as only 15.3% of the audiologist reported being confident in handling cases with misophonia. Conclusion: Although the exact assessment and management of misophonia is still the topic of debate, it is clear that audiologists are the team's key members. However, the results clearly show a lack of confidence in handling cases of misophonia among audiologists in India. This result shows the future need for Research in misophonia from an audiological perspective.

Understanding misophonia from an audiological perspective: a systematic review.

PURPOSE: Misophonia is a neurophysiological disorder in which certain sounds trigger an intensely emotional or physiological response caused by an increased autonomic nervous system reaction to the triggers. Misophonia is a relatively new condition, and the neurophysiological mechanism behind this condition is not known yet. The assessment and management of misophonia need a team approach. Audiologists are vital members of the team. However, their roles in this condition are not well-understood. The study aims to review the neurophysiological mechanism of misophonia, highlighting the mechanism involved in the audiological pathway and directing the discussion toward applications of findings in the assessment and management of misophonia from the audiological perspective. METHODS: We reviewed 12 articles from different databases to understand the neurophysiological mechanisms of misophonia. Most of the studies selected were experimental designs involving individuals with misophonia. RESULTS: The result of the review revealed abnormal activation and connection among the different higher cortical structures in participants with misophonia. By signifying various neurophysiological and neuroradiological findings, the review confirms that misophonia is a neurophysiological disorder that may border between audiology, neurology, and psychiatry. Assessment of study quality reported an overall low risk of bias. CONCLUSIONS: This review highlights the need to include an audiologist as a team member in the evaluation and management of misophonia.

Development and Standardization of Hearing Handicap Inventory for Adult (Screening Version) in Nepali Language.

Hearing handicap inventory for adult- screening version (HHIA-S) is one of the widely used questionnaire for assessing hearing handicap among adult population over the short period of time. This questionnaire has been translated in many languages worldwide including Indian, Sweden, and Spanish. However, there is lack of such questionnaire in Nepali language. Hence, this study is aimed at developing and standardizing the HHIA-S questionnaire in Nepali language. The English version of the HHIA-S was translated to the Nepali language using the translation-back-translation method. Further, it was given to 10 native Nepali speakers for content validation. The final HHIA-S Nepali version was then administered to 70 normal native Nepali speakers and 50 hearing impaired Nepali speaker. The responses were analyzed, and Cronbach's alpha was calculated to measure the internal consistency of the questionnaire. Results showed that the HHIA-S Nepali version has a Cronbach's alpha score of 0.94 for normal hearing group and 0.93 for hearing impaired group, which is considered good reliability. The HHIA-S Nepali version developed in this study is found to be valid and reliable. Hence, it can be used as a screening tool for assessing hearing handicap among Nepali population. Supplementary Information: The online version contains supplementary material available at 10.1007/s12070-022-03082-5.