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HYPOTHESIS PAPER
DIAGNOSIS AND TREATMENT OF MISOPHONIA AND HYPERACUSIS BASED ON THE NEUROPHYSIOLOGICAL MODEL
1
Jastreboff Hearing Disorders Foundation Inc., Guilford, CT, USA
2
Department of Otolaryngology, Emory University School of Medicine, Atlanta, GA, USA
These authors had equal contribution to this work
A - Research concept and design; B - Collection and/or assembly of data; C - Data analysis and interpretation; D - Writing the article; E - Critical revision of the article; F - Final approval of article;
Submission date: 2025-05-08
Final revision date: 2025-09-24
Acceptance date: 2025-09-25
Online publication date: 2025-12-19
Publication date: 2025-12-19
Corresponding author
Margaret M. Jastreboff
JHDF, Jastreboff Hearing Disorders Foundation Inc., 5570 Sterrett Pl, 21044, Columbia, MD, United States
JHDF, Jastreboff Hearing Disorders Foundation Inc., 5570 Sterrett Pl, 21044, Columbia, MD, United States
J Hear Sci 2025;1(SPECIAL ISSUE ON MISOPHONIA AND HYPERACUSIS 1):64-69
KEYWORDS
TOPICS
ABSTRACT
The complaints of patients with hyperacusis and misophonia are very similar, and frequently identical. However, there are distinctive differences between these conditions. The recognition of these differences is crucial to properly diagnose and treat hyperacusis and misophonia. Audiological evaluation, while helpful, is not sufficient for differential diagnosis. Specific patient interview is critical. The treatment for hyperacusis is based on the desensitization of auditory subconscious pathways and it is aimed at decreasing abnormally increased gain within the auditory system. For misophonia the treatment involves utilization of passive and active extinction of subconscious conditioned reflexes as well as purposefully creating and modifying complex conditioning stimuli. The treatments for both conditions include counseling and sound therapy but they are distinctively different. The treatment effective for hyperacusis is not successful for misophonia and the treatment for misophonia has limited effectiveness for hyperacusis. The treatment of Decreased Sound Tolerance (DST), based on the Neurophysiological Model of Tinnitus and Decreased Sound Tolerance, showed over 80% success rate of clinically significant improvement and can even provide a cure for hyperacusis and misophonia.
FUNDING
This research and article did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
REFERENCES (21)
1.
Jastreboff MM, Jastreboff PJ. Decreased Sound Tolerance and Tinnitus Retraining Therapy (TRT). Aust N Z J Audiol, 2002; 21(2): 74–81. https://doi.org/10.1375/audi.2....
2.
Jastreboff MM, Jastreboff PJ. Hyperacusis. Audiology Online, 2001. Available from: https://www.audiologyonline.co... [Accessed 20.03.2025].
3.
Jastreboff PJ, Jastreboff MM. Treatment for Decreased Sound Tolerance (Hyperacusis and Misophonia). Sem Hear, 2014; 35(02): 105–20. https://doi.org/10.1055/s-0034....
4.
Jastreboff P, Jastreboff M. The neurophysiological model for hyperacusis and misophonia. J Hear Sci, 2025; 15 (Special Issue): 58-63. https://doi.org/10.17430/jhs/2....
5.
Vidal JL, Park JM, Han JS, Alshaikh H, Park SN. Measurement of loudness discomfort levels as a test for hyperacusis: test-retest reliability and its clinical value. Clin Exp Otorhinolaryngol, 2022; 15(1): 84–90. https://doi.org/10.21053/ceo.2....
6.
Jastreboff PJ, Jastreboff MM. The neurophysiological approach to misophonia: theory and treatment. Front Neurosci, 2023;17: 895574. https://doi.org/10.3389/fnins.....
7.
American Academy of Audiology. Tinnitus, Decreased Sound Tolerance and Tensor Tympani Syndrome. Jastreboff PJ, Jastreboff MM, Editors. 21st Annual Convention & Expo. Dallas (TX): America Academy of Audiology; 2009.
8.
Westcott M, Sanchez TG, Diges I, Saba C, Dineen R, McNeill C, et al. Tonic tensor tympani syndrome in tinnitus and hyperacusis patients: a multi-clinic prevalence study. Noise Health, 2013; 15(63): 117–28. https://doi.org/10.4103/1463-1....
9.
Klochoff I. Impedance fluctuation and a “tensor tympani syndrome”. In: Proceedings of the Fourth International Symposium on Acoustic Impedance Measurement. Penha RL, Pizarro W, Editors. Lisbon: Universidad Nova de Lisboa, 1981.
10.
Schroder AE, Vulink NC, van Loon AJ, Denys DA. Cognitive behavioral therapy is effective in misophonia: an open trial. J Affect Disord, 2017; 217: 289–94. https://doi.org/10.1016/j.jad.....
11.
Ferrer-Torres A, Gimenez-Llort L. Misophonia: a systematic review of current and future trends in this emerging clinical field. Int J Environ Res Public Health, 2022; 19(11): 6790. https://doi.org/10.3390/ijerph....
12.
Nolan DR, Gupta R, Huber CG, Schneeberger AR. An effective treatment for tinnitus and hyperacusis based on cognitive behavioral therapy in an inpatient setting: a 10-year retrospective outcome analysis. Front Psychiatry, 2020; 11: 25. https://doi.org/10.3389/fpsyt.....
13.
Rouw R, Erfanian M. A large-scale study of misophonia. J Clin Psychol, 2018; 74(3): 453–79.
14.
Aazh H, Moore BC, Lammaing K, Cropley M. Tinnitus and hyperacusis therapy in a UK National Health Service audiology department: patients’ evaluations of the effectiveness of treatments. Int J Audiol, 2016; 55(9): 514–22. https://doi.org/10.1080/149920....
15.
Juris L, Andersson G, Larsen HC, Ekselius L. Cognitive behaviour therapy for hyperacusis: a randomized controlled trial. Behav Res Ther, 2014; 54: 30–7. https://doi.org/10.1016/j.brat....
16.
Kalsoom N, Fackrell K, El Nsouli D, Carter H. Current recommendations for the use of sound therapy in adults with hyperacusis: a scoping review. Brain Sci, 2024; 14(8): 797. https://doi.org/10.3390/brains....
17.
Mattson SA, D’Souza J, Wojcik KD, Guzick AG, Goodman WK, Storch EA. A systematic review of treatments for misophonia. Pers Med Psychiatry, 2023; 39–40. https://doi.org/10.1016/j.pmip....
18.
Aazh H. Cognitive Behavioural Therapy (CBT) for managing tinnitus, hyperacusis, and misophonia: The 2025 Tonndorf Lecture. Brain Sci, 2025; 15(5): 526. https://doi.org/10.3390/brains....
19.
Jastreboff MM, Jastreboff PJ. Questionnaires for assessment of the patients and treatment outcome. In: Proceedings of the Sixth International Tinnitus Seminar. Hazell JWP, editor. Cambridge (UK), London (UK): THC; 1999, p. 487–90.
20.
Newman CW, Sandridge SA, Jacobson GP. Psychometric adequacy of the Tinnitus Handicap Inventory (THI) for evaluating treatment outcome. J Am Acad Audiol, 1998; 9(2): 153–60.
21.
Henry JA, Jastreboff MM, Jastreboff PJ, Schechter MA, Fausti SA. Guide to conducting Tinnitus Retraining Therapy (TRT) initial and follow-up interviews. J Rehab Res Dev, 2003; 40(2): 157–78.
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