@article {pmid38479346, year = {2024}, author = {Steuber, ER and McGuire, JF}, title = {A meta-analysis of transcranial magnetic stimulation in Tourette syndrome.}, journal = {Journal of psychiatric research}, volume = {173}, number = {}, pages = {34-40}, doi = {10.1016/j.jpsychires.2024.02.057}, pmid = {38479346}, issn = {1879-1379}, abstract = {There is growing enthusiasm for the treatment of neuropsychiatric disorders using neuromodulation. While some reports claim that transcranial magnetic stimulation (TMS) can be used to treat Tourette Syndrome (TS), little research exists to support this assertion. This meta-analysis examined the efficacy of TMS to reduce tic severity in patients with TS. Additionally, it explored the effect of TMS to reduce premonitory urge severity-the primary mechanism implicated in the frontline evidence-based treatment of TS. Five treatment comparisons were selected using PRISMA guidelines. All studies included were required to be (1) a randomized controlled trial, (2) compare TMS to a sham condition, and (3) have all participants meet diagnostic criteria for a persistent tic disorder and/or TS. A random effects model meta-analysis examined the efficacy of using TMS to reduce tic severity and explored the effect of TMS to reduce premonitory urge severity. TMS did not significantly reduce tic severity (g = 0.44; 95% CI = -0.17, 1.05; z = 1.40; p = 0.16), but a moderate reduction in premonitory urge severity was found (g = 0.63; 95% CI = 0.9, 1.17; z = 2.27; p < 0.02). Trials with larger sample sizes and a preponderance of women were found to have greater therapeutic effects of TMS for tic severity. There is limited support for the use of TMS to reduce tic severity, though reductions in premonitory urge severity were observed. Major limitations of the existing literature are examined, with a call for research investigating newer TMS protocols and their use as a treatment augmentation strategy.}, } @article {pmid38440608, year = {2024}, author = {Bahramian, E and Gohari, N and Aazh, H}, title = {Preliminary Study on Speech in Noise Training in Children with Sensory Processing Disorder and Hyperacusis.}, journal = {Indian journal of otolaryngology and head and neck surgery : official publication of the Association of Otolaryngologists of India}, volume = {76}, number = {1}, pages = {344-350}, pmid = {38440608}, issn = {2231-3796}, abstract = {Hyperacusis is the perception of certain everyday sounds as too loud or painful. Past research suggests that some individuals with Sensory Processing Disorder (SPD) may also have a comorbid hyperacusis. The aim of this preliminary study was to explore if hyperacusis symptoms in children with SPD change following Speech in noise training (SPINT). This was a retrospective cross-sectional study. Data were included for 28 children with SPD and sound intolerance (12/28 were female, mean age was 8.7 ± 1.9 years old). Patients were assessed using the Persian Buffalo Model Questionnaire-Revised version (P-BMQ-R) that measures various behavioural aspects of auditory processing disorder and word in noise test (WINT) before and after SPINT. After SPINT the subscales of DEC, TFM with its Noi, and Mem, subcategories, APD, ΣCAP, and Gen of P-BMQ-R questionnaire significantly improved (P < 0.05), however, the changes in subscales of Var, INT and ORG were not statistically significant (P > 0.05). In addition, SPINT led to better performance in WINT in both ears (P < 0.05). This preliminary study showed promising result for the effect of SPINT on improving behavioural indicators of APD (as measured via P-BMQ-R and WINT) and decreasing hyperacusis symptoms (as measured via Noi).}, } @article {pmid38430053, year = {2024}, author = {Lewin, AB and Milgram, L and Cepeda, SL and Dickinson, S and Bolen, M and Kudryk, K and Bolton, C and Karlovich, AR and Grassie, HL and Kangavary, A and Harmon, SL and Guzick, A and Ehrenreich-May, J}, title = {Clinical characteristics of treatment-seeking youth with misophonia.}, journal = {Journal of clinical psychology}, volume = {}, number = {}, pages = {}, doi = {10.1002/jclp.23672}, pmid = {38430053}, issn = {1097-4679}, support = {//REAM Foundation/ ; //Misophonia Research Fund/ ; }, abstract = {OBJECTIVE: Misophonia is a psychiatric condition characterized by strong emotional and/or behavioral responses to auditory stimuli, leading to distress and functional impairment. Despite previous attempts to define and categorize this condition, misophonia is not currently included in the Diagnostic and Statistical Manual of Mental Disorders or International Classification of Diseases. The lack of formal diagnostic consensus presents challenges for research aimed at assessing and treating this clinical presentation.

METHODS: The current study presents clinical characteristics of youth (N = 47) with misophonia in the largest treatment-seeking sample to date. We examined demographic characteristics of the sample, frequency of comorbid disorders, frequency of specific misophonia symptoms (i.e., triggers, emotional and behavioral responses, and impairments), and caregiver-child symptom agreement. Misophonia symptoms were evaluated using a multimodal assessment including clinician, youth, and caregiver reports on empirically established misophonia measures, and concordance among measures was assessed.

RESULTS: Youth seeking treatment for misophonia presented with marked misophonia symptoms and an array of comorbid conditions. Youth and caregivers identified various triggers of misophonia symptoms (e.g., chewing sounds, breathing sounds), as well as a wide range of emotional (e.g., anger, annoyance, disgust) and behavioral (e.g., aggression, avoidance) responses to triggers. Youth and caregivers exhibited high agreement on misophonia triggers but lower agreement on symptom severity and associated impairment. Compared to younger children (aged 8-13), older children (aged 14+) appeared to report symptom severity and associated impairment more reliably.

CONCLUSION: Misophonia is a heterogenous and impairing clinical condition that warrants future investigation and evidence-based treatment development.}, } @article {pmid38420172, year = {2024}, author = {Norena, A}, title = {Did Kant suffer from misophonia?.}, journal = {Frontiers in psychology}, volume = {15}, number = {}, pages = {1242516}, pmid = {38420172}, issn = {1664-1078}, abstract = {Misophonia is a disorder of decreased tolerance to specific sounds, often produced by humans but not always, which can trigger intense emotional reactions (anger, disgust etc.). This relatively prevalent disorder can cause a reduction in the quality of life. The causes of misophonia are still unclear. In this article, we develop a hypothesis suggesting that misophonia can be caused by a failure in the organization of the perceived world. The perceived world is the result of both the structure of human thought and the many conditioning factors that punctuate human life, particularly social conditioning. It is made up of abstract symbols that map the world and help humans to orient himself in a potentially dangerous environment. In this context, the role of social rules acquired throughout life is considerable. Table manners, for example, are a set of deeply regulated and controlled behaviors (it's considered impolite to eat with the mouth open and to make noise while eating), which contribute to shape the way the perceived world is organized. So it's not surprising to find sounds from the mouth (chewing etc.) among the most common misophonic sound triggers. Politeness can be seen as an act of obedience to moral rules or courtesy, which is a prerequisite for peaceful social relations. Beyond this example, we also argue that any sound can become a misophonic trigger as long as it is not integrated into the perceived ordered and harmonious world, because it is considered an "anomaly," i.e., a disorder, an immorality or a vulgarity.}, } @article {pmid38414185, year = {2024}, author = {Simner, J and Rinaldi, LJ and Ward, J}, title = {An Automated Online Measure for Misophonia: The Sussex Misophonia Scale for Adults.}, journal = {Assessment}, volume = {}, number = {}, pages = {10731911241234104}, doi = {10.1177/10731911241234104}, pmid = {38414185}, issn = {1552-3489}, abstract = {Misophonia is a sound sensitivity disorder characterized by a strong aversion to specific sounds (e.g., chewing). Here we present the Sussex Misophonia Scale for Adults (SMS-Adult), within an online open-access portal, with automated scoring and results that can be shared ethically with users and professionals. Receiver operator characteristics show our questionnaire to be "excellent" and "good-to-excellent" at classifying misophonia, both when dividing our n = 501 adult participants by recruitment stream (self-declared misophonics vs. general population), and again when dividing them with by a prior measure of misophonia (as misophonics vs. non-misophonics). Factor analyses identified a five-factor structure in our 39 Likert-type items, and these were Feelings/Isolation, Life consequences, Intersocial reactivity, Avoidance/Repulsion, and Pain. Our measure also elicits misophonia triggers, each rated for their commonness in misophonia. We offer our open-access online tool for wider use (www.misophonia-hub.org), embedded within a well-stocked library of resources for misophonics, researchers, and clinicians.}, } @article {pmid38406262, year = {2023}, author = {McMahon, K and Cassiello-Robbins, C and Greenleaf, A and Guetta, R and Frazer-Abel, E and Kelley, L and Rosenthal, MZ}, title = {The unified protocol for transdiagnostic treatment of emotional disorders for misophonia: a pilot trial exploring acceptability and efficacy.}, journal = {Frontiers in psychology}, volume = {14}, number = {}, pages = {1294571}, pmid = {38406262}, issn = {1664-1078}, abstract = {INTRODUCTION: Misophonia is a recently defined disorder characterized by distressing responses to everyday sounds, such as chewing or sniffling. Individuals with misophonia experience significant functional impairment but have limited options for evidenced-based behavioral treatment. To address this gap in the literature, the current pilot trial explored the acceptability and efficacy of a transdiagnostic cognitive-behavioral approach to treating symptoms of misophonia.

METHODS: This trial was conducted in two studies: In Study 1, the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders (UP) was delivered to eight patients in order to receive feedback to guide revisions to the treatment to suit this population. In Study 2, ten patients received the revised UP treatment to explore its acceptability and preliminary efficacy. This study used a single-case experimental design with multiple baselines, randomizing patients to either a 2-week baseline or 4-week baseline prior to the 16 weeks of treatment, followed by four weeks of follow-up.

RESULTS: The findings from these studies suggested that patients found both the original and adapted versions of the UP to be acceptable and taught them skills for how to manage their misophonia symptoms. Importantly, the findings also suggested that the UP can help remediate symptoms of misophonia, particularly the emotional and behavioral responses.

DISCUSSION: These findings provide preliminary evidence that this transdiagnostic treatment for emotional disorders can improve symptoms of misophonia in adults.}, } @article {pmid38392460, year = {2024}, author = {Hayes, C and Gregory, J and Aziz, R and Cerejeira, J and Cruz, M and Simões, JA and Vitoratou, S}, title = {Psychometric Evaluation and Misophonic Experience in a Portuguese-Speaking Sample.}, journal = {Behavioral sciences (Basel, Switzerland)}, volume = {14}, number = {2}, pages = {}, doi = {10.3390/bs14020107}, pmid = {38392460}, issn = {2076-328X}, support = {102176/B/13/Z/WT_/Wellcome Trust/United Kingdom ; }, abstract = {Misophonia, a disorder characterised by an extreme sensitivity to certain sounds, is increasingly being studied in cross-cultural settings. The S-Five scale is a multidimensional psychometric tool initially developed to measure the severity of misophonia in English-speaking populations. The scale has been validated in several languages, and the present study aimed to validate the European Portuguese S-Five scale in a Portuguese-speaking sample. The scale was translated into Portuguese using a forward-backwards translation method. The psychometric properties of the S-Five scale were evaluated in a sample of 491 Portuguese-speaking adults. Confirmatory factor analysis supported a five-factor structure consistent with previous versions of the S-Five scale. The five factors were as follows: (1) internalising appraisals, (2) externalising appraisals, (3) perceived threat and avoidance behaviour, (4) outbursts, and (5) impact on functioning. The satisfactory psychometric properties of the S-Five scale further indicated its cross-cultural stability. As a psychometrically robust tool, the S-Five can measure misophonia in Portuguese-speaking populations, allowing future studies to explore and compare misophonia in this population.}, } @article {pmid38386641, year = {2024}, author = {Guetta, RE and Siepsiak, M and Shan, Y and Frazer-Abel, E and Rosenthal, MZ}, title = {Misophonia is related to stress but not directly with traumatic stress.}, journal = {PloS one}, volume = {19}, number = {2}, pages = {e0296218}, doi = {10.1371/journal.pone.0296218}, pmid = {38386641}, issn = {1932-6203}, abstract = {The relationship between misophonia, stress, and traumatic stress has not been well characterized scientifically. This study aimed to explore the relationships among misophonia, stress, lifetime traumatic events, and traumatic stress. A community sample of adults with self-reported misophonia (N = 143) completed structured diagnostic interviews and psychometrically validated self-report measures. Significant positive correlations were observed among perceived stress, traumatic stress, and misophonia severity. However, multivariate analyses revealed that perceived stress significantly predicted misophonia severity, over and above traumatic stress symptoms. The number of adverse life events was not associated with misophonia severity. Among symptom clusters of post-traumatic stress disorder, only hyperarousal was associated with misophonia severity. These findings suggest that transdiagnostic processes related to stress, such as perceived stress and hyperarousal, may be important phenotypic features and possible treatment targets for adults with misophonia.}, } @article {pmid38309959, year = {2024}, author = {, and , and , }, title = {[Standard technical specifications for methacholine chloride (Methacholine) bronchial challenge test (2023)].}, journal = {Zhonghua jie he he hu xi za zhi = Zhonghua jiehe he huxi zazhi = Chinese journal of tuberculosis and respiratory diseases}, volume = {47}, number = {2}, pages = {101-119}, doi = {10.3760/cma.j.cn112147-20231019-00247}, pmid = {38309959}, issn = {1001-0939}, support = {2018YFC1311900//State Key Research and Development Plan/ ; SRPG22-018//Guangzhou National Laboratory Independent Project/ ; }, abstract = {The methacholine challenge test (MCT) is a standard evaluation method of assessing airway hyperresponsiveness (AHR) and its severity, and has significant clinical value in the diagnosis and treatment of bronchial asthma. A consensus working group consisting of experts from the Pulmonary Function and Clinical Respiratory Physiology Committee of the Chinese Association of Chest Physicians, the Task Force for Pulmonary Function of the Chinese Thoracic Society, and the Pulmonary Function Group of Respiratory Branch of the Chinese Geriatric Society jointly developed this consensus. Based on the "Guidelines for Pulmonary Function-Bronchial Provocation Test" published in 2014, the issues encountered in its use, and recent developments, the group has updated the Standard technical specifications of methacholine chloride (methacholine) bronchial challenge test (2023). Through an extensive collection of expert opinions, literature reviews, questionnaire surveys, and multiple rounds of online and offline discussions, the consensus addressed the eleven core issues in MCT's clinical practice, including indications, contraindications, preparation of provocative agents, test procedures and methods, quality control, safety management, interpretation of results, and reporting standards. The aim was to provide clinical pulmonary function practitioners in healthcare institutions with the tools to optimize the use of this technique to guide clinical diagnosis and treatment.Summary of recommendationsQuestion 1: Who is suitable for conducting MCT? What are contraindications for performing MCT?Patients with atypical symptoms and a clinical suspicion of asthma, patients diagnosed with asthma requiring assessment of the severity of airway hyperresponsiveness, individuals with allergic rhinitis who are at risk of developing asthma, patients in need of evaluating the effectiveness of asthma treatment, individuals in occupations with high safety risks due to airway hyperresponsiveness, patients with chronic diseases prone to airway hyperresponsiveness, others requiring assessment of airway reactivity.Absolute contraindications: (1) Patients who are allergic to methacholine (MCh) or other parasympathomimetic drugs, with allergic reactions including rash, itching/swelling (especially of the face, tongue, and throat), severe dizziness, and dyspnea; (2) Patients with a history of life-threatening asthma attacks or those who have required mechanical ventilation for asthma attacks in the past three months; (3) Patients with moderate to severe impairment of baseline pulmonary function [Forced Expiratory Volume in one second (FEV1) less than 60% of the predicted value or FEV1<1.0 L]; (4) Severe urticaria; (5) Other situations inappropriate for forced vital capacity (FVC) measurement, such as myocardial infarction or stroke in the past three months, poorly controlled hypertension, aortic aneurysm, recent eye surgery, or increased intracranial pressure.Relative contraindications: (1) Moderate or more severe impairment of baseline lung function (FEV1%pred<70%), but individuals with FEV1%pred>60% may still be considered for MCT with strict observation and adequate preparation; (2) Experiencing asthma acute exacerbation; (3) Poor cooperation with baseline lung function tests that do not meet quality control requirements; (4) Recent respiratory tract infection (<4 weeks); (5) Pregnant or lactating women; (6) Patients currently using cholinesterase inhibitors (for the treatment of myasthenia gravis); (7) Patients who have previously experienced airway spasm during pulmonary function tests, with a significant decrease in FEV1 even without the inhalation of provocative.Question 2: How to prepare and store the challenge solution for MCT?Before use, the drug must be reconstituted and then diluted into various concentrations for provocation. The dilution concentration and steps for MCh vary depending on the inhalation method and provocation protocol used. It is important to follow specific steps. Typically, a specified amount of diluent is added to the methacholine reagent bottle for reconstitution, and the mixture is shaken until the solution becomes clear. The diluent is usually physiological saline, but saline with phenol (0.4%) can also be used. Phenol can reduce the possibility of bacterial contamination, and its presence does not interfere with the provocation test. After reconstitution, other concentrations of MCh solution are prepared using the same diluent, following the dilution steps, and then stored separately in sterile containers. Preparers should carefully verify and label the concentration and preparation time of the solution and complete a preparation record form. The reconstituted and diluted MCh solution is ready for immediate use without the need for freezing. It can be stored for two weeks if refrigerated (2-8 ℃). The reconstituted solution should not be stored directly in the nebulizer reservoir to prevent crystallization from blocking the capillary opening and affecting aerosol output. The temperature of the solution can affect the production of the nebulizer and cause airway spasms in the subject upon inhaling cold droplets. Thus, refrigerated solutions should be brought to room temperature before use.Question 3: What preparation is required for subjects prior to MCT?(1) Detailed medical history inquiry and exclusion of contraindications.(2) Inquiring about factors and medications that may affect airway reactivity and assessing compliance with medication washout requirements: When the goal is to evaluate the effectiveness of asthma treatment, bronchodilators other than those used for asthma treatment do not need to be discontinued. Antihistamines and cromolyn have no effect on MCT responses, and the effects of a single dose of inhaled corticosteroids and leukotriene modifiers are minimal, thus not requiring cessation before the test. For patients routinely using corticosteroids, whether to discontinue the medication depends on the objective of the test: if assisting in the diagnosis of asthma, differential diagnosis, aiding in step-down therapy for asthma, or exploring the effect of discontinuing anti-inflammatory treatment, corticosteroids should be stopped before the provocation test; if the patient is already diagnosed with asthma and the objective is to observe the level of airway reactivity under controlled medication conditions, then discontinuation is not necessary. Medications such as IgE monoclonal antibodies, IL-4Rα monoclonal antibodies, traditional Chinese medicine, and ethnic medicines may interfere with test results, and clinicians should decide whether to discontinue these based on the specific circumstances.(3) Explaining the test procedure and potential adverse reactions, and obtaining informed consent if necessary.Question 4: What are the methods of the MCT? And which ones are recommended in current clinical practice?Commonly used methods for MCT in clinical practice include the quantitative nebulization method (APS method), Forced Oscillalion method (Astograph method), 2-minute tidal breathing method (Cockcroft method), hand-held quantitative nebulization method (Yan method), and 5-breath method (Chai 5-breath method). The APS method allows for precise dosing of inhaled Methacholine, ensuring accurate and reliable results. The Astograph method, which uses respiratory resistance as an assessment indicator, is easy for subjects to perform and is the simplest operation. These two methods are currently the most commonly used clinical practice in China.Question 5: What are the steps involved in MCT?The MCT consists of the following four steps:(1) Baseline lung function test: After a 15-minute rest period, the subjects assumes a seated position and wear a nose clip for the measurement of pulmonary function indicators [such as FEV1 or respiratory resistance (Rrs)]. FEV1 should be measured at least three times according to spirometer quality control standards, ensuring that the best two measurements differ by less than 150 ml and recording the highest value as the baseline. Usually, if FEV1%pred is below 70%, proceeding with the challenge test is not suitable, and a bronchodilation test should be considered. However, if clinical assessment of airway reactivity is necessary and FEV1%pred is between 60% and 70%, the provocation test may still be conducted under close observation, ensuring the subject's safety. If FEV1%pred is below 60%, it is an absolute contraindication for MCT.(2) Inhalation of diluent and repeat lung function test for control values: the diluent, serving as a control for the inhaled MCh, usually does not significantly impact the subject's lung function. the higher one between baseline value and the post-dilution FEV1 is used as the reference for calculating the rate of FEV1 decline. If post-inhalation FEV1 decreases, there are usually three scenarios: ①If FEV1 decreases by less than 10% compared to the baseline, the test can proceed, continue the test and administer the first dose of MCh. ②If the FEV1 decreases by≥10% and<20%, indicating a heightened airway reactivity to the diluent, proceed with the lowest concentration (dose) of the provoking if FEV1%pred has not yet reached the contraindication criteria for the MCT. if FEV1%pred<60% and the risk of continuing the challenge test is considerable, it is advisable to switch to a bronchodilation test and indicate the change in the test results report. ③If FEV1 decreases by≥20%, it can be directly classified as a positive challenge test, and the test should be discontinued, with bronchodilators administered to alleviate airway obstruction.(3) Inhalation of MCh and repeat lung function test to assess decline: prepare a series of MCh concentrations, starting from the lowest and gradually increasing the inhaled concentration (dose) using different methods. Perform pulmonary function tests at 30 seconds and 90 seconds after completing nebulization, with the number of measurements limited to 3-4 times. A complete Forced Vital Capacity (FVC) measurement is unnecessary during testing; only an acceptable FEV1 measurement is required. The interval between two consecutive concentrations (doses) generally should not exceed 3 minutes. If FEV1 declines by≥10% compared to the control value, reduce the increment of methacholine concentration (dose) and adjust the inhalation protocol accordingly. If FEV1 declines by≥20% or more compared to the control value or if the maximum concentration (amount) has been inhaled, the test should be stopped. After inhaling the MCh, close observation of the subject's response is necessary. If necessary, monitor blood oxygen saturation and auscultate lung breath sounds. The test should be promptly discontinued in case of noticeable clinical symptoms or signs.(4) Inhalation of bronchodilator and repeat lung function test to assess recovery: when the bronchial challenge test shows a positive response (FEV1 decline≥20%) or suspiciously positive, the subject should receive inhaled rapid-acting bronchodilators, such as short-acting beta-agonists (SABA) or short-acting muscarinic antagonists (SAMA). Suppose the subject exhibits obvious symptoms of breathlessness, wheezing, or typical asthma manifestations, and wheezing is audible in the lungs, even if the positive criteria are not met. In that case, the challenge test should be immediately stopped, and rapid-acting bronchodilators should be administered. Taking salbutamol as an example, inhale 200-400 μg (100 μg per puff, 2-4 puffs, as determined by the physician based on the subject's condition). Reassess pulmonary function after 5-10 minutes. If FEV1 recovers to within 10% of the baseline value, the test can be concluded. However, if there is no noticeable improvement (FEV1 decline still≥10%), record the symptoms and signs and repeat the bronchodilation procedure as mentioned earlier. Alternatively, add Ipratropium bromide (SAMA) or further administer nebulized bronchodilators and corticosteroids for intensified treatment while keeping the subject under observation until FEV1 recovers to within 90% of the baseline value before allowing the subject to leave.Question 6: What are the quality control requirements for the APS and Astograph MCT equipment?(1) APS Method Equipment Quality Control: The APS method for MCT uses a nebulizing inhalation device that requires standardized flowmeters, compressed air power source pressure and flow, and nebulizer aerosol output. Specific quality control methods are as follows:a. Flow and volume calibration of the quantitative nebulization device: Connect the flowmeter, an empty nebulization chamber, and a nebulization filter in sequence, attaching the compressed air source to the bottom of the chamber to ensure airtight connections. Then, attach a 3 L calibration syringe to the subject's breathing interface and simulate the flow during nebulization (typically low flow:<2 L/s) to calibrate the flow and volume. If calibration results exceed the acceptable range of the device's technical standards, investigate and address potential issues such as air leaks or increased resistance due to a damp filter, then recalibrate. Cleaning the flowmeter or replacing the filter can change the resistance in the breathing circuit, requiring re-calibration of the flow.b. Testing the compressed air power source: Regularly test the device, connecting the components as mentioned above. Then, block the opening of the nebulization device with a stopper or hand, start the compressed air power source, and test its pressure and flow. If the test results do not meet the technical standards, professional maintenance of the equipment may be required.c. Verification of aerosol output of the nebulization chamber: Regularly verify all nebulization chambers used in provocation tests. Steps include adding a certain amount of saline to the chamber, weighing and recording the chamber's weight (including saline), connecting the nebulizer to the quantitative nebulization device, setting the nebulization time, starting nebulization, then weighing and recording the post-nebulization weight. Calculate the unit time aerosol output using the formula [(weight before nebulization-weight after nebulization)/nebulization time]. Finally, set the nebulization plan for the provocation test based on the aerosol output, considering the MCh concentration, single inhalation nebulization duration, number of nebulization, and cumulative dose to ensure precise dosing of the inhaled MCh.(2) Astograph method equipment quality control: Astograph method equipment for MCT consists of a respiratory resistance monitoring device and a nebulization medication device. Perform zero-point calibration, volume calibration, impedance verification, and nebulization chamber checks daily before tests to ensure the resistance measurement system and nebulization system function properly. Calibration is needed every time the equipment is turned on, and more frequently if there are significant changes in environmental conditions.a. Zero-point calibration: Perform zero-point calibration before testing each subject. Ensure the nebulization chamber is properly installed and plugged with no air leaks.b. Volume calibration: Use a 3 L calibration syringe to calibrate the flow sensor at a low flow rate (approximately 1 L/s).c. Resistance verification: Connect low impedance tubes (1.9-2.2 cmH2O·L[-1]·s[-1]) and high impedance tubes (10.2-10.7 cmH2O·L[-1]·s[-1]) to the device interface for verification.d. Bypass check: Start the bypass check and record the bypass value; a value>150 ml/s is normal.e. Nebulization chamber check: Check each of the 12 nebulization chambers daily, especially those containing bronchodilators, to ensure normal spraying. The software can control each nebulization chamber to produce spray automatically for a preset duration (e.g., 2 seconds). Observe the formation of water droplets on the chamber walls, indicating normal spraying. If no nebulization occurs, check for incorrect connections or blockages.Question 7: How to set up and select the APS method in MCT?The software program of the aerosol provocation system in the quantitative nebulization method can independently set the nebulizer output, concentration of the methacholine agent, administration time, and number of administrations and combine these parameters to create the challenge test process. In principle, the concentration of the methacholine agent should increase from low to high, and the dose should increase from small to large. According to the standard, a 2-fold or 4-fold incremental challenge process is generally used. In clinical practice, the dose can be simplified for subjects with good baseline lung function and no history of wheezing, such as using a recommended 2-concentration, 5-step method (25 and 50 g/L) and (6.25 and 25 g/L). Suppose FEV1 decreases by more than 10% compared to the baseline during the test to ensure subject safety. In that case, the incremental dose of the methacholine agent can be reduced, and the inhalation program can be adjusted appropriately. If the subject's baseline lung function declines or has recent daytime or nighttime symptoms such as wheezing or chest tightness, a low concentration, low dose incremental process should be selected.Question 8: What are the precautions for the operation process of the Astograph method in MCT?(1) Test equipment: The Astograph method utilizes the forced oscillation technique, applying a sinusoidal oscillating pressure at the mouthpiece during calm breathing. Subjects inhale nebulized MCh of increasing concentrations while continuous monitoring of respiratory resistance (Rrs) plots the changes, assessing airway reactivity and sensitivity. The nebulization system employs jet nebulization technology, comprising a compressed air pump and 12 nebulization cups. The first cup contains saline, cups 2 to 11 contain increasing concentrations of MCh, and the 12th cup contains a bronchodilator solution.(2) Provocation process: Prepare 10 solutions of MCh provocant with gradually increasing concentrations.(3) Operational procedure: The oscillation frequency is usually set to 3 Hz (7 Hz for children) during the test. The subject breathes calmly, inhales saline solution nebulized first, and records the baseline resistance value (if the subject's baseline resistance value is higher than 10 cmH2O·L[-1]·s[-1], the challenge test should not be performed). Then, the subject gradually inhales increasing concentrations of methacholine solution. Each concentration solution is inhaled for 1 minute, and the nebulization system automatically switches to the next concentration for inhalation according to the set time. Each nebulizer cup contains 2-3 ml of solution, the output is 0.15 ml/min, and each concentration is inhaled for 1 minute. The dose-response curve is recorded automatically. Subjects should breathe tidally during the test, avoiding deep breaths and swallowing. Continue until Rrs significantly rises to more than double the baseline value, or if the subject experiences notable respiratory symptoms or other discomfort, such as wheezing in both lungs upon auscultation. At this point, the inhalation of the provocant should be stopped and the subject switchs to inhaling a bronchodilator until Rrs returns to pre-provocation levels. If there is no significant increase in Rrs, stop the test after inhaling the highest concentration of MCh.Question 9: How to interpret the results of the MCT?The method chosen for the MCT determines the specific indicators used for interpretation. The most commonly used indicator is FEV1, although other parameters such as Peak Expiratory Flow (PEF) and Rrs can also be used to assess airway hyperresponsiveness.Qualitative judgment: The test results can be classified as positive, suspiciously positive, or negative, based on a combination of the judgment indicators and changes in the subject's symptoms. If FEV1 decreases by≥20% compared to the baseline value after not completely inhaling at the highest concentration, the result can be judged as positive for Methacholine bronchial challenge test. If the patient has obvious wheezing symptoms or wheezing is heard in both lungs, but the challenge test does not meet the positive criteria (the highest dose/concentration has been inhaled), and FEV1 decreases between 10% and 20% compared to the baseline level, the result can also be judged as positive. If FEV1 decreases between 15% and 20% compared to the baseline value without dyspnea or wheezing attacks, the result can be judged as suspiciously positive. Astograph method: If Rrs rises to 2 times or more of the baseline resistance before reaching the highest inhalation concentration, or if the subject's lungs have wheezing and severe coughing, the challenge test can be judged as positive. Regardless of the result of the Methacholine bronchial challenge test, factors that affect airway reactivity, such as drugs, seasons, climate, diurnal variations, and respiratory tract infections, should be excluded.Quantitative judgment: When using the APS method, the severity of airway hyperresponsiveness can be graded based on PD20-FEV1 or PC20-FEV1. Existing evidence suggests that PD20 shows good consistency when different nebulizers, inhalation times, and starting concentrations of MCh are used for bronchial provocation tests, whereas there is more variability with PC20. Therefore, PD20 is often recommended as the quantitative assessment indicator. The threshold value for PD20 with the APS method is 2.5 mg.The Astograph method often uses the minimum cumulative dose (Dmin value, in Units) to reflect airway sensitivity. Dmin is the minimum cumulative dose of MCh required to produce a linear increase in Rrs. A dose of 1 g/L of the drug concentration inhaled for 1-minute equals 1 unit. It's important to note that with the continuous increase in inhaled provocant concentration, the concept of cumulative dose in the Astograph method should not be directly compared to other methods. Most asthma patients have a Dmin<10 Units, according to Japanese guidelines. The Astograph method, having been used in China for over twenty years, suggests a high likelihood of asthma when Dmin≤6 Units, with a smaller Dmin value indicating a higher probability. When Dmin is between 6 and 10 Units, further differential diagnosis is advised to ascertain whether the condition is asthma.Precautions:A negative methacholine challenge test (MCT) does not entirely rule out asthma. The test may yield negative results due to the following reasons:(1) Prior use of medications that reduce airway responsiveness, such as β2 agonists, anticholinergic drugs, antihistamines, leukotriene receptor antagonists, theophylline, corticosteroids, etc., and insufficient washout time.(2) Failure to meet quality control standards in terms of pressure, flow rate, particle size, and nebulization volume of the aerosol delivery device.(3) Poor subject cooperation leads to inadequate inhalation of the methacholine agent.(4) Some exercise-induced asthma patients may not be sensitive to direct bronchial challenge tests like the Methacholine challenge and require indirect bronchial challenge tests such as hyperventilation, cold air, or exercise challenge to induce a positive response.(5) A few cases of occupational asthma may only react to specific antigens or sensitizing agents, requiring specific allergen exposure to elicit a positive response.A positive MCT does not necessarily indicate asthma. Other conditions can also present with airway hyperresponsiveness and yield positive results in the challenge test, such as allergic rhinitis, chronic bronchitis, viral upper respiratory infections, allergic alveolitis, tropical eosinophilia, cystic fibrosis, sarcoidosis, bronchiectasis, acute respiratory distress syndrome, post-cardiopulmonary transplant, congestive heart failure, and more. Furthermore, factors like smoking, air pollution, or exercise before the test may also result in a positive bronchial challenge test.Question 10: What are the standardized requirements for the MCT report?The report should include: (1) basic information about the subject; (2) examination data and graphics: present baseline data, measurement data after the last two challenge doses or concentrations in tabular form, and the percentage of actual measured values compared to the baseline; flow-volume curve and volume-time curve before and after challenge test; dose-response curve: showing the threshold for positive challenge; (3) opinions and conclusions of the report: including the operator's opinions, quality rating of the examination, and review opinions of the reviewing physician.Question 11: What are the adverse reactions and safety measures of MCT?During the MCT, the subject needs to repeatedly breathe forcefully and inhale bronchial challenge agents, which may induce or exacerbate bronchospasm and contraction and may even cause life-threatening situations. Medical staff should be fully aware of the indications, contraindications, medication use procedures, and emergency response plans for the MCT.}, } @article {pmid38269111, year = {2024}, author = {Webb, J and Williamson, A}, title = {Steroids for the Treatment of Misophonia and Misokinesia.}, journal = {Case reports in psychiatry}, volume = {2024}, number = {}, pages = {3976837}, pmid = {38269111}, issn = {2090-682X}, abstract = {Misophonia and misokinesia are disorders characterized by intensely negative physical and emotional reactions to specific auditory and visual stimuli. The availability of effective treatments, especially pharmacological ones, is limited. This report presents a case of a 35-year-old male with severe misophonia and misokinesia who experienced nearly complete resolution of symptoms while undergoing high-dose steroid therapy for an unrelated muscular injury. Two days after starting a 20 mg oral prednisone taper pack (in which the steroid dose is reduced by 4 mg daily), his Amsterdam Misophonia Scale (A-Miso-S) score drastically reduced from a baseline of 23 (i.e., extreme symptoms) to 1, with symptom relief persisting for approximately 2 weeks after completing the taper. Months later, a daily dose of prednisone (4 mg) was reintroduced. This again resulted in a marked reduction in symptoms (A-Miso-S of 6), enabling him to resume working in an office setting despite his triggers. Symptom improvement remained stable over several months. This case raises the possibility of the steroid prednisone as a novel treatment for misophonia and misokinesia. However, further investigation is needed to determine the generalizability of this observation.}, } @article {pmid38228276, year = {2024}, author = {Neacsiu, AD and Beynel, L and Gerlus, N and LaBar, KS and Bukhari-Parlakturk, N and Rosenthal, MZ}, title = {An experimental examination of neurostimulation and cognitive restructuring as potential components for Misophonia interventions.}, journal = {Journal of affective disorders}, volume = {350}, number = {}, pages = {274-285}, doi = {10.1016/j.jad.2024.01.120}, pmid = {38228276}, issn = {1573-2517}, abstract = {Misophonia is a disorder of decreased tolerance to certain aversive, repetitive common sounds, or to stimuli associated with these sounds. Two matched groups of adults (29 participants with misophonia and 30 clinical controls with high emotion dysregulation) received inhibitory neurostimulation (1 Hz) over a personalized medial prefrontal cortex (mPFC) target functionally connected to the left insula; excitatory neurostimulation (10 Hz) over a personalized dorsolateral PFC (dlPFC) target; and sham stimulation over either target. Stimulations were applied while participants were either listening or cognitively downregulating emotions associated with personalized aversive, misophonic, or neutral sounds. Subjective units of distress (SUDS) and psychophysiological measurements (e.g., skin conductance response [SCR] and level [SCL]) were collected. Compared to controls, participants with misophonia reported higher distress (∆SUDS = 1.91-1.93, ps < 0.001) when listening to and when downregulating misophonic distress. Both types of neurostimulation reduced distress significantly more than sham, with excitatory rTMS providing the most benefit (Cohen's dSUDS = 0.53; dSCL = 0.14). Excitatory rTMS also enhanced the regulation of emotions associated with misophonic sounds in both groups when measured by SUDS (dcontrol = 1.28; dMisophonia = 0.94), and in the misophonia group alone when measured with SCL (d = 0.20). Both types of neurostimulation were well tolerated. Engaging in cognitive restructuring enhanced with high-frequency neurostimulation led to the lowest misophonic distress, highlighting the best path forward for misophonia interventions.}, } @article {pmid38169247, year = {2023}, author = {Guzick, A and Storch, EA and Smárason, O and Minhajuddin, A and Drummond, K and Riddle, D and Hettema, JM and Mayes, TL and Pitts, S and Dodd, C and Trivedi, MH}, title = {Psychometric properties of the GAD-7 and PROMIS-Anxiety-4a among youth with depression and suicidality: Results from the Texas youth depression and suicide research network.}, journal = {Journal of psychiatric research}, volume = {170}, number = {}, pages = {237-244}, doi = {10.1016/j.jpsychires.2023.12.033}, pmid = {38169247}, issn = {1879-1379}, abstract = {There is a tremendous need for brief, valid, and free assessments of anxiety in child mental healthcare. The goal of this study was to determine the psychometric properties of two such measures, the GAD-7 and PROMIS-Anxiety-4a, in 1000 children, adolescents, and young adults (8-20 years-old) with depression and/or suicidality. The GAD-7, the PROMIS-Anxiety-4a, and other validated assessments of anxiety, physical functioning, and psychiatric diagnoses were completed. Confirmatory factor analyses showed an acceptable fit for a single factor in both measures via all indices but the RMSEA. They demonstrated measurement invariance across pre-adolescents (8-12 years-old) and adolescents and emerging adults (13-20 years-old), though scalar invariance was not observed for the GAD-7. Both measures showed strong convergent validity, GAD-7: r = 0.68; PROMIS-Anxiety-4a: r = 0.75, divergent validity with a measure of physical function, GAD-7: r = -0.24; PROMIS-Anxiety-4a: r = -0.28, good internal consistency, ω = 0.89 for both, and high test-retest reliability, GAD-7: r = 0.69; PROMIS-Anxiety-4a: r = 0.71. Both measures also showed acceptable sensitivity and specificity in detecting the presence of any anxiety disorder, GAD-7 cut-off score of 10: AUC = 0.75; PROMIS-Anxiety-4a cutoff score of 12: AUC = 0.79. The GAD-7 correlated similarly with the Screen for Child Anxiety Related Disorders total score and generalized anxiety subscale, and also showed similar diagnostic sensitivity and specificity when used to detect the presence of any anxiety disorder vs. generalized anxiety disorder specifically. Results suggest that both of these brief, publicly available instruments are valid and reliable assessments of anxiety among youth in treatment for depression and/or suicidality.}, } @article {pmid38125011, year = {2023}, author = {Gregory, J and Foster, C}, title = {Session-by-session change in misophonia: a descriptive case study using intensive CBT.}, journal = {Cognitive behaviour therapist}, volume = {16}, number = {}, pages = {s1754470x23000107}, pmid = {38125011}, issn = {1754-470X}, support = {102176/WT_/Wellcome Trust/United Kingdom ; }, abstract = {There is preliminary evidence that CBT may be helpful for improving symptoms of misophonia, but the key mechanisms of change are not yet known for this disorder of decreased tolerance to everyday sounds. This detailed case study aimed to describe the delivery of intensive, formulation-driven CBT for an individual with misophonia and report on session-by-session outcomes using a multidimensional measurement tool (S-Five). The patient was offered twelve hours of treatment over five sessions, using transdiagnostic and misophonia-specific interventions. Reliable and clinically significant change was found from baseline to one-month follow up. Visual inspection of outcome graphs indicated that change occurred on the "outbursts" and "internalising appraisals" S-Five subscales following assessment, and on the "emotional threat" subscale after first treatment session. The other two subscales started and remained below a clinically significant level. The biggest symptom change appeared to have occurred after second session, which included interventions engaging with trigger sounds. The results demonstrated the individualised nature of misophonia, supporting the use of individually tailored treatment for misophonia and highlighting the importance of using a multidimensional measurement tool.}, } @article {pmid38083504, year = {2023}, author = {Bahmei, B and Birmingham, E and Arzanpour, S}, title = {Misophonia Sound Recognition Using Vision Transformer.}, journal = {Annual International Conference of the IEEE Engineering in Medicine and Biology Society. IEEE Engineering in Medicine and Biology Society. Annual International Conference}, volume = {2023}, number = {}, pages = {1-4}, doi = {10.1109/EMBC40787.2023.10340283}, pmid = {38083504}, issn = {2694-0604}, mesh = {Humans ; *Emotions ; *Sound ; Noise ; Hearing Disorders/psychology ; }, abstract = {Misophonia is a condition characterized by an abnormal emotional response to specific sounds, such as eating, breathing, and clock ticking noises. Sound classification for misophonia is an important area of research since it can benefit in the development of interventions and therapies for individuals affected by the condition. In the area of sound classification, deep learning algorithms such as Convolutional Neural Networks (CNNs) have achieved a high accuracy performance and proved their ability in feature extraction and modeling. Recently, transformer models have surpassed CNNs as the dominant technology in the field of audio classification. In this paper, a transformer-based deep learning algorithm is proposed to automatically identify trigger sounds and the characterization of these sounds using acoustic features. The experimental results demonstrate that the proposed algorithm can classify trigger sounds with high accuracy and specificity. These findings provide a foundation for future research on the development of interventions and therapies for misophonia.}, } @article {pmid38064911, year = {2024}, author = {O'Brien, B and Lee, J and Kim, S and Nandra, GS and Pannu, P and Tamman, A and Amarneh, D and Swann, AC and Murphy, N and Averill, L and Jha, M and Mathew, SJ}, title = {Anti-suicidal effects of IV ketamine in a real-world setting.}, journal = {Psychiatry research}, volume = {331}, number = {}, pages = {115604}, doi = {10.1016/j.psychres.2023.115604}, pmid = {38064911}, issn = {1872-7123}, mesh = {Humans ; Male ; Adult ; Female ; *Ketamine/pharmacology/therapeutic use ; Psychometrics ; Suicidal Ideation ; *Suicide ; Risk Factors ; }, abstract = {The current study evaluated the effectiveness of intravenous ketamine treatment for suicidality in a community-based clinical sample of 295 outpatients (mean age= 40.37; 58.6 % male). We conducted growth mixture modeling to estimate latent classes of changes in symptoms of suicidality measured by the Concise Health Risk Tracking - Self-Report (CHRT-SR) across five infusions in a two-week course of treatment. Best-fit indices indicated three trajectory groups demonstrating non-linear, quadratic changes in CHRT-SR scores during ketamine treatment. The largest group of patients (n= 170, 57.6 %) had moderate CHRT-SR scores at baseline and showed gradual improvement during treatment. The other two groups of patients had severe CHRT-SR scores at baseline and diverged into one group with no improvement throughout treatment (n = 63, 21 %) and one group with rapid improvement (n = 62, 21 %). Of the clinical and demographic variables available and tested, only higher scores pertaining to active thoughts of death and/or plan were found to predict which of the patients with severe CHRT-SR scores at baseline would not benefit from treatment. The present study provides an important contribution to the knowledge of ketamine's effects on symptoms related to suicide over time. providing support for the possible effectiveness of ketamine in a proportion of patients.}, } @article {pmid38042307, year = {2024}, author = {Murphy, N and Lijffijt, M and Guzick, AG and Cervin, M and Clinger, J and Smith, EEA and Draper, I and Rast, CE and Goodman, WK and Schneider, S and Storch, EA}, title = {Alterations in attentional processing in youth with misophonia: A phenotypical cross-comparison with anxiety patients.}, journal = {Journal of affective disorders}, volume = {347}, number = {}, pages = {429-436}, doi = {10.1016/j.jad.2023.11.088}, pmid = {38042307}, issn = {1573-2517}, mesh = {Child ; Humans ; Female ; Adolescent ; Male ; *Anxiety ; *Anxiety Disorders/psychology ; Emotions ; Hearing Disorders ; }, abstract = {BACKGROUND: Misophonia is a complex condition characterized by extreme emotional distress in response to specific sounds or specific visual stimuli. Despite a growing body of clinical and neuroscientific literature, the etiology of this condition remains unclear. Hyperarousal, that is, a state of heightened alertness and disinhibition, as a core feature of misophonia is supported by behavioral and neuroimaging literature and might represent a viable clinical target for the development of both behavioral and pharmacological interventions. The aim of this study was to investigate how hyperarousal might be linked to neurocognitive processes associated with vigilance and stimulus discrimination in youth with misophonia.

METHODS: We compared 72 children and adolescents with misophonia (13.74 ± 2.44 years) (64 % female) and 89 children and adolescents with anxiety (12.35 ± 2.57 years) (58.4 % female) on behavioral and signal detection performance of the immediate memory task (IMT). Anxiety patients were used as a clinical control group to distinguish attentional processes specific for misophonia.

RESULTS: Both groups demonstrated similar behavioral performance, including response rate and reaction time. However, misophonia was associated with elevated stimulus discrimination (d prime), which in turn was positively correlated with the severity of misophonia trigger reports.

CONCLUSIONS: Our findings are in line with previous cognitive and neuroimaging studies, and support an arousal-based model of misophonia, where individuals with misophonia experience a state of heightened vigilance, being more aware of stimuli in the environment. Our findings provide a neurocognitive basis for future study of neurochemical imaging that might further progress towards clinical targets.}, } @article {pmid38040623, year = {2024}, author = {Guzick, AG and Cervin, M and Smith, EEA and Clinger, J and Draper, I and Goodman, WK and Lijffijt, M and Murphy, N and Lewin, AB and Schneider, SC and Storch, EA}, title = {Corrigendum to "Clinical characteristics, impairment, and psychiatric morbidity in 102 youth with misophonia" [J. Affect. Disord. volume 324 (2023) 395-402].}, journal = {Journal of affective disorders}, volume = {348}, number = {}, pages = {410}, doi = {10.1016/j.jad.2023.11.045}, pmid = {38040623}, issn = {1573-2517}, } @article {pmid38033539, year = {2023}, author = {Dibb, B and Golding, SE}, title = {Corrigendum: A longitudinal investigation of quality of life and negative emotions in misophonia.}, journal = {Frontiers in neuroscience}, volume = {17}, number = {}, pages = {1266908}, doi = {10.3389/fnins.2023.1266908}, pmid = {38033539}, issn = {1662-4548}, abstract = {[This corrects the article DOI: 10.3389/fnins.2022.900474.].}, } @article {pmid38019467, year = {2023}, author = {Greenberg, RL and Guzick, AG and Schneider, SC and Weinzimmer, SA and Kook, M and Perozo Garcia, AB and Storch, EA}, title = {Depressive Symptoms in Autistic Youth with Anxiety Disorders.}, journal = {Journal of developmental and behavioral pediatrics : JDBP}, volume = {44}, number = {9}, pages = {e597-e603}, pmid = {38019467}, issn = {1536-7312}, support = {P50HD103555//Eunice Kennedy Shriver National Institute of Child Health and Human Development/ ; }, mesh = {Child ; Adolescent ; Humans ; *Depression/epidemiology ; *Autistic Disorder ; Anxiety Disorders/epidemiology/therapy ; Anxiety ; Emotions ; }, abstract = {OBJECTIVE: Anxiety and depression often coexist in youth and share overlapping symptomatology; however, little is known about the comorbidity of anxiety and depression in autistic youth. This study explores (1) the frequency of depressive symptoms among autistic children with clinically significant anxiety, (2) clinical variables that may be associated with elevated depressive symptoms, and (3) whether pretreatment depressive symptoms predict cognitive behavioral therapy (CBT) outcomes for anxiety.

METHOD: Children aged 7 to 13 years (N = 87) and their parents participated in a randomized controlled trial comparing 2 versions of a parent-led, telehealth-delivered CBT program. Parents and children completed a variety of clinical assessments and self-report questionnaires before and after treatment.

RESULTS: Fifty-seven percent of the child sample reported experiencing elevated depressive symptoms while roughly 20% of parents reported elevated depressive symptoms in their child. A strong association between anxiety and depression was found. Heightened feelings of loneliness, per child report, and functional impairment, per parent report, were found to be uniquely associated with elevated depressive symptoms. Finally, depressive symptoms were not a significant predictor of CBT outcomes for anxiety.

CONCLUSION: Findings suggest high degrees of comorbidity between anxiety and depression among autistic children and that feelings of loneliness, anxiety, and functional impairment may be early indicators of mood-related concerns. Further research is needed to determine the full extent of the association between anxiety and depression and additional options for treating depression in autistic children.}, } @article {pmid37932925, year = {2023}, author = {Chan, KH and Baker, A and Gilbert, D and Tong, S and Rinaldi, J and Cypers, S and Zhu, A and Schoenborn, A}, title = {The Impact of Mental Health Symptoms in Children With Tinnitus and Misophonia: A Multi-disciplinary Approach.}, journal = {Clinical pediatrics}, volume = {}, number = {}, pages = {99228231211155}, doi = {10.1177/00099228231211155}, pmid = {37932925}, issn = {1938-2707}, abstract = {Tinnitus and misophonia are important "sound annoyance" disorders in pediatric otolaryngology and audiology practices. There is scant published literature to suggest increased anxiety and depression symptoms in these disorders. This study aimed at assessing the clinical characteristics of these 2 disorders and their prevalence in mental health-related symptoms in a 2-year retrospective chart review of a multi-disciplinary (otolaryngology, audiology, and psychology) clinic cohort. Analyses were based on 54 (tinnitus = 33 and misophonia = 21) children consisting of 19 males and 35 females with a mean age (standard deviation) of 14.3 (3.0) years. The entire cohort was negatively affected by diagnosis-based symptom severity instruments as assessed by Tinnitus Functional Index and Amsterdam Misophonia Scale. Both subgroups exhibited elevated anxiety and depression symptoms in psychometric instruments as assessed by Screen for Child Anxiety Related Emotional Disorders and Short Mood and Feelings Questionnaire. Evidence-based management of these disorders is lacking, and clinical trials are needed.}, } @article {pmid37910210, year = {2023}, author = {Aryal, S and Prabhu, P}, title = {Auditory cortical functioning in individuals with misophonia: an electrophysiological investigation.}, journal = {European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery}, volume = {}, number = {}, pages = {}, pmid = {37910210}, issn = {1434-4726}, abstract = {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.}, } @article {pmid37892760, year = {2023}, author = {Raj-Koziak, D and Gos, E and Kutyba, JJ and Skarzynski, PH and Skarzynski, H}, title = {Hyperacusis Assessment Questionnaire-A New Tool Assessing Hyperacusis in Subjects with Tinnitus.}, journal = {Journal of clinical medicine}, volume = {12}, number = {20}, pages = {}, pmid = {37892760}, issn = {2077-0383}, abstract = {Hyperacusis, a kind of decreased sound tolerance, is difficult to measure objectively. It often co-occurs with tinnitus. There is a need for valid and reliable patient-reported outcome measures to capture this subjective phenomenon. The aim of the study was to create a questionnaire capturing hyperacusis in terms of loudness, fear, and pain and to evaluate its psychometric properties. The study sample consisted of 106 adult patients with hyperacusis and tinnitus with a mean age of 45.2 years. A medical interview, an audiological examination, and several questionnaires (the Tinnitus Handicap Inventory, the Hyperacusis Questionnaire, the State-Trait Anxiety Inventory, and Visual Analog Scales) were applied. The final 14-item Hyperacusis Assessment Questionnaire showed an appropriate three-factor structure with 70.5% of the variance explained. Convergent and divergent validity were confirmed by correlations with other measures of hyperacusis, anxiety, tinnitus severity, misophonia, and hearing thresholds. The internal consistency assessed with Cronbach's alpha was excellent (α = 0.91), as was reproducibility (intraclass correlation, ICC = 0.96). The new Hyperacusis Assessment Questionnaire is a psychometrically sound and brief tool assessing the severity of hyperacusis in terms of loudness, fear, and pain. It can be used in clinical practice and scientific research for patients with hyperacusis and tinnitus.}, } @article {pmid37881332, year = {2023}, author = {Dozier, T and Mitchell, N}, title = {Novel five-phase model for understanding the nature of misophonia, a conditioned aversive reflex disorder.}, journal = {F1000Research}, volume = {12}, number = {}, pages = {808}, pmid = {37881332}, issn = {2046-1402}, mesh = {Humans ; *Emotions/physiology ; *Hearing Disorders/psychology ; Anxiety ; Reflex ; }, abstract = {Background: Misophonia is a recently identified condition in which a person perceives a subtle stimulus (e.g., eating sounds, hair twirling) and has an intense, negative emotional response. Misophonia cannot be classified with established nosological systems. Methods: We present a novel five-phase model of misophonia from a cognitive-behavioral framework. This model identifies a learned reflex of the autonomic nervous system as the primary etiology and maintenance of misophonia. Phase one is anticipatory anxiety and avoidance. Phase two is a conditioned physical reflex (for example, the tensing of calf muscles) that develops through stimulus-response Pavlovian conditioning. Phase three includes intense negative emotional responses and accompanying physiological distress, thoughts, urges, and emotion-driven behavior. Phase four is the individual's coping responses to emotional distress, and phase five is the environmental response and resulting internal and external consequences of the coping behaviors. Each phase helps explain the maintenance of the response and the individual's impairment. Results: Anticipatory anxiety and avoidance of phase one contributes to an increased arousal and awareness of triggers, resulting in increased severity of the trigger experience. Both the Pavlovian-conditioned physical reflex of phase two and the emotion-driven behavior caused by the conditioned emotional response of phase three increase with in vivo exposure to triggers. Phase four includes internal and external coping behaviors to the intense emotions and distress, and phase five includes the consequences of those behaviors. Internal consequences include beliefs fiveand new emotions based on environmental responses to anger and panic. For example, the development of emotions such as shame and guilt, and beliefs regarding how 'intolerable' the trigger is. Conclusions: We assert misophonia is a multi-sensory condition and includes anticipatory anxiety, conditioned physical reflexes, intense emotional and physical distress, subsequent internal and external responses, and environmental consequences.}, } @article {pmid37855114, year = {2023}, author = {Gregory, J and Graham, T and Hayes, B}, title = {Targeting beliefs and behaviours in misophonia: a case series from a UK specialist psychology service.}, journal = {Behavioural and cognitive psychotherapy}, volume = {}, number = {}, pages = {1-16}, doi = {10.1017/S1352465823000462}, pmid = {37855114}, issn = {1469-1833}, support = {102176/WT_/Wellcome Trust/United Kingdom ; }, abstract = {BACKGROUND: Misophonia, a disorder of decreased sound tolerance, can cause significant distress and impairment. Cognitive behavioural therapy (CBT) may be helpful for improving symptoms of misophonia, but the key mechanisms of the disorder are not yet known.

AIMS: This case series aimed to evaluate individual, formulation-driven CBT for patients with misophonia in a UK psychology service.

METHOD: A service evaluation of one-to-one therapy for patients with misophonia (n=19) was conducted in a specialist psychology service. Patients completed an average of 13 hours of therapy with a focus on the meaning applied to their reactions to sounds and associated behaviours. Primary outcome measures were the Misophonia Questionnaire (MQ) and the Amsterdam Misophonia Scale (A-MISO-S). Repeated measures t-tests were used to compare scores from pre-treatment to follow-up, and reliable and clinically significant change on the MQ was calculated.

RESULTS: Scores significantly improved on both misophonia measures, with an average of 38% change on the MQ and 40% change on the A-MISO-S. From pre-treatment to follow-up, 78% of patients showed reliable improvement on the MQ and 61% made clinically significant change.

CONCLUSIONS: Limitations included a lack of control group, small sample size, and the use of an outcome measure that had not been thoroughly validated for a treatment-seeking sample. These results suggest that one-to-one, formulation-driven CBT for misophonia is worth exploring further using experimental design. Potential mechanisms to explore further include feared consequences of escalating reactions, the role of safety-seeking behaviours and the impact of early memories associated with reactions to sounds.}, } @article {pmid37850971, year = {2024}, author = {Ash, PA and Benzaquén, E and Gander, PE and Berger, JI and Kumar, S}, title = {Mimicry in misophonia: A large-scale survey of prevalence and relationship with trigger sounds.}, journal = {Journal of clinical psychology}, volume = {80}, number = {1}, pages = {186-197}, doi = {10.1002/jclp.23605}, pmid = {37850971}, issn = {1097-4679}, support = {//Misophonia Research Fund/ ; }, mesh = {Humans ; Prevalence ; *Emotions ; *Hearing Disorders ; Surveys and Questionnaires ; }, abstract = {BACKGROUND: Misophonia is often referred to as a disorder that is characterized by excessive negative emotional responses, including anger and anxiety, to "trigger sounds" which are typically day-to-day sounds, such as those generated from people eating, chewing, and breathing. Misophonia (literally "hatred of sounds") has commonly been understood within an auditory processing framework where sounds cause distress due to aberrant processing in the auditory and emotional systems of the brain. However, a recent proposal suggests that it is the perceived action (e.g., mouth movement in eating/chewing sounds as triggers) of the trigger person, and not the sounds per se, that drives the distress in misophonia. Since observation or listening to sounds of actions of others are known to prompt mimicry in perceivers, we hypothesized that mimicking the action of the trigger person may be prevalent in misophonia. Apart from a few case studies and anecdotal information, a relation between mimicking and misophonia has not been systematically evaluated.

METHOD: In this work, we addressed this limitation by collecting data on misophonia symptoms and mimicry behavior using online questionnaires from 676 participants.

RESULTS: Analysis of these data shows that (i) more than 45% of individuals with misophonia reported mimicry, indicating its wide prevalence, (ii) the tendency to mimic varies in direct proportion to misophonia severity, (iii) compared to other human and environmental sounds, trigger sounds of eating and chewing are more likely to trigger mimicking, and (iv) the act of mimicking provides some degree of relief from distress to people with misophonia.

CONCLUSION: This study shows prevalence of mimicry and its relation to misophonia severity and trigger types. The theoretical framework of misophonia needs to incorporate the phenomenon of mimicry and its effect on management of misophonia distress.}, } @article {pmid37846484, year = {2023}, author = {Aazh, H and Moore, BCJ and Scaglione, T and Remmert, N}, title = {Psychometric Evaluation of the Misophonia Impact Questionnaire (MIQ) Using a Clinical Population of Patients Seeking Help for Tinnitus, Hyperacusis and/or Misophonia.}, journal = {Journal of the American Academy of Audiology}, volume = {}, number = {}, pages = {}, doi = {10.1055/a-2192-5668}, pmid = {37846484}, issn = {2157-3107}, abstract = {BACKGROUND: Misophonia is a decreased tolerance of certain sounds related to eating noises, lip smacking, sniffing, breathing, clicking sounds, and tapping. While several validated self-report misophonia questionnaires exist, none focus solely on the impact of misophonia on the patient's life. Additionally, there are no available validated pediatric self-report measures of misophonia. Therefore, a tool was needed to assess the impact of misophonia on both adult and pediatric patients.

PURPOSE: To evaluate the psychometric properties of the 8-item Misophonia Impact Questionnaire (MIQ).

RESEARCH DESIGN: This was a retrospective cross-sectional study.

STUDY SAMPLE: Patients who attended the Tinnitus and Hyperacusis Therapy Specialist Clinic (THTSC) in the UK seeking help for tinnitus, hyperacusis and/or misophonia (n = 256). A subsample of children aged 16 years or younger (n=15) was included for preliminary analyses of a version of the MIQ to be filled in by a parent (MIQ-P).

DATA COLLECTION AND ANALYSIS: Data were collected retrospectively from the records of patients held at the audiology department. These included demographic data, audiological measures and self-report questionnaires taken as part of routine care. Descriptive statistics and psychometric analyses were conducted. The MIQ was analyzed for item difficulty, factor structure, reliability, and construct validity.

RESULTS: Confirmatory factor analysis revealed that a one-factor model for the MIQ gave an excellent fit and its estimated reliability was excellent, with Cronbach's α = 0.94. The total MIQ scores were highly correlated with scores for the Hyperacusis Impact Questionnaire (HIQ) and Sound Sensitivity Symptoms Questionnaire (SSSQ). MIQ scores were not significantly correlated with scores for the Tinnitus Impact Questionnaire (TIQ) or average hearing thresholds. Preliminary data from the sub-sample indicated excellent internal consistency for the MIQ-P, with Cronbach's α = 0.92.

CONCLUSIONS: The MIQ is a promising questionnaire for assessing the impact of misophonia. Future studies should focus on establishing test/re-test reliability, identifying clinically significant change in MIQ scores, defining the severity of misophonia impact categories, and further exploring the psychometric properties of the MIQ-P.}, } @article {pmid37837477, year = {2023}, author = {Suraj, U and Nisha, KV and Prabhu, P}, title = {Normal linear and non-linear cochlear mechanisms and efferent system functioning in individuals with misophonia.}, journal = {European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery}, volume = {}, number = {}, pages = {}, pmid = {37837477}, issn = {1434-4726}, abstract = {BACKGROUND: Misophonia, a condition characterized by heightened sensitivity and strong emotional reactions to specific sounds, has sparked considerable interest and debate regarding its underlying auditory mechanisms. The study aimed to understand the auditory underpinnings of two such potential inner ear systems, non-linear and linear outer hair cell functioning along with auditory efferent functioning in individuals with misophonia.

METHODS: 40 ears with misophonia (20 participants) and 37 ears without misophonia (20 participants), both having normal hearing sensitivity were included in this study. Transient evoked otoacoustic emissions (TEOAEs) and distortion product otoacoustic emissions (DPOAEs) were obtained in two conditions (with and without contralateral noise).

RESULTS: Results of independent-samples t-test showed no statistically significant difference (p > 0.05) in the absolute amplitudes of both TEOAEs and DPOAEs between the individuals with and without misophonia. There was no statistically significant difference (p > 0.05) observed in the magnitude of suppression amplitude between the two groups for in both TEOAEs and DPOAEs between individuals with and without misophonia.

CONCLUSION: These results suggest that the cochlear and efferent auditory underpinnings examined in this study may not be major contributors to the development or manifestation of misophonia.}, } @article {pmid37789522, year = {2023}, author = {Brennan, CR and Lindberg, RR and Kim, G and Castro, AA and Khan, RA and Berenbaum, H and Husain, FT}, title = {Misophonia and Hearing Comorbidities in a Collegiate Population.}, journal = {Ear and hearing}, volume = {}, number = {}, pages = {}, doi = {10.1097/AUD.0000000000001435}, pmid = {37789522}, issn = {1538-4667}, abstract = {OBJECTIVES: Misophonia is a little-understood disorder in which certain sounds cause a strong emotional response in those who experience it. People who are affected by misophonia may find that noises like loud chewing, pen clicking, and/or sniffing trigger intense frustration, anger, or discomfort. The relationship of misophonia with other auditory disorders including loudness hyperacusis, tinnitus, and hearing loss is largely underexplored. This project aimed to investigate the prevalence and hearing-health comorbidities of misophonia in a college-aged population by using an online survey.

DESIGN: A total of 12,131 undergraduate and graduate students between the ages of 18 and 25 were given the opportunity to answer an in-depth online survey. These students were sampled in a roughly 50 of 50 sex distribution. The survey was created using Qualtrics and included the following components: electronic consent, demographics questionnaire, Misophonia Questionnaire (MQ), Khalfa's Hyperacusis Questionnaire (HQ), Tinnitus and Hearing Survey, and Tinnitus Functional Index (TFI). To be eligible for compensation, answers for each of the above components were required, with the exception of the TFI, which was only presented to students who indicated that they experienced tinnitus. Respondents were determined to have high or possible likelihood of having misophonia if they gave specific answers to the MQ's Emotion and Behavior Scale or the MQ Severity Scale.

RESULTS: After excluding duplicate responses and age-related outliers, 1,084 responses were included in the analysis. Just over 20% (n = 217) of the sample was determined to have a high or probable likelihood of having misophonia. The sample was primarily White, female, and of mid-to-high socioeconomic status. There was a strong positive correlation between MQ total scores and HQ total scores. High likelihood misophonia status showed a significant relationship with self-reported hearing loss and tinnitus. No statistically significant relationship was found between misophonia and age, ethnicity, or socioeconomic status. MQ total scores differed significantly when separating respondents by sex, self-reported tinnitus, and loudness hyperacusis. White respondents had significantly higher MQ total scores than Asian/Asian American respondents.

CONCLUSIONS: The estimated prevalence of misophonia was about 8% to 20% of the sample, which agrees with most of the currently published research examining misophonia symptoms in collegiate populations. Results of data analysis suggest that misophonia severity may be related to loudness hyperacusis, sex, and possibly tinnitus. Future studies are needed to further examine the characteristics of these relationships, possibly in populations more optimized to reflect the general population or those with hearing-health disorders.}, } @article {pmid37771338, year = {2023}, author = {Rosenthal, MZ and Campbell, J and Altimus, C}, title = {Editorial: Advances in understanding the nature and features of misophonia.}, journal = {Frontiers in neuroscience}, volume = {17}, number = {}, pages = {1267682}, pmid = {37771338}, issn = {1662-4548}, } @article {pmid37692107, year = {2023}, author = {Armstrong, GM and Greenberg, RL and Smárason, O and Frederick, RM and Guzick, AG and Schneider, SC and Spencer, SD and Cervin, M and Storch, EA}, title = {Factors associated with internalizing and externalizing symptoms in a clinical sample of youth with misophonia.}, journal = {Journal of obsessive-compulsive and related disorders}, volume = {39}, number = {}, pages = {}, pmid = {37692107}, issn = {2211-3649}, support = {P50 HD103555/HD/NICHD NIH HHS/United States ; }, abstract = {Misophonia is an often chronic condition characterized by strong, unpleasant emotional reactions when exposed to specific auditory or visual triggers. While not currently defined within existing classification systems, and not clearly fitting within the framework of extant psychiatric conditions, misophonia has historically been studied most frequently within the context of obsessive-compulsive and related disorders. Internalizing and externalizing psychiatric symptoms are common in misophonia, but specific factors that confer risk for these symptoms remain unknown. The present cross-sectional study examined whether sensory sensitivity and cognitive emotion regulation facets are associated with co-occurring internalizing and externalizing symptoms in 102 youth with misophonia aged 8-17 years (Nfemales = 69). Participants completed self-report assessments of misophonia severity, sensory sensitivity, cognitive emotion regulation, and emotional-behavioral functioning. In the final model, controlling for all variables, multiple linear regression analyses revealed that sensory sensitivity and age were significant predictors of internalizing symptoms, while sensory sensitivity and the other-blame cognitive emotion regulation facet were significant predictors of externalizing symptoms. Further, findings demonstrated that the positive reappraisal cognitive emotion regulation facet moderated the effect of misophonia severity on internalizing symptoms. Results highlight a strong, consistent relation between sensory sensitivities (beyond sound sensitivity) and psychiatric symptoms in misophonic youth. Further research is necessary to determine mechanisms and clinical variables impacting internalizing and externalizing symptoms within youth with misophonia.}, } @article {pmid37684420, year = {2023}, author = {Siepsiak, M and Turek, A and Michałowska, M and Gambin, M and Dragan, WŁ}, title = {Misophonia in Children and Adolescents: Age Differences, Risk Factors, Psychiatric and Psychological Correlates. A Pilot Study with Mothers' Involvement.}, journal = {Child psychiatry and human development}, volume = {}, number = {}, pages = {}, pmid = {37684420}, issn = {1573-3327}, support = {IV.4.1 IDUB University of Warsaw//Uniwersytet Warszawski/ ; IV.4.1 IDUB University of Warsaw//Uniwersytet Warszawski/ ; }, abstract = {Misophonia is a type of disorder characterized by decreased sound tolerance. While it typically begins in childhood, research on its characteristics in this population is limited. We assessed 90 children aged 7-18 with and without misophonia, along with their mothers, using interviews, questionnaires, and performance-based tests. Younger children with misophonia were more likely to use aggression in response to triggers than older, while adolescents largely reported self-harm during triggers. Children with misophonia did not differ from their peers in terms of ADHD, ODD, ASD, dyslexia, social and emotional competencies, head injuries, epilepsy, tinnitus, being prematurely born, or delivered via cesarean sections. However, they had significantly higher symptoms of anxiety and depression, more frequent occurrences of OCD, migraines, and psychosomatic complaints. Their mothers self-reported postpartum depression significantly more frequently than mothers in the control group. There is a need for further research on pediatric misophonia, with the involvement and assessment of parents.}, } @article {pmid37657963, year = {2024}, author = {Abramovitch, A and Herrera, TA and Etherton, JL}, title = {A neuropsychological study of misophonia.}, journal = {Journal of behavior therapy and experimental psychiatry}, volume = {82}, number = {}, pages = {101897}, doi = {10.1016/j.jbtep.2023.101897}, pmid = {37657963}, issn = {1873-7943}, mesh = {Humans ; *Hearing Disorders/diagnosis/psychology ; *Emotions ; Anxiety ; Anxiety Disorders/psychology ; }, abstract = {BACKGROUND AND OBJECTIVES: Misophonia is a recently identified condition characterized by negative emotional responsivity to certain types of sounds. Although progress has been made in understanding of neuronal, psychophysiological, and psychopathological mechanisms, important gaps in research remain, particularly insight into cognitive function. Accordingly, we conducted the first neuropsychological examination of misophonia, including clinical, diagnostic, and functional correlates.

METHODS: A misophonia group (n = 32) and a control group (n = 64) were screened for comorbidities using a formal semi-structured interview and completed a comprehensive neuropsychological battery and self-report measures of depression, anxiety, stress, impulsivity, and functional impairment.

RESULTS: The misophonia group significantly underperformed the control group on only 2 neuropsychological outcomes involving verbal memory retrieval. Subscales of the Misophonia Questionaaire (MQ) were inversely correlated only with measures of attention. The misophonia group reported significantly higher anxiety symptoms, behavioral impulsivity, and functional impairments, and had numerically higher rates of ADHD and OCD.

LIMITATIONS: To facilitate comparability, in lieu of a formal diagnostic algorithm for misophonia, we used a commonly used empirical definition for group allocation that has been utilized in numerous previous studies.

CONCLUSIONS: Misophonia was associated with a reduction in performance on a minority of cognitive tasks and a modest increase in some psychological symptoms and comorbid conditions. Correlational data suggest that difficulties with attention regulation and impulsivity may play a role in misophonia, albeit attention functions were intact. Results should be interpreted with caution given the variability in diagnostic definitions, and more research is needed to understand cognitive functioning under 'cold' conditions in misophonia.}, } @article {pmid37593659, year = {2023}, author = {Spencer, SD and Guzick, AG and Cervin, M and Storch, EA}, title = {Mindfulness and cognitive emotion regulation in pediatric misophonia.}, journal = {Journal of contextual behavioral science}, volume = {29}, number = {}, pages = {182-191}, pmid = {37593659}, issn = {2212-1447}, support = {P50 HD103555/HD/NICHD NIH HHS/United States ; R01 HD080096/HD/NICHD NIH HHS/United States ; }, abstract = {Misophonia is characterized by decreased tolerance of ordinary human-generated trigger sounds and associated visual stimuli (e.g., chewing, sniffing, lip smacking), coupled with intense affective reactions. The disorder often begins during childhood or adolescence and is associated with impairment and distress in numerous life domains. Research has begun to examine the underlying psychological mechanisms of misophonia in adults, but studies in youth are limited. Trait mindfulness (i.e., nonjudgmental and nonavoidant present-moment awareness) and cognitive emotion regulation (i.e., cognitive processing, or responding to, emotionally arousing situations) are two proposed mechanisms that may underpin pediatric misophonia and associated functional impairment. In the present exploratory cross-sectional study, we examined trait mindfulness and cognitive emotion regulation and their relations with misophonia features and adaptive functioning in 102 youth with misophonia (Mage = 13.7; SD = 2.5; range = 8-17). More severe misophonia was significantly associated with decreased levels of both trait mindfulness and adaptive functioning across domains, in addition to deficits in certain facets of cognitive emotion regulation, particularly self-blame. Neither trait mindfulness nor facets of cognitive emotion regulation moderated the association between misophonia severity and adaptive functioning across domains, with the notable exception that difficulties with adaptive functioning in peer relationships was attenuated in those high in mindfulness. Findings suggest that trait mindfulness- and to a lesser extent cognitive emotion regulation- may be potentially relevant processes in pediatric misophonia. However, more research is needed to uncover the precise nature of these processes to aid future characterization and intervention efforts, especially in light of equivocal findings in the present study.}, } @article {pmid37501042, year = {2023}, author = {Rinaldi, LJ and Simner, J}, title = {Mental Health Difficulties in Children who Develop Misophonia: An Examination of ADHD, Depression & Anxiety.}, journal = {Child psychiatry and human development}, volume = {}, number = {}, pages = {}, pmid = {37501042}, issn = {1573-3327}, support = {G9815508/MRC_/Medical Research Council/United Kingdom ; MC_PC_15018/MRC_/Medical Research Council/United Kingdom ; MC_PC_19009/MRC_/Medical Research Council/United Kingdom ; }, abstract = {Misophonia is a sound sensitivity disorder characterized by unusually strong aversions to a specific class of sounds (e.g., eating sounds). Here we demonstrate the mental health profile in children who develop misophonia, examining depression, anxiety and ADHD. Our participants were members of the birth cohort ALSPAC (Avon Longitudinal Study of Parents and Children). We screened them for misophonia as adults, then analysed their retrospective mental health data from ages 7 to 16 years inclusive, reported from both children and parents. Data from their Development and Wellbeing Assessments (7-15 years) and their Short Mood and Feelings Questionnaires (9-16 years) show that our misophonia group had a greater likelihood of childhood anxiety disorder and depression in childhood (but not ADHD). Our data provide the first evidence from a large general population sample of the types of mental health co-morbidities found in children who develop misophonia.}, } @article {pmid37497334, year = {2023}, author = {Aryal, S and Prabhu, P}, title = {Auditory brainstem functioning in individuals with misophonia.}, journal = {Journal of otology}, volume = {18}, number = {3}, pages = {139-145}, pmid = {37497334}, issn = {2524-1753}, abstract = {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.}, } @article {pmid37494117, year = {2024}, author = {Eberhart, L and Seegan, P and McGuire, J and Hu, H and Tripuraneni, BR and Miller, MJ}, title = {Attributes of Provider Referrals for Digital Mental Health Applications in an Integrated Health System, 2019-2021.}, journal = {Psychiatric services (Washington, D.C.)}, volume = {75}, number = {1}, pages = {6-16}, doi = {10.1176/appi.ps.20220401}, pmid = {37494117}, issn = {1557-9700}, mesh = {Humans ; Mental Health ; *Cognitive Behavioral Therapy ; Referral and Consultation ; *Delivery of Health Care, Integrated ; }, abstract = {OBJECTIVE: This article describes trends and attributes associated with digital mental health application (DMHA) referrals from December 2019 through December 2021.

METHODS: In total, 43,842 DMHA referrals for 25,213 unique patients were extracted from the electronic health record of a large, diverse, integrated health system. DMHAs were aggregated by type (cognitive-behavioral therapy [CBT] or mindfulness and meditation [MM]). Monthly referral patterns were described and categorized into mutually exclusive clusters (MM, CBT, or MM and CBT). Multinomial logistic regression and post hoc predicted probabilities were used to profile patient, clinical, and encounter attributes among referral clusters.

RESULTS: DMHA referrals increased, reached equilibrium, and then began to decline over the 25-month observation period. Compared with the referral cluster average, MM-alone referrals were more likely to occur for patients who were ages ≥65, who were Hispanic or Asian, whose reason for visit concerned mental health, and who had a primary diagnosis of other anxiety disorders. CBT-alone referrals were more likely to occur for patients with a primary diagnosis of depression and less likely to occur for Hispanic patients. Combined MM and CBT referrals were more likely to occur for patients who were ages 18-30, whose reason for visit was "other," and who had a primary diagnosis of depression and were less likely to occur for Hispanic patients and those ages ≥65.

CONCLUSIONS: Although this study demonstrates readiness to integrate DMHA referral into clinical workflows, observed variations in attributes of referral clusters support the need to further investigate provider decision making and whether referral patterns are optimal and sustainable.}, } @article {pmid37463856, year = {2023}, author = {Holohan, D and Marfilius, K and Smith, CJ}, title = {Misophonia: A Review of the Literature and Its Implications for the Social Work Profession.}, journal = {Social work}, volume = {68}, number = {4}, pages = {341-348}, doi = {10.1093/sw/swad029}, pmid = {37463856}, issn = {1545-6846}, mesh = {Humans ; *Social Work ; *Emotions/physiology ; Hearing Disorders/psychology ; Anxiety Disorders/psychology ; }, abstract = {Misophonia is a chronic condition that describes aversion to specific auditory stimuli. Misophonia is characterized by physiological responsivity and negative emotional reactivity. Specific sounds, commonly referred to as "triggers," are often commonplace and sometimes repetitive. They include chewing, coughing, slurping, keyboard tapping, and pen clicking. Common emotional responses include rage, disgust, anxiety, and panic while physical responses include muscle constriction and increased heart rate. This literature review identifies research priorities, limitations, and new directions, examining the implications of misophonia for the social work profession. Misophonia is largely absent from the social work literature. However, the profession is uniquely equipped to understand, screen for, and effectively treat misophonia in direct practice or within interprofessional treatment teams. By conceptualizing misophonia as idiosyncratic and contextual, social workers would enhance the existing body of research by applying an ecological perspective which captures the interaction of individuals and environments in producing human experience. Such an approach would assist clients and clinicians in developing treatment plans that consider the roles of social and physical environments in the development and course of misophonia. A discussion of current limitations within the misophonia literature further emphasizes the need for new perspectives.}, } @article {pmid37449825, year = {2023}, author = {Barahmand, U and Stalias-Mantzikos, ME and Xiang, Y and Rotlevi, E}, title = {The New York Misophonia Scale (NYMS): A New Instrument to Identify Misophonia in the General Population.}, journal = {Journal of psychiatric practice}, volume = {29}, number = {4}, pages = {269-281}, pmid = {37449825}, issn = {1538-1145}, mesh = {Adult ; Humans ; New York ; Reproducibility of Results ; *Hearing Disorders/psychology ; *Sound ; }, abstract = {Misophonia is a condition in which certain sounds and behaviors elicit distress that ranges from mild annoyance to disgust or anger. The aim of this research was to develop and validate an instrument to screen for misophonia in the general population. Study 1 developed and explored the factor structure and item quality of the New York Misophonia Scale (NYMS), which originally included 42 triggers and 13 behavioral reactions. A sample of 441 American adults responded to the instrument via social media platforms. Of the original 42 triggers, 25 clustered into 4 factors: repetitive actions, mouth sounds, ambient object sounds, and ambient people sounds. The 13 behavioral reactions loaded on to 2 factors, aggressive and nonaggressive reactions. Study 2 evaluated the psychometric properties of the final version of the NYMS using a sample of 200 American adults. The results supported the validity of the factor structure and the reliability of the final version of the NYMS from Study 1. Finally, Study 3 explored the concurrent and convergent validity of the final version of the NYMS with the Misophonia Questionnaire (MQ) and the Difficulties in Emotion Regulation Scale-Short Form (DERS-SF). A sample of 171 adult participants completed all of the scales. Good concurrent validity was found with the MQ and good convergent validity was found with the DERS-SF. Overall, the NYMS appears to be a useful and promising instrument for assessing misophonia triggers, severity of distress elicited, and behavioral reactions to the distress in the general population.}, } @article {pmid37429565, year = {2023}, author = {Campbell, J}, title = {Misophonia: A Need for audiologic diagnostic guidelines.}, journal = {Journal of the American Academy of Audiology}, volume = {}, number = {}, pages = {}, doi = {10.1055/a-2125-7645}, pmid = {37429565}, issn = {2157-3107}, abstract = {PURPOSE: The goal of this commentary is to present to audiologists the recent consensus definition of misophonia along with current clinical measures useful for audiologists in the diagnosis of misophonia. Up and coming behavioral methods that may be sensitive to misophonia are highlighted. Finally, a call is put out for translational audiologic research with the goal of developing diagnostic criteria for misophonia.

METHOD: The approach to the consensus definition is described, as well as the main characteristics of misophonia agreed upon by the expert panel. Next, available clinical measures that may be useful to audiologists for the diagnosis of misophonia are presented, followed by a brief review of current behavioral assessment methodology that still requires research to determine sensitivity and specificity to misophonia symptomatology. This discussion leads to the need for establishment of audiologic diagnostic criteria in misophonia, especially when differentiating from hyperacusis.

CONCLUSIONS: While the consensus definition for misophonia is an excellent first step in obtaining expert agreement on the descriptors of misophonic triggers, reactions, and behavior, clinical research is critical in developing criteria for misophonia as a specific sound tolerance disorder.}, } @article {pmid37352813, year = {2023}, author = {Seegan, PL and Miller, MJ and Heliste, JL and Fathi, L and McGuire, JF}, title = {Efficacy of stand-alone digital mental health applications for anxiety and depression: A meta-analysis of randomized controlled trials.}, journal = {Journal of psychiatric research}, volume = {164}, number = {}, pages = {171-183}, pmid = {37352813}, issn = {1879-1379}, support = {UL1 TR003098/TR/NCATS NIH HHS/United States ; }, mesh = {Humans ; Anxiety/therapy/etiology ; Anxiety Disorders/therapy ; *Depression/therapy/etiology ; *Mental Health ; Randomized Controlled Trials as Topic ; }, abstract = {BACKGROUND: Anxiety and depressive disorders affect 20% of the population, cause functional impairment, and represent a leading cause of disability. Although evidence-based treatments exist, the shortage of trained clinicians and high demand for mental health services have resulted in limited access to evidence-based care. Digital mental health applications (DMHA) present innovative, scalable, and sustainable solutions to address disparities in mental health care.

METHODS: The present study used meta-analytic techniques to evaluate the therapeutic effect of DMHAs in randomized controlled trials (RCTs) for individuals experiencing anxiety and/or depressive symptoms. Search terms were selected based on concepts related to digital mental health applications, mental health/wellness, intervention type, trial design, and anxiety and/or depression symptoms/diagnosis outcomes to capture all potentially eligible results. Potential demographic, DMHA, and trial design characteristics were examined as moderators of therapeutic effects.

RESULTS: Random effects meta-analyses found that stand-alone DMHAs produced a modest reduction in anxiety (g = 0.31) and depressive (g = 0.35) symptom severity. Several moderators influenced the therapeutic effects of DMHAs for anxiety and/or depressive symptoms including treatment duration, participant inclusion criteria, and outcome measures.

LIMITATIONS: Minimal information was available on DMHA usability and participant engagement with DMHAs within RCTs.

CONCLUSIONS: While DMHAs have the potential to be scalable and sustainable solutions to improve access and availability of evidence-based mental healthcare, moderator analyses highlight the considerations for implementation of DMHAs in practice. Further research is needed to understand factors that influence therapeutic effects of DMHAs and investigate strategies to optimize its implementation and overcome the extant research-to-practice gap.}, } @article {pmid37341653, year = {2023}, author = {Andermane, N and Bauer, M and Simner, J and Ward, J}, title = {A symptom network model of misophonia: From heightened sensory sensitivity to clinical comorbidity.}, journal = {Journal of clinical psychology}, volume = {79}, number = {10}, pages = {2364-2387}, doi = {10.1002/jclp.23552}, pmid = {37341653}, issn = {1097-4679}, mesh = {Humans ; *Hearing Disorders ; *Anxiety Disorders ; Anxiety/epidemiology ; Comorbidity ; }, abstract = {OBJECTIVES: Misophonia-an unusually strong intolerance of certain sounds-can cause significant distress and disruption to those who have it but is an enigma in terms of our scientific understanding. A key challenge for explaining misophonia is that, as with other disorders, it is likely to emerge from an interaction of traits that also occur in the general population (e.g., sensory sensitivity and anxiety) and that are transdiagnostic in nature (i.e., shared with other disorders).

METHODS: In this preregistered study with a large sample of participants (N = 1430), we performed a cluster analysis (based on responses to questions relating to misophonia) and identified two misophonia subgroups differing in severity, as well as a third group without misophonia. A subset of this sample (N = 419) then completed a battery of measures designed to assess sensory sensitivity and clinical comorbidities.

RESULTS: Clinical symptoms were limited to the most severe group of misophonics (including autistic traits, migraine with visual aura, anxiety sensitivity, obsessive-compulsive traits). Both the moderate and severe groups showed elevated attention-to-detail and hypersensitivity (across multiple senses). A novel symptom network model of the data shows the presence of a central hub linking misophonia to sensory sensitivity which, in turn, connects to other symptoms in the network (relating to autism, anxiety, etc.).

CONCLUSION: The core features of misophonia are sensory-attentional in nature with severity linked strongly to comorbidities.}, } @article {pmid37333720, year = {2023}, author = {Mattson, SA and D'Souza, J and Wojcik, KD and Guzick, AG and Goodman, WK and Storch, EA}, title = {A systematic review of treatments for misophonia.}, journal = {Personalized medicine in psychiatry}, volume = {39-40}, number = {}, pages = {}, pmid = {37333720}, issn = {2468-1725}, support = {P50 HD103555/HD/NICHD NIH HHS/United States ; }, abstract = {Research into misophonia treatments has been limited and it is unclear what treatment approaches may be effective. This systematic review extracted and synthesized relevant treatment research on misophonia to examine the efficacy of various intervention modalities and identify current trends in order to guide future treatment research. PubMed, PsycINFO, Google Scholar, and Cochrane Central were searched 4using the keywords "misophonia," "decreased sound tolerance," "selective sound sensitivity," or "decreased sound sensitivity." Of the 169 records available for initial screening, 33 studied misophonia treatment specifically. Data were available for one randomized controlled trial, one open label trial, and 31 case studies. Treatments included various forms of psychotherapy, medication, and combinations of the two. Cognitive-behavioral therapy (CBT) incorporating various components has been the most often utilized and effective treatment for reduction of misophonia symptoms in one randomized trial and several case studies/series. Beyond CBT, various case studies suggested possible benefit from other treatment approaches depending on the patient's symptom profile, although methodological rigor was limited. Given the limitations in the literature to date, including overall lack of rigor, lack of comparative studies, limited replication, and small sample size, the field would benefit from the development of mechanism-informed treatments, rigorous randomized trials, and treatment development with an eye towards dissemination and implementation.}, } @article {pmid37329250, year = {2023}, author = {Perez, VW and Friedman, A}, title = {Misophonia matters: A case study of the role of brain imaging in debates over new diagnoses.}, journal = {Sociology of health & illness}, volume = {}, number = {}, pages = {}, doi = {10.1111/1467-9566.13679}, pmid = {37329250}, issn = {1467-9566}, abstract = {Misophonia has gained attention in scientific circles that utilise brain imaging to validate diagnoses. The condition is promoted as not merely a symptom of other psychiatric diagnoses but as a discrete clinical entity. We illustrate the social construction of the diagnostic category of misophonia through examining prominent claims in research studies that use brain imaging to substantiate the diagnosis. We show that brain images are insufficient to establish the 'brain basis for misophonia' due to both technical and logical limitations of imaging data. Often misunderstood as providing direct access to the matter of the body, brain images are mediated and manipulated numerical data (Joyce, 2005, Social Studies of Science 35(3), p. 437). Interpretations of brain scans are further shaped by social expectations and attributes considered salient to the data. Causal inferences drawn from these studies are problematic because 'misophonics' are clinically pre-diagnosed before participating. We argue that imaging cannot replace the social process of diagnosis in the case of misophonia, nor validate diagnostic measures or otherwise substantiate the condition. More broadly, we highlight both the cultural authority and inherent limitations of brain imaging in the social construction of contested diagnoses while also illustrating its role in the disaggregation of symptoms into new diagnoses.}, } @article {pmid37275093, year = {2023}, author = {Patel, NM and Fameen, R and Shafeek, N and Prabhu, P}, title = {Prevalence of Misophonia in College Going Students of India: A Preliminary Survey.}, journal = {Indian journal of otolaryngology and head and neck surgery : official publication of the Association of Otolaryngologists of India}, volume = {75}, number = {2}, pages = {374-378}, pmid = {37275093}, issn = {2231-3796}, abstract = {Misophonia, meaning "hatred of sound", is a proposed neurological condition in which certain sounds trigger emotional or physiological responses others may deem unreasonable. The studies on prevalence of misophonia show that almost 20% of college going students exhibit experience misophonia like symptoms worldwide. These studies help us understand that decreased tolerance towards certain sounds has a high prevalence rate. In a country like India, the diversity in terms of exposure to various levels of noise and traditional habits spans across different age groups, locations, socio-economic statuses, and communities. This study aims to establish the prevalence rate and severity of misophonia in college going-students of India and also an attempt to determine gender dominance. The total participants were 328 undergraduate students all over India, with diverse cultural, linguistic, and economic backgrounds. An online survey was conducted through Google forms, wherein the participants filled the self-rating Amsterdam Misophonia Scale and Misophonia Questionnaire. The results of the study showed that the prevalence of misophonia was approximately 15.85%, with a moderate to severe degree of misophonia. The results indicate that misophonia is highly prevalent in India and there is no gender dominance in experiencing misophonia.}, } @article {pmid37263358, year = {2023}, author = {Cervin, M and Guzick, AG and Clinger, J and Smith, EEA and Draper, IA and Goodman, WK and Lijffijt, M and Murphy, N and Rast, CE and Schneider, SC and Storch, EA}, title = {Measuring misophonia in youth: A psychometric evaluation of child and parent measures.}, journal = {Journal of affective disorders}, volume = {338}, number = {}, pages = {180-186}, doi = {10.1016/j.jad.2023.05.093}, pmid = {37263358}, issn = {1573-2517}, support = {R01 HD080096/HD/NICHD NIH HHS/United States ; P50 HD103555/HD/NICHD NIH HHS/United States ; }, mesh = {Humans ; Adolescent ; Child ; *Quality of Life ; Psychometrics ; *Hearing Disorders/psychology ; Parents ; }, abstract = {BACKGROUND: Misophonia is characterized by intense emotional reactions to specific sounds or visual stimuli and typically onsets during childhood. An obstacle for research and clinical practice is that no comprehensively evaluated measures for pediatric misophonia exist.

METHODS: In a sample of 102 youth meeting the proposed diagnostic criteria of misophonia, we evaluated the child and parent-proxy versions of the self-reported Misophonia Assessment Questionnaire (MAQ; assessing broad aspects of misophonia) and the child version of the Amsterdam Misophonia Scale (A-MISO-S; assessing misophonia severity). Confirmatory and exploratory factor analysis were used to examine factor structures of the measures. Further, child-parent agreement on the MAQ and associations between both measures and misophonia-related impairment, quality of life, and misophonia-related school interference were examined to evaluate aspects of convergent validity.

RESULTS: For both youth- and parent-ratings, four MAQ factors emerged: pessimism, distress, interference, and non-recognition. A-MISO-S showed a unidimensional structure, but the item 'effort to resist' did not load significantly onto the unidimensional factor. Good child-parent agreement on the MAQ scales were found and both MAQ and A-MISO-S were moderately to strongly associated with misophonia-related impairment, quality of life (inverse association), and misophonia-related school interference.

LIMITATIONS: MAQ and A-MISO-S assess sensitivity to auditory but not visual stimuli, the sample size was modest, and repeated assessments were not conducted.

CONCLUSIONS: The combination of MAQ and A-MISO-S shows promise as a multidimensional assessment approach for pediatric misophonia. Future evaluations should include known-groups validity, screening performance, and sensitivity to change in symptom severity.}, } @article {pmid37153709, year = {2023}, author = {Aryal, S and Prabhu, P}, title = {Awareness and perspectives of audiologists on assessment and management of misophonia in India.}, journal = {Journal of otology}, volume = {18}, number = {2}, pages = {104-110}, pmid = {37153709}, issn = {2524-1753}, abstract = {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.}, } @article {pmid37153450, year = {2023}, author = {Andermane, N and Bauer, M and Sohoglu, E and Simner, J and Ward, J}, title = {A phenomenological cartography of misophonia and other forms of sound intolerance.}, journal = {iScience}, volume = {26}, number = {4}, pages = {106299}, pmid = {37153450}, issn = {2589-0042}, abstract = {People with misophonia have strong aversive reactions to specific "trigger" sounds. Here we challenge this key idea of specificity. Machine learning was used to identify a misophonic profile from a multivariate sound-response pattern. Misophonia could be classified from most sounds (traditional triggers and non-triggers) and, moreover, cross-classification showed that the profile was largely transferable across sounds (rather than idiosyncratic for each sound). By splitting our participants in other ways, we were able to show-using the same approach-a differential diagnostic profile factoring in potential co-morbidities (autism, hyperacusis, ASMR). The broad autism phenotype was classified via aversions to repetitive sounds rather than the eating sounds most easily classified in misophonia. Within misophonia, the presence of hyperacusis and sound-induced pain had widespread effects across all sounds. Overall, we show that misophonia is characterized by a distinctive reaction to most sounds that ultimately becomes most noticeable for a sub-set of those sounds.}, } @article {pmid37146655, year = {2023}, author = {Banks, WA and Hansen, KM and Erickson, MA and Crews, FT}, title = {High-mobility group box 1 (HMGB1) crosses the BBB bidirectionally.}, journal = {Brain, behavior, and immunity}, volume = {111}, number = {}, pages = {386-394}, doi = {10.1016/j.bbi.2023.04.018}, pmid = {37146655}, issn = {1090-2139}, mesh = {Animals ; Mice ; *Blood-Brain Barrier/metabolism ; *HMGB1 Protein/metabolism ; Inflammation ; Lipopolysaccharides ; Toll-Like Receptor 4/metabolism ; }, abstract = {High-mobility group box 1 (HMGB1) is a ubiquitous protein that regulates transcription in the nucleus, and is an endogenous damage-associated molecular pattern molecule that activates the innate immune system. HMGB1 activates the TLR4 and RAGE recepto, inducing downstream signals reminiscent of cytokines that have been found to cross the blood-brain barrier (BBB). Blood HMGB1 increases in stroke, sepsis, senescence, alcohol binge drinking and other conditions. Here, we examined the ability of HMGB1 radioactively labeled with iodine (I-HMGB1) to cross the BBB. We found that I-HMGB1 readily entered into mouse brain from the circulation with a unidirectional influx rate of 0.654 μl/g-min. All brain regions tested took up I-HMGB1; uptake was greatest by the olfactory bulb and least in the striatum. Transport was not reliably inhibited by unlabeled HMGB1 nor by inhibitors of TLR4, TLR2, RAGE, or CXCR4. Uptake was enhanced by co-injection of wheatgerm agglutinin, suggestive of involvement of absorptive transcytosis as a mechanism of transport. Induction of inflammation/neuroinflammation with lipopolysaccharide is known to increase blood HMGB1; we report here that brain transport is also increased by LPS-induced inflammation. Finally, we found that I-HMGB1 was also transported in the brain-to-blood direction, with both unlabeled HMGB1 or lipopolysaccharide increasing the transport rate. These results show that HMGB1 can bidirectionally cross the BBB and that those transport rates are enhanced by inflammation. Such transport provides a mechanism by which HMGB1 levels would impact neuroimmune signaling in both the brain and periphery.}, } @article {pmid37146649, year = {2023}, author = {Aazh, H and Taylor, L and Danesh, AA and Moore, BCJ}, title = {The Effectiveness of Unguided Internet-Based Cognitive Behavioral Therapy for Tinnitus for Patients with Tinnitus Alone or Combined with Hyperacusis and/or Misophonia: A Preliminary Analysis.}, journal = {Journal of the American Academy of Audiology}, volume = {}, number = {}, pages = {}, doi = {10.1055/a-2087-0262}, pmid = {37146649}, issn = {2157-3107}, abstract = {BACKGROUND: In the UK, audiologist-delivered cognitive behavioral therapy (CBT) is a key intervention to alleviate the distress caused by tinnitus and its comorbid hyperacusis. However, the availability of face-to-face CBT is limited, and such therapy involves significant costs. CBT provided via the internet provides a potential solution to improve access to CBT for tinnitus.

PURPOSE: The aim was to perform a preliminary assessment of the effect of a specific program of non-guided internet-based CBT for tinnitus, denoted iCBT(T), in alleviating the problems caused by tinnitus alone or tinnitus combined with hyperacusis.

RESEARCH DESIGN: This was a retrospective cross-sectional study.

STUDY SAMPLE: The data for 28 people with tinnitus who completed the iCBT(T) program and answered a series of questions about their tinnitus and hearing status were included in the study. Twelve patients reported also having hyperacusis (including five also with misophonia).

DATA COLLECTION AND ANALYSIS: The iCBT(T) program has seven self-help modules. Anonymous data were collected retrospectively from patients' answers to the questions in the iCBT(T) initial and final assessment modules. Questionnaires administered within the iCBT(T) program were: 4C Tinnitus Management Questionnaire (4C), Screening for Anxiety and Depression in Tinnitus (SAD-T), and the CBT Effectiveness Questionnaire (CBT-EQ).

RESULTS: Responses to the 4C showed a significant improvement from pre- to post-treatment, with a medium effect size. The mean improvement was similar for those with and without hyperacusis. Responses to the SAD-T questionnaire also showed a significant improvement from pre- to post-treatment with a medium effect size. The improvement was significantly greater for participants with tinnitus alone than for participants who also had hyperacusis. For both the 4C and the SAD-T, the improvements were not significantly related to age or gender. Participants' views of the effectiveness of the iCBT(T) program were assessed using the CBT-EQ. The mean score was 50 out of a maximum of 80, indicating moderately high effectiveness. CBT-EQ scores did not differ for those with and without hyperacusis.

CONCLUSIONS: Based on this preliminary analysis, the iCBT(T) program showed promising result in improving the ability to manage tinnitus and decreasing symptoms of anxiety and depression. Future studies with larger samples and control group(s) are required to further assess various aspects of this program.}, } @article {pmid37130567, year = {2023}, author = {Aazh, H and Stevens, J and Jacquemin, L}, title = {Exploding Head Syndrome among patients seeking help for tinnitus and/or hyperacusis at an Audiology Department in the UK: A preliminary study.}, journal = {Journal of the American Academy of Audiology}, volume = {}, number = {}, pages = {}, doi = {10.1055/a-2084-4808}, pmid = {37130567}, issn = {2157-3107}, support = {OJO grant from the Flemish Government//Antwerp Doctoral School of the University of Antwerp/ ; }, abstract = {BACKGROUND: Exploding Head Syndrome (EHS) is characterised by hearing a sudden loud noise or experiencing a sense of explosion in head during the transition of sleep-wake or wake-sleep. The experience of EHS shares similarities with tinnitus, where an individual perceives a sound without any sound source. To the authors' knowledge, the possible relationship between EHS and tinnitus has not been explored.

PURPOSE: Preliminary assessment of prevalence of EHS and its related factors among patients seeking help for tinnitus and/or hyperacusis.

RESEARCH DESIGN: Retrospective cross sectional study Study sample: 148 consecutive patients who sought help for tinnitus and/or hyperacusis at an audiology clinic in the UK.

DATA COLLECTION AND ANALYSIS: The data regarding demographics, medical history, audiological measures and self-report questionnaires were collected retrospectively from the patients' records. Audiological measures comprised of pure tone audiometry and uncomfortable loudness levels. The self-report questionnaires which were administered as a part of standard care comprised of the tinnitus handicap inventory (THI), numeric rating scale (NRS) of tinnitus loudness, annoyance and effect on life, Hyperacusis Questionnaire (HQ), Insomnia Severity Index (ISI), Generalized Anxiety Disorder (GAD-7), and Patient Health Questionnaire (PHQ-9). To establish presence of EHS, participants were asked "Do you ever hear a sudden, loud noise or feel a sense of explosion in your head at night?".

RESULTS: EHS was reported by 8.1% of patients with tinnitus and/or hyperacusis (n = 12 out of 148). The patients with and without EHS were compared, but no significant relationships were found, between the presence of EHS and age, gender, tinnitus/hyperacusis distress, symptoms of anxiety or depression, sleep difficulties, or audiological measures.

CONCLUSIONS: The prevalence of EHS in a tinnitus and hyperacusis population is similar to that in the general population. While there does not seem to be any association with sleep or mental factors, this might be due to the limited variability in our clinical sample (i.e., most patients exhibited high level of distress regardless of EHS). Replication of the results in a larger sample with more variety of symptom severity is warranted.}, } @article {pmid37056403, year = {2023}, author = {Möllmann, A and Heinrichs, N and Illies, L and Potthast, N and Kley, H}, title = {The central role of symptom severity and associated characteristics for functional impairment in misophonia.}, journal = {Frontiers in psychiatry}, volume = {14}, number = {}, pages = {1112472}, pmid = {37056403}, issn = {1664-0640}, abstract = {Misophonia is characterized by a preoccupation with and strong emotional and behavioral reactions to certain triggers, mostly sounds related to eating and breathing. We applied functional impairment due to misophonic symptoms as a central criterion to investigate differences between clinical misophonia and normative decreased sound tolerance in a large non-random sample of n = 1,881 individuals from an online survey. We assessed the frequency of self-reported misophonia symptoms across various symptom measures, compared severity, triggers and emotional reactions, general psychopathology, interpersonal emotion regulation, and quality of life between both groups with and without functional impairing misophonia. Individuals with functional impairment due to misophonia (n = 839) revealed significantly higher general psychopathology symptoms, lower interpersonal emotion regulation skills, and lower quality of life than individuals without impairment (n = 1,042). Anxious/distressed and annoyed reactions to triggers were experienced more frequently compared to emotional reactions of disgust and sadness or depression in both groups. Overall, the group differences were primarily quantitative in nature. We discuss practical implications regarding classification and treatment and provide cutoffs for each symptom measure derived from group assignment for functional impairment.}, } @article {pmid37034168, year = {2023}, author = {Jastreboff, PJ and Jastreboff, MM}, title = {The neurophysiological approach to misophonia: Theory and treatment.}, journal = {Frontiers in neuroscience}, volume = {17}, number = {}, pages = {895574}, pmid = {37034168}, issn = {1662-4548}, abstract = {Clinical observations of hundreds of patients who exhibited decreased tolerance to sound showed that many of them could not be diagnosed as having hyperacusis when negative reactions to a sound depend only on its physical characteristics. In the majority of these patients, the physical characteristics of bothersome sounds were secondary, and patients were able to tolerate other sounds with levels higher than sounds bothersome for them. The dominant feature determining the presence and strength of negative reactions are specific to a given patient's patterns and meaning of bothersome sounds. Moreover, negative reactions frequently depend on the situation in which the offensive sound is presented or by whom it is produced. Importantly, physiological and emotional reactions to bothersome sounds are very similar (even identical) for both hyperacusis and misophonia, so reactions cannot be used to diagnose and differentiate them. To label this non-reported phenomenon, we coined the term misophonia in 2001. Incorporating clinical observations into the framework of knowledge of brain functions allowed us to propose a neurophysiological model for misophonia. The observation that the physical characterization of misophonic trigger was secondary and frequently irrelevant suggested that the auditory pathways are working in identical manner in people with as in without misophonia. Descriptions of negative reactions indicated that the limbic and sympathetic parts of the autonomic nervous systems are involved but without manifestations of general malfunction of these systems. Patients with misophonia could not control internal emotional reactions (even when fully realizing that these reactions are disproportionate to benign sounds evoking them) suggesting that subconscious, conditioned reflexes linking the auditory system with other systems in the brain are the core mechanisms of misophonia. Consequently, the strength of functional connections between various systems in the brain plays a dominant role in misophonia, and the functional properties of the individual systems may be perfectly within the norms. Based on the postulated model, we proposed a treatment for misophonia, focused on the extinction of conditioned reflexes linking the auditory system with other systems in the brain. Treatment consists of specific counseling and sound therapy. It has been used for over 20 years with a published success rate of 83%.}, } @article {pmid36971223, year = {2023}, author = {Trent, ES and Viana, AG and Raines, EM and Busch, HEC and Silva, K and Storch, EA and Zvolensky, MJ}, title = {Childhood exposure to parental threatening behaviors and anxiety in emerging adulthood: Indirect effects of perceived stress.}, journal = {Journal of clinical psychology}, volume = {79}, number = {9}, pages = {1984-2008}, pmid = {36971223}, issn = {1097-4679}, support = {K23 AA025920/AA/NIAAA NIH HHS/United States ; F31 MH123103/MH/NIMH NIH HHS/United States ; U54 MD015946/MD/NIMHD NIH HHS/United States ; P50 HD103555/HD/NICHD NIH HHS/United States ; }, mesh = {Adult ; Humans ; Child ; Female ; Adolescent ; Male ; Cross-Sectional Studies ; *Anxiety ; *Anxiety Disorders ; Parenting ; Parents ; Stress, Psychological ; }, abstract = {BACKGROUND: Although childhood exposure to parental threatening behaviors is associated with elevated anxiety in emerging adulthood, the underlying mechanisms remain unexplored. Perceived stress-a subjective experience comprised of feelings of helplessness (being unable to cope or exert control) and poor self-efficacy (confidence in one's ability to manage stressors)-is one candidate mechanism. The present investigation examined the underlying role of perceived stress in the association between childhood exposure to parental threatening behaviors and anxiety symptom severity in a sample of emerging adults.

METHODS: Participants (N = 855; Mage  = 18.75 years, SD = 1.05, range 18-24; 70.8% female) were recruited from a large state university and administered a battery of self-report questionnaires assessing constructs of interest.

RESULTS: Structural equation modeling (SEM) analyses indicated that only greater childhood exposure to maternal threatening behaviors was directly associated with greater feelings of helplessness and lower self-efficacy. Furthermore, only childhood exposure to maternal threatening behaviors was indirectly associated with anxiety severity through greater feelings of helplessness and lower self-efficacy. In contrast, childhood exposure to paternal threatening behaviors was neither directly nor indirectly associated with anxiety severity.

LIMITATIONS: Limitations include a cross-sectional design, use of self-report measures, and a nonclinical sample. Replicating these findings in a clinical sample and testing the hypothesized model in a longitudinal design is necessary.

CONCLUSIONS: Findings underscore the need for intervention efforts that screen for and target perceived stress in emerging adults exposed to negative maternal parenting behaviors.}, } @article {pmid36950304, year = {2023}, author = {Rappoldt, LR and van der Pol, MM and de Wit, C and Slaghekke, S and Houben, C and Sondaar, T and Kan, KJ and van Steensel, FJAB and Denys, D and Vulink, NCC and Utens, EMWJ}, title = {Effectiveness of an innovative treatment protocol for misophonia in children and adolescents: Design of a randomized controlled trial.}, journal = {Contemporary clinical trials communications}, volume = {33}, number = {}, pages = {101105}, pmid = {36950304}, issn = {2451-8654}, abstract = {BACKGROUND: Misophonia is a recently identified disorder in which individuals experience intense, uncontrollable and disproportional irritation, anger or disgust when confronted with specific sounds or stimuli associated with these sounds. Prevalence rates in children and adolescents are currently still to be investigated. The reported average age of onset is around 13 years, in clinical practice children from 8 years old are referred.Misophonia is associated with avoidance and anticipation anxiety, possibly leading to serious educational and social consequences for children and families. Worldwide, no evidence-based treatment exists specifically for children and adolescents with misophonia.This article presents the design of a randomized controlled trial testing the effectiveness of cognitive behavioral therapy (CBT) combined with psychomotor therapy (PMT) for misophonia in children and adolescents (aged 8-18).

METHODS: In total, 82 patients will be randomly assigned to a treatment condition or waiting list condition of 3 months (WCG). Treatment consists of 7 weekly group therapy sessions (1.5 h CBT plus 1.5 h PMT) and a follow-up after 3 weeks. Pre and post treatment assessments will be conducted during a baseline assessment, after 3 and 6 months. The primary outcome will be assessed by the Amsterdam Misophonia Scale - Youth (AMISOS-Y) and secondary outcomes (e.g. quality of life) and putative predictors (e.g. parenting burden) will be studied.

CONCLUSION: This trial is the first study worldwide testing the effectiveness of a combined CBT plus PMT protocol for misophonia in children and adolescents. If proven effective, this protocol provides an innovation to improve care for youth with misophonia.}, } @article {pmid36947525, year = {2023}, author = {Vitoratou, S and Hayes, C and Uglik-Marucha, N and Pearson, O and Graham, T and Gregory, J}, title = {Misophonia in the UK: Prevalence and norms from the S-Five in a UK representative sample.}, journal = {PloS one}, volume = {18}, number = {3}, pages = {e0282777}, pmid = {36947525}, issn = {1932-6203}, support = {102176/B/13/Z/WT_/Wellcome Trust/United Kingdom ; /DH_/Department of Health/United Kingdom ; }, mesh = {Humans ; Prevalence ; *Hearing Disorders/epidemiology ; *Emotions ; United Kingdom/epidemiology ; }, abstract = {What is the reality of the misophonic experience in the general population? This is a study on misophonia in a large sample, representative of the UK general population. The study utilises a multidimensional psychometric tool, the S-Five, to study the intensity of the triggering misophonic sounds in everyday activities, the emotions/feelings related to them, and the norms of the key components of the misophonic experience: internalising and externalising appraisals, perceived threat and avoidance behaviours, outbursts, and the impact on functioning. Based on the S-Five scores and a semi-structured interview delivered by clinicians who specialise in misophonia, the estimated prevalence of people for whom symptoms of misophonia cause a significant burden in their life in the UK was estimated to be 18%. The psychometric properties of the S-Five in the UK general population were also evaluated and differences across gender and age were explored. Our results show that the five-factor structure is reproduced, and that the S-Five is a reliable and valid scale for the measurement of the severity of the misophonic experience in the general UK population.}, } @article {pmid36895028, year = {2023}, author = {Trager, RJ and Daniels, CJ and Meyer, KW and Stout, AC and Dusek, JA}, title = {Clinician approaches to spinal manipulation for persistent spinal pain after lumbar surgery: systematic review and meta-analysis of individual patient data.}, journal = {Chiropractic & manual therapies}, volume = {31}, number = {1}, pages = {10}, pmid = {36895028}, issn = {2045-709X}, mesh = {Adult ; Humans ; Male ; Middle Aged ; Aged ; Female ; *Manipulation, Spinal/methods ; Lumbosacral Region ; *Low Back Pain/therapy ; Lumbar Vertebrae/surgery ; }, abstract = {BACKGROUND: This review aimed to identify variables influencing clinicians' application of spinal manipulative therapy (SMT) for persistent spine pain after lumbar surgery (PSPS-2). We hypothesized markers of reduced clinical/surgical complexity would be associated with greater odds of applying SMT to the lumbar region, use of manual-thrust lumbar SMT, and SMT within 1-year post-surgery as primary outcomes; and chiropractors would have increased odds of using lumbar manual-thrust-SMT compared to other practitioners.

METHODS: Per our published protocol, observational studies describing adults receiving SMT for PSPS-2 were included. PubMed, Web of Science, Scopus, OVID, PEDro, and Index to Chiropractic Literature were searched from inception to January 6, 2022. Individual patient data (IPD) were requested from contact authors when needed for selection criteria. Data extraction and a customized risk-of-bias rubric were completed in duplicate. Odds ratios (ORs) for primary outcomes were calculated using binary logistic regressions, with covariates including age, sex, symptom distribution, provider, motion segments, spinal implant, and surgery-to-SMT interval.

RESULTS: 71 articles were included describing 103 patients (mean age 52 ± 15, 55% male). The most common surgeries were laminectomy (40%), fusion (34%), and discectomy (29%). Lumbar SMT was used in 85% of patients; and of these patients was non-manual-thrust in 59%, manual-thrust in 33%, and unclear in 8%. Clinicians were most often chiropractors (68%). SMT was used > 1-year post-surgery in 66% of cases. While no primary outcomes reached significance, non-reduced motion segments approached significance for predicting use of lumbar-manual-thrust SMT (OR 9.07 [0.97-84.64], P = 0.053). Chiropractors were significantly more likely to use lumbar-manual-thrust SMT (OR 32.26 [3.17-327.98], P = 0.003). A sensitivity analysis omitting high risk-of-bias cases (missing ≥ 25% IPD) revealed similar results.

CONCLUSIONS: Clinicians using SMT for PSPS-2 most often apply non-manual-thrust SMT to the lumbar spine, while chiropractors are more likely to use lumbar-manual-thrust SMT relative to other providers. As non-manual-thrust SMT may be gentler, the proclivity towards this technique suggests providers are cautious when applying SMT after lumbar surgery. Unmeasured variables such as patient or clinician preferences, or limited sample size may have influenced our findings. Large observational studies and/or international surveys are needed for an improved understanding of SMT use for PSPS-2. Systematic review registration PROSPERO (CRD42021250039).}, } @article {pmid36806854, year = {2023}, author = {Mahady, A and Takac, M and De Foe, A}, title = {What is autonomous sensory meridian response (ASMR)? A narrative review and comparative analysis of related phenomena.}, journal = {Consciousness and cognition}, volume = {109}, number = {}, pages = {103477}, doi = {10.1016/j.concog.2023.103477}, pmid = {36806854}, issn = {1090-2376}, mesh = {Humans ; *Meridians ; Hearing Disorders ; Synesthesia ; }, abstract = {A narrative review of autonomous sensory meridian response (ASMR) was carried out. Definitional factors relevant to ASMR were canvassed. Related, but distinctly unique, sensorial phenomena, including frisson, synaesthesia, and misophonia were considered. Finally, the status of literature with respect to clinical outcomes, individual differences, and current research applications was evaluated. ASMR is a nascent phenomenon that has rapidly progressed in scope and depth of study throughout the past decade; a notable shift from brief-form studies to an increase in formalised trials is noted. Yet, critical questions remain unaddressed, including expectancy and placebo effects, that future research should interrogate.}, } @article {pmid36760791, year = {2022}, author = {Smit, DJA and Bakker, M and Abdellaoui, A and Hoetink, AE and Vulink, N and Denys, D}, title = {A genome-wide association study of a rage-related misophonia symptom and the genetic link with audiological traits, psychiatric disorders, and personality.}, journal = {Frontiers in neuroscience}, volume = {16}, number = {}, pages = {971752}, pmid = {36760791}, issn = {1662-4548}, support = {MC_PC_17228/MRC_/Medical Research Council/United Kingdom ; MC_QA137853/MRC_/Medical Research Council/United Kingdom ; }, abstract = {INTRODUCTION: People with misophonia experience strong negative emotional responses to sounds and associated stimuli-mostly human produced-to an extent that it may cause impairment in social functioning. The exact nature of the disorder remains a matter of ongoing research and debate. Here, we investigated the genetic etiology of misophonia to understand contributing genetic factors and shed light on individual differences in characteristics that are related to the disorder.

METHODS: For misophonia, we used an unpublished genome-wide association study (GWAS) from genetic service provider 23andMe, Inc., on a self-report item probing a single common misophonic symptom: the occurrence of rage when others produce eating sounds. First, we used gene-based and functional annotation analyses to explore neurobiological determinants of the rage-related misophonia symptom. Next, we calculated genetic correlations (r G) of this rage-related misophonia symptom GWAS with a wide range of traits and disorders from audiology (tinnitus, hearing performance, and hearing trauma), psychiatry, neurology, and personality traits.

RESULTS: The rage-related misophonia symptom was significantly correlated with tinnitus, major depression disorder (MDD), post-traumatic stress disorder (PTSD), and generalized anxiety disorder (GAD; 0.12 < r G < 0.22). Stronger genetic correlations (0.21 < r G < 0.42) were observed for two clusters of personality traits: a guilt/neuroticism and an irritability/sensitivity cluster. Our results showed no genetic correlation with attention deficit and hyperactivity disorder, obsessive-compulsive disorder, and psychotic disorders. A negative correlation with autism spectrum disorder (ASD) was found, which may be surprising given the previously reported comorbidities and the sensory sensitivity reported in ASD. Clustering algorithms showed that rage-related misophonia consistently clustered with MDD, generalized anxiety, PTSD, and related personality traits.

DISCUSSION: We conclude that-based on the genetics of a common misophonia symptom-misophonia most strongly clusters with psychiatric disorders and a personality profile consistent with anxiety and PTSD.}, } @article {pmid36710896, year = {2022}, author = {Larsen, BS and Winther, S and Nissen, L and Diederichsen, A and Bøttcher, M and Renker, M and Struijk, JJ and Christensen, MG and Schmidt, SE}, title = {Improved pre-test likelihood estimation of coronary artery disease using phonocardiography.}, journal = {European heart journal. Digital health}, volume = {3}, number = {4}, pages = {600-609}, pmid = {36710896}, issn = {2634-3916}, abstract = {AIMS: Current early risk stratification of coronary artery disease (CAD) consists of pre-test probability scoring such as the 2019 ESC guidelines on chronic coronary syndromes (ESC2019), which has low specificity and thus rule-out capacity. A newer clinical risk factor model (risk factor-weighted clinical likelihood, RF-CL) showed significantly improved rule-out capacity over the ESC2019 model. The aim of the current study was to investigate if the addition of acoustic features to the RF-CL model could improve the rule-out potential of the best performing clinical risk factor models.

METHODS AND RESULTS: Four studies with heart sound recordings from 2222 patients were pooled and distributed into two data sets: training and test. From a feature bank of 40 acoustic features, a forward-selection technique was used to select three features that were added to the RF-CL model. Using a cutoff of 5% predicted risk of CAD, the developed acoustic-weighted clinical likelihood (A-CL) model showed significantly (P < 0.05) higher specificity of 48.6% than the RF-CL model (specificity of 41.5%) and ESC 2019 model (specificity of 6.9%) while having the same sensitivity of 84.9% as the RF-CL model. Area under the curve of the receiver operating characteristic for the three models was 72.5% for ESC2019, 76.7% for RF-CL, and 79.5% for A-CL.

CONCLUSION: The proposed A-CL model offers significantly improved rule-out capacity over the ESC2019 model and showed better overall performance than the RF-CL model. The addition of acoustic features to the RF-CL model was shown to significantly improve early risk stratification of symptomatic patients suspected of having stable CAD.}, } @article {pmid36688600, year = {2023}, author = {Aazh, H and McFerran, D and Danesh, AA and Louw, C and Moore, BCJ}, title = {A comparison of interaural asymmetry, audiogram slope, and psychometric measures of tinnitus, hyperacusis, anxiety and depression for patients with unilateral and bilateral tinnitus.}, journal = {International journal of audiology}, volume = {}, number = {}, pages = {1-7}, doi = {10.1080/14992027.2022.2160383}, pmid = {36688600}, issn = {1708-8186}, abstract = {OBJECTIVE: To evaluate differences in tinnitus impact, hyperacusis and hearing threshold level (HTL) between patients with unilateral and bilateral tinnitus. For patients with unilateral tinnitus, to compare audiological variables for the tinnitus ear and the non-tinnitus ear. To assess whether the presence of unilateral tinnitus increases the likelihood of interaural hearing asymmetry (relative to bilateral tinnitus) that warrants referral for an MRI scan.

DESIGN: Retrospective cross-sectional.

STUDY SAMPLE: Data regarding HTLs and responses to self-report questionnaires were collected from the records of 311 patients attending a tinnitus clinic.

RESULTS: 38.5% had unilateral tinnitus and the ears with tinnitus had higher HTLs and greater HTL slopes than the ears without tinnitus. There was no significant difference in tinnitus impact and hyperacusis between patients with unilateral and bilateral tinnitus. 40% of patients with unilateral tinnitus and 13% of patients with bilateral tinnitus had a between-ear difference in HTL ≥15 dB at two adjacent frequencies (2AF15 asymmetry). Unilateral tinnitus increased the risk of 2AF15 asymmetry by a factor of 4.4.

CONCLUSIONS: Unilateral tinnitus increases the risk of having interaural asymmetry in HTLs that warrants referral for an MRI scan.}, } @article {pmid36685219, year = {2022}, author = {Siepsiak, M and Vrana, SR and Rynkiewicz, A and Rosenthal, MZ and Dragan, WŁ}, title = {Does context matter in misophonia? A multi-method experimental investigation.}, journal = {Frontiers in neuroscience}, volume = {16}, number = {}, pages = {880853}, pmid = {36685219}, issn = {1662-4548}, abstract = {INTRODUCTION: Misophonia is a recently defined disorder in which certain aversive repetitive sounds and associated stimuli elicit distressing and impairing affective, behavioral, and physiological responses. The responses in misophonia may be stronger when the sound is produced by close friends and family, suggesting that the context in which a triggering cue occurs may have an important role in misophonia. As such, the goal of this study was to test experimentally whether the context of the sound source influences affective and psychophysiological responses to triggering stimuli in misophonia.

METHODS: Sixty one adults with misophonia and 45 controls listened to audio recordings (8 s) of human eating, animals eating, and human mouth smacking sounds (without eating). After a break, the same audio recordings were presented embedded within videos of human eating (congruent stimuli), animals eating (congruent stimuli), and, in the mouth smacking condition, with visually incongruent stimuli (hands playing in mud or in a bowl with a watery dough). Psychophysiological responses-skin conductance response (SCR) and heart rate (HR), and self-reported affective responses (valence, arousal, dominance) were gathered during the experiment in a laboratory.

RESULTS: Participants with misophonia assessed all the stimuli as more negative and arousing than the controls, and reported feeling less dominant with respect to the sounds. Animal and mouth smacking sounds were assessed by all the participants as less negative and arousing than human eating sounds, but only in the audio-video conditions. SCR data partially confirmed increased psychophysiological arousal in misophonia participants during an exposure to mouth sounds, but did not reflect the self-report changes in response to different contexts. Misophonia participants had deeper deceleration of HR than controls during human eating sound with congruent video stimuli, while there was no group difference during human mouth smacking with incongruent video stimuli.

CONCLUSION: Results suggest that the context of mouth sounds influences affective experiences in adults with misophonia, but also in participants without misophonia. Presentation of animal eating sounds with congruent visual stimuli, or human mouth smacking sounds with incongruent stimuli, decreased self-report reaction to common misophonic triggers.}, } @article {pmid36685217, year = {2022}, author = {Aazh, H}, title = {Commentary: Consensus definition of misophonia.}, journal = {Frontiers in neuroscience}, volume = {16}, number = {}, pages = {1077097}, pmid = {36685217}, issn = {1662-4548}, } @article {pmid36619047, year = {2022}, author = {Remmert, N and Jebens, A and Gruzman, R and Gregory, J and Vitoratou, S}, title = {A nomological network for misophonia in two German samples using the S-Five model for misophonia.}, journal = {Frontiers in psychology}, volume = {13}, number = {}, pages = {902807}, pmid = {36619047}, issn = {1664-1078}, abstract = {The Selective Sound Sensitivity Syndrome Scale (S-Five) is a contemporary and multidimensional self-report instrument measuring different aspects of misophonia. The five-factor scale consists of 25 items measuring the severity of the misophonic experience. The items capture misophonia in relation to internalising and externalising appraisals, perceived threat, aggressive behavior (outbursts), and adverse impact on individuals' lives. It is complemented by a trigger checklist (S-Five-T), measuring the emotional nature and intensity of reactions to sensory triggers. In this work, we administered the S-Five in two German samples with a majority of individuals with significant misophonia. The S-Five and the supplementary S-Five-T were both translated into German using a rigorous translation procedure (i.e., TRAPD) and were separately tested in large German community samples. Psychometric analyses included the evaluation of the factor structure, measurement invariance with respect to age and gender, reliability (internal consistency and stability over time), and an extensive examination of the construct validity in a proposed nomological network. The nomological network we explore in this work consists of several constructs including different misophonic manifestations, anger and aggression, disgust propensity, anxiety sensitivity, depression, obsessive-compulsive traits, and functional impairment in different life domains. Results indicate evidence in line with the nomological network as demonstrated by strong correlations between the S-Five dimensions and convergent measures. All S-Five dimensions strongly correlated with overall misophonic symptoms (r ≥ 0.53). Internalising appraisals were highly associated with insight into excessive or disproportionate reactions to sounds (r ≥ 0.59), externalising appraisals with anger and irritability (r ≥ 0.46), threat with trait anxiety and dysregulation facets (r ≥ 0.62), aggressive behavior (outbursts) with anger and behavioral dysregulation (r ≥ 0.70), and impact with distress and functional impairment (r ≥ 0.64). The results demonstrate that the S-Five has a robust five-factor structure and allows to draw reliable and valid conclusions about misophonic experiences in German samples. The proposed nomological network gives an initial insight into the nature of misophonia and provides a formalized fundament to develop and test further hypotheses about misophonia in a more sophisticated and symptom-oriented way.}, } @article {pmid36584703, year = {2023}, author = {Guzick, AG and Cervin, M and Smith, EEA and Clinger, J and Draper, I and Goodman, WK and Lijffijt, M and Murphy, N and Lewin, AB and Schneider, SC and Storch, EA}, title = {Clinical characteristics, impairment, and psychiatric morbidity in 102 youth with misophonia.}, journal = {Journal of affective disorders}, volume = {324}, number = {}, pages = {395-402}, pmid = {36584703}, issn = {1573-2517}, support = {P50 HD103555/HD/NICHD NIH HHS/United States ; }, mesh = {Humans ; Adolescent ; Child ; *Quality of Life ; *Hearing Disorders/diagnosis/psychology ; Anxiety Disorders/epidemiology/psychology ; Morbidity ; Syndrome ; }, abstract = {BACKGROUND: There is little information on the clinical presentation, functional impact, and psychiatric characteristics of misophonia in youth, an increasingly recognized syndrome characterized by high emotional reactivity to certain sounds and associated visual stimuli.

METHOD: One-hundred-two youth (8-17 years-old) with misophonia and their parents were recruited and compared with 94 youth with anxiety disorders. Participants completed validated assessments of misophonia severity, quality of life, as well as psychiatric symptoms and diagnoses.

RESULTS: The most common misophonia triggers included eating (96 %), breathing (84 %), throat sounds (66 %), and tapping (54 %). Annoyance/irritation, verbal aggression, avoidance behavior, and family impact were nearly universal. Misophonia severity was associated with internalizing symptoms, child-reported externalizing behaviors, and poorer quality of life. High rates of comorbidity with internalizing and neurodevelopmental disorders were found. Quality of life and externalizing behaviors were not significantly different between misophonia and anxiety samples; internalizing symptoms and autism characteristics were significantly higher among youth with anxiety disorders.

LIMITATIONS: This self-selected sample was characterized by limited multicultural diversity.

CONCLUSIONS: This study presents misophonia as a highly impairing psychiatric syndrome. Future interdisciplinary work should clarify the mechanisms of misophonia, establish evidence-based treatments, and extend these findings to randomly sampled and more culturally diverse populations.}, } @article {pmid36526161, year = {2023}, author = {Bertolín, S and Alonso, P and Martínez-Zalacaín, I and Menchón, JM and Jimenez-Murcia, S and Baker, JT and Bargalló, N and Batistuzzo, MC and Boedhoe, PSW and Brennan, BP and Feusner, JD and Fitzgerald, KD and Fontaine, M and Hansen, B and Hirano, Y and Hoexter, MQ and Huyser, C and Jahanshad, N and Jaspers-Fayer, F and Kuno, M and Kvale, G and Lazaro, L and Machado-Sousa, M and Marsh, R and Morgado, P and Nakagawa, A and Norman, L and Nurmi, EL and O'Neill, J and Ortiz, AE and Perriello, C and Piacentini, J and Picó-Pérez, M and Shavitt, RG and Shimizu, E and Simpson, HB and Stewart, SE and Thomopoulos, SI and Thorsen, AL and Walitza, S and Wolters, LH and , and Thompson, PM and van den Heuvel, OA and Stein, DJ and Soriano-Mas, C}, title = {Right Prefrontal Cortical Thickness Is Associated With Response to Cognitive-Behavioral Therapy in Children With Obsessive-Compulsive Disorder.}, journal = {Journal of the American Academy of Child and Adolescent Psychiatry}, volume = {62}, number = {4}, pages = {403-414}, pmid = {36526161}, issn = {1527-5418}, support = {K23 MH094613/MH/NIMH NIH HHS/United States ; U54 EB020403/EB/NIBIB NIH HHS/United States ; }, mesh = {Adult ; Adolescent ; Humans ; Child ; Child, Preschool ; Prefrontal Cortex/diagnostic imaging ; *Obsessive-Compulsive Disorder/diagnostic imaging/therapy ; Magnetic Resonance Imaging ; Frontal Lobe ; *Cognitive Behavioral Therapy/methods ; }, abstract = {OBJECTIVE: Cognitive-behavioral therapy (CBT) is considered a first-line treatment for obsessive-compulsive disorder (OCD) in pediatric and adult populations. Nevertheless, some patients show partial or null response. The identification of predictors of CBT response may improve clinical management of patients with OCD. Here, we aimed to identify structural magnetic resonance imaging (MRI) predictors of CBT response in 2 large series of children and adults with OCD from the worldwide ENIGMA-OCD consortium.

METHOD: Data from 16 datasets from 13 international sites were included in the study. We assessed which variations in baseline cortical thickness, cortical surface area, and subcortical volume predicted response to CBT (percentage of baseline to post-treatment symptom reduction) in 2 samples totaling 168 children and adolescents (age range 5-17.5 years) and 318 adult patients (age range 18-63 years) with OCD. Mixed linear models with random intercept were used to account for potential cross-site differences in imaging values.

RESULTS: Significant results were observed exclusively in the pediatric sample. Right prefrontal cortex thickness was positively associated with the percentage of CBT response. In a post hoc analysis, we observed that the specific changes accounting for this relationship were a higher thickness of the frontal pole and the rostral middle frontal gyrus. We observed no significant effects of age, sex, or medication on our findings.

CONCLUSION: Higher cortical thickness in specific right prefrontal cortex regions may be important for CBT response in children with OCD. Our findings suggest that the right prefrontal cortex plays a relevant role in the mechanisms of action of CBT in children.}, } @article {pmid36484853, year = {2023}, author = {Aryal, S and Prabhu, P}, title = {Understanding misophonia from an audiological perspective: a systematic review.}, journal = {European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery}, volume = {280}, number = {4}, pages = {1529-1545}, pmid = {36484853}, issn = {1434-4726}, mesh = {Humans ; *Audiology ; Emotions ; Hearing Disorders ; Sound ; }, abstract = {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.}, } @article {pmid36479555, year = {2022}, author = {Jakubovski, E and Müller, A and Kley, H and de Zwaan, M and Müller-Vahl, K}, title = {Prevalence and clinical correlates of misophonia symptoms in the general population of Germany.}, journal = {Frontiers in psychiatry}, volume = {13}, number = {}, pages = {1012424}, pmid = {36479555}, issn = {1664-0640}, abstract = {INTRODUCTION: Misophonia refers to a phenomenon in which affected individuals have a selective intolerance to sounds of mostly oral or nasal origin. This intolerance is typically associated with strong emotional reactions such as anger, irritation, and disgust. The aim of this study was to conduct the first large epidemiological survey to determine the prevalence of misophonia symptoms in the adult population in Germany.

METHODS: We conducted a large-scale representative population survey between December 2020 and March 2021. For this purpose, a sample of 2,519 people were visited in their households and assessed with the Misophonia Questionnaire (MQ) and the Amsterdam Misophonia Questionnaire (AMISOS-R) to document misophonic symptoms. The primary estimate of clinical misophonia symptoms prevalence was based on the MQ Severity Scale and a secondary estimate was based on the AMISOS-R. The survey further included self-ratings to measure perfectionism, not-just-right experience (NJRE), autonomous sensory meridian response (ASMR) and general health as well as demographic data.

RESULTS: Five percent of the sample scored equal or above the MQ Severity Scale threshold for clinical misophonia symptoms (5.9% based on AMISOS-R). Individuals with clinical misophonia symptoms had a higher rate of perfectionism, a higher occurrence of NJRE, higher susceptibility to ASMR, and a worse general health status than those scoring below the cut-off-score. All those factors also independently predicted the severity of misophonia symptoms in a multiple regression model.

CONCLUSION: Misophonia is a frequent condition and should further be examined as an independent diagnostic entity.}, } @article {pmid36440420, year = {2022}, author = {Webb, J and Keane, S}, title = {MDMA for the treatment of misophonia, a proposal.}, journal = {Frontiers in psychiatry}, volume = {13}, number = {}, pages = {983285}, pmid = {36440420}, issn = {1664-0640}, abstract = {Misophonia is a disorder characterized by negative physical and emotional reactions to certain trigger sounds, such as chewing food. Up to 50% of population samples endorse some symptoms of misophonia, with about 20% having symptoms that impair normal life functioning. Most misophonia patients exhibit intense negative emotions and autonomic arousal (the fight-flight-freeze response) in response to a trigger, similarly to how someone with post-traumatic stress disorder (PTSD) might respond to a trauma trigger. Curiously, misophonia trigger sounds are often most distressing when coming from a specific person, suggesting the disorder may be responsive to interpersonal relationship factors. Treatment of misophonia is currently limited to the use of hearing modifications (e.g., earplugs or headphones) and psychotherapy, but many patients continue to suffer despite these best efforts. Phase 3 clinical trials suggest that MDMA is efficacious at treating the symptoms of autonomic arousal, negative emotions, and interpersonal suffering found in PTSD. As such, we propose that MDMA may represent an ideal treatment for some suffering from severe misophonia. In this perspective article, we review the symptoms of misophonia, and outline how MDMA may be uniquely suited for treating it, perhaps using a protocol analogous to the MAPS Phase 3 studies for PTSD.}, } @article {pmid36410290, year = {2022}, author = {Bagrowska, P and Pionke-Ubych, R and Gawęda, Ł}, title = {Do they make these sounds to hurt me? The mediating role of emotion regulation, anxiety and hostile attributions in the relationship between misophonia and paranoia-like thoughts.}, journal = {Schizophrenia research}, volume = {250}, number = {}, pages = {137-142}, doi = {10.1016/j.schres.2022.11.005}, pmid = {36410290}, issn = {1573-2509}, mesh = {Humans ; *Emotional Regulation ; Anxiety Disorders/psychology ; Anxiety ; Hearing Disorders ; }, abstract = {Misophonia is a complex syndrome in which selective auditory stimuli, such as sounds of breathing, sniffing or eating, trigger an intense, negative emotional response. Previous studies have shown that the symptoms of misophonia coexist with a number of mental disorders, such as OCD, depression and anxiety. However, still little is known about other mental states that may be present in this context. A total of 312 people from the non-clinical sample participated in an online correlational study, which aimed at investigating whether there is a significant association between misophonia symptoms and paranoia-like thoughts, as well as to examine what factors might underlie this potential relationship. The results revealed that misophonia positively correlates with paranoia-like thoughts. A serial mediation analysis showed that difficulties in regulating emotions, anxiety and hostile attributions are significant mediators in the relationship between misophonia and paranoia-like thoughts. Importantly, these mediators, above all, form a potential coherent explanatory mechanism underlying this association. Hence, our results highlight the important role of socio-cognitive factors in the conceptualization of misophonia and its relation to paranoia-like thoughts.}, } @article {pmid36362696, year = {2022}, author = {Malaty, IA and Anderson, S and Bennett, SM and Budman, CL and Coffey, BJ and Coffman, KA and Greenberg, E and McGuire, JF and Müller-Vahl, KR and Okun, MS and Quezada, J and Robichaux-Viehoever, A and Black, KJ}, title = {Diagnosis and Management of Functional Tic-Like Phenomena.}, journal = {Journal of clinical medicine}, volume = {11}, number = {21}, pages = {}, pmid = {36362696}, issn = {2077-0383}, support = {R01 MH104030/MH/NIMH NIH HHS/United States ; }, abstract = {Over the past 3 years, a global phenomenon has emerged characterized by the sudden onset and frequently rapid escalation of tics and tic-like movements and phonations. These symptoms have occurred not only in youth known to have tics or Tourette syndrome (TS), but also, and more notably, in youth with no prior history of tics. The Tourette Association of America (TAA) convened an international, multidisciplinary working group to better understand this apparent presentation of functional neurological disorder (FND) and its relationship to TS. Here, we review and summarize the literature relevant to distinguish the two, with recommendations to clinicians for diagnosis and management. Finally, we highlight areas for future emphasis and research.}, } @article {pmid36275232, year = {2022}, author = {Rosenthal, MZ and McMahon, K and Greenleaf, AS and Cassiello-Robbins, C and Guetta, R and Trumbull, J and Anand, D and Frazer-Abel, ES and Kelley, L}, title = {Phenotyping misophonia: Psychiatric disorders and medical health correlates.}, journal = {Frontiers in psychology}, volume = {13}, number = {}, pages = {941898}, pmid = {36275232}, issn = {1664-1078}, abstract = {Misophonia is characterized by decreased tolerance to specific sounds and associated stimuli that causes significant psychological distress and impairment in daily functioning (Swedo et al., 2022). Aversive stimuli (often called "triggers") are commonly repetitive facial (e.g., nose whistling, sniffling, and throat clearing) or oral (e.g., eating, drinking, and mouth breathing) sounds produced by other humans. Few empirical studies examining the nature and features of misophonia have used clinician-rated structured diagnostic interviews, and none have examined the relationship between misophonia and psychiatric disorders in the Diagnostic and Statistical Manual-5th version (DSM-5; American Psychiatric Association, 2013). In addition, little is known about whether there are any medical health problems associated with misophonia. Accordingly, the purpose of the present study was to improve the phenotypic characterization of misophonia by investigating the psychiatric and medical health correlates of this newly defined disorder. Structured diagnostic interviews were used to assess rates of lifetime and current DSM-5 psychiatric disorders in a community sample of 207 adults. The three most commonly diagnosed current psychiatric disorders were: (1) social anxiety disorder, (2) generalized anxiety disorder, and (3) specific phobia. The three most common lifetime psychiatric disorders were major depressive disorder, social anxiety disorder, and generalized anxiety disorder. A series of multiple regression analyses indicated that, among psychiatric disorders that were correlated with misophonia, those that remained significant predictors of misophonia severity after controlling for age and sex were borderline personality disorder, obsessive compulsive disorder, and panic disorder. No medical health problems were significantly positively correlated with misophonia severity.}, } @article {pmid36274664, year = {2022}, author = {Yektatalab, S and Mohammadi, A and Zarshenas, L}, title = {The Prevalence of Misophonia and Its Relationship with Obsessive-compulsive Disorder, Anxiety, and Depression in Undergraduate Students of Shiraz University of Medical Sciences: A Cross-Sectional Study.}, journal = {International journal of community based nursing and midwifery}, volume = {10}, number = {4}, pages = {259-268}, pmid = {36274664}, issn = {2322-4835}, mesh = {Humans ; Female ; Male ; Cross-Sectional Studies ; Prevalence ; *Depression/epidemiology ; Hyperacusis ; Anxiety/epidemiology ; *Obsessive-Compulsive Disorder/epidemiology ; Students ; }, abstract = {BACKGROUND: Misophonia is a severe emotional response to repetitive sounds. This disorder may limit a person's communication, reduce his/her ability, or disrupt his/her social and personal life. This study aimed to determine the prevalence of Misophonia and its relationship with obsessive-compulsive disorder, anxiety, and depression in undergraduate students of Shiraz University of Medical Sciences.

METHODS: The present study is an analytical descriptive study conducted in October 2020. The study samples consisted of 390 undergraduate students of Shiraz University of Medical Sciences. A relative and systematic sampling method was used. In this study, demographic questionnaire, misophonia questionnaire (A score of 7 or higher is considered as misophonia), Beck anxiety questionnaire, Beck depression questionnaire, and Maudsley obsessive-compulsive inventory questionnaire were used, and the data were analyzed using SPSS 24 software. In this study, chi-square test was used to examine the relationship between the variables. Due to the non-normality of the data, the Spearman correlation coefficient was used for data analysis. The significance level was considered equal to and less than 0.05.

RESULTS: Of the 390 participants in the study, 93 (23.8%) had experienced misophonia. Among these 93 students, 37 (39.8%) had obsessive-compulsive disorder, 8 (8.6%) suffered anxiety, and 9 (9.7%) were depressed. There was a significant and direct relationship between misophonia and obsessive-compulsive disorder,anxiety and depression respectively(P<0.001).

CONCLUSION: Due to the prevalence of misophonia among students and its direct relationship with obsessive-compulsive disorder, anxiety and depression, we recommend that future studies should be conducted to find the ways to prevent and reduce the incidence of misophonia.}, } @article {pmid36247223, year = {2022}, author = {Pan, EJ and Weleff, J and Anand, A and Barnett, BS}, title = {Treatment of Misophonia with Risperidone in a Patient with Autism Spectrum Disorder.}, journal = {Case reports in psychiatry}, volume = {2022}, number = {}, pages = {3169834}, pmid = {36247223}, issn = {2090-682X}, abstract = {We report the case of a 32-year-old male with autism spectrum disorder (ASD) suffering from severe misophonia. After titrating risperidone to 2 mg twice a day, the patient reported a significant reduction in his symptoms and his Amsterdam misophonia scale-revised (AMISOS-R) score dropped by from 31 to 5. Upon discharge, the patient was noted to have decreased irritability and overall improved behavior and effect. This significant symptomatic improvement was likely not explained by inpatient admission alone or other simultaneous pharmacologic treatments, as the effect was seen during an isolated titration of risperidone with other treatments remaining constant. Although, unfortunately, follow-up findings indicated that the treatment was not curative for the patient, risperidone's potential for treating misophonia may warrant systematic investigation.}, } @article {pmid36213735, year = {2022}, author = {Mednicoff, SD and Barashy, S and Gonzales, D and Benning, SD and Snyder, JS and Hannon, EE}, title = {Auditory affective processing, musicality, and the development of misophonic reactions.}, journal = {Frontiers in neuroscience}, volume = {16}, number = {}, pages = {924806}, pmid = {36213735}, issn = {1662-4548}, abstract = {Misophonia can be characterized both as a condition and as a negative affective experience. Misophonia is described as feeling irritation or disgust in response to hearing certain sounds, such as eating, drinking, gulping, and breathing. Although the earliest misophonic experiences are often described as occurring during childhood, relatively little is known about the developmental pathways that lead to individual variation in these experiences. This literature review discusses evidence of misophonic reactions during childhood and explores the possibility that early heightened sensitivities to both positive and negative sounds, such as to music, might indicate a vulnerability for misophonia and misophonic reactions. We will review when misophonia may develop, how it is distinguished from other auditory conditions (e.g., hyperacusis, phonophobia, or tinnitus), and how it relates to developmental disorders (e.g., autism spectrum disorder or Williams syndrome). Finally, we explore the possibility that children with heightened musicality could be more likely to experience misophonic reactions and develop misophonia.}, } @article {pmid36179361, year = {2022}, author = {Zai, G and Dembo, J and Levitsky, N and Richter, MA}, title = {Misophonia: A Detailed Case Series and Literature Review.}, journal = {The primary care companion for CNS disorders}, volume = {24}, number = {5}, pages = {}, doi = {10.4088/PCC.21cr03124}, pmid = {36179361}, issn = {2155-7780}, mesh = {*Anxiety Disorders ; Humans ; *Hyperacusis ; }, } @article {pmid36085651, year = {2022}, author = {Castillo-Escario, Y and Werthen-Brabants, L and Groenendaal, W and Deschrijver, D and Jane, R}, title = {Convolutional Neural Networks for Apnea Detection from Smartphone Audio Signals: Effect of Window Size.}, journal = {Annual International Conference of the IEEE Engineering in Medicine and Biology Society. IEEE Engineering in Medicine and Biology Society. Annual International Conference}, volume = {2022}, number = {}, pages = {666-669}, doi = {10.1109/EMBC48229.2022.9871396}, pmid = {36085651}, issn = {2694-0604}, mesh = {Algorithms ; Humans ; Neural Networks, Computer ; Polysomnography ; *Sleep Apnea Syndromes/diagnosis ; *Smartphone ; }, abstract = {Although sleep apnea is one of the most prevalent sleep disorders, most patients remain undiagnosed and untreated. The gold standard for sleep apnea diagnosis, polysomnography, has important limitations such as its high cost and complexity. This leads to a growing need for novel cost-effective systems. Mobile health tools and deep learning algorithms are nowadays being proposed as innovative solutions for automatic apnea detection. In this work, a convolutional neural network (CNN) is trained for the identification of apnea events from the spectrograms of audio signals recorded with a smartphone. A systematic comparison of the effect of different window sizes on the model performance is provided. According to the results, the best models are obtained with 60 s windows (sensitivity-0.72, specilicity-0.89, AUROC = 0.88), For smaller windows, the model performance can be negatively impacted, because the windows become shorter than most apnea events, by which sound reductions can no longer be appreciated. On the other hand, longer windows tend to include multiple or mixed events, that will confound the model. This careful trade-off demonstrates the importance of selecting a proper window size to obtain models with adequate predictive power. This paper shows that CNNs applied to smartphone audio signals can facilitate sleep apnea detection in a realistic setting and is a first step towards an automated method to assist sleep technicians. Clinical Relevance- The results show the effect of the window size on the predictive power of CNNs for apnea detection. Furthermore, the potential of smartphones, audio signals, and deep neural networks for automatic sleep apnea screening is demonstrated.}, } @article {pmid36033627, year = {2022}, author = {Grossini, E and Stecco, A and Gramaglia, C and De Zanet, D and Cantello, R and Gori, B and Negroni, D and Azzolina, D and Ferrante, D and Feggi, A and Carriero, A and Zeppegno, P}, title = {Misophonia: Analysis of the neuroanatomic patterns at the basis of psychiatric symptoms and changes of the orthosympathetic/ parasympathetic balance.}, journal = {Frontiers in neuroscience}, volume = {16}, number = {}, pages = {827998}, pmid = {36033627}, issn = {1662-4548}, abstract = {BACKGROUND/AIM: Misophonia is a disorder characterized by reduced tolerance to specific sounds or stimuli known as "triggers," which tend to evoke negative emotional, physiological, and behavioral responses. In this study, we aimed to better characterize participants with misophonia through the evaluation of the response of the autonomic nervous system to "trigger sounds," a psychometric assessment, and the analysis of the neurological pathways.

MATERIALS AND METHODS: Participants included 11 adults presenting with misophonic disturbance and 44 sex-matched healthy controls (HCs). Following recently proposed diagnostic criteria, the participants listened to six "trigger sounds" and a "general annoyance" sound (baby crying) during a series of physiological tests. The effects were examined through functional magnetic resonance imaging (fMRI), the analysis of heart rate variability (HRV), and of galvanic skin conductance (GSC). The fMRI was performed on a 3T Scanner. The HRV was obtained through the analysis of electrocardiogram, whereas the GSC was examined through the positioning of silver-chloride electrodes on fingers. Furthermore, the psychometric assessment included questionnaires focused on misophonia, psychopathology, resilience, anger, and motivation.

RESULTS: Participants with misophonia showed patterns of increased sympathetic activation in response to trigger sounds and a general annoyance sound, the low frequency (LF) component of HRV, the sympathetic index, and the number of significant GSC over the threshold, where the amplitude/phasic response of GSC was higher. The fMRI analysis provided evidence for the activation of the temporal cortex, the limbic area, the ventromedial prefrontal/premotor/cingulate cortex, and the cerebellum in participants with misophonia. In addition, the psychometric assessment seemed to differentiate misophonia as a construct independent from general psychopathology.

CONCLUSION: These results suggest the activation of a specific auditory-insula-limbic pathway at the basis of the sympathetic activation observed in participants with misophonia in response to "trigger and general annoyance sounds." Further studies should disentangle the complex issue of whether misophonia represents a new clinical disorder or a non-pathological condition. These results could help to build diagnostic tests to recognize and better classify this disorder. The relevance of this question goes beyond purely theoretical issues, as in the first case, participants with misophonia should receive a diagnosis and a targeted treatment, while in the second case, they should not.}, } @article {pmid36017175, year = {2022}, author = {Hansen, HA and Stefancin, P and Leber, AB and Saygin, ZM}, title = {Neural evidence for non-orofacial triggers in mild misophonia.}, journal = {Frontiers in neuroscience}, volume = {16}, number = {}, pages = {880759}, pmid = {36017175}, issn = {1662-4548}, abstract = {Misophonia, an extreme aversion to certain environmental sounds, is a highly prevalent yet understudied condition plaguing roughly 20% of the general population. Although neuroimaging research on misophonia is scant, recent work showing higher resting-state functional connectivity (rs-fMRI) between auditory cortex and orofacial motor cortex in misophonia vs. controls has led researchers to speculate that misophonia is caused by orofacial mirror neurons. Since orofacial motor cortex was defined using rs-fMRI, we attempted to theoretically replicate these findings using orofacial cortex defined by task-based fMRI instead. Further, given our recent work showing that a wide variety of sounds can be triggering (i.e., not just oral/nasal sounds), we investigated whether there is any neural evidence for misophonic aversion to non-orofacial stimuli. Sampling 19 adults with varying misophonia from the community, we collected resting state data and an fMRI task involving phoneme articulation and finger-tapping. We first defined "orofacial" cortex in each participant using rs-fMRI as done previously, producing what we call resting-state regions of interest (rsROIs). Additionally, we functionally defined regions (fROIs) representing "orofacial" or "finger" cortex using phoneme or finger-tapping activation from the fMRI task, respectively. To investigate the motor specificity of connectivity differences, we subdivided the rsROIs and fROIs into separate sensorimotor areas based on their overlap with two common atlases. We then calculated rs-fMRI between each rsROI/fROI and a priori non-sensorimotor ROIs. We found increased connectivity in mild misophonia between rsROIs and both auditory cortex and insula, theoretically replicating previous results, with differences extending across multiple sensorimotor regions. However, the orofacial task-based fROIs did not show this pattern, suggesting the "orofacial" cortex described previously was not capturing true orofacial cortex; in fact, using task-based fMRI evidence, we find no selectivity to orofacial action in these previously described "orofacial" regions. Instead, we observed higher connectivity between finger fROIs and insula in mild misophonia, demonstrating neural evidence for non-orofacial triggers. These results provide support for a neural representation of misophonia beyond merely an orofacial/motor origin, leading to important implications for the conceptualization and treatment of misophonia.}, } @article {pmid35992931, year = {2022}, author = {Efraim Kaufman, A and Weissman-Fogel, I and Rosenthal, MZ and Kaplan Neeman, R and Bar-Shalita, T}, title = {Opening a window into the riddle of misophonia, sensory over-responsiveness, and pain.}, journal = {Frontiers in neuroscience}, volume = {16}, number = {}, pages = {907585}, pmid = {35992931}, issn = {1662-4548}, abstract = {INTRODUCTION: Misophonia and sensory over-responsiveness (SOR) share physiological and psychological symptoms. While individuals with SOR demonstrate pain perception alterations, these were not explored in misophonia.

METHODS: This exploratory study comprised thirty healthy adults with (n = 15; based on the Misophonia Questionnaire) and without misophonia. The Sensory Responsiveness Questionnaire (SRQ) was used for evaluating sensory responsiveness. In addition, psychophysical tests were applied for quantification of: (i) stimulus-response function of painful stimuli, (ii) the individual perceived pain intensity, (iii) pain modulation efficiency, (iv) auditory intensity discrimination capability, and (v) painful and unpleasantness responses to six ecological daily sounds using the Battery of Aversiveness to Sounds (BAS).

RESULTS: Individuals with misophonia reported higher scores in the SRQ-Aversive (p = 0.022) and SRQ-Hedonic (p = 0.029) scales as well as in auditory (p = 0.042) and smell (p = 0.006) sub-scales, indicating higher sensory responsiveness. Yet they were not identified with the SOR type of sensory modulation dysfunction. Groups did not differ in the pain psychophysical tests, and in auditory discrimination test scores (p > 0.05). However, in the misophonia group the BAS evoked higher pain intensity (p = 0.046) and unpleasantness (p <0.001) ratings in the apple biting sound, and higher unpleasantness rating in the scraping a dish sound (p = 0.007), compared to the comparison group.

CONCLUSION: Findings indicate increased sensory responsiveness in individuals with misophonia, yet not defined as SOR. Thus, this suggests that misophonia and SOR are two distinct conditions, differing in their behavioral responses to painful and non-painful stimuli.}, } @article {pmid35984415, year = {2023}, author = {Larsen, EA and Hovland, T and Nielsen, GE and Larsen, L}, title = {Preliminary validation of the Norwegian version of misophonia questionnaire (MQ-NOR).}, journal = {International journal of audiology}, volume = {62}, number = {10}, pages = {1002-1007}, doi = {10.1080/14992027.2022.2111372}, pmid = {35984415}, issn = {1708-8186}, mesh = {Humans ; Reproducibility of Results ; Surveys and Questionnaires ; *Emotions ; Norway ; Psychometrics ; }, abstract = {OBJECTIVE: To perform a psychometric validation of a Norwegian version of the Misophonia Questionnaire (MQ-NOR) and to test the link between the personality trait neuroticism and misophonia assessed with the MQ-NOR.

DESIGN: Participants completed online versions of the MQ-NOR on two occasions about two weeks apart and the neuroticism scale from BFI-20.

STUDY SAMPLE: Two-hundred and twenty-seven (T1) and 173 (T2) participants with self-reported misophonia.

RESULTS: The MQ-NOR was found to comprise two factors: Symptom Scale and Emotions and Behaviours Scale. Overall, the MQ-NOR evidenced good internal consistency and test-retest reliability. Regression analyses supported a positive relationship between misophonia and neuroticism that was moderated by participant age, but not gender.

CONCLUSION: The MQ-NOR demonstrates good psychometric properties, but until more extensively validated, it is cautiously recommended for use by clinicians in Norway to assessing misophonia. Future validation studies should be carried out.}, } @article {pmid35970326, year = {2022}, author = {Smith, EEA and Guzick, AG and Draper, IA and Clinger, J and Schneider, SC and Goodman, WK and Brout, JJ and Lijffijt, M and Storch, EA}, title = {Perceptions of various treatment approaches for adults and children with misophonia.}, journal = {Journal of affective disorders}, volume = {316}, number = {}, pages = {76-82}, pmid = {35970326}, issn = {1573-2517}, support = {P50 HD103555/HD/NICHD NIH HHS/United States ; }, mesh = {Adolescent ; Adult ; Child ; *Emotions ; Humans ; *Hyperacusis ; Self Report ; Surveys and Questionnaires ; Treatment Outcome ; }, abstract = {OBJECTIVE: Misophonia is a complex disorder characterized by a heightened reaction to certain sounds and associated stimuli. While there is no uniformly accepted treatment to date, different intervention approaches are being investigated. Individual's perceptions of different misophonia treatment methods may affect compliance and satisfaction with treatment options. We sought to gather data on patient perceptions of currently available misophonia treatments.

METHODS: Using an online survey, we collected data about treatment preferences, treatment usage, and diagnosis history from parents of children with misophonia (N = 141) and adults with misophonia (N = 252).

RESULTS: Most respondents were not satisfied with misophonia treatments that they or their children had previously received. Audiologic interventions including active and passive noise cancelling and lifestyle modifications were rated as most appropriate for treatment of misophonia by both parent and adult respondents.

LIMITATIONS: Because of the descriptive nature of this study, we chose to use a completer-only approach to ensure the data reflect the true responses of participants, though this did result in a meaningful proportion of missing data. Participants were selected through convenience sampling and responses were self-reported. Individuals with more severe misophonia symptoms may be more likely to participate and complete a research survey.

CONCLUSIONS: Most interventions are considered inappropriate by parents of youth with misophonia and by adults with misophonia. This should be interpreted in the light of a general lack of misophonia-specific interventions. Findings suggest dissatisfaction with currently available treatments and an opportunity for development of effective treatment strategies corresponding to participants' preferences. Deeper understanding of treatment preferences has the potential to guide future treatment development.}, } @article {pmid35959032, year = {2022}, author = {Vitoratou, S and Wang, J and Hayes, C and Wang, Q and Stefanatou, P and Gregory, J}, title = {Evidence of Cross-Cultural Consistency of the S-Five Model for Misophonia: Psychometric Conclusions Emerging From the Mandarin Version.}, journal = {Frontiers in psychology}, volume = {13}, number = {}, pages = {879881}, pmid = {35959032}, issn = {1664-1078}, abstract = {Misophonia is a disorder generally characterised by a decreased tolerance to everyday sounds. Although research is increasing in misophonia, a cross-cultural validation of a psychometric tool for measuring misophonia has not been evaluated. This study investigated the validity of the S-Five multidimensional model of the misophonic experience in a sample of Chinese participants. The S-Five was translated in a forward-backward method to Mandarin to establish a satisfactory translation. The translation was also independently back translated to English, with no significant differences when compared to the original S-Five. Through exploratory factor analysis, using responses from 256 Chinese individuals, the five dimensions (internalising appraisals, externalising appraisals, perceived threat and avoidance behaviour, outbursts, and impact on functioning) were replicated, indicating the cross-cultural uniformity of the experience of misophonia as captured by the S-Five. That is, current results point to the stability of the manifestation of misophonia across cultures, seen here for the first time in the literature. By design, the S-Five items were developed to reflect sound sensitivities in a manner that is not specific or matching to individuals of a certain age, gender, ethnicity, nationality, socio-economic status, and educational level. Testimonial to this fact is not only the replication of the five factors, but also the replication of the evidence towards satisfactory psychometric properties (reliability and validity) of the scale. Based on the results of this study, the S-Five is a psychometrically robust tool to be used within the Chinese population.}, } @article {pmid35958984, year = {2022}, author = {Neacsiu, AD and Szymkiewicz, V and Galla, JT and Li, B and Kulkarni, Y and Spector, CW}, title = {The neurobiology of misophonia and implications for novel, neuroscience-driven interventions.}, journal = {Frontiers in neuroscience}, volume = {16}, number = {}, pages = {893903}, pmid = {35958984}, issn = {1662-4548}, abstract = {Decreased tolerance in response to specific every-day sounds (misophonia) is a serious, debilitating disorder that is gaining rapid recognition within the mental health community. Emerging research findings suggest that misophonia may have a unique neural signature. Specifically, when examining responses to misophonic trigger sounds, differences emerge at a physiological and neural level from potentially overlapping psychopathologies. While these findings are preliminary and in need of replication, they support the hypothesis that misophonia is a unique disorder. In this theoretical paper, we begin by reviewing the candidate networks that may be at play in this complex disorder (e.g., regulatory, sensory, and auditory). We then summarize current neuroimaging findings in misophonia and present areas of overlap and divergence from other mental health disorders that are hypothesized to co-occur with misophonia (e.g., obsessive compulsive disorder). Future studies needed to further our understanding of the neuroscience of misophonia will also be discussed. Next, we introduce the potential of neurostimulation as a tool to treat neural dysfunction in misophonia. We describe how neurostimulation research has led to novel interventions in psychiatric disorders, targeting regions that may also be relevant to misophonia. The paper is concluded by presenting several options for how neurostimulation interventions for misophonia could be crafted.}, } @article {pmid35937869, year = {2022}, author = {Dibb, B and Golding, SE}, title = {A longitudinal investigation of quality of life and negative emotions in misophonia.}, journal = {Frontiers in neuroscience}, volume = {16}, number = {}, pages = {900474}, pmid = {35937869}, issn = {1662-4548}, abstract = {AIMS: This longitudinal study examined the role of anger, disgust, and anxiety in the experience of misophonia, the quality of life of those with self-reported misophonia in comparison to those without misophonia, and the association of misophonia and quality of life over time.

METHODS: An online longitudinal survey was conducted, with misophonia, anger, disgust, anxiety, depression, self-esteem, and quality of life measured at two time points (6-months apart) in two groups of people (those with self-reported misophonia and those without misophonia).

RESULTS: Anger and disgust emerged as the primary predictors of misophonic responses. Anxiety and depression were not significantly associated with misophonia over time. Differences in quality of life were observed between those with and without self-reported misophonia in the current study, with lower scores across the SF-36 domains of role limitations due to emotional problems, energy/fatigue, emotional wellbeing, social functioning, and general health for those with misophonia compared to those without misophonia. Compared with other studies, scores for those with self-reported misophonia were lower than those with long-term physical conditions, similar to those with tinnitus, but higher than those with obsessive compulsive disorder. Misophonia was predictive of quality of life over time but only on two domains: role limitations due to emotional problems (predictors: avoidance, emotional responses, and impact on participation in life) and pain (predictor: impact on participation in life). Depression remained a strong predictor of quality of life over time.

CONCLUSION: Anger and disgust are more strongly associated with the experience of misophonia than anxiety. Quality of life in people with self-reported misophonia is lower than in the general population and may be similar to those with tinnitus. Depression, avoiding triggers, the extent of the emotional response, and perceived impact on participation in life are associated with perceptions of lower quality of life over time for people with self-reported misophonia.}, } @article {pmid35936331, year = {2022}, author = {Williams, ZJ and Cascio, CJ and Woynaroski, TG}, title = {Psychometric validation of a brief self-report measure of misophonia symptoms and functional impairment: The duke-vanderbilt misophonia screening questionnaire.}, journal = {Frontiers in psychology}, volume = {13}, number = {}, pages = {897901}, pmid = {35936331}, issn = {1664-1078}, support = {F30 DC019510/DC/NIDCD NIH HHS/United States ; P50 HD103537/HD/NICHD NIH HHS/United States ; T32 GM007347/GM/NIGMS NIH HHS/United States ; }, abstract = {Misophonia is a newly described disorder of sound tolerance characterized by strong negative emotional reactions to specific "trigger" sounds, resulting in significant distress, pathological avoidance, and impairment in daily life. Research on misophonia is still in its infancy, and most existing psychometric tools for assessing misophonia symptoms have not been extensively validated. The purpose of the current study was to introduce and psychometrically validate the duke-vanderbilt Misophonia Screening Questionnaire (DVMSQ), a novel self-report measure of misophonia symptoms that can be used to determine misophonia "caseness" in clinical and research settings. Employing large online samples of general population adults (n = 1403) and adults on the autism spectrum (n = 936), we rigorously evaluated the internal structure, reliability, validity, and measurement invariance of the DVMSQ. Results indicated that 17 of the 20 original DVMSQ items fit well to a bifactor structure with one "general misophonia" factor and four specific factors (anger/aggression, distress/avoidance, impairment, and global impact). DVMSQ total and subscale scores were highly reliable in both general population and autistic adult samples, and the measure was found to be approximately invariant across age, sex, education level, and autism status. DVMSQ total scores also correlated strongly with another measure of misophonia symptoms (Duke Misophonia Questionnaire-Symptom Scale), with correlations between these two measures being significantly stronger than correlations between the DVMSQ and scales measuring other types of sound intolerance (Inventory of Hyperacusis Symptoms [General Loudness subscale] and DSM-5 Severity Measure for Specific Phobia [modified for phonophobia]). Additionally, DVMSQ items were used to operationalize diagnostic criteria for misophonia derived from the Revised Amsterdam Criteria, which were further updated to reflect a recent consensus definition of misophonia (published after the development of the DVMSQ). Using the new DVMSQ algorithm, 7.3% of general population adults and 35.5% of autistic adults met criteria for clinically significant misophonia. Although additional work is needed to further investigate the psychometric properties of the DVMSQ and validate its theory-based screening algorithm using best-estimate clinical diagnoses, this novel measure represents a potentially useful tool to screen for misophonia and quantify symptom severity and impairment in both autistic adults and the general population.}, } @article {pmid35936325, year = {2022}, author = {Samermit, P and Young, M and Allen, AK and Trillo, H and Shankar, S and Klein, A and Kay, C and Mahzouni, G and Reddy, V and Hamilton, V and Davidenko, N}, title = {Development and Evaluation of a Sound-Swapped Video Database for Misophonia.}, journal = {Frontiers in psychology}, volume = {13}, number = {}, pages = {890829}, pmid = {35936325}, issn = {1664-1078}, abstract = {Misophonia has been characterized as intense negative reactions to specific trigger sounds (often orofacial sounds like chewing, sniffling, or slurping). However, recent research suggests high-level, contextual, and multisensory factors are also involved. We recently demonstrated that neurotypicals' negative reactions to aversive sounds (e.g., nails scratching a chalkboard) are attenuated when the sounds are synced with positive attributable video sources (PAVS; e.g., tearing a piece of paper). To assess whether this effect generalizes to misophonic triggers, we developed a Sound-Swapped Video (SSV) database for use in misophonia research. In Study 1, we created a set of 39 video clips depicting common trigger sounds (original video sources, OVS) and a corresponding set of 39 PAVS temporally synchronized with the OVS videos. In Study 2, participants (N = 34) rated the 39 PAVS videos for their audiovisual match and pleasantness. We selected the 20 PAVS videos with best match scores for use in Study 3. In Study 3, a new group of participants (n = 102) observed the 20 selected PAVS and 20 corresponding OVS and judged the pleasantness or unpleasantness of each sound in the two contexts accompanying each video. Afterward, participants completed the Misophonia Questionnaire (MQ). The results of Study 3 show a robust attenuating effect of PAVS videos on the reported unpleasantness of trigger sounds: trigger sounds were rated as significantly less unpleasant when paired with PAVS with than OVS. Moreover, this attenuating effect was present in nearly every participant (99 out of 102) regardless of their score on the MQ. In fact, we found a moderate positive correlation between the PAVS-OVS difference and misophonia severity scores. Overall our results provide validation that the SSV database is a useful stimulus database to study how misophonic responses can be modulated by visual contexts. Here, we release the SSV database with the best 18 PAVS and 18 OVS videos used in Study 3 along with aggregate ratings of audio-video match and pleasantness (https://osf.io/3ysfh/). We also provide detailed instructions on how to produce these videos, with the hope that this database grows and improves through collaborations with the community of misophonia researchers.}, } @article {pmid35936236, year = {2022}, author = {Heller, LM and Smith, JM}, title = {Identification of Everyday Sounds Affects Their Pleasantness.}, journal = {Frontiers in psychology}, volume = {13}, number = {}, pages = {894034}, pmid = {35936236}, issn = {1664-1078}, abstract = {This study examines the role of source identification in the emotional response to everyday sounds. Although it is widely acknowledged that sound identification modulates the unpleasantness of sounds, this assumption is based on sparse evidence on a select few sounds. We gathered more robust evidence by having listeners judge the causal properties of sounds, such as actions, materials, and causal agents. Participants also identified and rated the pleasantness of the sounds. We included sounds from a variety of emotional categories, such as Neutral, Misophonic, Unpleasant, and Pleasant. The Misophonic category consists of everyday sounds that are uniquely distressing to a subset of listeners who suffer from Misophonia. Sounds from different emotional categories were paired together based on similar causal properties. This enabled us to test the prediction that a sound's pleasantness should increase or decrease if it is misheard as being in a more or less pleasant emotional category, respectively. Furthermore, we were able to induce more misidentifications by imposing spectral degradation in the form of envelope vocoding. Several instances of misidentification were obtained, all of which showed pleasantness changes that agreed with our predictions.}, } @article {pmid35900389, year = {2022}, author = {Paunovic, KŽ and Milenković, SM}, title = {The proposed criteria for high perceived misophonia in young healthy adults and the association between Misophonia symptoms and noise sensitivity.}, journal = {Noise & health}, volume = {24}, number = {113}, pages = {40-48}, pmid = {35900389}, issn = {1998-4030}, mesh = {Adult ; Anxiety/etiology ; *Anxiety Disorders/epidemiology ; Cross-Sectional Studies ; Humans ; *Hyperacusis ; Sound ; }, abstract = {CONTEXT: The association between noise sensitivity and misophonia has not been explored in any population, according to the available literature.

AIMS: To assess the proportion of misophonia symptoms among young healthy adults, to propose the criteria for high perceived misophonia, and to explore the association between misophonia with noise sensitivity with adjustment for sex, age, perceived anxiety, and depression.

SETTINGS AND DESIGN: A cross-sectional study on 1132 medical students, aged 21.4 ± 2.1 years.

METHODS AND MATERIAL: Misophonia symptoms were self-reported using the Amsterdam Misophonia Scale. Nine criteria for high perceived misophonia are proposed. Noise sensitivity was measured with Weinstein scale. Perceived anxiety and depression were measured using the Hamilton Anxiety Rating Scale and the Hamilton Depression Rating Scale, respectively.

STATISTICAL ANALYSIS USED: Multiple logistic regression.

RESULTS: Almost half of the students reported the feeling of irritation against people making provoking sounds. Only one in 10 claimed the feeling of loss of self-control when exposed to provoking sounds. High noise sensitivity and high depression were associated with higher odds of meeting the criteria for high perceived misophonia.

CONCLUSION: Noise-sensitive students are at higher risk of reporting misophonia symptoms and of being classified with high perceived misophonia. The combination of at least four or more symptoms, which classifies every 10th student with high perceived misophonia, is proposed as a self-assessment tool for epidemiological studies among young healthy adults.}, } @article {pmid35873831, year = {2022}, author = {Brout, JJ}, title = {A Brief Commentary on the Consensus Definition of Misophonia.}, journal = {Frontiers in neuroscience}, volume = {16}, number = {}, pages = {879070}, pmid = {35873831}, issn = {1662-4548}, } @article {pmid35864982, year = {2022}, author = {Aazh, H and Erfanian, M and Danesh, AA and Moore, BCJ}, title = {Audiological and Other Factors Predicting the Presence of Misophonia Symptoms Among a Clinical Population Seeking Help for Tinnitus and/or Hyperacusis.}, journal = {Frontiers in neuroscience}, volume = {16}, number = {}, pages = {900065}, pmid = {35864982}, issn = {1662-4548}, abstract = {This paper evaluates the proportion and the audiological and other characteristics of patients with symptoms of misophonia among a population seeking help for tinnitus and/or hyperacusis at an audiology clinic (n = 257). To assess such symptoms, patients were asked "over the last 2 weeks, how often have you been bothered by any of the following problems? Feeling angry or anxious when hearing certain sounds related to eating noises, lip-smacking, sniffling, breathing, clicking sounds, tapping?". The results of routine audiological tests and self-report questionnaires were gathered retrospectively from the records of the patients. Measures included: pure tone audiometry, uncomfortable loudness levels (ULLs), and responses to the tinnitus impact questionnaire (TIQ), the hyperacusis impact questionnaire (HIQ), and the screening for anxiety and depression in tinnitus (SAD-T) questionnaire. The mean age of the patients was 53 years (SD = 16) (age range 17 to 97 years). Fifty four percent were female. Twenty-three percent of patients were classified as having misophonia. The presence and frequency of reporting misophonia symptoms were not related to audiometric thresholds, except that a steeply sloping audiogram reduced the likelihood of frequent misophonia symptoms. Those with more frequent misophonia symptoms had lower values of ULLmin (the across-frequency average of ULLs for the ear with lower average ULLs) than those with less frequent or no reported symptoms. The reported frequency of experiencing misophonia symptoms increased with increasing impact of tinnitus (TIQ score ≥9), increasing impact of hyperacusis (HIQ score >11), and symptoms of anxiety and depression (SAD-T score ≥4). It is concluded that, when assessing individuals with tinnitus and hyperacusis, it is important to screen for misophonia, particularly when ULLmin is abnormally low or the TIQ, HIQ or SAD-T score is high. This will help clinicians to distinguish patients with misophonia, guiding the choice of therapeutic strategies.}, } @article {pmid35859827, year = {2022}, author = {Wang, Q and Vitoratou, S and Uglik-Marucha, N and Gregory, J}, title = {Emotion Processes Predicting Outbursts and Functional Impact in Misophonia.}, journal = {Frontiers in psychology}, volume = {13}, number = {}, pages = {903142}, pmid = {35859827}, issn = {1664-1078}, abstract = {Misophonia involves a decreased tolerance to certain sounds and is associated with a range of emotions and emotion processes. In addition to the distress caused by misophonia, some individuals report having aggressive outbursts and significant impact on doing things they would like to be able to do. This study aimed to examine whether misophonia-specific cognitive and emotional processes were associated with misophonic outbursts and impact, and whether these relationships could be explained in part by emotion processes not specific to misophonia. A sample of 703 individuals, 315 of whom identified with having misophonia, completed measures of misophonia, depression and anxiety symptoms, anxiety and disgust sensitivity, interoception and beliefs about emotions. Exploratory correlation and regression analyses were used to build mediation models, which were tested using multiple linear regression. Externalising appraisals (blaming others for causing one's reaction to sounds) were positively associated with misophonic outbursts, and this relationship was partially explained by anxiety symptoms and disgust sensitivity. Sense of emotional threat in misophonia predicted functional impact of misophonia, and this was partially explained by depression symptoms and negative beliefs about emotions. Anxiety sensitivity and interoception were not significant independent predictors of misophonic outbursts or functional impact. These results provide support for the relevance of emotion processes in misophonia and highlight the importance of using multi-dimensional measures of misophonia to improve our understanding of the condition.}, } @article {pmid35858241, year = {2022}, author = {Henry, JA and Theodoroff, SM and Edmonds, C and Martinez, I and Myers, PJ and Zaugg, TL and Goodworth, MC}, title = {Sound Tolerance Conditions (Hyperacusis, Misophonia, Noise Sensitivity, and Phonophobia): Definitions and Clinical Management.}, journal = {American journal of audiology}, volume = {31}, number = {3}, pages = {513-527}, doi = {10.1044/2022_AJA-22-00035}, pmid = {35858241}, issn = {1558-9137}, support = {I01 CX002149/CX/CSRD VA/United States ; }, mesh = {Anxiety ; Humans ; *Hyperacusis/diagnosis/psychology/therapy ; Pain ; Sound ; *Tinnitus/diagnosis/therapy ; }, abstract = {UNLABELLED: Purpose: For some people, exposure to everyday sounds presents a significant problem. The purpose of this tutorial was to define and differentiate between the various sound tolerance conditions and to review some options for their clinical management.

METHOD: We informally reviewed the literature regarding sound tolerance conditions. The terminology and definitions provided are mostly consistent with how these terms are defined. However, many inconsistencies are noted. Methods of assessment and treatment also differ, and different methodologies are briefly described.

RESULTS: Hyperacusis describes physical discomfort or pain when any sound reaches a certain level of loudness that would be tolerable for most people. Misophonia refers to intense emotional reactions to certain sounds (often body sounds such as chewing and sniffing) that are not influenced by the perceived loudness of those sounds. Noise sensitivity refers to increased reactivity to sounds that may include general discomfort (annoyance or feeling overwhelmed) due to a perceived noisy environment, regardless of its loudness. Phonophobia, as addressed in the audiology profession, describes anticipatory fear of sound. Phonophobia is an emotional response such as anxiety and avoidance of sound due to the "fear" that sound(s) may occur that will cause a comorbid condition to get worse (e.g., tinnitus) or the sound itself will result in discomfort or pain. (Note that phonophobia is a term used by neurologists to describe "migraineur phonophobia"-a different condition not addressed herein.) Conclusions: The literature addresses sound tolerance conditions but reveals many inconsistencies, indicating lack of consensus in the field. When doing an assessment for decreased sound tolerance, it is important to define any terms used so that the patient and all health care professionals involved in the care of the patient are aligned with the goals of the treatment plan. Treatment generally involves gradual and systematic sound desensitization and counseling.

SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.20164130.}, } @article {pmid35856746, year = {2023}, author = {Pfeiffer, E and Allroggen, M and Sachser, C}, title = {[Misophonia in Childhood and Adolescence: A Narrative Review].}, journal = {Zeitschrift fur Kinder- und Jugendpsychiatrie und Psychotherapie}, volume = {51}, number = {3}, pages = {222-232}, doi = {10.1024/1422-4917/a000885}, pmid = {35856746}, issn = {1422-4917}, mesh = {Adult ; Child ; Humans ; Adolescent ; *Hearing Disorders/diagnosis ; *Mental Disorders/diagnosis/epidemiology/therapy ; Prevalence ; }, abstract = {Misophonia in Childhood and Adolescence: A Narrative Review Abstract. Misophonia describes a phenomenon in which the affected children and adolescents show a strong negative physiological and emotional reaction when confronted with specific (misophonic) auditory stimuli (most commonly eating or breathing sounds). Several studies with adults yielded prevalence rates between 6 % and 20 % in various (clinical) samples, but the representativeness of samples was largely limited. More than 80 % of the first manifestation of symptoms occurs during childhood and adolescence. Regarding comorbid disorders, studies show great heterogeneity, with estimates ranging from 28-76 % of comorbid mental disorders and approximately 25 % with comorbid physical disorders. The exact etiology is currently not well studied. Initial neurophysiological explanations and imaging studies point to a specific physiological response in misophonia patients. Although many case reports are now available, and diagnostic criteria and measurement tools have been developed, misophonia currently does not represent a distinct neurological, audiological, or psychiatric disorder in the DSM-5 or ICD-11.}, } @article {pmid35836662, year = {2022}, author = {Jager, I and Vulink, N and van Loon, A and van der Pol, M and Schröder, A and Slaghekke, S and Denys, D}, title = {Synopsis and Qualitative Evaluation of a Treatment Protocol to Guide Systemic Group-Cognitive Behavioral Therapy for Misophonia.}, journal = {Frontiers in psychiatry}, volume = {13}, number = {}, pages = {794343}, pmid = {35836662}, issn = {1664-0640}, abstract = {Misophonia is a disorder in which patients suffer from anger or disgust when confronted with specific sounds such as those associated with eating or breathing, causing avoidance of cue related situations resulting in significant functional impairment. Functional magnetic resonance imaging studies suggest misophonia is associated with increased activity in the auditory cortex and salience network, which might reflect increased vigilance toward specific misophonia triggers. New treatments have been developed and investigated in the last years in which this vigilance plays an important role. This is a synopsis of the first group protocol for systemic Cognitive Behavioral Therapy (G-CBT) for misophonia. We discuss the model of CBT for misophonia, provide a detailed guide to the treatment illustrated with a case study, discuss advantages, limitations, and possible pitfalls by a qualitative evaluation of the protocol, and review evidence for the protocol.}, } @article {pmid35817311, year = {2023}, author = {Kula, FB and Cropley, M and Aazh, H}, title = {Hyperacusis and Misophonia: A Systematic Review of Psychometric Measures.}, journal = {Journal of the American Academy of Audiology}, volume = {}, number = {}, pages = {}, doi = {10.1055/a-1896-5032}, pmid = {35817311}, issn = {2157-3107}, abstract = {BACKGROUND: Hyperacusis can be defined as an intolerance of certain everyday sounds, which are perceived as too loud or uncomfortable and which cause significant distress and impairment in the individual's day-to-day activities. Misophonia is defined as a high magnitude of emotional and behavioral reaction to certain sounds produced by human beings, such as eating sounds and breathing sounds. Several psychometric instruments have been developed to assess symptoms and the impact of hyperacusis and misophonia; however, to the authors' knowledge, no study has evaluated and compared the methodological quality of the studies on psychometric properties of the existing instruments.

PURPOSE:  This article systematically reviews the research studies assessing the psychometric properties of the instruments used for hyperacusis and misophonia and assesses the quality and appropriateness of the methodologies used.

RESEARCH DESIGN:  Systematic review.

DATA COLLECTION AND ANALYSIS:  A systematic literature search was performed using five electronic literature databases (PubMed, Scopus, PsycINFO, Google Scholar, and Web of Science). Studies were included if they were written in English and reported information about the psychometric properties of instruments measuring hyperacusis or misophonia symptoms or their impact. The quality of the studies and that of the psychometric instruments were evaluated using the consensus-based standards for the selection of health-measurement instruments (COSMIN) tool.

RESULTS:  The title and abstracts of 916 articles were screened and 39 articles were selected for full-text evaluation, with 14 articles meeting the inclusion criteria. From these 14 articles, 8 different instruments (5 for hyperacusis and 3 for misophonia) were identified and reviewed comprising: (1) Hyperacusis Questionnaire (HQ), (2) Inventory of Hyperacusis Symptoms, (3) questionnaire on hypersensitivity to sound, (4) Hyperacusis Handicap Questionnaire, (5) short HQ, (6) Amsterdam Misophonia Scale, (7) MisoQuest, and (8) the Misophonia Questionnaire.

CONCLUSION:  None of the papers reviewed reported all the information required to meet the COSMIN standards. The studies' methodological quality varied between "very good" and "inadequate" depending on their grade on the COSMIN tool. There is a need for further research on the psychometric properties of the instruments included in this review.}, } @article {pmid35812229, year = {2022}, author = {Ward, RT and Gilbert, FE and Pouliot, J and Chiasson, P and McIlvanie, S and Traiser, C and Riels, K and Mears, R and Keil, A}, title = {The Relationship Between Self-Reported Misophonia Symptoms and Auditory Aversive Generalization Leaning: A Preliminary Report.}, journal = {Frontiers in neuroscience}, volume = {16}, number = {}, pages = {899476}, pmid = {35812229}, issn = {1662-4548}, support = {F32 MH127793/MH/NIMH NIH HHS/United States ; }, abstract = {Misophonia is characterized by excessive aversive reactions to specific "trigger" sounds. Although this disorder is increasingly recognized in the literature, its etiological mechanisms and maintaining factors are currently unclear. Several etiological models propose a role of Pavlovian conditioning, an associative learning process heavily researched in similar fear and anxiety-related disorders. In addition, generalization of learned associations has been noted as a potential causal or contributory factor. Building upon this framework, we hypothesized that Misophonia symptoms arise as a consequence of overgeneralized associative learning, in which aversive responses to a noxious event also occur in response to similar events. Alternatively, heightened discrimination between conditioned threat and safety cues may be present in participants high in Misophonia symptoms, as predicted by associative learning models of Misophonia. This preliminary report (n = 34) examines auditory generalization learning using self-reported behavioral (i.e., valence and arousal ratings) and EEG alpha power reduction. Participants listened to three sine tones differing in pitch, with one pitch (i.e., CS+) paired with an aversive loud white noise blast, prompting aversive Pavlovian generalization learning. We assessed the extent to which overgeneralization versus heightened discrimination learning is associated with self-reported Misophonia symptoms, by comparing aversive responses to the CS+ and other tones similar in pitch. Behaviorally, all participants learned the contingencies between CS+ and noxious noise, with individuals endorsing elevated Misophonia showing heightened aversive sensitivity to all stimuli, regardless of conditioning and independent of hyperacusis status. Across participants, parieto-occipital EEG alpha-band power reduction was most pronounced in response to the CS+ tone, and this difference was greater in those with self-reported Misophonia symptoms. The current preliminary findings do not support the notion that overgeneralization is a feature of self-reported emotional experience in Misophonia, but that heightened sensitivity and discrimination learning may be present at the neural level.}, } @article {pmid35800773, year = {2022}, author = {Banker, SM and Na, S and Beltrán, J and Koenigsberg, HW and Foss-Feig, JH and Gu, X and Schiller, D}, title = {Disrupted computations of social control in individuals with obsessive-compulsive and misophonia symptoms.}, journal = {iScience}, volume = {25}, number = {7}, pages = {104617}, pmid = {35800773}, issn = {2589-0042}, abstract = {Misophonia is a disorder in which certain sounds produced by other people lead to intense negative reactions. It remains unknown how misophonia relates to other psychiatric conditions or impairments. To identify latent constructs underlying symptoms, we conducted a factor analysis consisting of items from questionnaires assessing symptoms of misophonia and other psychiatric conditions. One thousand forty-two participants completed the questionnaires and a social exchange task in which they either could ("controllable") or could not ("uncontrollable") influence future monetary offers from other people. Misophonia and obsessive-compulsive (OC) symptoms loaded onto the same factor. Compared with individuals with low Miso-OC factor scores, individuals with high scores reported higher perceived controllability of their social interactions during the uncontrollable condition and stronger aversion to social norm violations in the uncontrollable compared with the controllable condition. Together, these results suggest misophonia, and OC symptoms share a latent psychiatric dimension characterized by aberrant computations of social controllability.}, } @article {pmid35729298, year = {2023}, author = {Rinaldi, LJ and Simner, J and Koursarou, S and Ward, J}, title = {Autistic traits, emotion regulation, and sensory sensitivities in children and adults with Misophonia.}, journal = {Journal of autism and developmental disorders}, volume = {53}, number = {3}, pages = {1162-1174}, pmid = {35729298}, issn = {1573-3432}, support = {REAM Foundation Misophonia Research Fund//REAM Foundation Misophonia Research Fund/ ; }, mesh = {Humans ; Adult ; Child ; *Autistic Disorder ; *Emotional Regulation ; *Autism Spectrum Disorder ; Hearing Disorders ; }, abstract = {Misophonia is an unusually strong aversion to everyday sounds such as chewing, crunching, or breathing. Previous studies have suggested that rates of autism might be elevated in misophonia, and here we examine this claim in detail. We present a comprehensive review of the relevant literature, and two empirical studies examining children and adults with misophonia. We tested 142 children and 379 adults for traits associated with autism (i.e., attention-to-detail, attention-switching, social processing, communication, imagination, emotion regulation, and sensory sensitivity across multiple domains). Our data show that autistic traits are indeed elevated in misophonics compared to controls. We discuss our findings in relation to models of the interface between autism, sensory sensitivities, and the specific features of misophonia.}, } @article {pmid35727794, year = {2022}, author = {Remmert, N and Schmidt, KMB and Mussel, P and Hagel, ML and Eid, M}, title = {The Berlin Misophonia Questionnaire Revised (BMQ-R): Development and validation of a symptom-oriented diagnostical instrument for the measurement of misophonia.}, journal = {PloS one}, volume = {17}, number = {6}, pages = {e0269428}, pmid = {35727794}, issn = {1932-6203}, mesh = {Cross-Sectional Studies ; Humans ; *Hyperacusis ; Reproducibility of Results ; Surveys and Questionnaires ; }, abstract = {Misophonia is a clinical syndrome which is characterized by intense emotional and physical reactions to idiosyncratic sounds. However, its psychometric measurement is still in the early stages. This study describes the optimization of a self-report instrument, the Berlin Misophonia Questionnaire (BMQ), and addresses its strengths in comparison to existing psychometric measures. This new measure integrates contemporary empirical findings and is based on the latest criteria of misophonia. A cross-sectional online study was conducted using data of 952 affected as well as non-affected individuals. The final BMQ-R consists of 77 items in 21 scales, which were selected using a probabilistic item selection algorithm (Ant Colony Optimization). The results of confirmatory factor analyses, the assessment of reliability, and an extensive construct validation procedure supported the reliability and validity of the developed scales. One outstanding strength of the BMQ-R is its comprehensive measurement of misophonic emotional and physical responses. The instrument further allows for distinguishing between behavioral, cognitive, and emotional dysregulation; the measurement of clinical insight and significance; as well as discerning reactive and anticipating avoidance strategies. Our work offers several improvements to the measurement of misophonia by providing a reliable and valid multidimensional diagnostical instrument. In line with the scientific consensus on defining misophonia, the BMQ-R allows to formally recognize individuals with misophonia and so to compare findings of future studies. Undoubtedly, this measure fills a research gap, which we hope will facilitate the investigation of causes and treatment of misophonia.}, } @article {pmid35692416, year = {2022}, author = {Savard, MA and Sares, AG and Coffey, EBJ and Deroche, MLD}, title = {Specificity of Affective Responses in Misophonia Depends on Trigger Identification.}, journal = {Frontiers in neuroscience}, volume = {16}, number = {}, pages = {879583}, pmid = {35692416}, issn = {1662-4548}, abstract = {Individuals with misophonia, a disorder involving extreme sound sensitivity, report significant anger, disgust, and anxiety in response to select but usually common sounds. While estimates of prevalence within certain populations such as college students have approached 20%, it is currently unknown what percentage of people experience misophonic responses to such "trigger" sounds. Furthermore, there is little understanding of the fundamental processes involved. In this study, we aimed to characterize the distribution of misophonic symptoms in a general population, as well as clarify whether the aversive emotional responses to trigger sounds are partly caused by acoustic salience of the sound itself, or by recognition of the sound. Using multi-talker babble as masking noise to decrease participants' ability to identify sounds, we assessed how identification of common trigger sounds related to subjective emotional responses in 300 adults who participated in an online study. Participants were asked to listen to and identify neutral, unpleasant and trigger sounds embedded in different levels of the masking noise (signal-to-noise ratios: -30, -20, -10, 0, +10 dB), and then to evaluate their subjective judgment of the sounds (pleasantness) and emotional reactions to them (anxiety, anger, and disgust). Using participants' scores on a scale quantifying misophonia sensitivity, we selected the top and bottom 20% scorers from the distribution to form a Most-Misophonic subgroup (N = 66) and Least-Misophonic subgroup (N = 68). Both groups were better at identifying triggers than unpleasant sounds, which themselves were identified better than neutral sounds. Both groups also recognized the aversiveness of the unpleasant and trigger sounds, yet for the Most-Misophonic group, there was a greater increase in subjective ratings of negative emotions once the sounds became identifiable, especially for trigger sounds. These results highlight the heightened salience of trigger sounds, but furthermore suggest that learning and higher-order evaluation of sounds play an important role in misophonia.}, } @article {pmid35682372, year = {2022}, author = {Ferrer-Torres, A and Giménez-Llort, L}, title = {Misophonia: A Systematic Review of Current and Future Trends in This Emerging Clinical Field.}, journal = {International journal of environmental research and public health}, volume = {19}, number = {11}, pages = {}, pmid = {35682372}, issn = {1660-4601}, mesh = {Anger/physiology ; Anxiety Disorders ; Emotions/physiology ; Humans ; *Hyperacusis ; *Quality of Life ; }, abstract = {Misophonia is a scarcely known disorder. This systematic review (1) offers a quantitative and qualitative analysis of the literature since 2001, (2) identifies the most relevant aspects but also controversies, (3) identifies the theoretical and methodological approaches, and (4) highlights the outstanding advances until May 2022 as well as aspects that remain unknown and deserve future research efforts. Misophonia is characterized by strong physiological, emotional, and behavioral reactions to auditory, visual, and/or kinesthetic stimuli of different nature regardless of their physical characteristics. These misophonic responses include anger, general discomfort, disgust, anxiety, and avoidance and escape behaviors, and decrease the quality of life of the people with the disorder and their relatives. There is no consensus on the diagnostic criteria yet. High comorbidity between misophonia and other psychiatric and auditory disorders is reported. Importantly, the confusion with other disorders contributes to its underdiagnosis. In recent years, assessment systems with good psychometric properties have increased considerably, as have treatment proposals. Although misophonia is not yet included in international classification systems, it is an emerging field of growing scientific and clinical interest.}, } @article {pmid35647776, year = {2022}, author = {Cakiroglu, S and Cosgun, S and Gormez, V}, title = {The prevalence and severity of misophonia in the Turkish population and validation of the Amsterdam Misophonia Scale-Revised.}, journal = {Bulletin of the Menninger Clinic}, volume = {86}, number = {2}, pages = {159-180}, doi = {10.1521/bumc.2022.86.2.159}, pmid = {35647776}, issn = {1943-2828}, mesh = {Cross-Sectional Studies ; Female ; Hearing Disorders ; Humans ; Male ; *Prevalence ; Psychometrics ; Reproducibility of Results ; }, abstract = {The Amsterdam Misophonia Scale-Revised (AMISOS-R) is a self-report scale that measures the presence and severity of symptoms experienced in response to specific auditory stimuli. This cross-sectional, descriptive study aims to evaluate psychometric properties of the AMISOS-R in the Turkish language and to examine psychosocial factors associated with misophonia. A total of 374 individuals (female/male: 154/220) between 15 and 45 years of age were included in the study. Confirmatory factor analysis showed that the fit indices were at a good level, and they supported the single-factor structure. Test-retest results and Cronbach's alpha coefficient showed that the scale had high reliability. Misophonia scores were also found to be moderately correlated with obsessive-compulsive disorder and neuroticism. The AMISOS-R was found to be a valid and reliable tool to evaluate misophonia in the Turkish language.}, } @article {pmid35645198, year = {2022}, author = {Bendowska, A and Malak, R and Zok, A and Baum, E}, title = {The Ethics of Translational Audiology.}, journal = {Audiology research}, volume = {12}, number = {3}, pages = {273-280}, pmid = {35645198}, issn = {2039-4330}, abstract = {Translational research moves promising primary research results from the laboratory to practical application. The transition from basic science to clinical research and from clinical research to routine healthcare applications presents many challenges, including ethical. This paper addresses issues in the ethics of translational audiology and discusses the ethical principles that should guide research involving people with hearing loss. Four major ethical principles are defined and explained, which are as follows: beneficence, nonmaleficence, autonomy, and justice. In addition, the authors discuss issues of discrimination and equal access to medical services among people with hearing loss. Despite audiology's broad field of interest, which includes evaluation and treatment of auditory disorders (e.g., deafness, tinnitus, misophonia, or hyperacusis) and balance disorders, this study focuses primarily on deafness and its therapies.}, } @article {pmid35465571, year = {2022}, author = {Rinaldi, LJ and Smees, R and Ward, J and Simner, J}, title = {Poorer Well-Being in Children With Misophonia: Evidence From the Sussex Misophonia Scale for Adolescents.}, journal = {Frontiers in psychology}, volume = {13}, number = {}, pages = {808379}, pmid = {35465571}, issn = {1664-1078}, abstract = {OBJECTIVE: Misophonia is an unusually strong aversion to a specific class of sounds - most often human bodily sounds such as chewing, crunching, or breathing. A number of studies have emerged in the last 10 years examining misophonia in adults, but little is known about the impact of the condition in children. Here we set out to investigate the well-being profile of children with misophonia, while also presenting the first validated misophonia questionnaire for children.

MATERIALS AND METHODS: We screened 142 children (10-14 years; Mean 11.72 SD 1.12; 65 female, 77 male) using our novel diagnostic [the Sussex Misophonia Scale for Adolescents (SMS-Adolescent)]. This allowed us to identify a group of children already manifesting misophonia at that age - the first population-sampled cohort of child misophonics examined to date. Children and their parents also completed measures of well-being (for convergent validation of our SMS-Adolescent) and creative self-construct (for discriminant validation).

RESULTS: Data show that children with misophonia have significantly elevated levels of anxiety and obsessive compulsive traits. Additionally children with misophonia have significantly poorer life-satisfaction, and health-related quality of life. As predicted, they show no differences in creative self-construct.

CONCLUSION: Together our data suggest the first evidence in population sampling of poorer life outcomes for children with misophonia, and provide preliminary convergent and discriminant validation for our novel misophonia instrument. Our data suggest a need for greater recognition and therapeutic outlets for adolescents with misophonia.}, } @article {pmid35443144, year = {2022}, author = {Lee, JP and Binger, C and Harrington, N and Evelyn, S and Kent-Walsh, J and Gevarter, C and Richardson, J and Hahs-Vaughn, D}, title = {Aided Language Measures: Establishing Observer Agreement for Communicators in Early Language Phases.}, journal = {American journal of speech-language pathology}, volume = {31}, number = {3}, pages = {1394-1411}, pmid = {35443144}, issn = {1558-9110}, support = {R01 DC016321/DC/NIDCD NIH HHS/United States ; }, mesh = {Child ; Communication ; *Communication Aids for Disabled ; Humans ; *Language ; Language Development ; Language Tests ; }, abstract = {PURPOSE: Although many valid, reliable, and developmentally sensitive measures exist to monitor the language gains of children who rely on spoken language to communicate, the same is not true for graphic symbol communicators. This study is a first step in developing such measures by examining the interobserver agreement (IOA) and within-observer agreement of 13 measures designed to monitor the language progress of children who use aided augmentative and alternative communication (AAC). These measures are based on the Graphic Symbol Utterance and Sentence Development Framework (Binger et al., 2020) and are hypothesized to capture various phases of graphic symbol communication.

METHOD: Four graduate student observers coded 13 measures across 57 different play-based sessions of children with Down syndrome ages 3;0-5;11 (years;months). For IOA, sessions were coded by two different observers. For within-observer agreement, all sessions were recoded by the same coders. Corpus-level analyses were completed to characterize the nature of the samples (e.g., average mean length of utterance for the samples). IOA and within-observer agreement were examined for each utterance.

RESULTS: Across all observers and measures, acceptable levels of IOA and within-observer agreement were achieved, with most measures yielding relatively high levels of agreement. Some differences were noted across measures, with the less experienced coders demonstrating less agreement on select measures.

CONCLUSIONS: Results provide initial evidence that many measures based on the Graphic Symbol Utterance and Sentence Development Framework can be reliably coded. These findings are a first step in developing psychometrically sound measures to monitor the expressive language progress of children who use AAC.

SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.19601551.}, } @article {pmid35418830, year = {2022}, author = {Norris, JE and Kimball, SH and Nemri, DC and Ethridge, LE}, title = {Toward a Multidimensional Understanding of Misophonia Using Cluster-Based Phenotyping.}, journal = {Frontiers in neuroscience}, volume = {16}, number = {}, pages = {832516}, pmid = {35418830}, issn = {1662-4548}, abstract = {Misophonia is a condition characterized by hypersensitivity and strong emotional reactivity to specific auditory stimuli. Misophonia clinical presentations are relatively complex and reflect individualized experiences across clinical populations. Like some overlapping neurodevelopmental and neuropsychiatric disorders, misophonia is potentially syndromic where symptom patterns rather than any one symptom contribute to diagnosis. The current study conducted an exploratory k-means cluster analysis to evaluate symptom presentation in a non-clinical sample of young adult undergraduate students (N = 343). Individuals participated in a self-report spectrum characteristics survey indexing misophonia, tinnitus severity, sensory hypersensitivity, and social and psychiatric symptoms. Results supported a three-cluster solution that split participants on symptom presentation: cluster 1 presented with more severe misophonia symptoms but few overlapping formally diagnosed psychiatric co-occurring conditions; cluster 3 was characterized by a more nuanced clinical presentation of misophonia with broad-band sensory hypersensitivities, tinnitus, and increased incidence of social processing and psychiatric symptoms, and cluster 2 was relatively unaffected by misophonia or other sensitivities. Clustering results illustrate the spectrum characteristics of misophonia where symptom patterns range from more "pure" form misophonia to presentations that involve more broad-range sensory-related and psychiatric symptoms. Subgroups of individuals with misophonia may characterize differential neuropsychiatric risk patterns and stem from potentially different causative factors, highlighting the importance of exploring misophonia as a multidimensional condition of complex etiology.}, } @article {pmid35414290, year = {2022}, author = {Swonke, ML and Neve, L and Rossi, NA and McKinnon, B and Daram, S and Pine, HS}, title = {Misophonia: An Underrecognized Disease in Pediatric Patients.}, journal = {Ear, nose, & throat journal}, volume = {}, number = {}, pages = {1455613221095606}, doi = {10.1177/01455613221095606}, pmid = {35414290}, issn = {1942-7522}, abstract = {Misophonia is a chronic condition in which patients experience a strong negative, emotional, or psychologic reaction to specific sounds. These sounds cause the individual to have a sudden, uncontrolled, and disproportionate negative reaction affecting their daily activities. The literature describes several cases of misophonia in the adult population; however, only 2 pediatric case studies are reported. Herein, we present 2 additional cases. An exaggerated response to an auditory stimulus is observed in other disorders such as tinnitus, hyperacusis, migraines, and many psychiatric disorders. Sound aversion has a broad differential diagnosis and may require visits to numerous specialists, placing strain on the patient and the healthcare system. Furthermore, misophonia is underdiagnosed in the pediatric population as it requires self-reporting of symptoms. The pathophysiology, prevalence, and treatment of misophonia continue to be relatively unknown. We attempt to highlight this rarely reported pediatric diagnosis and elaborate on its clinical presentation to increase awareness among otolaryngologists.}, } @article {pmid35377090, year = {2022}, author = {Weinzimmer, SA and Goetz, AR and Guzick, AG and Hana, LM and Cepeda, SL and Schneider, SC and Kennedy, SM and Amos Nwankwo, GN and Christian, CC and Shaw, AM and Salloum, A and Shah, AA and Goodman, WK and Ehrenreich-May, J and Storch, EA}, title = {Primary Outcomes for Adults Receiving the Unified Protocol after Hurricane Harvey in an Integrated Healthcare Setting.}, journal = {Community mental health journal}, volume = {58}, number = {8}, pages = {1522-1534}, pmid = {35377090}, issn = {1573-2789}, support = {P50 HD103555/HD/NICHD NIH HHS/United States ; P50HD103555/NH/NIH HHS/United States ; }, mesh = {Adult ; Humans ; *Cyclonic Storms ; Depression/epidemiology/therapy/psychology ; Anxiety/psychology ; Anxiety Disorders/therapy ; *Delivery of Health Care, Integrated ; }, abstract = {The Unified Protocol for Transdiagnostic Treatment of Emotional Disorders (UP) has demonstrated efficacy for treating anxiety and depression. However, there are limited effectiveness data when conducted in real-world settings with diverse populations, including those with trauma. We evaluated treatment outcomes in a naturalistic, community setting among 279 adults who received UP following Hurricane Harvey. We examined change in overall clinical severity, depression and anxiety symptoms, functional impairment, and baseline outcome predictors (i.e., demographic characteristics, impact from Hurricane Harvey, co-occurrence of depression and anxiety symptoms). Global clinical severity, depression and anxiety symptoms, and functional impairment decreased by end-of-treatment. Participants experienced global symptom improvement to a lesser degree than demonstrated in efficacy trials. Participants who experienced greater storm impact reported larger reductions in anxiety symptoms than those less impacted by Harvey. Further studies evaluating the effectiveness of the UP post-disaster and with diverse samples are needed.}, } @article {pmid35372559, year = {2022}, author = {Ashall, V}, title = {A Feminist Ethic of Care for the Veterinary Profession.}, journal = {Frontiers in veterinary science}, volume = {9}, number = {}, pages = {795628}, pmid = {35372559}, issn = {2297-1769}, abstract = {I can still see the dog's face as its eyes connected with mine, framed by the black bin bag it had been carried in. I can still hear the clicking sound, louder than the animal's shrill cries, made by a mass of maggots moving against one another beneath the dogs matted fur, moistened by fluids leaking from its damaged flesh. My hands were shaking with panic and rage and I could hardly draw up the euthatal into the syringe quickly enough. I wanted to put an end to this, immediately. As the lethal fluid flowed into the tiny vein the dog's body finally relaxed. At my hand, like so many others, she had ceased to exist. Through the window I could see her owners waiting outside in the sunshine to pay me and I thought about the silky feel of the fur which covered an expensively shaped head. I knew this dog was loved once. This paper develops two neglected areas of veterinary thought; anthropological studies of the veterinary profession and feminist care approaches in veterinary ethics. I argue that the development of veterinary anthropology is crucial to advancing our understanding of veterinary lived experiences, through highlighting the previously under acknowledged emotional, relational and contextual realities of veterinary practice. I further propose that an ethic of care for the veterinary profession, which meaningfully connects with veterinary lived experiences, may provide a valuable approach through which to further develop veterinary ethical thinking. I share an autoethnographic account of a difficult veterinary encounter, which I then analyse using a novel feminist care approach. Through analyses centered on both emotional and relational aspects of veterinary care, I challenge the boundaries of traditional veterinary ethical approaches in terms of the scope, scale and complexity of veterinary ethical decision making. I describe the concept of emotional sponge work in veterinary practice and outline its potential impact for advancing understanding of both veterinary well-being and the profession's societal role. Finally, I propose that a feminist ethic of care might provide a framework for redefining the focus of veterinary professional responsibility, beyond animal health and toward the maintenance of healthy relationships between humans and animals.}, } @article {pmid35368272, year = {2022}, author = {Swedo, SE and Baguley, DM and Denys, D and Dixon, LJ and Erfanian, M and Fioretti, A and Jastreboff, PJ and Kumar, S and Rosenthal, MZ and Rouw, R and Schiller, D and Simner, J and Storch, EA and Taylor, S and Werff, KRV and Altimus, CM and Raver, SM}, title = {Consensus Definition of Misophonia: A Delphi Study.}, journal = {Frontiers in neuroscience}, volume = {16}, number = {}, pages = {841816}, pmid = {35368272}, issn = {1662-4548}, abstract = {Misophonia is a disorder of decreased tolerance to specific sounds or their associated stimuli that has been characterized using different language and methodologies. The absence of a common understanding or foundational definition of misophonia hinders progress in research to understand the disorder and develop effective treatments for individuals suffering from misophonia. From June 2020 through January 2021, the authors conducted a study to determine whether a committee of experts with diverse expertise related to misophonia could develop a consensus definition of misophonia. An expert committee used a modified Delphi method to evaluate candidate definitional statements that were identified through a systematic review of the published literature. Over four rounds of iterative voting, revision, and exclusion, the committee made decisions to include, exclude, or revise these statements in the definition based on the currently available scientific and clinical evidence. A definitional statement was included in the final definition only after reaching consensus at 80% or more of the committee agreeing with its premise and phrasing. The results of this rigorous consensus-building process were compiled into a final definition of misophonia that is presented here. This definition will serve as an important step to bring cohesion to the growing field of researchers and clinicians who seek to better understand and support individuals experiencing misophonia.}, } @article {pmid35342204, year = {2022}, author = {Naguy, A and Al-Humoud, AM and Pridmore, S and Abuzeid, MY and Singh, A and Elsori, D}, title = {Low-Dose Risperidone for an Autistic Child with Comorbid ARFID and Misophonia.}, journal = {Psychopharmacology bulletin}, volume = {52}, number = {1}, pages = {91-94}, pmid = {35342204}, issn = {2472-2448}, mesh = {*Autism Spectrum Disorder/complications/drug therapy ; *Autistic Disorder/drug therapy ; *Avoidant Restrictive Food Intake Disorder ; Child ; *Feeding and Eating Disorders ; Humans ; Risperidone ; }, abstract = {Avoidant/Restrictive Food Intake Disorder and misophonia seem to be overrepresented in autism spectrum disorder. Literature is mute on psychopharmacotherapy in these complex presentations. Here, authors report on a challenging case of low-functioning ASD child with comorbid ARFID and misophonia that responded favorably to a low-dose risperidone. This is followed by a brief discussion of purported pharmacodynamic mechanisms and relevant literature.}, } @article {pmid35331082, year = {2021}, author = {Simner, J and Koursarou, S and Rinaldi, LJ and Ward, J}, title = {Attention, flexibility, and imagery in misophonia: Does attention exacerbate everyday disliking of sound?.}, journal = {Journal of clinical and experimental neuropsychology}, volume = {43}, number = {10}, pages = {1006-1017}, doi = {10.1080/13803395.2022.2056581}, pmid = {35331082}, issn = {1744-411X}, mesh = {Humans ; *Hyperacusis/diagnosis ; Phobic Disorders ; Self Report ; *Sound ; }, abstract = {INTRODUCTION: Misophonia is an unusually strong aversion to everyday sounds, such as chewing, crunching, or breathing. Here, we ask whether misophonia might be tied to an unusual profile of attention (and related traits), which serves to substantially heighten an otherwise everyday disliking of sounds.

METHODS: In Study 1, we tested 136 misophonics and 203 non-misophonics on self-report measures of attention to detail, cognitive inflexibility, and auditory imagery, as well as collecting details about their misophonia. In Study 2, we administered the Embedded Figures task to 20 misophonics and 36 non-misophonics.

RESULTS: We first showed that the degree to which sounds trigger misophonia reflects the pattern by which they are (more mildly) disliked by everyone. This suggests that misophonia is scaffolded onto existing mechanisms rather than qualitatively different ones. Compared to non-misophonics, we also found that misophonics self-reported greater attention to detail, cognitive inflexibility, and auditory imagery. As their symptoms worsen, they also become more accurate in an attentional task (Embedded Figures).

CONCLUSIONS: Our findings provide a better understanding of misophonia and support the hypothesis that dispositional traits of attention to detail may be key to elevating everyday disliking of sound into the more troubling aversions of misophonia.}, } @article {pmid35259551, year = {2022}, author = {Siepsiak, M and Rosenthal, MZ and Raj-Koziak, D and Dragan, W}, title = {Psychiatric and audiologic features of misophonia: Use of a clinical control group with auditory over-responsivity.}, journal = {Journal of psychosomatic research}, volume = {156}, number = {}, pages = {110777}, doi = {10.1016/j.jpsychores.2022.110777}, pmid = {35259551}, issn = {1879-1360}, mesh = {Adult ; Control Groups ; Cross-Sectional Studies ; *Depressive Disorder, Major ; Humans ; Hyperacusis ; Phobic Disorders ; }, abstract = {OBJECTIVE: This cross-sectional study was designed to add to the emerging empirical literature characterizing the psychiatric and audiologic features of misophonia. Because most research to date has not compared misophonia to clinical control groups, the present study used both participants who did not report any sound intolerance problems and a clinical control group of participants with auditory over-responsivity not formally meeting criteria for a diagnosis of misophonia using proposed diagnostic criteria by Schroeder et al. (2013). Severity of misophonia symptoms, frequency of current or lifetime psychiatric disorders, loudness discomfort, and hearing loss were compared across groups.

METHODS: Structured interviews, questionnaires, and objective measures of audiologic functioning were administered to a sample of adult participants (N = 156). Measures included an interviewer-rated diagnostic assessment of misophonia, the MisoQuest, (Siepsiak et al., 2020), M.I.N·I (Sheehan et al., 1998), loudness discomfort level (LDL), and hearing loss (PTA).

RESULTS: Group differences in misophonia symptom severity among all three groups were observed: FWelch (2,50.57) = 149.92, p < .001, n2 = 0.64, validating group assignment. Psychiatric disorders were significantly more frequent in the misophonia group (71%) than in the auditory over-responsivity group (40%) and control group (40%): X[2] (2, N = 142) = 14.3; p = .001; V = 0.317. A wide range of psychiatric disorders were observed in the misophonia group, (e.g., major depressive episode, suicidality and panic disorder were the most common). There were no significant differences between groups with regards to audiologic functioning.

CONCLUSION: Misophonia co-occurs with a variety of psychiatric disorders but does not appear to be associated with loudness discomfort or hearing impairments.}, } @article {pmid35177354, year = {2022}, author = {Allusoglu, S and Aksoy, S}, title = {The reliability and validity of decreased sound tolerance scale-screening.}, journal = {Brazilian journal of otorhinolaryngology}, volume = {88 Suppl 3}, number = {Suppl 3}, pages = {S155-S163}, pmid = {35177354}, issn = {1808-8686}, mesh = {Humans ; *Hyperacusis/diagnosis/therapy ; Reproducibility of Results ; *Sound ; }, abstract = {OBJECTIVES: Decreased Sound Tolerance (DST) is a negative reaction to a sound that does not cause any reaction in an individual with normal hearing. DST's subclasses include hyperacusis, phonophobia, and misophonia, which are distinct and have therapy variations. There is no diagnostic method or scale that distinguishes them in the literature. This study's purpose was to develop a screening scale that distinguishes these three DSTs.

METHODS: The study comprised 257 willing participants with normal hearing. Cronbach alpha coefficient, item-total correlation, and item differentiation of the Decreased Sound Tolerance Scale-Screening (DSTS-S) were evaluated. Structural validity of DSTS-S was performed by Varimax rotation with Kaiser normalization using Explanatory Factor Analysis (EFA), and Confirmatory Factor Analysis (CFA) was performed to assess its structural compatibility. The scale's total scores from each section were compared using the Mann-Whitney U test in symptom (+) and symptom (-) participants.

RESULTS: The Cronbach alpha value for hyperacusis, phonophobia, and misophonia sections of DSTS-S was calculated as 0.881, 0.775, and 0.938, respectively. The difference between the independent samplet-test and the variables was statistically significant (p < 0.01). The Mann-Whitney U test showed a significant difference between the median values of the total groups' scores with and without hyperacusis, phonophobia, and misophonia (HTS, PTS, and MTS, respectively) (p < 0.05). Evaluation by ROC analysis showed that hyperacusis was useful in predicting the presence of hyperacusis, phonophobia was useful in predicting the presence of phonophobia, and misophonia was useful in predicting the presence of misophonia (p < 0.001). Hyperacusis and misophonia sections showed high reliability, and phonophobia section showed a moderately reliable level. The Kappa test showed that the compatibility between test-retest for the total scores was statistically significant (p < 0.001).

CONCLUSION: The study's results indicated that DSTS-S is a valid and reliable scale for identifying subtypes/problems/classes of decreased sound tolerance.}, } @article {pmid35148347, year = {2022}, author = {Guetta, RE and Cassiello-Robbins, C and Trumbull, J and Anand, D and Rosenthal, MZ}, title = {Examining emotional functioning in misophonia: The role of affective instability and difficulties with emotion regulation.}, journal = {PloS one}, volume = {17}, number = {2}, pages = {e0263230}, pmid = {35148347}, issn = {1932-6203}, mesh = {Adult ; Anxiety/psychology ; Depression/psychology ; Emotional Regulation/*physiology ; Female ; Humans ; Linear Models ; Male ; Mental Health ; Phobic Disorders/*psychology ; Surveys and Questionnaires ; }, abstract = {Misophonia is a newly described condition characterized by sensory and emotional reactivity (e.g., anxiety, anger, disgust) to repetitive, pattern-based sounds (e.g., throat clearing, chewing, slurping). Individuals with misophonia report significant functional impairment and interpersonal distress. Growing research indicates ineffective coping and emotional functioning broadly (e.g., affective lability, difficulties with emotion regulation) are central to the clinical presentation and severity of misophonia. Preliminary evidence suggests an association between negative emotionality and deficits in emotion regulation in misophonia. Still, little is known about (a) the relationships among specific components of emotional functioning (e.g., emotion regulation, affective lability) with misophonia, and (b) which component(s) of misophonia (e.g., noise frequency, emotional and behavioral responses, impairment) are associated with emotional functioning. Further, despite evidence that mood and anxiety disorders co-occur with misophonia, investigation thus far has not controlled for depression and anxiety symptoms. Examination of these relationships will help inform treatment development for misophonia. The present study begins to disambiguate the relationships among affective lability, difficulties with emotion regulation, and components of misophonia. A sample of 297 participants completed questionnaires assessing misophonia, emotional functioning, depression, anxiety, and COVID-19 impact. Findings indicated that misophonia severity was positively associated with each of these constructs with small to medium effect sizes. When controlling for depression, anxiety, and COVID-19 impact, results from this preliminary study suggest that (a) difficulties with emotion regulation may be correlated with misophonia severity, and (b) misophonic responses, not number of triggers or perceived severity, are associated with difficulties with emotion regulation. Overall, these findings begin to suggest that emotion regulation is important to our understanding the risk factors and treatment targets for misophonia.}, } @article {pmid35135895, year = {2022}, author = {Zarotti, N and Tuthill, A and Fisher, P}, title = {Online Emotion Regulation for an Adolescent With Misophonia: A Case Study.}, journal = {Journal of cognitive psychotherapy}, volume = {}, number = {}, pages = {}, doi = {10.1891/JCP-2021-0015}, pmid = {35135895}, issn = {1938-887X}, abstract = {Misophonia is a novel diagnosis characterised by extreme and uncontrollable autonomic reactions and emotional responses to selective auditory stimuli, which can significantly impair an individual's daily life. No agreed diagnostic criteria are currently available for misophonia, and any therapeutic guidance is yet to be formalised. In this case study, a tailored psychological intervention based on the cognitive model and developed around emotion regulation principles and techniques was adopted to treat misophonia in a 16-year-old female from the United Kingdom. The treatment lasted for 15 weeks and was delivered online due to the ongoing COVID-19 social distancing regulations. The results showed that the intervention was feasible and acceptable, and effective at reducing levels of misophonic symptoms from severe to moderate/mild while also improving emotion dysregulation and overall anxiety and depression. Particular improvements were observed for specific skills such as acceptance and awareness of emotional responses and increased access to emotion regulation strategies. These findings also translated into a number of reported daily life improvements in the client's psychological and social well-being. As the current evidence base on misophonia continues to develop, more methodologically rigorous research is warranted to build on the present findings and inform the adoption of further psychotherapeutic approaches to treat this new condition.}, } @article {pmid35029866, year = {2022}, author = {}, title = {Misophonia Successfully Treated of With Fluoxetine: A Case Report: Erratum.}, journal = {Clinical neuropharmacology}, volume = {45}, number = {1}, pages = {15}, doi = {10.1097/WNF.0000000000000493}, pmid = {35029866}, issn = {1537-162X}, } @article {pmid35029865, year = {2022}, author = {Webb, J}, title = {β-Blockers for the Treatment of Misophonia and Misokinesia.}, journal = {Clinical neuropharmacology}, volume = {45}, number = {1}, pages = {13-14}, doi = {10.1097/WNF.0000000000000492}, pmid = {35029865}, issn = {1537-162X}, mesh = {*Adrenergic beta-Antagonists/therapeutic use ; Humans ; *Hyperacusis/drug therapy ; Male ; *Phobic Disorders/drug therapy ; }, abstract = {Misophonia is an adverse physical and emotional reaction to certain repetitive trigger sounds, usually generated by other people. Misokinesia refers to visual triggers that are sometimes (but not always) related to trigger sounds. Despite how common and disabling these conditions can be, medication treatment of misophonia and misokinesia is largely unexplored. We present the first case of using a β-blocker (propranolol) to successfully treat a patient experiencing misophonia and misokinesia. A moderate dose (60 mg) of propranolol completely eliminated multiple auditory and visual trigger symptoms related to other people eating. His trigger response symptoms included overwhelming negative emotions and prominent sympathetic overactivity (fight-or-flight response). These symptoms were so severe that he had avoided most meals with friends and family for the past several years. Propranolol eliminated the emotional and physiological effects of both the auditory and visual triggers, with an Amsterdam Misophonia Scale score reduction from 15 to 2. This enabled him to resume eating meals with family and friends with no distress. The medication was well tolerated. In summary, we report the novel finding that β-blockers were markedly effective at treating the physical and emotional symptoms of a patient with misophonia and misokinesia. This suggests a novel treatment approach for these conditions.}, } @article {pmid34989343, year = {2022}, author = {La Buissonnière-Ariza, V and Guzik, AG and Schneider, SC and Cepeda, SL and Goodman, WK and Storch, EA}, title = {Family Accommodation of Symptoms in Adults With Obsessive-Compulsive Disorder: Factor Structure and Usefulness of the Family Accommodation Scale for OCD-Patient Version.}, journal = {Journal of psychiatric practice}, volume = {28}, number = {1}, pages = {36-47}, doi = {10.1097/PRA.0000000000000597}, pmid = {34989343}, issn = {1538-1145}, mesh = {Adult ; Family ; Humans ; *Obsessive-Compulsive Disorder/diagnosis ; Surveys and Questionnaires ; }, abstract = {For individuals with obsessive-compulsive disorder (OCD), family accommodation of symptoms, such as over-reassurance, participation in rituals, or facilitation of avoidance, is one of the key factors associated with symptom severity, maintenance, and related impairment. Most studies have assessed accommodation behaviors based on reports from family members or other loved ones. Recently, a patient-rated questionnaire, the Family Accommodation Scale for OCD-Patient Version (FAS-PV) was developed to assess family accommodation from the patient's perspective. This study investigated the factor structure of the FAS-PV and clinical variables associated with patient-reported family accommodation in a sample of 151 treatment-seeking adults with OCD. A confirmatory factor analysis suggested that a 4-factor model best characterized the scale, with the following factors: (1) participation in symptoms, (2) avoidance of OCD triggers, (3) taking on responsibilities, and (4) modifying responsibilities. Internal consistency was high for the total score and for scores on the 4 subscales of the FAS-PV. Approximately 87% of the sample reported accommodation behaviors at some level. Family accommodation was positively correlated with OCD symptom severity and functional disability, and partially mediated the associations between these 2 factors, so that greater OCD severity was associated with greater accommodation, which, in turn, was associated with greater disability. Our findings parallel those of studies that have employed other versions of the FAS and suggest that the FAS-PV is a useful tool for assessing family accommodation of OCD symptoms from the patient's perspective.}, } @article {pmid34698077, year = {2021}, author = {Vitoratou, S and Uglik-Marucha, N and Hayes, C and Erfanian, M and Pearson, O and Gregory, J}, title = {Item Response Theory Investigation of Misophonia Auditory Triggers.}, journal = {Audiology research}, volume = {11}, number = {4}, pages = {567-581}, pmid = {34698077}, issn = {2039-4330}, support = {102176/B/13/Z/WT_/Wellcome Trust/United Kingdom ; }, abstract = {Misophonia is characterised by a low tolerance for day-to-day sounds, causing intense negative affect. This study conducts an in-depth investigation of 35 misophonia triggers. A sample of 613 individuals who identify as experiencing misophonia and 202 individuals from the general population completed self-report measures. Using contemporary psychometric methods, we studied the triggers in terms of internal consistency, stability in time, precision, severity, discrimination ability, and information. Three dimensions of sensitivity were identified, namely, to eating sounds, to nose/throat sounds, and to general environmental sounds. The most informative and discriminative triggers belonged to the eating sounds. Participants identifying with having misophonia had also significantly increased odds to endorse eating sounds as auditory triggers than others. This study highlights the central role of eating sounds in this phenomenon and finds that different triggers are endorsed by those with more severe sound sensitivities than those with low sensitivity.}, } @article {pmid34698068, year = {2021}, author = {Danesh, AA and Howery, S and Aazh, H and Kaf, W and Eshraghi, AA}, title = {Hyperacusis in Autism Spectrum Disorders.}, journal = {Audiology research}, volume = {11}, number = {4}, pages = {547-556}, pmid = {34698068}, issn = {2039-4330}, abstract = {Hyperacusis is highly prevalent in the autism spectrum disorder (ASD) population. This auditory hypersensitivity can trigger pragmatically atypical reactions that may impact social and academic domains. Objective: The aim of this report is to describe the relationship between decreased sound tolerance disorders and the ASD population. Topics covered: The main topics discussed include (1) assessment and prevalence of hyperacusis in ASD; (2) etiology of hyperacusis in ASD; (3) treatment of hyperacusis in ASD. Conclusions: Knowledge of the assessment and treatment of decreased sound tolerance disorders within the ASD population is growing and changing.}, } @article {pmid34659024, year = {2021}, author = {Rosenthal, MZ and Anand, D and Cassiello-Robbins, C and Williams, ZJ and Guetta, RE and Trumbull, J and Kelley, LD}, title = {Development and Initial Validation of the Duke Misophonia Questionnaire.}, journal = {Frontiers in psychology}, volume = {12}, number = {}, pages = {709928}, pmid = {34659024}, issn = {1664-1078}, support = {T32 GM007347/GM/NIGMS NIH HHS/United States ; }, abstract = {Misophonia is characterized by decreased tolerance and accompanying defensive motivational system responding to certain aversive sounds and contextual cues associated with such stimuli, typically repetitive oral (e. g., eating sounds) or nasal (e.g., breathing sounds) stimuli. Responses elicit significant psychological distress and impairment in functioning, and include acute increases in (a) negative affect (e.g., anger, anxiety, and disgust), (b) physiological arousal (e.g., sympathetic nervous system activation), and (c) overt behavior (e.g., escape behavior and verbal aggression toward individuals generating triggers). A major barrier to research and treatment of misophonia is the lack of rigorously validated assessment measures. As such, the primary purpose of this study was to develop and psychometrically validate a self-report measure of misophonia, the Duke Misophonia Questionnaire (DMQ). There were two phases of measure development. In Phase 1, items were generated and iteratively refined from a combination of the scientific literature and qualitative feedback from misophonia sufferers, their family members, and professional experts. In Phase 2, a large community sample of adults (n = 424) completed DMQ candidate items and other measures needed for psychometric analyses. A series of iterative analytic procedures (e.g., factor analyses and IRT) were used to derive final DMQ items and scales. The final DMQ has 86 items and includes subscales: (1) Trigger frequency (16 items), (2) Affective Responses (5 items), (3) Physiological Responses (8 items), (4) Cognitive Responses (10 items), (5) Coping Before (6 items), (6) Coping During (10 items), (7) Coping After (5 items), (8) Impairment (12 items), and Beliefs (14 items). Composite scales were derived for overall Symptom Severity (combined Affective, Physiological, and Cognitive subscales) and Coping (combined the three Coping subscales). Depending on the needs of researchers or clinicians, the DMQ may be use in full form, individual subscales, or with the derived composite scales.}, } @article {pmid34643532, year = {2021}, author = {Rodriguez, M and Eisenlohr-Moul, TA and Weisman, J and Rosenthal, MZ}, title = {The Use of Task Shifting to Improve Treatment Engagement in an Internet-Based Mindfulness Intervention Among Chinese University Students: Randomized Controlled Trial.}, journal = {JMIR formative research}, volume = {5}, number = {10}, pages = {e25772}, pmid = {34643532}, issn = {2561-326X}, abstract = {BACKGROUND: Traditional in-person psychotherapies are incapable of addressing global mental health needs. Use of computer-based interventions is one promising solution for closing the gap between the amount of global mental health treatment needed and received.

OBJECTIVE: Although many meta-analyses have provided evidence supporting the efficacy of self-guided, computer-based interventions, most report low rates of treatment engagement (eg, high attrition and low adherence). The aim of this study is to investigate the efficacy of an adjunctive treatment component that uses task shifting, wherein mental health care is provided by nonspecialist peer counselors to enhance engagement in an internet-based, self-directed, evidence-based mindfulness intervention among Chinese university students.

METHODS: From 3 universities across China, 54 students who reported at least mild stress, anxiety, or depression were randomly assigned to a 4-week internet-based mindfulness intervention (MIND) or to the intervention plus peer counselor support (MIND+), respectively. Be Mindful delivers all the elements of mindfulness-based cognitive therapy in an internet-based, 4-week course. Participants completed daily monitoring of mindfulness practice and mood, as well as baseline and posttreatment self-reported levels of depression, anxiety, stress, and trait mindfulness. We screened 56 volunteer peer counselor candidates who had no former training in the delivery of mental health services. Of these, 10 were invited to participate in a day-long training, and 4 were selected. Peer counselors were instructed to provide 6 brief (15-20 minute) sessions each week, to help encouraging participants to complete the internet-based intervention. Peer counselors received weekly web-based group supervision.

RESULTS: For both conditions, participation in the internet-based intervention was associated with significant improvements in mindfulness and mental health outcomes. The pre-post effect sizes (Cohen d) for mindfulness, depression, anxiety, and stress were 0.55, 0.95, 0.89, and 1.13, respectively. Participants assigned to the MIND+ (vs MIND) condition demonstrated significantly less attrition and more adherence, as indicated by a greater likelihood of completing posttreatment assessments (16/27, 59% vs 7/27, 26%; χ[2]1=6.1; P=.01) and a higher percentage of course completion (72.6/100, 72.6% vs 50.7/100, 50.7%; t52=2.10; P=.04), respectively. No significant between-group differences in daily frequency and duration of mindfulness practice were observed. Multilevel logistic growth models showed that MIND+ participants reported significantly greater pre-post improvements in daily stress ratings (interaction estimate 0.39, SE 0.18; t317=2.29; P=.02) and depression (interaction estimate 0.38, SE 0.16; t330=2.37; P=.02) than those in the MIND condition.

CONCLUSIONS: This study provides new insights into effective ways of leveraging technology and task shifting to implement large-scale mental health initiatives that are financially feasible, easily transportable, and quickly scalable in low-resource settings. The findings suggest that volunteer peer counselors receiving low-cost, low-intensity training and supervision may significantly improve participants' indices of treatment engagement and mental health outcomes in an internet-based mindfulness intervention among Chinese university students.}, } @article {pmid34589178, year = {2021}, author = {Jager, I and Vulink, N and de Roos, C and Denys, D}, title = {EMDR therapy for misophonia: a pilot study of case series.}, journal = {European journal of psychotraumatology}, volume = {12}, number = {1}, pages = {1968613}, pmid = {34589178}, issn = {2000-8066}, mesh = {Adult ; *Eye Movement Desensitization Reprocessing ; Female ; Humans ; Male ; Netherlands ; Phobic Disorders/*therapy ; Pilot Projects ; Surveys and Questionnaires ; *Treatment Outcome ; }, abstract = {BACKGROUND: Misophonia is a disorder in which patients suffer from anger or disgust when confronted with specific sounds such as loud chewing or breathing, causing avoidance of cue-related situations resulting in significant functional impairment. Though the first treatment studies with cognitive behavioural therapy (CBT) showed promising results, an average of 50% of the patients has not improved much clinically.

OBJECTIVE: The aim of this pilot study was to assess the effectiveness of eye movement desensitization and reprocessing (EMDR) therapy as a trauma-focused approach in treating misophonia symptoms.

METHOD: A sample of 10 adult participants with misophonia was studied at the outpatient clinic of the Academic Medical Center in Amsterdam. Participants were either on the waiting list for CBT or non-responders to CBT. EMDR was focused on misophonia-related emotionally disturbing memories and delivered in a mean of 2.6 sessions of 60-90 minutes. Pre- and post-treatment self-assessed ratings of misophonia symptoms (AMISOS-R, primary outcome), of general psychopathology (SCL-90-R) and of quality of life (SDS) were administered. The co-primary outcome was the Clinical Global Impression Improvement scale (CGI-I).

RESULTS: A paired t-test (n = 8) showed improvement on the primary outcome (-6.14 [MD], 5.34 [SD]) on the AMISOS-R (P = .023). Three of the eight patients showed clinically significant improvement measured with the CGI-I. No significant effect on secondary outcomes was found.

CONCLUSIONS: These preliminary results suggest that EMDR therapy focused on emotionally disturbing misophonia-related memories can reduce misophonia symptoms. RCTs with sufficient sample sizes are required to firmly establish the value of EMDR therapy for misophonia.}, } @article {pmid34531770, year = {2021}, author = {Palm, L and Haas, M and Pisarenko, A and Jakubovski, E and Müller-Vahl, KR}, title = {Validation of the Rage Attack Questionnaire-Revised (RAQ-R) in a Mixed Psychiatric Population.}, journal = {Frontiers in psychiatry}, volume = {12}, number = {}, pages = {724802}, pmid = {34531770}, issn = {1664-0640}, abstract = {Rage Attacks (RA) represent a clinically relevant symptom in patients with different psychiatric disorders. However, only recently the Rage Attack Questionnaire Revised (RAQ-R, 22 items, range, 0-66) has been developed as a new instrument for the assessment of RA. This study aimed to validate the RAQ-R in a large mixed psychiatric and psychosomatic sample. We tested internal consistency, convergent and discriminant validity as well as factor structure. In order to further explore the relationship of RA to other psychiatric symptoms, we calculated Pearson correlations between the RAQ-R and several other self-assessments including measurements for general psychological distress, quality of life, depression, anxiety, attention deficit/hyperactivity disorder (ADHD), impulsivity, and self-regulation abilities. Most relevant predictors of RA were examined in a multiple regression with stepwise elimination. In order to assess the manifestation of RA in different psychiatric disorders, group differences between diagnostic categories and healthy controls were calculated. Additionally, psychiatric patients were compared to patients with Tourette syndrome along RAQ-R scores. Data from healthy subjects and patients with Tourette syndrome were obtained from a previous study of our group. In this study, we included 156 patients with a wide and typical spectrum of psychiatric diseases. The RAQ-R was found to have excellent internal consistency and strong construct validity in this sample (Cronbach's α = 0.97, Average Variance Extracted = 0.58). Thus, the RAQ-R was shown to be a psychometrically sound assessment of RA in patients with different psychiatric disorders. Close constructs to RA were found to be aggression and hostility (r = 0.68) as well as low frustration tolerance and impulse control (r = 0.69). Compared to healthy controls, RA were significantly more common in the psychiatric sample (p < 0.001). More specifically, RAQ-R scores in all diagnostic categories assessed were higher compared to controls. Highest scores and effect sizes were found in patients with ADHD and borderline personality disorder (p < 0.001). Our results suggest that RA are a common and relevant symptom in many psychiatric disorders. As depression and RA showed only a moderate relation, RA should be distinguished from the concept of anger attacks, which are described as a core symptom of depression.}, } @article {pmid34524587, year = {2022}, author = {Scheerer, NE and Boucher, TQ and Bahmei, B and Iarocci, G and Arzanpour, S and Birmingham, E}, title = {Family Experiences of Decreased Sound Tolerance in ASD.}, journal = {Journal of autism and developmental disorders}, volume = {52}, number = {9}, pages = {4007-4021}, pmid = {34524587}, issn = {1573-3432}, mesh = {Adolescent ; Adult ; Anxiety ; Anxiety Disorders/psychology ; *Autism Spectrum Disorder ; Child ; Child, Preschool ; Emotions ; Humans ; Hyperacusis ; Young Adult ; }, abstract = {Decreased sound tolerance (DST) is the most common sensory difficulty experienced by autistic individuals. Parents of 88 autistic children and young adults between the ages of 3 and 30 described coping strategies and physical and emotional responses used to deal with distressing sounds, and their impact on daily activities. Loud, sudden, and high-pitched sounds were most commonly endorsed as distressing, most often causing autistic children and young adults to cover their ears or yell, while producing stress, irritation, fear, and anxiety. Parents reported warning their child, providing breaks, or avoiding noisy settings as the most used coping strategies. Overall, findings indicate that DST leads to fewer opportunities for autistic children and young adults to participate at home, at school, and in the community. Further, results suggest hyperacusis, misophonia, and phonophobia, subtypes of DST, are present in autistic children and young adults.}, } @article {pmid34461433, year = {2021}, author = {Eijsker, N and Schröder, A and Liebrand, LC and Smit, DJA and van Wingen, G and Denys, D}, title = {White matter abnormalities in misophonia.}, journal = {NeuroImage. Clinical}, volume = {32}, number = {}, pages = {102787}, pmid = {34461433}, issn = {2213-1582}, mesh = {Anisotropy ; Brain/diagnostic imaging ; Diffusion Tensor Imaging ; Humans ; Phobic Disorders ; *White Matter/diagnostic imaging ; }, abstract = {Misophonia is a condition in which specific ordinary sounds provoke disproportionately strong negative affect and physiological arousal. Evidence for neurobiological abnormalities underlying misophonia is scarce. Since many psychiatric disorders show white matter (WM) abnormalities, we tested for both macro and micro-structural WM differences between misophonia patients and healthy controls. We collected T1-weighted and diffusion-weighted magnetic resonance images from 24 patients and 25 matched controls. We tested for group differences in WM volume using whole-brain voxel-based morphometry and used the significant voxels from this analysis as seeds for probabilistic tractography. After calculation of diffusion tensors, we compared group means for fractional anisotropy, mean diffusivity, and directional diffusivities, and applied tract-based spatial statistics for voxel-wise comparison. Compared to controls, patients had greater left-hemispheric WM volumes in the inferior fronto-occipital fasciculus, anterior thalamic radiation, and body of the corpus callosum connecting bilateral superior frontal gyri. Patients also had lower averaged radial and mean diffusivities and voxel-wise comparison indicated large and widespread clusters of lower mean diffusivity. We found both macro and microstructural WM abnormalities in our misophonia sample, suggesting misophonia symptomatology is associated with WM alterations. These biological alterations may be related to differences in social-emotional processing, particularly recognition of facial affect, and to attention for affective information.}, } @article {pmid34457175, year = {2021}, author = {Tarnowska, KA and Dispoto, BC and Conragan, J}, title = {Explainable AI-based clinical decision support system for hearing disorders.}, journal = {AMIA Joint Summits on Translational Science proceedings. AMIA Joint Summits on Translational Science}, volume = {2021}, number = {}, pages = {595-604}, pmid = {34457175}, issn = {2153-4063}, mesh = {*Decision Support Systems, Clinical ; Hearing Disorders ; Humans ; Machine Learning ; }, abstract = {In clinical system design, human-computer interaction and explainability are important topics of research. Clinical systems need to provide users with not only results but also an account of their behaviors. In this research, we propose a knowledge-based clinical decision support system (CDSS) for the diagnosis and therapy of hearing disorders, such as tinnitus, hyperacusis, and misophonia. Our prototype eTRT system offers an explainable output that we expect to increase its trustworthiness and acceptance in the clinical setting. Within this paper, we: (1) present the problem area of tinnitus and its treatment; (2) describe our data-driven approach based on machine learning, such as association- and action rule discovery; (3) present the evaluation results from the inference on the extracted rule-based knowledge and chosen test cases of patients; (4) discuss advantages of explainable output incorporated into a graphical user interface; (5) conclude with the results achieved and directions for future work.}, } @article {pmid34390941, year = {2021}, author = {Dibb, B and Golding, SE and Dozier, TH}, title = {The development and validation of the Misophonia response scale.}, journal = {Journal of psychosomatic research}, volume = {149}, number = {}, pages = {110587}, doi = {10.1016/j.jpsychores.2021.110587}, pmid = {34390941}, issn = {1879-1360}, mesh = {*Emotions ; Factor Analysis, Statistical ; Humans ; Psychometrics ; Reproducibility of Results ; Self Report ; Surveys and Questionnaires ; }, abstract = {OBJECTIVE: Most current Misophonia scales are not validated, do not include both emotional and physiological responses to triggers, and/or focus only on auditory triggers. This research aimed to develop and validate a measure of the magnitude of the Misophonic response that addressed these omissions.

METHOD: Three studies were carried out with individuals with self-diagnosed Misophonia. In study 1, expert opinion and participants commented on initial items to determine both face and content validity. In study 2, scale structure, reliability, and convergent and discriminant validity were determined using correlations, principal component analysis (PCA), and reliability analysis. In study 3, factor structure was confirmed in another sample of participants using confirmatory factor analysis (CFA).

RESULTS: The final 22-item scale assesses the magnitude of responses to triggers across any sensory modality. There are three subscales (emotional, physiological, and participation in life), with three additional items measuring frequency of triggers, avoidance of triggers, and time taken to recover from the triggers. The final scale showed suitable discriminant and convergent validity, with good internal consistency (Cronbach's alphas range 0.77 to 0.89). The three-component solution extracted using PCA explained 53.97% of variance, with all items loading between 0.45 and 0.84. The structure was confirmed with CFA (χ[2] = 269.01, p < .001; CFI = 0.96; TLI = 0.96 and RMSEA = 0.045 (CI 0.037-0.053).

CONCLUSION: The Misophonia Response Scale, which is valid and reliable, will facilitate understanding of Misophonia as it is short and easy to use for self-report in research.}, } @article {pmid34381296, year = {2021}, author = {Zitelli, L}, title = {Evaluation and Management of Misophonia Using a Hybrid Telecare Approach: A Case Report.}, journal = {Seminars in hearing}, volume = {42}, number = {2}, pages = {123-135}, pmid = {34381296}, issn = {0734-0451}, abstract = {Decreased sound tolerance (DST) is a negative reaction to environmental sounds and is estimated to affect 3.5% of the population. This case report presents the evaluation and management of an adult female with severe, longstanding misophonia. Her evaluation included comprehensive audiometric testing (including uncomfortable loudness levels) and a detailed assessment of the impact of DST on her life. She enrolled in tinnitus retraining therapy and began receiving treatment aiming to facilitate habituation of bothersome environmental sounds. This case was complicated by the advent of the coronavirus disease 2019 (COVID-19) pandemic and a telemedicine hybrid approach was employed to increase access to audiologic care. Using this structure, some appointments occurred in person in the clinic and others occurred via a telemedicine video visit format. Telemedicine video visits facilitated in-depth discussions, afforded the opportunity to answer questions, and provided the option of cloud-based remote programming of on-ear devices. Future care will continue to employ a hybrid approach.}, } @article {pmid34362858, year = {2021}, author = {Rabasco, A and McKay, D}, title = {Exposure Therapy for Misophonia: Concepts and Procedures.}, journal = {Journal of cognitive psychotherapy}, volume = {35}, number = {3}, pages = {156-166}, doi = {10.1891/JCPSY-D-20-00042}, pmid = {34362858}, issn = {1938-887X}, mesh = {Adult ; Attention ; Humans ; Hyperacusis ; *Implosive Therapy ; Noise ; Sound ; }, abstract = {Misophonia, a condition marked by extreme intolerance to certain classes of sounds (e.g., respiratory or gustatory noises), has recently attracted increased research attention. As yet there are no evidence-based treatments, although some promising options are under empirical consideration. This paper presents a stress management and exposure therapy-based treatment protocol for adults with misophonia. The protocol details considerations specific to exposure therapy for misophonia, including unique considerations for developing hierarchies and example misophonia exposure exercises and exposure homework. Stress management approaches employed to facilitate engagement with exposure are also described. Two case examples are included, which illustrate the application of the misophonia treatment protocol. The first case describes treatment for a client whose misophonia symptoms are the primary focus and the second case describes treatment for a client whose misophonia symptoms are secondary to relationship difficulties. This protocol can be used to stimulate further treatment research for misophonia and guide treatment for individuals with misophonia.}, } @article {pmid34353403, year = {2021}, author = {Kılıç, C and Öz, G and Avanoğlu, KB and Aksoy, S}, title = {The prevalence and characteristics of misophonia in Ankara, Turkey: population-based study.}, journal = {BJPsych open}, volume = {7}, number = {5}, pages = {e144}, pmid = {34353403}, issn = {2056-4724}, abstract = {BACKGROUND: Misophonia is defined as significant distress (anger, distress or disgust) when exposed to certain sounds that would not affect most people, such as lip smacking or gum chewing. Although misophonia is common, the aetiology, prevalence and effective treatments are largely unknown.

AIMS: Based on our proposed diagnostic criteria, we examined the prevalence of misophonia and its relationship with clinical and demographic variables in a large representative population sample.

METHOD: We used a household sample (N = 541) of all residents aged >15 years, living in 300 homes randomly selected in Ankara city centre, Turkey. All participants were assessed at their homes by trained interviewers, for sociodemographic variables, misophonic sounds and related factors, using a semi-structured interview (the Misophonia Interview Schedule) developed for the current research.

RESULTS: The current misophonia diagnosis prevalence was 12.8% (n = 69 of 541), although 427 (78.9%) participants reported at least one sound that was distressing. The mean number of misophonic sounds was 8.6 (s.d. 8.9, range 0-44); the figure was 17.6 in those with misophonia compared with 7.3 in those without misophonia. Of those with misophonia, only 5.8% contacted services for their condition. Predictors of misophonia diagnosis included younger age, family history of misophonia and previous contact with mental health services.

CONCLUSIONS: Our study showed that misophonia is common in the general population, may cause significant disruption in daily life and is undertreated. Although more evidence is needed to classify misophonia as a psychiatric disorder, our findings support others who claim that the condition belongs to the group of mental disorders.}, } @article {pmid34351116, year = {2021}, author = {Fife, TD and Tourkevich, R}, title = {Tinnitus, Hyperacusis, Otalgia, and Hearing Loss.}, journal = {Continuum (Minneapolis, Minn.)}, volume = {27}, number = {2}, pages = {491-525}, pmid = {34351116}, issn = {1538-6899}, mesh = {Earache/diagnosis/etiology ; *Hearing Loss/diagnosis ; Humans ; Hyperacusis/diagnosis ; *Tinnitus/diagnosis/etiology/therapy ; }, abstract = {PURPOSE OF REVIEW: This article reviews the causes of tinnitus, hyperacusis, and otalgia, as well as hearing loss relevant for clinicians in the field of neurology.

RECENT FINDINGS: Important causes of unilateral and bilateral tinnitus are discussed, including those that are treatable or caused by serious structural or vascular causes. Concepts of hyperacusis and misophonia are covered, along with various types of neurologic disorders that can lead to pain in the ear. Hearing loss is common but not always purely otologic.

SUMMARY: Tinnitus and hearing loss are common symptoms that are sometimes related to a primary neurologic disorder. This review, tailored to neurologists who care for patients who may be referred to or encountered in neurology practice, provides information on hearing disorders, how to recognize when a neurologic process may be involved, and when to refer to otolaryngology or other specialists.}, } @article {pmid34331723, year = {2021}, author = {Beukes, EW and Baguley, DM and Manchaiah, V and Andersson, G and Allen, PM and Kaldo, V and Jacquemin, L and Lourenco, MPCG and Onozuka, J and Stockdale, D and Maidment, DW}, title = {Investigating tinnitus subgroups based on hearing-related difficulties.}, journal = {International journal of clinical practice}, volume = {75}, number = {10}, pages = {e14684}, doi = {10.1111/ijcp.14684}, pmid = {34331723}, issn = {1742-1241}, support = {R21DC017214//National Institute on Deafness and Other Communication Disorders (NIDCD) of the National Institutes of Health (NIH)/ ; 722046//European Union's Horizon 2020 Research and Innovation Programme/ ; }, mesh = {Adult ; Audiometry, Pure-Tone ; *COVID-19 ; Cross-Sectional Studies ; Female ; Hearing ; *Hearing Loss/complications/diagnosis/epidemiology ; Humans ; Middle Aged ; Pandemics ; SARS-CoV-2 ; *Tinnitus/epidemiology ; }, abstract = {PURPOSE: Meaningfully grouping individuals with tinnitus who share a common characteristics (ie, subgrouping, phenotyping) may help tailor interventions to certain tinnitus subgroups and hence reduce outcome variability. The purpose of this study was to test if the presence of tinnitus subgroups are discernible based on hearing-related comorbidities, and to identify predictors of tinnitus severity for each subgroup identified.

METHODS: An exploratory cross-sectional study was used. The study was nested within an online survey distributed worldwide to investigate tinnitus experiences during the COVID-19 pandemic. The main outcome measure was the tinnitus Handicap Inventory- Screening Version.

RESULTS: From the 3400 respondents, 2980 were eligible adults with tinnitus with an average age of 58 years (SD = 14.7) and 49% (n = 1457) being female. A three-cluster solution identified distinct subgroups, namely, those with tinnitus-only (n = 1306; 44%), those presenting with tinnitus, hyperacusis, hearing loss and/or misophonia (n = 795; 27%), and those with tinnitus and hearing loss (n = 879; 29%). Those with tinnitus and hyperacusis reported the highest tinnitus severity (M = 20.3; SD = 10.5) and those with tinnitus and no hearing loss had the lowest tinnitus severity (M = 15.7; SD = 10.4). Younger age and the presence of mental health problems predicted greater tinnitus severity for all groups (β ≤ -0.1, P ≤ .016).

CONCLUSION: Further exploration of these potential subtypes are needed in both further research and clinical practice by initially triaging tinnitus patients prior to their clinical appointments based on the presence of hearing-related comorbidities. Unique management pathways and interventions could be tailored for each tinnitus subgroup.}, } @article {pmid34276431, year = {2021}, author = {Ferrer-Torres, A and Giménez-Llort, L}, title = {Sounds of Silence in Times of COVID-19: Distress and Loss of Cardiac Coherence in People With Misophonia Caused by Real, Imagined or Evoked Triggering Sounds.}, journal = {Frontiers in psychiatry}, volume = {12}, number = {}, pages = {638949}, pmid = {34276431}, issn = {1664-0640}, abstract = {The extreme, unprecedented situations in the current COVID-19 pandemic are risk factors for psychosocial stress for the entire population. However, strict confinement had a particular impact on people suffering from misophonia and their families. Misophonia is a condition in which hearing certain sounds triggers intense anger, disgust and even severe autonomic nervous system responses. This prospective cohort study examined the impact of strict confinement (Spain, March 14-June 21, 2020) on a sample of 24 people (16 women and eight men) who had been diagnosed with moderate to extreme misophonia and were regularly attending a medical psychology center in Barcelona. The 3-month period of confinement caused general emotional maladjustment, distress, and a transitory crisis. Long-term biomonitoring of their heart variability rate (HRV) enabled to identify a significant increase in physiological arousal after the confinement period, which had already been recorded in a loss of cardiac coherence under basal rest/relaxation conditions. Certain auditory stimuli triggered adverse responses, lowered HRV scores, and an increased stress level and heart rate. Loss of cardiac coherence in their responses to these auditory stimuli (triggering mouth, nose and other sounds), as well as to non-triggering mouth, nose and other sounds was increased when compared to two assessments performed during the previous year. Despite the limited sample size, sex differences were observed in the incidence. Loss of cardiac coherence worsened with the severity of the misophonia. Most importantly, imagined or evoked triggering sounds, as well as real ones, were enough to cause the aversive responses, as displayed by the increased loss of cardiac coherence with respect to the at-rest basal level. A semi-structured interview revealed the exceptional nature of the situations, increased hyper-sensorial sensitivity, fear of being infected with or dying from COVID-19, the patients' coping strategies, and the difficulties and constraints they faced. Finally, the article gives recommendations for better management of misophonia. Improved knowledge of this disorder would help address the current lack of health and social care, hopefully preventing this shortfall's impact on social and affective relationships, which are particulary important for well-being now and in the coming periods of physical distancing measures.}, } @article {pmid34273684, year = {2021}, author = {Eijsker, N and Schröder, A and Smit, DJA and van Wingen, G and Denys, D}, title = {Structural and functional brain abnormalities in misophonia.}, journal = {European neuropsychopharmacology : the journal of the European College of Neuropsychopharmacology}, volume = {52}, number = {}, pages = {62-71}, doi = {10.1016/j.euroneuro.2021.05.013}, pmid = {34273684}, issn = {1873-7862}, mesh = {Amygdala/diagnostic imaging ; Brain/diagnostic imaging ; Brain Mapping ; Cerebral Cortex ; *Gray Matter/diagnostic imaging ; Humans ; *Magnetic Resonance Imaging ; Phobic Disorders ; }, abstract = {Misophonia is a newly described condition in which specific ordinary sounds provoke disproportionately strong negative affect. Since evidence for neurobiological abnormalities underlying misophonia is scarce, we tested whether misophonia patients differed from healthy controls in grey matter volumes and resting-state functional connectivity. We collected structural magnetic resonance imaging and resting-state functional magnetic resonance imaging data from 24 misophonia patients and 25 matched controls. Compared to controls, voxel-based morphometry showed larger right amygdala volume in misophonia patients. Follow-up seed-based functional connectivity analysis of the amygdala showed a different pattern of connectivity with the cerebellum, driven by greater connectivity with the left amygdala. Additional data-driven independent component analysis showed greater connectivity within lateral occipital cortices and fusiform gyri in the ventral attention network. We propose that the amygdala enlargement may be associated with heightened emotional reactivity in misophonia. The higher connectivity between left amygdala and cerebellum might be linked to a tendency to exhibit reflex-like physical reactions to triggers. Higher attention network connectivity may reflect sensory enhancement of visual triggers or visual imagery related to trigger sounds. In sum, we found structural and functional abnormalities which implicate dysfunction of emotional and attentional systems in misophonia.}, } @article {pmid34269321, year = {2021}, author = {Sarigedik, E and Yurteri, N}, title = {Misophonia Successfully Treated of With Fluoxetine: A Case Report.}, journal = {Clinical neuropharmacology}, volume = {44}, number = {5}, pages = {191-192}, doi = {10.1097/WNF.0000000000000465}, pmid = {34269321}, issn = {1537-162X}, mesh = {Adolescent ; Child ; Diagnostic and Statistical Manual of Mental Disorders ; Female ; *Fluoxetine/therapeutic use ; Humans ; Hyperacusis ; *Quality of Life ; }, abstract = {OBJECTIVE: A large number of people experience misophonia. In 2013, the Amsterdam Study Group recommended diagnostic criteria for misophonia. However, misophonia is not yet included in the Diagnostic and Statistical Manual of Mental Disorders. This report is the first report on drug use that directly affects misophonia and demonstrates a 14-year-old adolescent girl with misophonia successfully treated with fluoxetine.

METHODS: The patient's misophonia symptoms had been continuing for approximately 2 years, and her quality of life was significantly reduced. Psychotherapy conditions could not be applied, and fluoxetine 10 mg/d was started and increased to 20 mg/d after a week. At the second-month follow-up, because of partial improvement, fluoxetine dose was increased to 30 mg/d.

RESULTS: At the fourth-month follow-up, there was a 40% decrease in Amsterdam Misophonia Scale score with a 70% decrease in the children's global assessment scale scores. By the 16th week, the overall functionality level was good at the end.

CONCLUSIONS: Fluoxetine may be used as an effective drug in the treatment of misophonia.}, } @article {pmid34170337, year = {2022}, author = {Schwemmle, C and Arens, C}, title = {["Ear rage": misophonia : Review and current state of knowledge].}, journal = {HNO}, volume = {70}, number = {1}, pages = {3-13}, pmid = {34170337}, issn = {1433-0458}, mesh = {Emotions ; Humans ; *Hyperacusis/diagnosis ; *Insular Cortex ; Phobic Disorders ; Sound ; }, abstract = {Misophonia is a devastating disorder. It is known as an affective sound-processing disorder characterized by the experience of strong negative emotions (e.g., anger, distress) in response to human sounds such as eating/swallowing/breathing. Other sounds produced by humans but not directly by human bodies can also be misophonic triggers (e.g. pen clicking) or environmental sounds (animal sounds/sounds of machines). The type of aversive triggers is individual. The reaction to trigger sounds can depend on many factors, such as assessment of the sound, personal experience, social context or psychological profile. However, there is currently no consensus in defining misophonia. Misophonia is also not yet classified by any official diagnostic system, although it seems to be a separate disorder. There are also associations with other disorders such as activity disorders, tinnitus, hyperacusis, and autism spectrum disorders. In 2013, the first definition criteria were published for the diagnosis of misophonia. Specifically, fMRI showed abnormal activation of the anterior insular cortex (AIC) and other brain areas responsible for the processing and regulation of emotions. To date, no randomized controlled trials evaluating treatments have been published. The use of cognitive and behavioral interventions have been reported as well as external sound systems and sound masking systems as known in the tinnitus retraining therapy. Sufferers try to minimize the trigger sounds by wearing ear plugs or music headphones. Otolaryngologists may also encounter patients with symptoms of misophonia, e.g., when hearing screening is requested or advice should be given on different therapeutic options. This report provides an overview of the current state of knowledge in misophonia and its diagnosis and treatment.}, } @article {pmid34123591, year = {2021}, author = {Morales, R and Ramírez-Benavides, D and Villena-Gonzalez, M}, title = {Autonomous Sensory Meridian Response self-reporters showed higher scores for cognitive reappraisal as an emotion regulation strategy.}, journal = {PeerJ}, volume = {9}, number = {}, pages = {e11474}, pmid = {34123591}, issn = {2167-8359}, abstract = {BACKGROUND: Autonomous Sensory Meridian Response (ASMR) describes the experience of a pleasant tingling sensation along the back of the head, accompanied with a feeling of well-being and relaxation, in response to specific audio-visual stimuli, such as whispers, soft sounds, and personal attention. Previous works have assessed individual variations in personality traits associated with ASMR, but no research to date has explored differences in emotion regulation associated with ASMR. This omission occurred even when ASMR, a sensory-emotional experience, has been proposed to be located in a sound sensitivity spectrum as the opposite end of misophonia, a phenomenon associated with difficulties regulating emotions. The present work aimed to assess group differences between ASMR self-reporters and non-ASMR controls associated with emotion regulation strategies.

METHODS: We used the validated Spanish version of the Emotion Regulation Questionnaire to assess individual differences in the use of cognitive reappraisal and expressive suppression.

RESULTS: Our results showed that participants who experience ASMR had higher scores in the cognitive reappraisal subscale of the emotion regulation questionnaire than the non-ASMR group.

CONCLUSIONS: Individuals who experience ASMR reported higher use of cognitive reevaluation of emotionally arousing situations, suggesting more effectiveness in regulating emotions. Our finding further elucidates individual differences related to this experience, supporting that ASMR is a real psychophysiological phenomenon associated with other psychological constructs and has remarkable consequences in affective/emotional dimensions and general well-being.}, } @article {pmid34115383, year = {2021}, author = {Hansen, HA and Leber, AB and Saygin, ZM}, title = {What sound sources trigger misophonia? Not just chewing and breathing.}, journal = {Journal of clinical psychology}, volume = {77}, number = {11}, pages = {2609-2625}, doi = {10.1002/jclp.23196}, pmid = {34115383}, issn = {1097-4679}, mesh = {Humans ; *Hyperacusis ; *Mastication ; Self Report ; Sound ; }, abstract = {OBJECTIVES: Misophonia is a highly prevalent yet understudied condition characterized by aversion toward particular environmental sounds. Oral/nasal sounds (e.g., chewing, breathing) have been the focus of research, but variable experiences warrant an objective investigation. Experiment 1 asked whether human-produced oral/nasal sounds were more aversive than human-produced nonoral/nasal sounds and non-human/nature sounds. Experiment 2 additionally asked whether machine-learning algorithms could predict the presence and severity of misophonia.

METHOD: Sounds were presented to individuals with misophonia (Exp.1: N = 48, Exp.2: N = 45) and members of the general population (Exp.1: N = 39, Exp.2: N = 61). Aversiveness ratings to each sound were self-reported.

RESULTS: Sounds from all three source categories-not just oral/nasal sounds-were rated as significantly more aversive to individuals with misophonia than controls. Further, modeling all sources classified misophonia with 89% accuracy and significantly predicted misophonia severity (r = 0.75).

CONCLUSIONS: Misophonia should be conceptualized as more than an aversion to oral/nasal sounds, which has implications for future diagnostics and experimental consistency moving forward.}, } @article {pmid34040551, year = {2021}, author = {Ferrer-Torres, A and Giménez-Llort, L}, title = {Confinement and the Hatred of Sound in Times of COVID-19: A Molotov Cocktail for People With Misophonia.}, journal = {Frontiers in psychiatry}, volume = {12}, number = {}, pages = {627044}, pmid = {34040551}, issn = {1664-0640}, abstract = {Forced strict confinement to hamper the COVID-19 pandemic seriously affected people suffering from misophonia (M+) and those living with them. Misophonia is a complex neurophysiological and behavioral disorder of multifactorial origin, characterized by an intense physiological and emotional response produced by intolerance to auditory stimuli of the same pattern, regardless of physical properties. The present work studied the secondary impact that strict confinement caused in 342 adults (224 women: 118 men) regularly attending a medical psychological center in Barcelona. Misophonia, usually underdiagnosed, showed a prevalence of 35%, the same for women (37%) than men (31%). A retrospective analysis using a physical-psychological-social inventory of 10 variables evaluated the number of individuals that during confinement and self-confinement (March 11 - June 29, 2020) canceled (mostly M-) and/or requested a therapeutic intervention, the reasons for their request, and the strategies they used to self-manage the situation. Ten main variables indicated that the confinement exponentially increased the effects of misophonia compared with results from the same individuals during the last quarter of 2019. Most people diagnosed with misophonia continued with tele-assistance during the confinement because of this impact's self-concern. Besides the impacts as part of the general population, M+ also developed different symptoms causing significant personal, social, and job/occupational imbalance, as compared to M-. Health, fears, conflicts with neighbors, study-related difficulties were outstanding reasons for consultations. The LSB-50 test for 'Psychological and Psychosomatic Symptoms' applied to M+ revealed the increase of 8 of 9 items of this psychopathological test. Sleep disorders (coronasomnia), hostility, depression, and somatization were more severe than in previous assessments. Women presented the worst psychological and psychosomatic states (eight out of nine, as compared to one out of nine in males). The study unveiled the complex physical-psychological-social burden, the need for dissemination and a gender perspective to understand the secondary impact of COVID-19 pandemic on the mental health of the population with misophonia. The results also show that in this new COVID era people suffering from misophonia need to develop coping strategies addressing modifiable risk and protective factors. They deserve familial/social comprehension, stronger clinical support and a gender medicine perspective.}, } @article {pmid34040061, year = {2021}, author = {Enzler, F and Loriot, C and Fournier, P and Noreña, AJ}, title = {A psychoacoustic test for misophonia assessment.}, journal = {Scientific reports}, volume = {11}, number = {1}, pages = {11044}, pmid = {34040061}, issn = {2045-2322}, mesh = {Adult ; Affective Symptoms/*diagnosis/physiopathology ; Arousal/*physiology ; Emotions/*physiology ; Female ; Humans ; Hyperacusis/*diagnosis/physiopathology ; Male ; Psychoacoustics ; Self Report ; Surveys and Questionnaires ; }, abstract = {Misophonia is a condition where a strong arousal response is triggered when hearing specific human generated sounds, like chewing, and/or repetitive tapping noises, like pen clicking. It is diagnosed with clinical interviews and questionnaires since no psychoacoustic tools exist to assess its presence. The present study was aimed at developing and testing a new assessment tool for misophonia. The method was inspired by an approach we have recently developed for hyperacusis. It consisted of presenting subjects (n = 253) with misophonic, pleasant, and unpleasant sounds in an online experiment. The task was to rate them on a pleasant to unpleasant visual analog scale. Subjects were labeled as misophonics (n = 78) or controls (n = 55) by using self-report questions and a misophonia questionnaire, the MisoQuest. There was a significant difference between controls and misophonics in the median global rating of misophonic sounds. On the other hand, median global rating of unpleasant, and pleasant sounds did not differ significantly. We selected a subset of the misophonic sounds to form the core discriminant sounds of misophonia (CDSMiso). A metric: the CDS score, was used to quantitatively measure misophonia, both with a global score and with subscores. The latter could specifically quantify aversion towards different sound sources/events, i.e., mouth, breathing/nose, throat, and repetitive sounds. A receiver operating characteristic analysis showed that the method accurately classified subjects with and without misophonia (accuracy = 91%). The present study suggests that the psychoacoustic test we have developed can be used to assess misophonia reliably and quickly.}, } @article {pmid34021042, year = {2021}, author = {Kumar, S and Dheerendra, P and Erfanian, M and Benzaquén, E and Sedley, W and Gander, PE and Lad, M and Bamiou, DE and Griffiths, TD}, title = {The Motor Basis for Misophonia.}, journal = {The Journal of neuroscience : the official journal of the Society for Neuroscience}, volume = {41}, number = {26}, pages = {5762-5770}, pmid = {34021042}, issn = {1529-2401}, support = {/WT_/Wellcome Trust/United Kingdom ; MR/T032553/1/MRC_/Medical Research Council/United Kingdom ; MR/V006568/1/MRC_/Medical Research Council/United Kingdom ; }, mesh = {Acoustic Stimulation ; Adult ; Affective Symptoms/*physiopathology ; Brain Mapping ; Cerebral Cortex/*physiopathology ; Female ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Mirror Neurons/*physiology ; Neural Pathways/*physiopathology ; *Noise ; }, abstract = {Misophonia is a common disorder characterized by the experience of strong negative emotions of anger and anxiety in response to certain everyday sounds, such as those generated by other people eating, drinking, and breathing. The commonplace nature of these "trigger" sounds makes misophonia a devastating disorder for sufferers and their families. How such innocuous sounds trigger this response is unknown. Since most trigger sounds are generated by orofacial movements (e.g., chewing) in others, we hypothesized that the mirror neuron system related to orofacial movements could underlie misophonia. We analyzed resting state fMRI (rs-fMRI) connectivity (N = 33, 16 females) and sound-evoked fMRI responses (N = 42, 29 females) in misophonia sufferers and controls. We demonstrate that, compared with controls, the misophonia group show no difference in auditory cortex responses to trigger sounds, but do show: (1) stronger rs-fMRI connectivity between both auditory and visual cortex and the ventral premotor cortex responsible for orofacial movements; (2) stronger functional connectivity between the auditory cortex and orofacial motor area during sound perception in general; and (3) stronger activation of the orofacial motor area, specifically, in response to trigger sounds. Our results support a model of misophonia based on "hyper-mirroring" of the orofacial actions of others with sounds being the "medium" via which action of others is excessively mirrored. Misophonia is therefore not an abreaction to sounds, per se, but a manifestation of activity in parts of the motor system involved in producing those sounds. This new framework to understand misophonia can explain behavioral and emotional responses and has important consequences for devising effective therapies.SIGNIFICANCE STATEMENT Conventionally, misophonia, literally "hatred of sounds" has been considered as a disorder of sound emotion processing, in which "simple" eating and chewing sounds produced by others cause negative emotional responses. Our data provide an alternative but complementary perspective on misophonia that emphasizes the action of the trigger-person rather than the sounds which are a byproduct of that action. Sounds, in this new perspective, are only a "medium" via which action of the triggering-person is mirrored onto the listener. This change in perspective has important consequences for devising therapies and treatment methods for misophonia. It suggests that, instead of focusing on sounds, which many existing therapies do, effective therapies should target the brain representation of movement.}, } @article {pmid34001373, year = {2021}, author = {Lewin, AB and Dickinson, S and Kudryk, K and Karlovich, AR and Harmon, SL and Phillips, DA and Tonarely, NA and Gruen, R and Small, B and Ehrenreich-May, J}, title = {Transdiagnostic cognitive behavioral therapy for misophonia in youth: Methods for a clinical trial and four pilot cases.}, journal = {Journal of affective disorders}, volume = {291}, number = {}, pages = {400-408}, doi = {10.1016/j.jad.2021.04.027}, pmid = {34001373}, issn = {1573-2517}, mesh = {Adolescent ; Anxiety ; Anxiety Disorders ; Child ; *Cognitive Behavioral Therapy ; Emotions ; Humans ; *Tourette Syndrome ; Treatment Outcome ; }, abstract = {BACKGROUND: Misophonia is a condition marked by dysregulated emotions and behaviors in response to trigger sounds, often chewing, breathing, or coughing. Evidence suggests that misophonia develops in adolescence and the emotions and behaviors are a conditioned response to distress, resulting in social avoidance, stress, and family conflict. In addition, co-occurrence with other psychiatric illnesses such as anxiety, OCD, and Tourette syndrome is common. A transdiagnostic cognitive behavioral therapeutic (CBT) approach appears appropriate. There are currently no controlled studies of youth with misophonia. The current paper describes the approach to a pilot randomized, blinded family-based treatment study for youth ages 8-16 years. Preliminary results from a pilot open trial also are described.

METHODS: A 2-phase dual site telehealth treatment study using a transdiagnostic CBT approach, the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders in Children and Adolescents (UP-C/A; Ehrenreich-May et al., 2018), is proposed. Phase 1 consisted of a 4-case pilot of UP-C/A. Phase 2 includes a randomized trial comparing the UP-C/A to a standard relaxation and education protocol.

RESULTS: Preliminary results from the pilot show modest improvements in evaluator-rated misophonia symptoms on the Clinical Global Impression Severity and Improvement scales.

LIMITATIONS: There is little research to inform evidence-based practice for youth with misophonia. Study limitations include lack of standardized misophonia assessment instruments and an absence of formal diagnostic criteria.

CONCLUSIONS: The current paper describes proposed methods for the first randomized controlled trial for youth with misophonia and their families along with results from a 4-case pilot.}, } @article {pmid34000167, year = {2021}, author = {Zuschlag, ZD and Leventhal, KC}, title = {Rapid and Sustained Resolution of Misophonia-Type Hyperacusis With the Selective Serotonin Reuptake Inhibitor Sertraline.}, journal = {The primary care companion for CNS disorders}, volume = {23}, number = {3}, pages = {}, doi = {10.4088/PCC.20l02731}, pmid = {34000167}, issn = {2155-7780}, mesh = {Humans ; *Hyperacusis/chemically induced ; *Selective Serotonin Reuptake Inhibitors/adverse effects ; *Sertraline/adverse effects ; }, } @article {pmid33914068, year = {2021}, author = {Symanski, E and Ensor, KB and Piedra, PA and Sheth, K and Caton, K and Williams, SL and Persse, D and Banerjee, D and Hopkins, L}, title = {Population-Based Estimates of SARS-CoV-2 Seroprevalence in Houston, Texas as of September 2020.}, journal = {The Journal of infectious diseases}, volume = {224}, number = {10}, pages = {1649-1657}, doi = {10.1093/infdis/jiab203}, pmid = {33914068}, issn = {1537-6613}, support = {93.323/CC/CDC HHS/United States ; }, mesh = {Antibodies, Viral ; *COVID-19/epidemiology ; Humans ; RNA, Viral/analysis ; *SARS-CoV-2/genetics ; Sensitivity and Specificity ; Seroepidemiologic Studies ; Texas/epidemiology ; }, abstract = {BACKGROUND: In contrast to studies that relied on volunteers or convenience sampling, there are few population-based severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) seroprevalence investigations and most were conducted early in the pandemic. The health department of the fourth largest US city recognized that sound estimates of viral impact were needed to inform decision making.

METHODS: Adapting standardized disaster research methodology, in September 2020 the city was divided into high and low strata based on reverse-transcriptase polymerase chain reaction (RT-PCR) positivity rates; census block groups within each stratum were randomly selected with probability proportional to size, followed by random selection of households within each group. Using 2 immunoassays, the proportion of infected individuals was estimated for the city, by positivity rate and sociodemographic and other characteristics. The degree of underascertainment of seroprevalence was estimated based on RT-PCR-positive cases.

RESULTS: Seroprevalence was estimated to be 14% with near 2-fold difference in areas with high (18%) versus low (10%) RT-PCR positivity rates and was 4 times higher compared to case-based surveillance data.

CONCLUSIONS: Seroprevalence was higher than previously reported and greater than estimated from RT-PCR data. Results will be used to inform public health decisions about testing, outreach, and vaccine rollout.}, } @article {pmid33908407, year = {2021}, author = {Knettel, BA and Fernandez, KM and Wanda, L and Amiri, I and Cassiello-Robbins, C and Watt, MH and Mmbaga, BT and Relf, MV}, title = {The Role of Community Health Workers in HIV Care Engagement: A Qualitative Study of Stakeholder Perspectives in Tanzania.}, journal = {The Journal of the Association of Nurses in AIDS Care : JANAC}, volume = {32}, number = {6}, pages = {682-692}, pmid = {33908407}, issn = {1552-6917}, support = {D43 TW009337/TW/FIC NIH HHS/United States ; P30 AI064518/AI/NIAID NIH HHS/United States ; R21 AI124344/AI/NIAID NIH HHS/United States ; R21 TW011053/TW/FIC NIH HHS/United States ; }, mesh = {Ambulatory Care Facilities ; *Community Health Workers ; *HIV Infections/therapy ; Humans ; Qualitative Research ; Tanzania/epidemiology ; }, abstract = {Suboptimal retention in HIV care is a major driver of the global epidemic, including in sub-Saharan Africa. In Tanzania, the national Community-Based HIV Services program integrates volunteer community health workers (CHWs) to support patient care engagement and reduce the burden placed on HIV clinic nurses; however, few studies have assessed the value of CHWs supporting HIV care. Qualitative interviews were conducted with 48 administrators, nurses, CHWs, and patients to explore strengths and limitations of the Community-Based HIV Services program. Stakeholders believed CHWs are uniquely positioned to establish trust and provide patient support. Patients who had frequent contact with CHWs described them as valued sources of education and encouragement, but fewer than half of the patients interviewed had ever met with a CHW. Clinic nurses described feeling disconnected from CHWs, and stakeholders highlighted the need for financial, logistical, and educational support to rejuvenate the program and effectively address care engagement challenges.}, } @article {pmid33534637, year = {2021}, author = {Weinzimmer, SA and Schneider, SC and Cepeda, SL and Guzick, AG and Lázaro-Muñoz, G and McIngvale, E and Goodman, WK and Sheth, SA and Storch, EA}, title = {Perceptions of Deep Brain Stimulation for Adolescents with Obsessive-Compulsive Disorder.}, journal = {Journal of child and adolescent psychopharmacology}, volume = {31}, number = {2}, pages = {109-117}, pmid = {33534637}, issn = {1557-8992}, mesh = {Adolescent ; Adult ; Child ; *Deep Brain Stimulation/ethics ; Female ; Humans ; Male ; Obsessive-Compulsive Disorder/*therapy ; Parents/*education ; *Patient Education as Topic ; *Perception ; *Severity of Illness Index ; Surveys and Questionnaires ; }, abstract = {Objective: The present study aims to understand perceptions of deep brain stimulation (DBS) for severe obsessive-compulsive disorder (OCD) in adolescents among two groups: parents of children with a history of OCD and adults with a history of OCD. Methods: Two hundred sixty participants completed a questionnaire exploring their treatment history, relevant symptom severity, DBS knowledge, and DBS attitudes using an acceptability scale and a series of statements indicating levels of willingness or reluctance to consider DBS for adolescents with severe OCD or severe epilepsy. Results: Overall, participants found DBS to be fairly acceptable for adolescents with severe OCD, with 63% reporting at least 7/10 on a 0-10 acceptability Likert scale. Respondents were more willing to consider DBS for epilepsy than for OCD. Several factors were associated with greater willingness to consider DBS for OCD, including familiarity with DBS, the presence of suicidal thoughts, assurances of daily functioning improvements, and assurances of substantial symptom reduction. Concerns about safety, personality changes, and long-term effects on the body were associated with greatest reluctance to consider DBS for OCD. Conclusions: Our findings support the importance of increasing parents' familiarity with DBS, monitoring factors participants identified as most important to their DBS perceptions in future DBS research, and communicating benefits and risks clearly. We also highlight the need for further research on perceptions of DBS for severe and refractory OCD in adolescents.}, } @article {pmid33530474, year = {2021}, author = {Raj-Koziak, D and Gos, E and Kutyba, J and Skarzynski, H and Skarzynski, PH}, title = {Decreased Sound Tolerance in Tinnitus Patients.}, journal = {Life (Basel, Switzerland)}, volume = {11}, number = {2}, pages = {}, pmid = {33530474}, issn = {2075-1729}, abstract = {(1) Background: Decreased sound tolerance is a significant problem in tinnitus sufferers. The aim of the study was to evaluate the relationship between tinnitus and decreased sound tolerance (hyperacusis and misophonia). (2) Methods: The study sample consisted of 74 patients with tinnitus and decreased sound tolerance. The procedure comprised patient interviews, pure tone audiometry, impedance audiometry, measurement of uncomfortable loudness levels, and administration of the Hyperacusis Questionnaire, Tinnitus Handicap Inventory, and Visual Analogue Scales. (3) Results: The majority (69%) of the patients reported that noise aggravated their tinnitus. The correlation between tinnitus and hyperacusis was found to be statistically significant and positive: r = 0.44; p < 0.01. The higher the tinnitus severity, the greater the hyperacusis. There was no correlation between misophonia and hyperacusis (r = 0.18; p > 0.05), or between misophonia and tinnitus (r = 0.06; p > 0.05). (4) Conclusions: For tinnitus patients the more significant problem was hyperacusis rather than misophonia. The diagnosis and treatment of decreased sound tolerance should take into account not only audiological, but also psychological problems of the patients.}, } @article {pmid33519567, year = {2020}, author = {Cassiello-Robbins, C and Anand, D and McMahon, K and Brout, J and Kelley, L and Rosenthal, MZ}, title = {A Preliminary Investigation of the Association Between Misophonia and Symptoms of Psychopathology and Personality Disorders.}, journal = {Frontiers in psychology}, volume = {11}, number = {}, pages = {519681}, pmid = {33519567}, issn = {1664-1078}, abstract = {Misophonia is a condition characterized by defensive motivational system emotional responding to repetitive and personally relevant sounds (e.g., eating, sniffing). Preliminary research suggests misophonia may be associated with a range of psychiatric disorders, including personality disorders. However, very little research has used clinician-rated psychometrically validated diagnostic interviews when assessing the relationship between misophonia and psychopathology. The purpose of this study was to extend the early research in this area by examining the relationship between symptoms of misophonia and psychiatric diagnoses in a sample of community adults, using semi-structured diagnostic interviews. Results indicated higher misophonia symptoms were associated with more clinician-rated symptoms of personality disorders, but not other disorders. Anxiety partially mediated the relationship between personality disorder symptoms and misophonia. These results suggest misophonia may be associated with a range of psychiatric symptoms and highlight the role of anxiety in this poorly understood condition.}, } @article {pmid33487793, year = {2021}, author = {Roushani, K and Mehrabizadeh Honarmand, M}, title = {The Effectiveness of Cognitive-behavioral Therapy on Anger in Female Students with Misophonia: A Single-Case Study.}, journal = {Iranian journal of medical sciences}, volume = {46}, number = {1}, pages = {61-67}, pmid = {33487793}, issn = {0253-0716}, mesh = {*Anger ; Anger Management Therapy/methods/*standards/statistics & numerical data ; Cognitive Behavioral Therapy/methods/*standards/statistics & numerical data ; Female ; Humans ; Iran ; Reproducibility of Results ; Sound/*adverse effects ; Surveys and Questionnaires ; Young Adult ; }, abstract = {BACKGROUND: Misophonia is an unpleasant condition, in which the feeling of excessive anger is triggered by specific sounds. The main objective of the present study was to investigate the effectiveness of cognitive-behavioral therapy (CBT) on anger in female students with misophonia.

METHODS: A study based on a non-concurrent multiple baseline design was conducted in 2018 at the School of Education and Psychology, Shahid Chamran University of Ahvaz, Ahvaz, Iran. Three female students aged 20-22 years were recruited using the multi-stage random sampling method. The study was conducted in three stages, namely baseline, intervention, and follow-up sessions. The Novaco anger questionnaire was used during the baseline sessions, intervention sessions (sessions three, six, and eight), and six weeks follow-up (two, four, and six weeks after the last intervention session). Data were analyzed using visual analysis, reliability change index (RCI), and recovery percentage formula.

RESULTS: CBT reduced the feeling of anger after the intervention and follow-up sessions. The recovery percentage at the end of the intervention sessions were 43.82, 42.28, and 9.09 for the first, second, and third participants, respectively.

CONCLUSION: The findings of the present study confirm the effectiveness of CBT in reducing the feeling of anger in female students with misophonia.}, } @article {pmid33434050, year = {2021}, author = {Lugg, W}, title = {'Misophonia in pregnancy - a case report'.}, journal = {Australasian psychiatry : bulletin of Royal Australian and New Zealand College of Psychiatrists}, volume = {29}, number = {4}, pages = {472-473}, doi = {10.1177/1039856220986719}, pmid = {33434050}, issn = {1440-1665}, mesh = {Female ; Humans ; *Hyperacusis ; Pregnancy ; }, } @article {pmid33360763, year = {2021}, author = {Holmes, E and Utoomprurkporn, N and Hoskote, C and Warren, JD and Bamiou, DE and Griffiths, TD}, title = {Simultaneous auditory agnosia: Systematic description of a new type of auditory segregation deficit following a right hemisphere lesion.}, journal = {Cortex; a journal devoted to the study of the nervous system and behavior}, volume = {135}, number = {}, pages = {92-107}, pmid = {33360763}, issn = {1973-8102}, support = {MR/T032553/1/MRC_/Medical Research Council/United Kingdom ; P50 DC000242/DC/NIDCD NIH HHS/United States ; /DH_/Department of Health/United Kingdom ; }, mesh = {*Agnosia ; *Auditory Cortex ; Auditory Perception ; Female ; Humans ; Magnetic Resonance Imaging ; Speech ; }, abstract = {We investigated auditory processing in a young patient who experienced a single embolus causing an infarct in the right middle cerebral artery territory. This led to damage to auditory cortex including planum temporale that spared medial Heschl's gyrus, and included damage to the posterior insula and inferior parietal lobule. She reported chronic difficulties with segregating speech from noise and segregating elements of music. Clinical tests showed no evidence for abnormal cochlear function. Follow-up tests confirmed difficulties with auditory segregation in her left ear that spanned multiple domains, including words-in-noise and music streaming. Testing with a stochastic figure-ground task-a way of estimating generic acoustic foreground and background segregation-demonstrated that this was also abnormal. This is the first demonstration of an acquired deficit in the segregation of complex acoustic patterns due to cortical damage, which we argue is a causal explanation for the symptomatic deficits in the segregation of speech and music. These symptoms are analogous to the visual symptom of simultaneous agnosia. Consistent with functional imaging studies on normal listeners, the work implicates non-primary auditory cortex. Further, the work demonstrates a (partial) lateralisation of the necessary anatomical substrate for segregation that has not been previously highlighted.}, } @article {pmid33336858, year = {2020}, author = {Jager, IJ and Vulink, NCC and Bergfeld, IO and van Loon, AJJM and Denys, DAJP}, title = {Cognitive behavioral therapy for misophonia: A randomized clinical trial.}, journal = {Depression and anxiety}, volume = {38}, number = {7}, pages = {708-718}, pmid = {33336858}, issn = {1520-6394}, abstract = {BACKGROUND: Patients with misophonia suffer from anger or disgust confronted with specific sounds such as smacking or breathing. Avoidance of cue-related situations results in social isolation and significant functional impairment. This is the first randomized, controlled cognitive behavioral therapy (CBT) trial for misophonia, evaluating the short- and long-term efficacy.

METHODS: The evaluator-blinded, randomized clinical trial was conducted from May 2017 until December 2018 at an academic outpatient clinic. Misophonia patients were randomly assigned to 3 months of weekly group-CBT or a waiting list and tested at baseline, 3 months (following CBT or waiting list), 6 months (after cross-over), and 15/18 months (1-year follow-up). CBT consisted of task concentration and arousal reduction, positive affect labeling, and stimulus manipulation. Co-primary outcomes were symptom severity assessed by the Amsterdam Misophonia Scale-Revised (AMISOS-R) and improvement on the Clinical Global Impression-Improvement (CGI-I). Secondary outcomes were self-assessed ratings of general psychopathology (Symptom Checklist-90-Revised [SCL-90-R]) and quality of life (five-dimensional EuroQol [EQ5-D], Sheehan Disability Scale [SDS], WHO Quality of Life-BREF [WHOQoL-BREF]).

RESULTS: In all, 54 out of 71 patients were included (mean age, 33.06 [SD, 14.13] years; 38 women [70.4%]) and 46 (85%) completed the study. In the randomized phase, CBT resulted in statistically significant less misophonia symptoms in the short-term (-9.7 AMISOS-R; 95% CI, -12.0 to -7.4; p < .001, d = 1.97). The CBT group had an observed clinical improvement (CGI-I < 3) in 37% compared to 0% in the waiting list group (p < .001). The effect of CBT was maintained at 1-year follow-up on primary and secondary outcomes.

CONCLUSIONS: This first randomized control trial shows both short-term and long-term efficacy of CBT for misophonia.}, } @article {pmid33334808, year = {2021}, author = {Rasouli, N and Younes, N and Utzschneider, KM and Inzucchi, SE and Balasubramanyam, A and Cherrington, AL and Ismail-Beigi, F and Cohen, RM and Olson, DE and DeFronzo, RA and Herman, WH and Lachin, JM and Kahn, SE and , }, title = {Association of Baseline Characteristics With Insulin Sensitivity and β-Cell Function in the Glycemia Reduction Approaches in Diabetes: A Comparative Effectiveness (GRADE) Study Cohort.}, journal = {Diabetes care}, volume = {44}, number = {2}, pages = {340-349}, pmid = {33334808}, issn = {1935-5548}, support = {UL1 TR000445/TR/NCATS NIH HHS/United States ; UL1 TR002529/TR/NCATS NIH HHS/United States ; P30 DK020541/DK/NIDDK NIH HHS/United States ; UL1 TR002378/TR/NCATS NIH HHS/United States ; P30 DK020572/DK/NIDDK NIH HHS/United States ; UL1 TR002243/TR/NCATS NIH HHS/United States ; UL1 TR002345/TR/NCATS NIH HHS/United States ; P30 DK017047/DK/NIDDK NIH HHS/United States ; UL1 TR002548/TR/NCATS NIH HHS/United States ; U34 DK088043/DK/NIDDK NIH HHS/United States ; UL1 TR002537/TR/NCATS NIH HHS/United States ; P30 DK092926/DK/NIDDK NIH HHS/United States ; UL1 TR002535/TR/NCATS NIH HHS/United States ; P30 DK072476/DK/NIDDK NIH HHS/United States ; P30 DK079626/DK/NIDDK NIH HHS/United States ; UL1 TR001409/TR/NCATS NIH HHS/United States ; U01 DK098246/DK/NIDDK NIH HHS/United States ; UL1 TR001449/TR/NCATS NIH HHS/United States ; UL1 TR002489/TR/NCATS NIH HHS/United States ; U54 GM104940/GM/NIGMS NIH HHS/United States ; UL1 TR001108/TR/NCATS NIH HHS/United States ; P30 DK045735/DK/NIDDK NIH HHS/United States ; UL1 TR000439/TR/NCATS NIH HHS/United States ; }, mesh = {Blood Glucose ; C-Peptide ; Child ; Child, Preschool ; Cross-Sectional Studies ; *Diabetes Mellitus, Type 2 ; Female ; Humans ; Infant ; Insulin ; *Insulin Resistance ; Male ; }, abstract = {OBJECTIVE: We investigated sex and racial differences in insulin sensitivity, β-cell function, and glycated hemoglobin (HbA1c) and the associations with selected phenotypic characteristics.

RESEARCH DESIGN AND METHODS: This is a cross-sectional analysis of baseline data from 3,108 GRADE (Glycemia Reduction Approaches in Diabetes: A Comparative Effectiveness Study) participants. All had type 2 diabetes diagnosed <10 years earlier and were on metformin monotherapy. Insulin sensitivity and β-cell function were evaluated using the HOMA of insulin sensitivity and estimates from oral glucose tolerance tests, including the Matsuda Index, insulinogenic index, C-peptide index, and oral disposition index (DI).

RESULTS: The cohort was 56.6 ± 10 years of age (mean ± SD), 63.8% male, with BMI 34.2 ± 6.7 kg/m[2], HbA1c 7.5 ± 0.5%, and type 2 diabetes duration 4.0 ± 2.8 years. Women had higher DI than men but similar insulin sensitivity. DI was the highest in Black/African Americans, followed by American Indians/Alaska Natives, Asians, and Whites in descending order. Compared with Whites, American Indians/Alaska Natives had significantly higher HbA1c, but Black/African Americans and Asians had lower HbA1c. However, when adjusted for glucose levels, Black/African Americans had higher HbA1c than Whites. Insulin sensitivity correlated inversely with BMI, waist-to-hip ratio, triglyceride-to-HDL-cholesterol ratio (TG/HDL-C), and the presence of metabolic syndrome, whereas DI was associated directly with age and inversely with BMI, HbA1c, and TG/HDL-C.

CONCLUSIONS: In the GRADE cohort, β-cell function differed by sex and race and was associated with the concurrent level of HbA1c. HbA1c also differed among the races, but not by sex. Age, BMI, and TG/HDL-C were associated with multiple measures of β-cell function and insulin sensitivity.}, } @article {pmid33285160, year = {2021}, author = {Williams, ZJ and He, JL and Cascio, CJ and Woynaroski, TG}, title = {A review of decreased sound tolerance in autism: Definitions, phenomenology, and potential mechanisms.}, journal = {Neuroscience and biobehavioral reviews}, volume = {121}, number = {}, pages = {1-17}, pmid = {33285160}, issn = {1873-7528}, support = {P50 HD103537/HD/NICHD NIH HHS/United States ; T32 GM007347/GM/NIGMS NIH HHS/United States ; F30 DC019510/DC/NIDCD NIH HHS/United States ; }, mesh = {Adult ; Anxiety ; Anxiety Disorders ; *Autistic Disorder ; Child ; Humans ; Hyperacusis ; Sound ; }, abstract = {Atypical behavioral responses to environmental sounds are common in autistic children and adults, with 50-70 % of this population exhibiting decreased sound tolerance (DST) at some point in their lives. This symptom is a source of significant distress and impairment across the lifespan, contributing to anxiety, challenging behaviors, reduced community participation, and school/workplace difficulties. However, relatively little is known about its phenomenology or neurocognitive underpinnings. The present article synthesizes a large body of literature on the phenomenology and pathophysiology of DST-related conditions to generate a comprehensive theoretical account of DST in autism. Notably, we argue against conceptualizing DST as a unified construct, suggesting that it be separated into three phenomenologically distinct conditions: hyperacusis (the perception of everyday sounds as excessively loud or painful), misophonia (an acquired aversive reaction to specific sounds), and phonophobia (a specific phobia of sound), each responsible for a portion of observed DST behaviors. We further elaborate our framework by proposing preliminary neurocognitive models of hyperacusis, misophonia, and phonophobia that incorporate neurophysiologic findings from studies of autism.}, } @article {pmid33174254, year = {2020}, author = {McGeoch, PD and Rouw, R}, title = {How everyday sounds can trigger strong emotions: ASMR, misophonia and the feeling of wellbeing.}, journal = {BioEssays : news and reviews in molecular, cellular and developmental biology}, volume = {42}, number = {12}, pages = {e2000099}, doi = {10.1002/bies.202000099}, pmid = {33174254}, issn = {1521-1878}, mesh = {Cerebral Cortex ; Cognition ; *Emotions ; Humans ; *Hyperacusis ; *Meridians ; }, abstract = {We propose that synesthetic cross-activation between the primary auditory cortex and the anatomically adjacent insula may help explain two puzzling conditions-autonomous sensory meridian response (ASMR) and misophonia-in which quotidian sounds involuntarily trigger strong emotional responses. In ASMR the sounds engender relaxation, while in misophonia they trigger an aversive response. The insula both plays an important role in autonomic nervous system control and integrates multiple interoceptive maps representing the physiological state of the body to substantiate a dynamic representation of emotional wellbeing. We propose that in ASMR cross-activation of the map for affective (sensual) touch leads to an increase in subjective wellbeing and parasympathetic activity. Conversely, in misophonia the effect of the cross-activation is to decrease emotional wellbeing and increase sympathetic activity. Our hypothesis also illuminates the connection between hearing and wellbeing more broadly and helps explain why so many people experience decreased wellbeing from modern urban soundscapes.}, } @article {pmid33005154, year = {2020}, author = {Cassiello-Robbins, C and Anand, D and McMahon, K and Guetta, R and Trumbull, J and Kelley, L and Rosenthal, MZ}, title = {The Mediating Role of Emotion Regulation Within the Relationship Between Neuroticism and Misophonia: A Preliminary Investigation.}, journal = {Frontiers in psychiatry}, volume = {11}, number = {}, pages = {847}, pmid = {33005154}, issn = {1664-0640}, abstract = {Misophonia is a newly described condition characterized by heightened emotional reactivity (e.g., anger, anxiety, and disgust) to common repetitive sounds (e.g., oral or nasal sounds made by others), accompanied by difficulties responding to these sounds (e.g., intolerance, avoidance, and escape) and associated impairment in functioning. Although research indicates that problematic emotional responses are a key characteristic of misophonia, it is unknown whether individual differences in experiencing and regulating emotional responses influence severity of misophonia symptoms. Examination of individual differences in emotional functioning will help to guide treatment development for misophonia. Accordingly, the present study examined the associations among trait neuroticism, difficulties with emotion regulation, and symptoms of misophonia. For this study, a sample of 49 adults completed the Difficulties with Emotion Regulation Scale, the Misophonia Questionnaire, and the neuroticism subscale of the NEO-Personality inventory. Findings indicated that difficulties with emotion regulation and neuroticism were significantly positively correlated with symptoms of misophonia. Bootstrapped mediation analyses suggested that difficulties controlling impulsive behavior while experiencing intense negative emotions fully mediated the relationship between neuroticism and symptoms of misophonia. Results from this study suggest that neuroticism and difficulties with emotion regulation may be important risk factors and treatment targets for adults with misophonia, and difficulties controlling impulsive behavior when distressed may be an important individual difference accounting for the relationship between neuroticism and misophonia.}, } @article {pmid32975915, year = {2020}, author = {Osuagwu, FC and Osuagwu, VC and Machoka, AM}, title = {Methylphenidate Ameliorates Worsening Distractibility Symptoms of Misophonia in an Adolescent Male.}, journal = {The primary care companion for CNS disorders}, volume = {22}, number = {5}, pages = {}, doi = {10.4088/PCC.19l02553}, pmid = {32975915}, issn = {2155-7780}, mesh = {Adolescent ; *Attention Deficit Disorder with Hyperactivity/drug therapy ; *Central Nervous System Stimulants ; *Cognition Disorders ; Humans ; Male ; *Methylphenidate/adverse effects ; }, } @article {pmid32955918, year = {2020}, author = {Vanaja, CS and Abigail, MS}, title = {Misophonia: An Evidence-Based Case Report.}, journal = {American journal of audiology}, volume = {29}, number = {4}, pages = {685-690}, doi = {10.1044/2020_AJA-19-00111}, pmid = {32955918}, issn = {1558-9137}, mesh = {Adult ; Emotions ; Female ; Humans ; *Hyperacusis/diagnosis ; *Quality of Life ; Sound ; Surveys and Questionnaires ; }, abstract = {Purpose Misophonia is a sound tolerance disorder condition in certain sounds that trigger intense emotional or physiological responses. While some persons may experience misophonia, a few patients suffer from misophonia. However, there is a dearth of literature on audiological assessment and management of persons with misophonia. The purpose of this report is to discuss the assessment of misophonia and highlight the management option that helped a patient with misophonia. Method A case study of a 26-year-old woman with the complaint of decreased tolerance to specific sounds affecting quality of life is reported. Audiological assessment differentiated misophonia from hyperacusis. Management included retraining counseling as well as desensitization and habituation therapy based on the principles described by P. J. Jastreboff and Jastreboff (2014). A misophonia questionnaire was administered at regular intervals to monitor the effectiveness of therapy. Results A detailed case history and audiological evaluations including pure-tone audiogram and Johnson Hyperacusis Index revealed the presence of misophonia. The patient benefitted from intervention, and the scores of the misophonia questionnaire indicated a decrease in the severity of the problem. Conclusions It is important to differentially diagnose misophonia and hyperacusis in persons with sound tolerance disorders. Retraining counseling as well as desensitization and habituation therapy can help patients who suffer from misophonia.}, } @article {pmid32913947, year = {2020}, author = {Adhikari, Y and Jin, X}, title = {Intraperitoneal injection of lipopolysaccharide prevents seizure-induced respiratory arrest in a DBA/1 mouse model of SUDEP.}, journal = {Epilepsia open}, volume = {5}, number = {3}, pages = {386-396}, pmid = {32913947}, issn = {2470-9239}, abstract = {OBJECTIVE: Sudden unexpected death in epilepsy (SUDEP) is the cause of premature death of 50% patients with chronic refractory epilepsy. Respiratory failure during seizures is regarded as an important mechanism of SUDEP. Previous studies have shown that abnormal serotonergic neurotransmission is involved in the pathogenesis of seizure-induced respiratory failure, while enhancing serotonergic neurotransmission in the brainstem suppresses it. Because peripheral inflammation is known to enhance serotonergic neuron activation and 5-HT synthesis and release, we investigated the effect of intraperitoneal lipopolysaccharide (LPS)-induced inflammation on the S-IRA susceptibility during audiogenic seizures in DBA/1 mice.

METHODS: After DBA/1 mice were primed by exposing to sound stimulation for three consecutive days, they were tested for seizure severity and seizure-induced respiratory arrest (S-IRA) induced by sound stimulation under different conditions. We determined the dose and time course of the effects of intraperitoneal administration of LPS on audiogenic seizures and S-IRA. The effects of blocking TLR4 or RAGE receptors and blocking 5-HT receptors on the LPS-induced effect on S-IRA were investigated. Statistical significance was evaluated using the Kruskal-Wallis test.

RESULTS: Intraperitoneal injection of LPS significantly had dose-dependent effects in reducing the incidence of S-IRA as well as seizure severity in DBA/1 mice. The protective effect of LPS on S-IRA peaked at 8-12 hours after LPS injection and was related to both reducing seizure severity and enhancing autoresuscitation. Blocking TLR4 or RAGE receptor with TAK-242 or FPS-ZM1, respectively, prior to LPS injection attenuated its effects on S-IRA and seizure severity. Injection of a nonselective 5-HT receptor antagonist, cyproheptadine, or a 5-HT3 receptor antagonist, ondansetron, was effective in blocking LPS-induced effect on S-IRA. Immunostaining results showed a significant increase in c-Fos-positive serotonergic neurons in the dorsal raphe.

SIGNIFICANCE: This is the first study that demonstrates the effect of intraperitoneal LPS injection-induced inflammation on reducing S-IRA susceptibility and provides additional evidence supporting the serotonin hypothesis on SUDEP. Our study suggests that inflammation may enhance brainstem 5-HT neurotransmission to promote autoresuscitation during seizure and prevent SUDEP.}, } @article {pmid32848552, year = {2020}, author = {Lovelace, JW and Ethell, IM and Binder, DK and Razak, KA}, title = {Minocycline Treatment Reverses Sound Evoked EEG Abnormalities in a Mouse Model of Fragile X Syndrome.}, journal = {Frontiers in neuroscience}, volume = {14}, number = {}, pages = {771}, pmid = {32848552}, issn = {1662-4548}, abstract = {Fragile X Syndrome (FXS) is a leading known genetic cause of intellectual disability. Many symptoms of FXS overlap with those in autism including repetitive behaviors, language delays, anxiety, social impairments and sensory processing deficits. Electroencephalogram (EEG) recordings from humans with FXS and an animal model, the Fmr1 knockout (KO) mouse, show remarkably similar phenotypes suggesting that EEG phenotypes can serve as biomarkers for developing treatments. This includes enhanced resting gamma band power and sound evoked total power, and reduced fidelity of temporal processing and habituation of responses to repeated sounds. Given the therapeutic potential of the antibiotic minocycline in humans with FXS and animal models, it is important to determine sensitivity and selectivity of EEG responses to minocycline. Therefore, in this study, we examined if a 10-day treatment of adult Fmr1 KO mice with minocycline (oral gavage, 30 mg/kg per day) would reduce EEG abnormalities. We tested if minocycline treatment has specific effects based on the EEG measurement type (e.g., resting versus sound-evoked) from the frontal and auditory cortex of the Fmr1 KO mice. We show increased resting EEG gamma power and reduced phase locking to time varying stimuli as well as the 40 Hz auditory steady state response in the Fmr1 KO mice in the pre-drug condition. Minocycline treatment increased gamma band phase locking in response to auditory stimuli, and reduced sound-evoked power of auditory event related potentials (ERP) in Fmr1 KO mice compared to vehicle treatment. Minocycline reduced resting EEG gamma power in Fmr1 KO mice, but this effect was similar to vehicle treatment. We also report frequency band-specific effects on EEG responses. Taken together, these data indicate that sound-evoked EEG responses may serve as more sensitive measures, compared to resting EEG measures, to isolate minocycline effects from placebo in humans with FXS. Given the use of minocycline and EEG recordings in a number of neurodegenerative and neurodevelopmental conditions, these findings may be more broadly applicable in translational neuroscience.}, } @article {pmid32829440, year = {2021}, author = {Naylor, J and Caimino, C and Scutt, P and Hoare, DJ and Baguley, DM}, title = {The Prevalence and Severity of Misophonia in a UK Undergraduate Medical Student Population and Validation of the Amsterdam Misophonia Scale.}, journal = {The Psychiatric quarterly}, volume = {92}, number = {2}, pages = {609-619}, pmid = {32829440}, issn = {1573-6709}, mesh = {Acoustic Stimulation ; Adolescent ; *Emotions ; Female ; Hearing Disorders/diagnosis/*epidemiology/*physiopathology ; Humans ; Male ; Prevalence ; Reproducibility of Results ; Students, Medical/*statistics & numerical data ; Surveys and Questionnaires ; United Kingdom/epidemiology ; Young Adult ; }, abstract = {Misophonia is a condition of abnormal emotional responses to specific auditory stimuli. There is limited information available on the prevalence of this condition. This study aimed to estimate the prevalence of misophonia in an undergraduate medical student population at the University of Nottingham. A secondary aim of this study was to assess the psychometric validity of the Amsterdam Misophonia Scale (A-Miso-S) questionnaire tool in this population. The A-Miso-S was administered online to medical students at the University of Nottingham. To assess the validity of the A-Miso-S, a factor analysis was conducted. To determine prevalence and severity the results of the questionnaire were quantitatively analysed using SPSS. Actor analysis was conducted. Free text responses to one questionnaire item were analysed using a thematic approach. Responses were obtained from 336 individuals. Clinically significant misophonic symptoms appear to be common, effecting 49.1% of the sample population. This is statistically significantly higher prevalence than previous studies have found (p < 0.00001). Using the classification of the A-Miso-S, mild symptoms were seen in 37%, moderate in 12%, severe in 0.3% of participants. No extreme cases were seen. The A-Miso-S was found to be a uni-factorial tool, with good internal consistency. This study has provided new information on misophonia and validity of the A-Miso-S questionnaire in a sample population of UK undergraduate medical students. The results indicate that misophonia is a phenomenon that a significant proportion of medical students experience though only a small subset experience it severely.}, } @article {pmid32751203, year = {2020}, author = {Siepsiak, M and Sobczak, AM and Bohaterewicz, B and Cichocki, Ł and Dragan, WŁ}, title = {Prevalence of Misophonia and Correlates of Its Symptoms among Inpatients with Depression.}, journal = {International journal of environmental research and public health}, volume = {17}, number = {15}, pages = {}, pmid = {32751203}, issn = {1660-4601}, mesh = {Anxiety Disorders ; Depression/*epidemiology ; Hearing Disorders/*epidemiology ; Humans ; Inpatients ; Prevalence ; Quality of Life ; Stress Disorders, Post-Traumatic ; }, abstract = {Misophonia is an underexplored condition that significantly decreases the quality of life of those who suffer from it. It has neurological and physiological correlates and is associated with a variety of psychiatric symptoms; however, a growing body of data suggests that it is a discrete disorder. While comorbid diagnoses among people with misophonia have been a matter of research interest for many years there is no data on the frequency of misophonia among people with psychiatric disorders. This could be the next step to reveal additional mechanisms underlying misophonia. Until recently, the use of a variety of non-validated questionnaires and the dominance of internet-based studies have been also a major obstacles to a proper definition of misophonia. A total of 94 inpatients diagnosed with depression were assessed for misophonia with face-to-face interviews as well as with MisoQuest-a validated misophonia questionnaire. The prevalence of misophonia among these patients and the congruence of MisoQuest with face-to-face interviews were evaluated. Additionally, the patients filled in a series of questionnaires that measured a variety of psychiatric symptoms and psychological traits. Anxiety, depression, impulsivity, somatic pain, vegetative symptoms, post-traumatic stress disorder (PTSD) symptoms, gender, and age were analyzed in relation to the severity of symptoms of misophonia. Between 8.5 to 12.76% of inpatients with depression were diagnosed with misophonia (depending on measurement and inclusion criteria). MisoQuest accuracy was equal to 92.55%, sensitivity-66.67% and specificity-96.34%. Severity of misophonia symptoms was positively correlated to the greatest extent with anxiety. Moderate positive correlation was also found between severity of misophonia symptoms and depressive symptoms, intrusions, and somatic pain; a weak positive correlation was found between severity of misophonia and non-planning impulsivity, motor impulsivity, avoidance, and vegetative symptoms. There was no relationship between the severity of misophonia symptoms and attentional impulsivity or the age of participants.}, } @article {pmid32739788, year = {2020}, author = {Araújo, BR and Furtado, DZS and de Moura Leite, FBV and de Assunção, NA and Carrilho, E}, title = {Metabolic profiling of organic acids in urine samples of Cri Du Chat syndrome individuals by gas chromatography-mass spectrometry.}, journal = {Journal of chromatography. B, Analytical technologies in the biomedical and life sciences}, volume = {1153}, number = {}, pages = {122267}, doi = {10.1016/j.jchromb.2020.122267}, pmid = {32739788}, issn = {1873-376X}, mesh = {Adolescent ; Adult ; Carboxylic Acids/*urine ; Child ; Cluster Analysis ; *Cri-du-Chat Syndrome/diagnosis/metabolism/urine ; Female ; Gas Chromatography-Mass Spectrometry/*methods ; Humans ; Limit of Detection ; Male ; Metabolome/*physiology ; Metabolomics/*methods ; Reproducibility of Results ; Young Adult ; }, abstract = {Cri Du Chat (CDC) syndrome is a rare genetic condition caused by the deletion of genetic material on the small arm (the p arm) of chromosome 5. A high-pitched cry that sounds like that of a cat, dysmorphic characteristics, and cytogenetic methods are often used for diagnosing the syndrome. In this study, we applied GC-MS analysis for determining organic acids in urine from 17 control volunteers without CDC syndrome, and from 16 individuals with the CDC syndrome in order to determine the profile of organic acids and biochemical pathways alterations resulting from this genetic condition. First, performing multivariate data analysis selected the best method for extracting organic acids with greater signal intensities and good reproducibility. After selection, multivariate (PLS-DA) and univariate (Mann-Whitney test) data analysis discriminated the metabolites responsible for separation between groups. Nine organic acid metabolites had values of VIP ≥ 1.0 and p-values ≤ 0.05, with highest intensities in the samples from CDC individuals, indicating the strongest discriminative power (tricarballylic acid, indoleacetic acid, anthranilic acid, 4-hydroxyphenylacetic acid, 4-hydroxybenzoic acid, 4-hydroxyhippuric acid, pantothenic acid, homovanillic acid, and vanillylmandelic acid). These metabolites are involved in several biochemical pathways like in the tyrosine and phenylalanine metabolism, as well as the tryptophan metabolism, which could be associated (i) to some neuropsychiatric alterations commonly observed in CDC individuals, (ii) to exogenous compounds related to transformation products by intestinal microbial, and (iii) to a possible deficiency in enzyme activity due to the syndrome.}, } @article {pmid32369688, year = {2020}, author = {Sharan, R and Sharma, V}, title = {A Case of Bipolar Disorder and Misophonia.}, journal = {The primary care companion for CNS disorders}, volume = {22}, number = {3}, pages = {}, doi = {10.4088/PCC.19l02523}, pmid = {32369688}, issn = {2155-7780}, mesh = {Adult ; *Auditory Perception/physiology ; Bipolar Disorder/*complications ; Female ; Humans ; Perceptual Disorders/*etiology ; }, } @article {pmid32294104, year = {2020}, author = {Jager, I and de Koning, P and Bost, T and Denys, D and Vulink, N}, title = {Misophonia: Phenomenology, comorbidity and demographics in a large sample.}, journal = {PloS one}, volume = {15}, number = {4}, pages = {e0231390}, pmid = {32294104}, issn = {1932-6203}, mesh = {Adult ; Attention Deficit Disorder with Hyperactivity/complications/pathology ; Autistic Disorder/complications/pathology ; Diagnostic and Statistical Manual of Mental Disorders ; Female ; Humans ; *Impulsive Behavior ; Male ; Mental Disorders/complications/*diagnosis/pathology ; Middle Aged ; Mood Disorders/complications/pathology ; Netherlands ; Obsessive-Compulsive Disorder/complications/pathology ; Severity of Illness Index ; Young Adult ; }, abstract = {OBJECTIVE: Analyze a large sample with detailed clinical data of misophonia subjects in order to determine the psychiatric, somatic and psychological nature of the condition.

METHODS: This observational study of 779 subjects with suspected misophonia was conducted from January 2013 to May 2017 at the outpatient-clinic of the Amsterdam University Medical Centers, location AMC, the Netherlands. We examined DSM-IV diagnoses, results of somatic examination (general screening and hearing tests), and 17 psychological questionnaires (e.g., SCL-90-R, WHOQoL).

RESULTS: The diagnosis of misophonia was confirmed in 575 of 779 referred subjects (74%). In the sample of misophonia subjects (mean age, 34.17 [SD = 12.22] years; 399 women [69%]), 148 (26%) subjects had comorbid traits of obsessive-compulsive personality disorder, 58 (10%) mood disorders, 31 (5%) attention-deficit (hyperactivity) disorder, and 14 (3%) autism spectrum conditions. Two percent reported tinnitus and 1% hyperacusis. In a random subgroup of 109 subjects we performed audiometry, and found unilateral hearing loss in 3 of them (3%). Clinical neurological examination and additional blood test showed no abnormalities. Psychological tests revealed perfectionism (97% CPQ>25) and neuroticism (stanine 7 NEO-PI-R). Quality of life was heavily impaired and associated with misophonia severity (rs (184) = -.34 p = < .001, p = < .001).

LIMITATIONS: This was a single site study, leading to possible selection-and confirmation bias, since AMC-criteria were used.

CONCLUSIONS: This study with 575 subjects is the largest misophonia sample ever described. Based on these results we propose a set of revised criteria useful to diagnose misophonia as a psychiatric disorder.}, } @article {pmid32258795, year = {2020}, author = {Nannucci, L and Barattini, P and Bossis, I and Woźniakowski, G and Balka, G and Pugliese, C}, title = {Point-of-service Diagnostic Technology for Detection of Swine Viral Diseases.}, journal = {Journal of veterinary research}, volume = {64}, number = {1}, pages = {15-23}, pmid = {32258795}, issn = {2450-7393}, abstract = {INTRODUCTION: A research project is underway aiming to develop a field diagnostic tool for six important viruses of the pig sector, namely: African swine fever virus (ASFV), porcine reproductive and respiratory syndrome virus (PRRSV), swine influenza virus (SIV), porcine parvovirus (PPV), porcine circovirus (PCV2), and classical swine fever virus (CSFV).

MATERIAL AND METHODS: To obtain a preliminary sounding of the interest in this type of instrument among its potential operators, a questionnaire was drawn up and submitted to three categories of stakeholders: farmers, veterinarians, and others (including scientific and technical staff working on animal farms). Four countries participated: Italy, Greece, Hungary, and Poland.

RESULTS: In total, 83 replies were collected and analysed in a breakdown by stakeholder type and pertinence, where the areas were the importance of the main diseases within the different countries, diagnostic tool operational issues, and economic issues.

CONCLUSION: The main end-users of this kind of instrument are expected to be private veterinarians and pig producers. The infectious agents seeming to be most interesting to diagnose with the instrument are PRRSV, SIV, PPV, and PCV2. The most decisive parameters which have been selected by the stakeholders are sensitivity, cost, simplicity, and time required to obtain results. The economic issue analysis showed that the majority of those who would prefer to buy rather than rent the device are willing to pay up to €3,000 for a diagnostic field tool.}, } @article {pmid32164250, year = {2020}, author = {Siepsiak, M and Śliwerski, A and Łukasz Dragan, W}, title = {Development and Psychometric Properties of MisoQuest-A New Self-Report Questionnaire for Misophonia.}, journal = {International journal of environmental research and public health}, volume = {17}, number = {5}, pages = {}, pmid = {32164250}, issn = {1660-4601}, mesh = {Female ; Humans ; *Hyperacusis ; Male ; *Psychometrics/methods ; Reproducibility of Results ; Self Report ; Sound ; Surveys and Questionnaires/standards ; }, abstract = {Background: Misophonia is a condition related to experiencing psychophysiological sensations when exposed to specific sound triggers. In spite of progress in research on the subject, a fully validated questionnaire assessing misophonia has not been published yet. The goal of this study was to create and validate a new questionnaire to measure misophonia. Methods: MisoQuest is based on the diagnostic criteria proposed by Schröder et al. in 2013, with minor changes implemented by the authors of MisoQuest. A total of 705 participants took part in the study, completing the online questionnaires. Exploratory Factor Analysis (EFA) and analyses using the Item Response Theory (IRT) were performed. Internal consistency was evaluated with Cronbach's alpha. Results: The reliability of the MisoQuest was excellent (α = 0.955). The stability at five weeks was strong. There was a significant difference in results between people classified as those with misophonia and those without misophonia. Conclusions: MisoQuest has good psychometric values and can be helpful in the identification of misophonia. A deeper analysis showed that certain triggers might be more specific for people with misophonia. Consideration of violent behavior in response to misophonic triggers as a symptom of misophonia was undermined.}, } @article {pmid32111866, year = {2020}, author = {Schröder, A and van Wingen, G and Eijsker, N and San Giorgi, R and Vulink, NC and Turbyne, C and Denys, D}, title = {Publisher Correction: Misophonia is associated with altered brain activity in the auditory cortex and salience network.}, journal = {Scientific reports}, volume = {10}, number = {1}, pages = {4066}, doi = {10.1038/s41598-020-59862-y}, pmid = {32111866}, issn = {2045-2322}, abstract = {An amendment to this paper has been published and can be accessed via a link at the top of the paper.}, } @article {pmid31945068, year = {2020}, author = {Daniels, EC and Rodriguez, A and Zabelina, DL}, title = {Severity of misophonia symptoms is associated with worse cognitive control when exposed to misophonia trigger sounds.}, journal = {PloS one}, volume = {15}, number = {1}, pages = {e0227118}, pmid = {31945068}, issn = {1932-6203}, mesh = {Adolescent ; Adult ; Affective Symptoms/*physiopathology ; Anxiety/*physiopathology ; *Auditory Perception ; *Cognition ; Emotions ; Female ; Humans ; Male ; Neuroticism ; Noise/*adverse effects ; Stroop Test ; }, abstract = {The present study aimed to investigate the extent to which the severity of misophonia symptoms is linked with cognitive control under misophonia symptom-provocation circumstances in the general population sample. Participants (N = 79) completed a measure of cognitive control-a Stroop color naming task, which consists of congruent and incongruent stimuli, and requires inhibition of a prepotent response (reading a word) in the service of a less predominant response (naming a color), while listening to misophonia symptom-provocation or universally unpleasant sounds. Participants' misophonia sound sensitivity, and emotional behaviors towards trigger sounds were assessed using the Misophonia Questionnaire. Stronger emotional behavioral reactions to misophonia trigger sounds were significantly associated with the larger Stroop effect when participants were exposed to the misophonia trigger sounds, but not when they were exposed to the universally unpleasant sounds. This effect held when controlling for the personality trait of Neuroticism and for baseline levels of anxiety. Both elevated misophonia sound sensitivity and emotional behaviors towards trigger sounds significantly correlated with higher self-reported anxiety when performing the Stroop task. However, only elevated emotional behaviors towards trigger sounds were linked with higher anxiety levels at baseline, suggesting that people who experience stronger emotions and behavioral reactions to misophonia trigger sounds may have higher anxiety at a trait level. Limitations and future directions are discussed.}, } @article {pmid31749641, year = {2019}, author = {Aazh, H and Landgrebe, M and Danesh, AA and Moore, BC}, title = {Cognitive Behavioral Therapy For Alleviating The Distress Caused By Tinnitus, Hyperacusis And Misophonia: Current Perspectives.}, journal = {Psychology research and behavior management}, volume = {12}, number = {}, pages = {991-1002}, pmid = {31749641}, issn = {1179-1578}, abstract = {This article reviews the evidence related to the efficacy of Cognitive Behavioral Therapy (CBT) for alleviating the distress caused by tinnitus, hyperacusis and misophonia. Where available, the review was focused on meta-analyses of randomized controlled trials (RCTs) using either passive control groups (typically waiting list or education only) or active control groups (receiving some other form of treatment). Where data from RCTs were not available, case studies and retrospective studies were reviewed. Analyses were conducted separately for studies of patients with tinnitus, hyperacusis and misophonia. RCTs show that CBT is effective in alleviating the distress caused by tinnitus in comparison to passive control groups and sometimes active control groups. CBT for tinnitus can be effective both in individual and in group settings, whether delivered by psychiatrists, clinical psychologists, or specially trained audiologists. CBT for tinnitus can also be effective when delivered via the internet, when combined with help from audiologists. Usually, CBT does not reduce the loudness of tinnitus but it can improve quality of life. Case studies and some limited RCTs suggest that CBT can also be effective in alleviating the distress caused by hyperacusis and misophonia. However, RCTs with active control groups are currently lacking. There is strong evidence supporting the effectiveness of CBT in alleviating the distress caused by tinnitus. However, it is not yet clear whether CBT is more effective than some other forms of treatment. RCTs with active control groups are needed to establish more clearly the extent to which CBT is effective in alleviating the distress caused by hyperacusis and misophonia.}, } @article {pmid31708818, year = {2019}, author = {Eijsker, N and Schröder, A and Smit, DJA and van Wingen, G and Denys, D}, title = {Neural Basis of Response Bias on the Stop Signal Task in Misophonia.}, journal = {Frontiers in psychiatry}, volume = {10}, number = {}, pages = {765}, pmid = {31708818}, issn = {1664-0640}, abstract = {Objective: Misophonia is a newly described condition in which specific ordinary sounds provoke disproportionately strong negative affect. Since evidence for psychobiological dysfunction underlying misophonia is scarce, we tested whether misophonia patients, like many patients with impulse control or obsessive-compulsive spectrum disorders, show impaired ability to inhibit an ongoing motor response. Methods: We collected functional magnetic resonance imaging data during a stop signal task in 22 misophonia patients and 21 matched healthy controls. Results: Compared to controls, patients tended to show longer stop signal delays, which is the time between stimuli signaling response initiation and inhibition. Additionally, patients tended to activate left dorsolateral prefrontal cortex more during responding rather than successful inhibition, as was seen in controls. Furthermore, patients lacked inhibition success-related activity in posterior cingulate cortices and activated the superior medial frontal gyri less during inhibition success compared to failure, a feature correlated with stop signal delays over the sample. Conclusions: Misophonia patients did not show impaired response inhibition. However, they tended to show a response bias on the stop signal task, favoring accuracy over speed. This implies perfectionism and compulsive, rather than impulsive, behavior. Moreover, brain activations were in line with patients, compared to controls, engaging more cognitive control for slowing responses, while employing more attentional resources for successful inhibition.}, } @article {pmid31537171, year = {2020}, author = {Frank, B and Roszyk, M and Hurley, L and Drejaj, L and McKay, D}, title = {Inattention in misophonia: Difficulties achieving and maintaining alertness.}, journal = {Journal of clinical and experimental neuropsychology}, volume = {42}, number = {1}, pages = {66-75}, doi = {10.1080/13803395.2019.1666801}, pmid = {31537171}, issn = {1744-411X}, mesh = {Adult ; Attention/*physiology ; Auditory Perceptual Disorders/*physiopathology ; Female ; Humans ; Male ; Neuropsychological Tests/*standards ; Randomized Controlled Trials as Topic ; }, abstract = {Introduction: Misophonia is marked by abnormal negative reactions to specific and idiosyncratic sounds. Despite unclear etiology and diagnostic conceptualization, neuropsychology may be able to help characterize the syndrome. In the current study, we administered the Attention Network Test (ANT) under symptom provocation conditions, as well as secondary measures of concept formation, perseveration, processing speed, and frustration tolerance. We assessed treatment seeking individuals with misophonia and non-clinical controls. We hypothesized higher alerting, orienting, and conflict effects on the ANT suggesting overall poorer performance for the misophonia group.Methods: The sample consisted of symptomatic individuals recruited from a randomized treatment trial prior to the mandatory waitlist (n = 11) and age, gender matched controls (n = 11). Symptomatic individuals were screened with the Misophonia Questionnaire, as well as a number of additional self-report and diagnostic measures.Results: Robust Bayesian estimation in multi-level models suggested worse alerting attention for symptomatic individuals, βMedian = 2.766, βSD = 1.253, 95% CI [0.322, 5.2876], Bayes factor = 31.41. There were no effects respective to block (i.e., blocks before versus during and after symptom provocation) or interaction effects. There were also no effects particular to executive functioning measures but some evidence this domain should be further explored (e.g., ANT conflict effects, perseveration, and serial math accuracy).Conclusions: We propose that symptom provocation alone does not explain the observed group difference in alerting attention, which could reflect a long-standing neuropsychological weakness. Future studies should attempt to characterize misophonia with more comprehensive neuropsychological batteries and larger samples.}, } @article {pmid31384719, year = {2019}, author = {Lovre, D and Peacock, E and Katalenich, B and Moreau, C and Xu, B and Tate, C and Utzschneider, KM and Gautier, JF and Fonseca, V and Mauvais-Jarvis, F}, title = {Conjugated Estrogens and Bazedoxifene Improve β Cell Function in Obese Menopausal Women.}, journal = {Journal of the Endocrine Society}, volume = {3}, number = {8}, pages = {1583-1594}, pmid = {31384719}, issn = {2472-1972}, support = {I01 BX003725/BX/BLRD VA/United States ; R01 DK074970/DK/NIDDK NIH HHS/United States ; K12 HD043451/HD/NICHD NIH HHS/United States ; U54 GM104940/GM/NIGMS NIH HHS/United States ; R01 DK107444/DK/NIDDK NIH HHS/United States ; P30 DK017047/DK/NIDDK NIH HHS/United States ; }, abstract = {CONTEXT: Studies suggest that menopausal hormone therapy (MHT) prevents type 2 diabetes (T2D). The combination of conjugated estrogens (CE) with the selective estrogen receptor modulator bazedoxifene (BZA) is an MHT that improves obesity and T2D in preclinical models of menopausal metabolic syndrome. The effect of CE/BZA on adiposity and glucose homeostasis in obese postmenopausal women is unknown.

OBJECTIVE: To investigate the effect of CE/BZA on body composition, glucose homeostasis, and markers of inflammation in obese postmenopausal women.

Randomized, double-blind, placebo-controlled pilot trial of 12 obese menopausal women assigned to 12-week treatment with CE 0.45 mg/BZA 20 mg (n = 7) or placebo (n = 5). At baseline and after 12 weeks, we assessed body composition (dual-energy X-ray absorptiometry), glucose homeostasis (IV glucose tolerance test), and inflammation biomarkers.

RESULTS: Women treated with CE/BZA exhibited increased β cell function using homeostatic model assessment-B [median (interquartile range) CE/BZA vs placebo: 18.5 (-0.9 to 320.6) μU/mM vs -25.5 (-39.9 to -0.1) μU/mM; P = 0.045], and decreased basal glucose concentrations (Gb) [-5.2 (-9.2 to -1.7) mg/dL vs 2.7 (0.9 to 4.9) mg/dL; P = 0.029]. Insulin sensitivity was higher in the placebo arm [1.35 (1.12 to 1.82) (μU/mL) min[-1] vs -0.24 (-1.50 to 0.19) (μU/mL) min[-1]; P = 0.029]. No changes between treatment groups were observed for the acute insulin response to glucose (AIRg), the disposition index (DI), body composition, and inflammatory biomarkers.

CONCLUSIONS: A 12-week treatment of obese postmenopausal women with CEs/BZA improves fasting β cell function and glucose concentrations without change in AIRg, HOMA-IR, DI, body composition, or markers of inflammation.}, } @article {pmid31317969, year = {2019}, author = {Siepsiak, M and Dragan, W}, title = {Misophonia - a review of research results and theoretical concepts.}, journal = {Psychiatria polska}, volume = {53}, number = {2}, pages = {447-458}, doi = {10.12740/PP/92023}, pmid = {31317969}, issn = {2391-5854}, mesh = {Affective Symptoms/*diagnosis ; Hearing Disorders/*diagnosis ; Humans ; Hyperacusis/*diagnosis ; Perceptual Disorders ; Quality of Life ; *Sound ; }, abstract = {Misophonia is a new and relatively under-explored condition characterized by experiencing strong emotions (mainly anger and disgust) and a physical response (such as muscle constriction, increased heart rate) when exposed to specific sounds. Among the most frequent aversive triggers are the sounds of eating, breathing, or typing. The experience of misophonia is associated with suffering and a significant decrease in quality of life. The phenomenon was first described in 2002. Since then, numerous case studies and data from psychophysiological and neurological and survey research on this phenomenon have been published. These data indicate that misophonia is a consistent phenomenon and preliminary identification is possible. The most recent results show that misophonia occurs independent of other disorders. There are still, however, many questions regarding the definition and diagnostic criteria to be answered. The most important diagnostic issues that are faced during clinical work with people with misophonia are described in this article. Furthermore, the main theoretical concepts and research on misophonia are reviewed and analyzed.}, } @article {pmid31101901, year = {2019}, author = {Schröder, A and van Wingen, G and Eijsker, N and San Giorgi, R and Vulink, NC and Turbyne, C and Denys, D}, title = {Misophonia is associated with altered brain activity in the auditory cortex and salience network.}, journal = {Scientific reports}, volume = {9}, number = {1}, pages = {7542}, pmid = {31101901}, issn = {2045-2322}, mesh = {Adult ; Affective Symptoms/*physiopathology ; Aggression/*physiology ; Auditory Cortex/*physiology ; Disgust ; Electrocardiography ; Emotions/physiology ; Female ; Gyrus Cinguli/physiology ; Heart Rate/physiology ; Humans ; Hyperacusis/*physiopathology ; Magnetic Resonance Imaging ; Male ; Rage/*physiology ; Surveys and Questionnaires ; Temporal Lobe/physiology ; }, abstract = {Misophonia is characterized by intense rage and disgust provoked by hearing specific human sounds resulting in social isolation due to avoidance. We exposed patients with symptom provoking audiovisual stimuli to investigate brain activity of emotional responses. 21 patients with misophonia and 23 matched healthy controls were recruited at the psychiatry department of the Amsterdam UMC. Participants were presented with three different conditions, misophonia related cues (video clips with e.g. lip smacking and loud breathing), aversive cues (violent or disgusting clips from movies), and neutral cues (video clips of e.g. someone meditating) during fMRI. Electrocardiography was recorded to determine physiological changes and self-report measures were used to assess emotional changes. Misophonic cues elicited anger, disgust and sadness in patients compared to controls. Emotional changes were associated with increases in heart rate. The neuroimaging data revealed increased activation of the right insula, right anterior cingulate cortex and right superior temporal cortex during viewing of the misophonic video clips compared to neutral clips. Our results demonstrate that audiovisual stimuli trigger anger and physiological arousal in patients with misophonia, associated with activation of the auditory cortex and salience network.}, } @article {pmid31066600, year = {2019}, author = {Erfanian, M and Kartsonaki, C and Keshavarz, A}, title = {Misophonia and comorbid psychiatric symptoms: a preliminary study of clinical findings.}, journal = {Nordic journal of psychiatry}, volume = {73}, number = {4-5}, pages = {219-228}, doi = {10.1080/08039488.2019.1609086}, pmid = {31066600}, issn = {1502-4725}, mesh = {Acoustic Stimulation/*adverse effects ; Adult ; Aged ; Comorbidity ; Female ; Humans ; Male ; Mental Disorders/diagnosis/*epidemiology/*psychology ; Middle Aged ; *Neuropsychological Tests ; Prevalence ; Speech Sound Disorder/diagnosis/*epidemiology/*psychology ; }, abstract = {Objective: Misophonia is a neurophysiological disorder, phenotypically characterized by heightened autonomic nervous system arousal which is accompanied by a high magnitude of emotional reactivity to repetitive and pattern-based auditory stimuli. This study identifies the prevalence of psychiatric symptoms in misophonia sufferers, the association between severity of misophonia and psychiatric symptoms, and the association between misophonia severity and gender. Methods: Fifty-two misophonia sufferers, 30 females (mean age = 40.93 ± 15.29) and 22 males (mean age = 51.18 ± 15.91) were recruited in our study and they were diagnosed according the criteria proposed by Schröder et al. The participants were evaluated by the A-MISO-S for the severity of misophonia and the MINI to assess the presence of psychiatric symptoms. Results: The most common comorbid symptoms reported by the misophonia patients were respectively PTSD (N = 8, 15.38%), OCD (N = 6, 11.53%), MDD (N = 5, 9.61%), and anorexia (N = 5, 9.61%). Misophonia severity was associated with the symptoms of MDD, OCD, and PTSD as well as anorexia. There was an indication of a significant difference between men and women in the severity of misophonic symptoms. Conclusion: Our findings highlight the importance of recognizing psychiatric comorbidity among misophonia sufferers. The presence of these varying psychiatric disorders' features in individuals with misophonia suggests that while misophonia has unique clinical characteristics with an underlying neurophysiological mechanism, may be associated with psychiatric symptoms. Therefore, when assessing individuals with misophonia symptoms, it is important to screen for psychiatric symptoms. This will assist researchers and clinicians to better understand the nature of the symptoms and how they may be interacting and ultimately allocating the most effective therapeutic strategies.}, } @article {pmid31059490, year = {2019}, author = {Samermit, P and Saal, J and Davidenko, N}, title = {Cross-Sensory Stimuli Modulate Reactions to Aversive Sounds.}, journal = {Multisensory research}, volume = {32}, number = {3}, pages = {197-213}, doi = {10.1163/22134808-20191344}, pmid = {31059490}, issn = {2213-4808}, mesh = {Acoustic Stimulation ; Auditory Perception/*physiology ; Emotions/*physiology ; Female ; Humans ; Male ; Photic Stimulation ; Visual Perception/*physiology ; Young Adult ; }, abstract = {We propose that cross-sensory stimuli presenting a positive attributable source of an aversive sound can modulate negative reactions to the sound. In Experiment 1, participants rated original video sources (OVS) of eight aversive sounds (e.g., nails scratching a chalkboard) as more aversive than eight positive attributable video sources (PAVS) of those same sounds (e.g., someone playing a flute) when these videos were presented silently. In Experiment 2, new participants were presented with those eight aversive sounds in three blocks. In Blocks 1 and 3, the sounds were presented alone; in Block 2, four of the sounds were randomly presented concurrently with their corresponding OVS videos, and the other four with their corresponding PAVS videos. Participants rated each sound, presented with or without video, on three scales: discomfort, unpleasantness, and bodily sensations. We found the concurrent presentation of videos robustly modulates participants' reactions to the sounds: compared to the sounds alone (Block 1), concurrent presentation of PAVS videos significantly reduced negative reactions to the sounds, and the concurrent presentation of OVS videos significantly increased negative reactions, across all three scales. These effects, however, did not linger into Block 3 when the sounds were presented alone again. Our results provide novel evidence that negative reactions to aversive sounds can be modulated through cross-sensory temporal syncing with a positive attributable video source. Although this research was conducted with a neurotypical population, we argue that our findings have implications for the treatment of misophonia.}, } @article {pmid30859581, year = {2019}, author = {Potgieter, I and MacDonald, C and Partridge, L and Cima, R and Sheldrake, J and Hoare, DJ}, title = {Misophonia: A scoping review of research.}, journal = {Journal of clinical psychology}, volume = {75}, number = {7}, pages = {1203-1218}, doi = {10.1002/jclp.22771}, pmid = {30859581}, issn = {1097-4679}, mesh = {Cognitive Behavioral Therapy ; Female ; Humans ; Hyperacusis/*diagnosis/*therapy ; Outcome Assessment, Health Care ; Prevalence ; }, abstract = {OBJECTIVE: To scope the literature describing misophonia populations, management, and research opportunities.

METHOD: Literature searches for research studies describing patients diagnosed with misophonia, defining a patient profile, or outlining development or testing of an intervention for misophonia. A data extraction form was developed and piloted before data from each article were independently charted by two researchers. Researchers then agreed on a final data set for each article.

RESULTS: Thirty-one records were included. The misophonia population was described in terms of onset age, triggers, reaction, coping strategies, and comorbid conditions. We identified nine outcome measures. Case studies on treatments included cognitive behavioral therapy, counterconditioning, mindfulness and acceptance, dialectical behavioral therapy, and pharmaceuticals. Future research priorities identified included clarifying the phenomenology and prevalence of misophonia, and randomized controlled trials of treatments.

CONCLUSION: Misophonia is under-researched but there are strong foundations for future research to finalize diagnostic criteria, validate outcome measures, and trial treatments.}, } @article {pmid30773283, year = {2019}, author = {Martino, D and Hedderly, T}, title = {Tics and stereotypies: A comparative clinical review.}, journal = {Parkinsonism & related disorders}, volume = {59}, number = {}, pages = {117-124}, doi = {10.1016/j.parkreldis.2019.02.005}, pmid = {30773283}, issn = {1873-5126}, mesh = {Autism Spectrum Disorder/diagnosis/*physiopathology/therapy ; Humans ; Stereotypic Movement Disorder/diagnosis/*physiopathology/therapy ; Tic Disorders/diagnosis/*physiopathology/therapy ; }, abstract = {Tics and stereotypies are the most common pathological repetitive complex motor behaviors occurring during the neurodevelopmental period. Although they may appear transiently during development without acquiring a pathological status, when they become chronic they may be distressing, socially impairing, or even, in the case of malignant tics, potentially physically harmful. Despite a certain similarity in their phenomenology, physicians should be able to distinguish them for their different variability over time, topographical distribution, association with sensory manifestations, and relationship with environmental triggers. The complex phenomenology of tics and stereotypies is constantly enriched by the characterization of novel variants, e.g. tics triggered by auditory stimuli in association with misophonia and stereotypies associated with intense imagery activity. Their pathophysiology remains partially elusive, but both animal model and brain imaging studies confirm the involvement of all the three major loops (sensorimotor, associative and limbic) within the cortico-basal ganglia circuitry. From a management perspective, the greatest advances witnessed in the last decade involve the diffusion of behavioral strategies (e.g. habit reversal training or response interruption and redirection), including the development of protocols for telehealth on online training in order to optimise access. In the context of severe tics, e.g. in refractory Tourette syndrome, there is increasing experience with deep brain stimulation of the intralaminar thalamic nuclei or the globus pallidus internus, although more research is needed to fine tune target choice and stimulation setting definition.}, } @article {pmid30136676, year = {2018}, author = {Aazh, H and Knipper, M and Danesh, AA and Cavanna, AE and Andersson, L and Paulin, J and Schecklmann, M and Heinonen-Guzejev, M and Moore, BCJ}, title = {Insights from the third international conference on hyperacusis: causes, evaluation, diagnosis, and treatment.}, journal = {Noise & health}, volume = {20}, number = {95}, pages = {162-170}, pmid = {30136676}, issn = {1463-1741}, mesh = {Audiometry/methods ; Autism Spectrum Disorder/complications ; Cognitive Behavioral Therapy/methods ; Congresses as Topic ; Female ; Humans ; Hyperacusis/*diagnosis/etiology/*therapy ; Male ; }, abstract = {BACKGROUND: Hyperacusis is intolerance of certain everyday sounds that causes significant distress and impairment in social, occupational, recreational, and other day-to-day activities.

OBJECTIVE: The aim of this report is to summarize the key findings and conclusions from the Third International Conference on Hyperacusis.

TOPICS COVERED: The main topics discussed comprise (1) diagnosis of hyperacusis and audiological evaluations, (2) neurobiological aspect of hyperacusis, (3) misophonia, (4) hyperacusis in autism spectrum disorder, (5) noise sensitivity, (6) hyperacusis-related distress and comorbid psychiatric illness, and (7) audiologist-delivered cognitive behavioral therapy for hyperacusis.

CONCLUSIONS: Implications for research and clinical practice are summarised.}, } @article {pmid30123700, year = {2018}, author = {Janik McErlean, AB and Banissy, MJ}, title = {Increased misophonia in self-reported Autonomous Sensory Meridian Response.}, journal = {PeerJ}, volume = {6}, number = {}, pages = {e5351}, pmid = {30123700}, issn = {2167-8359}, abstract = {BACKGROUND: Autonomous Sensory Meridian Response (ASMR) is a sensory experience elicited by auditory and visual triggers, which so far received little attention from the scientific community. This self-reported phenomenon is described as a relaxing tingling sensation, which typically originates on scalp and spreads through a person's body. Recently it has been suggested that ASMR shares common characteristics with another underreported condition known as misophonia, where sounds trigger negative physiological, emotional and behavioural responses. The purpose of this study was to elucidate whether ASMR is associated with heightened levels of misophonia.

METHODS: The Misophonia Questionnaire (MQ) was administered to individuals reporting to experience ASMR and to age and gender matched controls.

RESULTS: Compared to controls ASMR group scored higher on all subscales of MQ including the Misophonia Symptom Scale, the Misophonia Emotions and Behaviors Scale and the Misophonia Severity Scale.

DISCUSSION: Individuals reporting ASMR experience have elevated levels of misophonia.}, } @article {pmid30115115, year = {2018}, author = {Inderjeeth, AJ and Webberley, KM and Muir, J and Marshall, BJ}, title = {The potential of computerised analysis of bowel sounds for diagnosis of gastrointestinal conditions: a systematic review.}, journal = {Systematic reviews}, volume = {7}, number = {1}, pages = {124}, pmid = {30115115}, issn = {2046-4053}, mesh = {Auscultation/*methods ; *Diagnosis, Computer-Assisted ; *Diagnostic Tests, Routine ; Gastrointestinal Diseases/*diagnosis ; Humans ; }, abstract = {BACKGROUND: Gastrointestinal (GI) conditions are highly prevalent, and their standard diagnostic tests are costly and carry risks. There is a need for new, cost-effective, non-invasive tests. Our main objective was to assess the potential for use of bowel sounds computerised analysis in the diagnosis of GI conditions.

METHODS: The systematic review followed the PRISMA requirements. Searches were made of four databases (PubMed, MEDLINE, Embase, and IEEE Xplore) and the references of included papers. Studies of all types were included. The titles and abstracts were screened by one author. Full articles were reviewed and data collected by two authors independently. A third reviewer decided on inclusion in the event of disagreement. Bias and applicability were assessed via a QUADAS tool adapted to accommodate studies of multiple types.

RESULTS: Two thousand eight hundred eighty-four studies were retrieved; however, only 14 studies were included. Most of these simply assessed associations between a bowel sound feature and a condition. Four studies also included assessments of diagnostic accuracy. We found many significant associations between a bowel sound feature and a GI condition. Receiver operating characteristic curve analyses revealed high sensitivity and specificity for an irritable bowel syndrome test, and a high negative predictive value for a test for post-operative ileus. Assessment of methodological quality identified weaknesses in all studies. We particularly noted a high risk of bias in patient selection. Because of the limited number of trials included and the variety in conditions, technology, and statistics, we were unable to conduct pooled analyses.

CONCLUSIONS: Due to concerns over quality and small sample sizes, we cannot yet recommend an existing BSCA diagnostic test without additional studies. However, the preliminary results found in the included studies and the technological advances described in excluded studies indicate excellent future potential. Research combining sophistical clinical and engineering skills is likely to be fruitful.

The review protocol (review ID number 42016054028) was developed by three authors (AI, KMW, and JM) and was published in the PROSPERO International prospective register of systematic reviews. It can be accessed from https://www.crd.york.ac.uk/PROSPERO/ .}, } @article {pmid30113140, year = {2018}, author = {Egron, C and Roszyk, L and Rochette, E and Jabaudon, M and Sapin, V and Mulliez, A and Labbé, A and Coste, K}, title = {Serum soluble receptor for advanced glycation end-products during acute bronchiolitis in infant: Prospective study in 93 cases.}, journal = {Pediatric pulmonology}, volume = {53}, number = {10}, pages = {1429-1435}, pmid = {30113140}, issn = {1099-0496}, mesh = {Acute Disease ; Biomarkers/blood ; Bronchiolitis/blood/*diagnosis ; Female ; Hospitalization ; Humans ; Infant ; Male ; Prognosis ; Prospective Studies ; Receptor for Advanced Glycation End Products/*blood ; Recurrence ; Respiratory Sounds/diagnosis ; Severity of Illness Index ; }, abstract = {INTRODUCTION: Acute bronchiolitis is a major cause of acute respiratory distress in infants. The soluble receptor for advanced glycation end-products (sRAGE) is a biomarker of pulmonary damage processes, with a diagnostic and a prognostic value in acute respiratory distress syndrome (ARDS). The RAGE pathway is also implicated in the pathogenesis of other respiratory diseases like asthma, but the value of sRAGE levels in acute bronchiolitis remains under-investigated.

MATERIAL AND METHODS: A prospective, observational, and analytical study was conducted at Clermont-Ferrand University Hospital. The main objective was to evaluate the correlation between serum sRAGE and clinical severity of bronchiolitis in hospitalized infants aged <1 year. We analyzed correlations between serum sRAGE and Wainwright score, short-term morbidity attributable to bronchiolitis, causal viruses and risk for recurrent wheezing at 1 year.

RESULTS: The study included 93 infants. sRAGE levels were significantly lower in acute bronchiolitis patients (mean 1101 pg/mL) than in controls (2203 pg/mL, P < 0.001) but did not correlate with clinical severity. No correlation was found between serum sRAGE and severity score, respiratory viruses, and recurrent wheezing at 1 year. Serum sRAGE levels were negatively correlated with age (r = -0.45, P < 0.001).

CONCLUSION: Serum sRAGE levels are decreased in acute bronchiolitis but not correlated with disease severity. sRAGE levels should be age-adjusted in infants. Serum sRAGE levels measured in the setting of acute bronchiolitis were not predictive of recurrent wheezing.}, } @article {pmid30008683, year = {2018}, author = {Palumbo, DB and Alsalman, O and De Ridder, D and Song, JJ and Vanneste, S}, title = {Misophonia and Potential Underlying Mechanisms: A Perspective.}, journal = {Frontiers in psychology}, volume = {9}, number = {}, pages = {953}, pmid = {30008683}, issn = {1664-1078}, abstract = {There is a growing research interest in the diagnosis rate of misophonia, a condition characterized by a negative emotional/autonomic reaction to specific everyday sounds. Diagnosis of misophonia requires a thorough case history and audiological test procedures. Associative and non-associative learning models for understanding the underlying mechanisms of misophonia have been presented. Currently, there is no cure or pharmaceutical agent for misophonia; however, therapy programs addressing misophonia and its characteristics do exist. Investigation of comorbid conditions and other psychological therapy strategies might help to reveal more about the underlying mechanisms and potentially lead to a successful treatment method.}, } @article {pmid29973546, year = {2018}, author = {Quek, TC and Ho, CS and Choo, CC and Nguyen, LH and Tran, BX and Ho, RC}, title = {Misophonia in Singaporean Psychiatric Patients: A Cross-Sectional Study.}, journal = {International journal of environmental research and public health}, volume = {15}, number = {7}, pages = {}, pmid = {29973546}, issn = {1660-4601}, mesh = {Adult ; Anxiety Disorders/epidemiology/*etiology/*psychology ; Cross-Sectional Studies ; Depressive Disorder/epidemiology/*etiology/*psychology ; Female ; Humans ; Male ; Middle Aged ; Multivariate Analysis ; Psychiatric Status Rating Scales ; Singapore/epidemiology ; Sound/*adverse effects ; }, abstract = {Misophonia, also known as selective sound sensitivity syndrome, is a condition characterized by strong dislike of specific sounds with accompanying distressing reactions. To date, misophonia is still poorly understood. This study aimed to identify factors associated with severity of misophonic symptoms in Singaporean psychiatric patients. Ninety-two psychiatric patients were recruited from a large teaching hospital in Singapore in a cross-sectional study. Socio-demographics, severity of depression, anxiety and stress, and severity of misophonic symptoms were analyzed. Correlation analysis showed that anxiety, depression, and stress scores&mdash;as measured by the Depression, Anxiety and Stress Scales-21 (DASS-21)&mdash;were significantly positively correlated with the Amsterdam Misophonia Scale (A-MISO-S) scores. After adjustment for confounding factors, multivariate regression analysis showed that anxiety (β = 0.385, p = 0.029) remained significantly associated with A-MISO-S. Age, gender, depression, and stress were not significantly associated with the severity of misophonia. The findings showed that the severity of anxiety was associated with severity of misophonia in Singaporean psychiatric patients. Further research is needed to explore the nature of misophonia and its relationship with other psychiatric disorders.}, } @article {pmid29688102, year = {2018}, author = {Aazh, H and McFerran, D and Moore, BCJ}, title = {Uncomfortable loudness levels among children and adolescents seeking help for tinnitus and/or hyperacusis.}, journal = {International journal of audiology}, volume = {57}, number = {8}, pages = {618-623}, doi = {10.1080/14992027.2018.1453617}, pmid = {29688102}, issn = {1708-8186}, mesh = {Acoustic Stimulation ; Adolescent ; *Adolescent Behavior ; Age Factors ; Auditory Threshold ; Child ; *Child Behavior ; Child, Preschool ; Hearing ; Hearing Tests ; Humans ; Hyperacusis/diagnosis/epidemiology/physiopathology/*psychology ; *Loudness Perception ; *Patient Acceptance of Health Care ; Persons With Hearing Impairments/*psychology ; Prevalence ; Retrospective Studies ; Severity of Illness Index ; Tinnitus/diagnosis/epidemiology/physiopathology/*psychology ; }, abstract = {OBJECTIVE: To assess the prevalence of hyperacusis and severe hyperacusis among children and adolescents seen at an audiology outpatient tinnitus and hyperacusis service.

DESIGN: This was a retrospective study. Hyperacusis was considered as present if the average uncomfortable loudness level (ULL) at 0.25, 0.5, 1, 2, 4 and 8 kHz for the ear with the lower average ULL, which is denoted as ULLmin, was ≤77 dB HL. Severe hyperacusis was considered as present if the ULL was 30 dB HL or less for at least one of the measured frequencies for at least one ear.

STUDY SAMPLE: There were 62 young patients with an average age of 12 years (SD = 4.1 years, range 4-18 years).

RESULTS: Eighty-five percent of patients had hyperacusis and 17% had severe hyperacusis. On average, ULLs at 8 kHz were 9.3 dB lower than ULLs at 0.25 kHz. For 33% of patients, ULLs were at least 20 dB lower at 8 than at 0.25 kHz.

CONCLUSIONS: Among children and adolescents seen at an audiology outpatient clinic for tinnitus and hyperacusis, hyperacusis diagnosed on the basis of ULLs is very prevalent and it is often characterised by lower ULLs at 8 than at 0.25 kHz.}, } @article {pmid29673780, year = {2019}, author = {Silva, FED and Sanchez, TG}, title = {Evaluation of selective attention in patients with misophonia.}, journal = {Brazilian journal of otorhinolaryngology}, volume = {85}, number = {3}, pages = {303-309}, pmid = {29673780}, issn = {1808-8686}, mesh = {Adolescent ; Adult ; Age Distribution ; Attention/*physiology ; Auditory Perceptual Disorders/*physiopathology ; Case-Control Studies ; Female ; Humans ; Hyperacusis/*physiopathology ; Male ; Middle Aged ; Young Adult ; }, abstract = {INTRODUCTION: Misophonia is characterized by the aversion to very selective sounds, which evoke a strong emotional reaction. It has been inferred that misophonia, as well as tinnitus, is associated with hyperconnectivity between auditory and limbic systems. Individuals with bothersome tinnitus may have selective attention impairment, but it has not been demonstrated in case of misophonia yet.

OBJECTIVE: To characterize a sample of misophonic subjects and compare it with two control groups, one with tinnitus individuals (without misophonia) and the other with asymptomatic individuals (without misophonia and without tinnitus), regarding the selective attention.

METHODS: We evaluated 40 normal-hearing participants: 10 with misophonia, 10 with tinnitus (without misophonia) and 20 without tinnitus and without misophonia. In order to evaluate the selective attention, the dichotic sentence identification test was applied in three situations: firstly, the Brazilian Portuguese test was applied. Then, the same test was applied, combined with two competitive sounds: chewing sound (representing a sound that commonly triggers misophonia), and white noise (representing a common type of tinnitus which causes discomfort to patients).

RESULTS: The dichotic sentence identification test with chewing sound, showed that the average of correct responses differed between misophonia and without tinnitus and without misophonia (p=0.027) and between misophonia and tinnitus (without misophonia) (p=0.002), in both cases lower in misophonia. Both, the dichotic sentence identification test alone, and with white noise, failed to show differences in the average of correct responses among the three groups (p≥0.452).

CONCLUSION: The misophonia participants presented a lower percentage of correct responses in the dichotic sentence identification test with chewing sound; suggesting that individuals with misophonia may have selective attention impairment when they are exposed to sounds that trigger this condition.}, } @article {pmid29576731, year = {2018}, author = {Bransfield, RC}, title = {Aggressiveness, violence, homicidality, homicide, and Lyme disease.}, journal = {Neuropsychiatric disease and treatment}, volume = {14}, number = {}, pages = {693-713}, pmid = {29576731}, issn = {1176-6328}, abstract = {BACKGROUND: No study has previously analyzed aggressiveness, homicide, and Lyme disease (LD).

MATERIALS AND METHODS: Retrospective LD chart reviews analyzed aggressiveness, compared 50 homicidal with 50 non-homicidal patients, and analyzed homicides.

RESULTS: Most aggression with LD was impulsive, sometimes provoked by intrusive symptoms, sensory stimulation or frustration and was invariably bizarre and senseless. About 9.6% of LD patients were homicidal with the average diagnosis delay of 9 years. Postinfection findings associated with homicidality that separated from the non-homicidal group within the 95% confidence interval included suicidality, sudden abrupt mood swings, explosive anger, paranoia, anhedonia, hypervigilance, exaggerated startle, disinhibition, nightmares, depersonalization, intrusive aggressive images, dissociative episodes, derealization, intrusive sexual images, marital/family problems, legal problems, substance abuse, depression, panic disorder, memory impairments, neuropathy, cranial nerve symptoms, and decreased libido. Seven LD homicides included predatory aggression, poor impulse control, and psychosis. Some patients have selective hyperacusis to mouth sounds, which I propose may be the result of brain dysfunction causing a disinhibition of a primitive fear of oral predation.

CONCLUSION: LD and the immune, biochemical, neurotransmitter, and the neural circuit reactions to it can cause impairments associated with violence. Many LD patients have no aggressiveness tendencies or only mild degrees of low frustration tolerance and irritability and pose no danger; however, a lesser number experience explosive anger, a lesser number experience homicidal thoughts and impulses, and much lesser number commit homicides. Since such large numbers are affected by LD, this small percent can be highly significant. Much of the violence associated with LD can be avoided with better prevention, diagnosis, and treatment of LD.}, } @article {pmid29553971, year = {2018}, author = {Robinson, S and Hedderly, T and Conte, G and Malik, O and Cardona, F}, title = {Misophonia in Children with Tic Disorders: A Case Series.}, journal = {Journal of developmental and behavioral pediatrics : JDBP}, volume = {39}, number = {6}, pages = {516-522}, doi = {10.1097/DBP.0000000000000563}, pmid = {29553971}, issn = {1536-7312}, mesh = {Adolescent ; Affective Symptoms/etiology/*physiopathology ; Auditory Perception/*physiology ; Child ; Female ; Humans ; Male ; Perceptual Disorders/etiology/*physiopathology ; *Self-Control ; Tic Disorders/complications/*physiopathology ; Tourette Syndrome/complications/physiopathology ; }, abstract = {OBJECTIVE: Misophonia is a condition characterized by the dislike or hatred (miso) of specific sounds (phonia) that results in an extreme emotional response. There has been growing interest in misophonia, with emerging evidence from neurodevelopmental populations and ongoing debate regarding the psychiatric classification and the mechanisms underlying this phenomenon. This is the first article to report on misophonic experiences and associated clinical characteristics in young people with tic disorders.

METHOD: In this article, we present the cases of 12 children and young people with tic disorders who have attended clinics in the United Kingdom and Italy who report misophonia. Misophonia was classified as a selective aversive response in accordance with the criteria proposed by Schröder.

RESULTS: These cases support the view that a range of auditory stimuli may lead to negative/aversive emotional responses of varying degrees, with misophonia seeming to contribute to behavioral reactions. Among these, the most frequent was anger outbursts, followed by an increase in tics, trigger avoidance, repetition of the sound, and self-injurious behavior. No single treatment approach was effective, with some patients responding to cognitive behavioral therapies and others to pharmacological support.

CONCLUSION: We postulate that misophonia could be an underestimated causative phenomenon for abrupt emotional dysregulation in individuals with tic disorders and should be considered as part of a comprehensive clinical assessment. This article presents findings of relevance to general discussions regarding the classification of misophonia, as well as the potential relationship between sensory abnormalities and the broader phenotype of tic disorders during development.}, } @article {pmid29548862, year = {2018}, author = {Badulak, JH and Schurr, M and Sauaia, A and Ivashchenko, A and Peltz, E}, title = {Defining the criteria for intubation of the patient with thermal burns.}, journal = {Burns : journal of the International Society for Burn Injuries}, volume = {44}, number = {3}, pages = {531-538}, doi = {10.1016/j.burns.2018.02.016}, pmid = {29548862}, issn = {1879-1409}, mesh = {Adolescent ; Adult ; Aged ; Burns/epidemiology/*therapy ; Consciousness Disorders/epidemiology ; Deglutition Disorders/epidemiology ; Edema/epidemiology ; Facial Injuries/epidemiology ; Female ; Humans ; Hypercapnia/epidemiology ; Hypoxia/epidemiology ; Intubation, Intratracheal/*methods ; Laryngoscopy ; Male ; Middle Aged ; Odds Ratio ; *Patient Selection ; Respiration, Artificial/*methods ; Respiratory Distress Syndrome/epidemiology ; Respiratory Sounds ; Retrospective Studies ; Smoke Inhalation Injury/epidemiology ; Soot ; Young Adult ; }, abstract = {OBJECTIVES: Recent studies demonstrate that burn patients are undergoing unnecessary intubations. We sought to determine the clinical criteria that predict intubations with benefit.

METHODS: This was a retrospective review of intubated adults admitted to our center with thermal burns 2008-2013. Criteria for intubation were defined as traditional criteria (suspected smoke inhalation, oropharynx soot, hoarseness, dysphagia, singed facial hair, oral edema, oral burn, non-full thickness facial burns), or ABA criteria as defined by the 2011 ABA guidelines (full thickness facial burns, stridor, respiratory distress, swelling on laryngoscopy, upper airway trauma, altered mentation, hypoxia/hypercarbia, hemodynamic instability). Patients with <26days free from mechanical ventilation (ventilator-free days (VFD)) out of 28, were deemed indicated long-term intubations. Those with ≥26 VFD were deemed unnecessary short-term intubations.

RESULTS: Of 218 patients, 151 had long-term and 67 had short-term intubations. Long-term intubation was strongly associated with ABA criteria (77.5%) compared to traditional criteria (22.5%) (p<0.001). Sensitivity of ABA criteria for long-term intubation was 77% and specificity 46%. Traditional criteria associated with long-term intubation included suspected smoke inhalation (OR 2.45 [95% CI, 1.18-5.11]), and singed facial hair (OR 2.53 [95% CI, 1.25-5.09]). The addition of these to ABA criteria created the Denver criteria, which exhibited an increased sensitivity for long-term intubations (95%), but decreased specificity (24%).

CONCLUSIONS: Intubation should be considered for patients displaying the Denver criteria, which includes full thickness facial burns, stridor, respiratory distress, swelling on laryngoscopy, upper airway trauma, altered mentation, hypoxia/hypercarbia, hemodynamic instability, suspected smoke inhalation, and singed facial hair. Patients lacking these criteria should not be intubated.}, } @article {pmid29530266, year = {2018}, author = {McKay, D and Kim, SK and Mancusi, L and Storch, EA and Spankovich, C}, title = {Profile Analysis of Psychological Symptoms Associated With Misophonia: A Community Sample.}, journal = {Behavior therapy}, volume = {49}, number = {2}, pages = {286-294}, doi = {10.1016/j.beth.2017.07.002}, pmid = {29530266}, issn = {1878-1888}, mesh = {Adolescent ; Adult ; Aged ; Female ; Hearing Disorders/*physiopathology/*psychology ; Humans ; Male ; Middle Aged ; *Sound ; Young Adult ; }, abstract = {Misophonia is characterized by extreme aversive reactions to certain classes of sounds. It has recently been recognized as a condition associated with significant disability. Research has begun to evaluate psychopathological correlates of misophonia. This study sought to identify profiles of psychopathology that characterize misophonia in a large community sample. A total of N = 628 adult participants completed a battery of measures assessing anxiety and anxiety sensitivity, depression, stress responses, anger, dissociative experiences, obsessive-compulsive symptoms and beliefs, distress tolerance, bodily perceptions, as well as misophonia severity. Profile Analysis via Multidimensional Scaling (PAMS) was employed to evaluate profiles associated with elevated misophonia and those without symptoms. Three profiles were extracted. The first two accounted for 70% total variance and did not show distinctions between groups. The third profile accounted for 11% total variance, and showed that misophonia is associated with lower obsessive-compulsive symptoms for neutralizing, obsessions generally, and washing compared to those not endorsing misophonia, and higher levels of obsessive-compulsive symptoms associated with ordering and harm avoidance. This third profile extracted also showed significant differences between those with and without misophonia on the scale assessing physical concerns (that is, sensitivity to interoceptive sensations) as assessed with the ASI-3. Further research is called for involving diagnostic interviewing and experimental methods to clarify these putative mechanisms associated with misophonia.}, } @article {pmid29467604, year = {2018}, author = {Brout, JJ and Edelstein, M and Erfanian, M and Mannino, M and Miller, LJ and Rouw, R and Kumar, S and Rosenthal, MZ}, title = {Investigating Misophonia: A Review of the Empirical Literature, Clinical Implications, and a Research Agenda.}, journal = {Frontiers in neuroscience}, volume = {12}, number = {}, pages = {36}, pmid = {29467604}, issn = {1662-4548}, abstract = {Misophonia is a neurobehavioral syndrome phenotypically characterized by heightened autonomic nervous system arousal and negative emotional reactivity (e. g., irritation, anger, anxiety) in response to a decreased tolerance for specific sounds. The aims of this review are to (a) characterize the current state of the field of research on misophonia, (b) highlight what can be inferred from the small research literature to inform treatment of individuals with misophonia, and (c) outline an agenda for research on this topic. We extend previous reviews on this topic by critically reviewing the research investigating mechanisms of misophonia and differences between misophonia and other conditions. In addition, we integrate this small but growing literature with basic and applied research from other literatures in a cross-disciplinary manner.}, } @article {pmid29308941, year = {2018}, author = {Pennetti, A}, title = {A multimodal physical therapy approach utilizing the Maitland concept in the management of a patient with cervical and lumbar radiculitis and Ehlers-Danlos syndrome-hypermobility type: A case report.}, journal = {Physiotherapy theory and practice}, volume = {34}, number = {7}, pages = {559-568}, doi = {10.1080/09593985.2017.1422207}, pmid = {29308941}, issn = {1532-5040}, mesh = {Adult ; Back Pain/diagnosis/etiology/physiopathology/*rehabilitation ; Biomechanical Phenomena ; Cervical Vertebrae/diagnostic imaging/*physiopathology ; Clinical Decision-Making ; Combined Modality Therapy ; Ehlers-Danlos Syndrome/complications/diagnosis/physiopathology/*rehabilitation ; Female ; Humans ; Lumbar Vertebrae/diagnostic imaging/*physiopathology ; Pain Measurement ; *Physical Therapy Modalities ; Predictive Value of Tests ; Radiculopathy/diagnosis/etiology/physiopathology/*rehabilitation ; Range of Motion, Articular ; Recovery of Function ; Treatment Outcome ; }, abstract = {The purpose of this case report is to present a multimodal approach for patient management using the Maitland concept framework for cervical and lumbar radiculitis with an underlying diagnosis of Ehlers-Danlos Syndrome-Hypermobility Type (EDS-HT). This case presents care guided by evidence, patient values, and rationale for the selected course of physical therapy treatment provided by therapist experience. A 35-year-old female with a 2-year history of worsening lumbar and cervical pain was referred to physical therapy to address these musculoskeletal issues concurrent with diagnostic testing for EDS. A multimodal approach including manual therapy, therapeutic exercise, postural and body mechanics education, and a home exercise program was used. The patient specific functional scale (PSFS) was used to gauge patient's perceived improvements which were demonstrated by increased scores at reevaluation and at discharge. Following the Maitland concept framework, the physical therapist was able to make sound clinical decisions by tracking the logical flow of constant patient assessment. A 10-month course of treatment designed to maximize recovery of function was successful with a chronic history of pain and the EDS-HT diagnosis. The role of education and empowering the patient is shown to be of utmost importance. Optimizing therapeutic outcomes long-term for this patient population requires maintaining a home exercise program, adaptation and modifications of work and lifestyle activities.}, } @article {pmid29252938, year = {2018}, author = {Renier, W and Winckelmann, KH and Verbakel, JY and Aertgeerts, B and Buntinx, F}, title = {Signs and symptoms in adult patients with acute dyspnea: a systematic review and meta-analysis.}, journal = {European journal of emergency medicine : official journal of the European Society for Emergency Medicine}, volume = {25}, number = {1}, pages = {3-11}, doi = {10.1097/MEJ.0000000000000429}, pmid = {29252938}, issn = {1473-5695}, mesh = {Acute Coronary Syndrome/diagnosis ; Adult ; Asthma/diagnosis ; Dyspnea/*diagnosis/epidemiology ; Emergency Service, Hospital ; Heart Failure/diagnosis ; Humans ; Male ; Physical Examination/*statistics & numerical data ; Pulmonary Disease, Chronic Obstructive/diagnosis ; }, abstract = {INTRODUCTION: Rapid and accurate diagnosis of patients with a new episode of acute dyspnea is a common challenge for Primary Care or Emergency Physicians.

OBJECTIVE: To determine the diagnostic accuracy of signs and symptoms in adult patients with a new episode of acute dyspnea presenting to a GP or an Emergency Physician (EP).

PATIENTS AND METHODS: This was a diagnostic systematic review. Using MEDLINE, Cumulative Index to Nursing and Allied Health Literature, EMBASE, tracing references, and by contacting experts, studies were identified on the diagnostic accuracy of additional signs and symptoms in adult patients with acute or suddenly worsening dyspnea, presenting to a GP or an EP. Study quality was assessed using QUADAS and results were pooled using a random-effects model. Sensitivity, specificity, positive and negative likelihood ratio (NLR), and positive and negative predictive values for a diagnosis of heart failure (HF) were calculated for the combination of acute dyspnea and each additional sign or symptom in the selected studies.

RESULTS: Eight of the 24 identified studies were carried out in the ED and provided us with all the required data, including 4737 patients. All publications reported HF; two studies additionally investigated pulmonary embolism, acute exacerbations of chronic obstructive pulmonary disease or asthma, acute pulmonary infectious diseases, or acute coronary syndrome. The prevalence of HF in patients with acute dyspnea ranged from 25 to 59%. Heterogeneity was present in all analyses.Comparing signs and symptoms, sensitivity was very poor for the presence of fever (0.05) and sputum production (0.06), and poor for fatigue (0.36-0.76), orthopnea (0.2-0.76), paroxysmal nocturnal dyspnea (0.23-0.70), elevated jugular venous pressure (0.19-0.70), rales (0.32-0.88), and peripheral edema (0.29-0.77). Specificity was poor for fatigue (0.28-0.69), moderate for the presence of fever (0.76-0.88), sputum production (0.73-0.89), orthopnea (0.49-0.92), paroxysmal nocturnal dyspnea (0.52-0.93), and rales (0.31-0.98), and good for elevated jugular venous pressure (0.75-0.97) and peripheral edema (0.67-0.89).For all other signs and symptoms, sensitivities varied between 0.20 and 0.43; specificities for symptoms varied widely between 0.37 and 0.91 and those of signs between 0.20 and 1.0.The pooled sensitivities, however, remained poor: below 0.55. Pooled specificity of most signs ranged between 0.69 and 0.88. The positive likelihood ratio was between 0.64 and 4.11 and the NLR was between 0.59 and 1.29 with one outlier: rales (pooled NLR=0.35).

CONCLUSION: This systematic review, which only included patients from ED settings, did not identify any single sign or symptom that had acceptable sensitivity to be useful in ruling out a diagnosis of HF, chronic obstructive pulmonary disease, asthma, or pulmonary embolism. Elevated jugular venous pressure (0.88, pooled odds ratio: 7), added third heart sound (0.97), and lung crepitations (0.77, pooled odds ratio: 11) are useful in ruling in HF.}, } @article {pmid29184520, year = {2017}, author = {Dozier, TH and Lopez, M and Pearson, C}, title = {Proposed Diagnostic Criteria for Misophonia: A Multisensory Conditioned Aversive Reflex Disorder.}, journal = {Frontiers in psychology}, volume = {8}, number = {}, pages = {1975}, pmid = {29184520}, issn = {1664-1078}, } @article {pmid29018601, year = {2017}, author = {Barratt, EL and Spence, C and Davis, NJ}, title = {Sensory determinants of the autonomous sensory meridian response (ASMR): understanding the triggers.}, journal = {PeerJ}, volume = {5}, number = {}, pages = {e3846}, pmid = {29018601}, issn = {2167-8359}, abstract = {The autonomous sensory meridian response (ASMR) is an atypical sensory phenomenon involving electrostatic-like tingling sensations in response to certain sensory, primarily audio-visual, stimuli. The current study used an online questionnaire, completed by 130 people who self-reported experiencing ASMR. We aimed to extend preliminary investigations into the experience, and establish key multisensory factors contributing to the successful induction of ASMR through online media. Aspects such as timing and trigger load, atmosphere, and characteristics of ASMR content, ideal spatial distance from various types of stimuli, visual characteristics, context and use of ASMR triggers, and audio preferences are explored. Lower-pitched, complex sounds were found to be especially effective triggers, as were slow-paced, detail-focused videos. Conversely, background music inhibited the sensation for many respondents. These results will help in designing media for ASMR induction.}, } @article {pmid28922587, year = {2017}, author = {Kamody, RC and Del Conte, GS}, title = {Using Dialectical Behavior Therapy to Treat Misophonia in Adolescence.}, journal = {The primary care companion for CNS disorders}, volume = {19}, number = {5}, pages = {}, doi = {10.4088/PCC.17l02105}, pmid = {28922587}, issn = {2155-7780}, mesh = {Adolescent ; Auditory Perception ; *Behavior Therapy/methods ; Comorbidity ; Female ; Humans ; Mental Disorders/*therapy ; }, } @article {pmid28859824, year = {2017}, author = {Erfanian, M and Jo Brout, J and Edelstein, M and Kumar, S and Mannino, M and Miller, LJ and Rouw, R and Rosenthal, MZ}, title = {REMOVED: Investigating misophonia: A review of the literature, clinical implications and research agenda reflecting current neuroscience and emotion research perspectives.}, journal = {European psychiatry : the journal of the Association of European Psychiatrists}, volume = {41S}, number = {}, pages = {S681}, doi = {10.1016/j.eurpsy.2017.01.1180}, pmid = {28859824}, issn = {1778-3585}, abstract = {This article has been removed: please see Elsevier Policy on Article Withdrawal (https://www.elsevier.com/about/our-business/policies/article-withdrawal). This article has been removed at the request of the authors due to errors in the author list.}, } @article {pmid28823694, year = {2018}, author = {Sanchez, TG and Silva, FED}, title = {Familial misophonia or selective sound sensitivity syndrome : evidence for autosomal dominant inheritance?.}, journal = {Brazilian journal of otorhinolaryngology}, volume = {84}, number = {5}, pages = {553-559}, pmid = {28823694}, issn = {1808-8686}, mesh = {Adolescent ; Adult ; Aged ; *Anger ; Anxiety Disorders/diagnosis/epidemiology/*genetics/*psychology ; Child ; Depression/diagnosis/epidemiology/genetics/psychology ; *Emotions ; Family ; Female ; Hearing Disorders/diagnosis/epidemiology/*genetics/*psychology ; Humans ; Male ; Middle Aged ; Obsessive-Compulsive Disorder/diagnosis/epidemiology/*genetics/*psychology ; Quality of Life ; Sound ; Surveys and Questionnaires ; Syndrome ; Young Adult ; }, abstract = {INTRODUCTION: Misophonia is a recently described, poorly understood and neglected condition. It is characterized by strong negative reactions of hatred, anger or fear when subjects have to face some selective and low level repetitive sounds. The most common ones that trigger such aversive reactions are those elicited by the mouth (chewing gum or food, popping lips) or the nose (breathing, sniffing, and blowing) or by the fingers (typing, kneading paper, clicking pen, drumming on the table). Previous articles have cited that such individuals usually know at least one close relative with similar symptoms, suggesting a possible hereditary component.

OBJECTIVE: We found and described a family with 15 members having misophonia, detailing their common characteristics and the pattern of sounds that trigger such strong discomfort.

METHODS: All 15 members agreed to give us their epidemiological data, and 12 agreed to answer a specific questionnaire which investigated the symptoms, specific trigger sounds, main feelings evoked and attitudes adopted by each participant.

RESULTS: The 15 members belong to three generations of the family. Their age ranged from 9 to 73 years (mean 38.3 years; median 41 years) and 10 were females. Analysis of the 12 questionnaires showed that 10 subjects (83.3%) developed the first symptoms during childhood or adolescence. The mean annoyance score on the Visual Analog Scale from 0 to 10 was 7.3 (median 7.5). Individuals reported hatred/anger, irritability and anxiety in response to sounds, and faced the situation asking to stop the sound, leaving/avoiding the place and even fighting. The self-reported associated symptoms were anxiety (91.3%), tinnitus (50%), obsessive-compulsive disorder (41.6%), depression (33.3%), and hypersensitivity to sounds (25%).

CONCLUSION: The high incidence of misophonia in this particular familial distribution suggests that it might be more common than expected and raises the possibility of having a hereditary etiology.}, } @article {pmid28706477, year = {2017}, author = {Kumar, S and Griffiths, TD}, title = {Response: Commentary: The Brain Basis for Misophonia.}, journal = {Frontiers in behavioral neuroscience}, volume = {11}, number = {}, pages = {127}, pmid = {28706477}, issn = {1662-5153}, support = {//Wellcome Trust/United Kingdom ; }, } @article {pmid28626391, year = {2017}, author = {Schröder, A and van Wingen, G and Vulink, NC and Denys, D}, title = {Commentary: The Brain Basis for Misophonia.}, journal = {Frontiers in behavioral neuroscience}, volume = {11}, number = {}, pages = {111}, pmid = {28626391}, issn = {1662-5153}, } @article {pmid28579480, year = {2018}, author = {Tavassoli, T and Miller, LJ and Schoen, SA and Jo Brout, J and Sullivan, J and Baron-Cohen, S}, title = {Sensory reactivity, empathizing and systemizing in autism spectrum conditions and sensory processing disorder.}, journal = {Developmental cognitive neuroscience}, volume = {29}, number = {}, pages = {72-77}, pmid = {28579480}, issn = {1878-9307}, support = {G0600977/MRC_/Medical Research Council/United Kingdom ; }, mesh = {Adolescent ; Autism Spectrum Disorder/diagnosis/*physiopathology/*psychology ; Child ; Child Development ; Child, Preschool ; *Cognition ; *Empathy ; Female ; Humans ; Male ; *Sensation ; }, abstract = {Although the DSM-5 added sensory symptoms as a criterion for ASC, there is a group of children who display sensory symptoms but do not have ASC; children with sensory processing disorder (SPD). To be able to differentiate these two disorders, our aim was to evaluate whether children with ASC show more sensory symptomatology and/or different cognitive styles in empathy and systemizing compared to children with SPD and typically developing (TD) children. The study included 210 participants: 68 children with ASC, 79 with SPD and 63 TD children. The Sensory Processing Scale Inventory was used to measure sensory symptoms, the Autism Spectrum Quotient (AQ) to measure autistic traits, and the Empathy Quotient (EQ) and Systemizing Quotient (SQ) to measure cognitive styles. Across groups, a greater sensory symptomatology was associated with lower empathy. Further, both the ASC and SPD groups showed more sensory symptoms than TD children. Children with ASC and SPD only differed on sensory under-reactivity. The ASD group did, however, show lower empathy and higher systemizing scores than the SPD group. Together, this suggest that sensory symptoms alone may not be adequate to differentiate children with ASC and SPD but that cognitive style measures could be used for differential diagnosis.}, } @article {pmid28571795, year = {2017}, author = {Taylor, S}, title = {Misophonia: A new mental disorder?.}, journal = {Medical hypotheses}, volume = {103}, number = {}, pages = {109-117}, doi = {10.1016/j.mehy.2017.05.003}, pmid = {28571795}, issn = {1532-2777}, mesh = {Affective Symptoms/*diagnosis ; Anger ; Anxiety ; Anxiety Disorders/psychology ; Behavior ; Diagnostic and Statistical Manual of Mental Disorders ; *Emotions ; Hearing Disorders/*diagnosis/*psychology ; Humans ; Hyperacusis/complications ; Mental Disorders/complications ; Models, Theoretical ; *Sound ; Tinnitus/complications ; }, abstract = {Misophonia, a phenomenon first described in the audiology literature, is characterized by intense emotional reactions (e.g., anger, rage, anxiety, disgust) in response to highly specific sounds, particularly sounds of human origin such as oral or nasal noises made by other people (e.g., chewing, sniffing, slurping, lip smacking). Misophonia is not listed in any of the contemporary psychiatric classification systems. Some investigators have argued that misophonia should be regarded as a new mental disorder, falling within the spectrum of obsessive-compulsive related disorders. Other researchers have disputed this claim. The purpose of this article is to critically examine the proposition that misophonia should be classified as a new mental disorder. The clinical and research literature on misophonia was examined and considered in the context of the broader literature on what constitutes a mental disorder. There have been growing concerns that diagnostic systems such as DSM-5 tend to over-pathologize ordinary quirks and eccentricities. Accordingly, solid evidence is required for proposing a new psychiatric disorder. The available evidence suggests that (a) misophonia meets many of the general criteria for a mental disorder and has some evidence of clinical utility as a diagnostic construct, but (b) the nature and boundaries of the syndrome are unclear; for example, in some cases misophonia might be simply one feature of a broader pattern of sensory intolerance, and (c) considerably more research is required, particularly work concerning diagnostic validity, before misophonia, defined as either as a disorder or as a key feature of some broader syndrome of sensory intolerance, should be considered as a diagnostic construct in the psychiatric nomenclature. A research roadmap is proposed for the systematic evaluation as to whether misophonia should be considered for future editions of DSM or ICD.}, } @article {pmid28561277, year = {2018}, author = {Rouw, R and Erfanian, M}, title = {A Large-Scale Study of Misophonia.}, journal = {Journal of clinical psychology}, volume = {74}, number = {3}, pages = {453-479}, doi = {10.1002/jclp.22500}, pmid = {28561277}, issn = {1097-4679}, mesh = {Adult ; Affective Symptoms/epidemiology/*physiopathology ; Comorbidity ; Female ; Hearing Disorders/epidemiology/*physiopathology ; Humans ; Male ; Middle Aged ; Pain/epidemiology/*physiopathology ; Perceptual Disorders/epidemiology/*physiopathology ; *Quality of Life ; Severity of Illness Index ; Stress Disorders, Post-Traumatic/epidemiology/*physiopathology ; Synesthesia ; }, abstract = {OBJECTIVE: We aim to elucidate misophonia, a condition in which particular sounds elicit disproportionally strong aversive reactions.

METHOD: A large online study extensively surveyed personal, developmental, and clinical characteristics of over 300 misophonics.

RESULTS: Most participants indicated that their symptoms started in childhood or early teenage years. Severity of misophonic responses increases over time. One third of participants reported having family members with similar symptoms. Half of our participants reported no comorbid clinical conditions, and the other half reported a variety of conditions. Only posttraumatic stress disorder (PTSD) was related to the severity of the misophonic symptoms. Remarkably, half of the participants reported experiencing euphoric, relaxing, and tingling sensations with particular sounds or sights, a relatively unfamiliar phenomenon called autonomous sensory meridian response (ASMR).

CONCLUSION: It is unlikely that another "real" underlying clinical, psychiatric, or psychological disorder can explain away the misophonia. The possible relationship with PTSD and ASMR warrants further investigation.}, } @article {pmid28555110, year = {2017}, author = {Tan, H and Bungert-Plümke, S and Fahlke, C and Stölting, G}, title = {Reduced Membrane Insertion of CLC-K by V33L Barttin Results in Loss of Hearing, but Leaves Kidney Function Intact.}, journal = {Frontiers in physiology}, volume = {8}, number = {}, pages = {269}, pmid = {28555110}, issn = {1664-042X}, abstract = {In the mammalian ear, transduction of sound stimuli is initiated by K[+] entry through mechano-sensitive channels into inner hair cells. K[+] entry is driven by a positive endocochlear potential that is maintained by the marginal cell layer of the stria vascularis. This process requires basolateral K[+] import by NKCC1 Na[+]-2Cl[-]-K[+] co-transporters as well as Cl[-] efflux through ClC-Ka/barttin or ClC-Kb/barttin channels. Multiple mutations in the gene encoding the obligatory CLC-K subunit barttin, BSND, have been identified in patients with Bartter syndrome type IV. These mutations reduce the endocochlear potential and cause deafness. As CLC-K/barttin channels are also expressed in the kidney, patients with Bartter syndrome IV typically also suffer from salt-wasting hyperuria and electrolyte imbalances. However, there was a single report on a BSND mutation that resulted only in deafness, but not kidney disease. We herein studied the functional consequences of another recently discovered BSND mutation that predicts exchange of valine at position 33 by leucine. We combined whole-cell patch clamp, confocal microscopy and protein biochemistry to analyze how V33L affects distinct functions of barttin. We found that V33L reduced membrane insertion of CLC-K/barttin complexes without altering unitary CLC-K channel function. Our findings support the hypothesis of a common pathophysiology for the selective loss of hearing due to an attenuation of the total chloride conductance in the stria vascularis while providing enough residual function to maintain normal kidney function.}, } @article {pmid28441620, year = {2017}, author = {Schröder, AE and Vulink, NC and van Loon, AJ and Denys, DA}, title = {Cognitive behavioral therapy is effective in misophonia: An open trial.}, journal = {Journal of affective disorders}, volume = {217}, number = {}, pages = {289-294}, doi = {10.1016/j.jad.2017.04.017}, pmid = {28441620}, issn = {1573-2517}, mesh = {Adult ; *Anger ; Cognitive Behavioral Therapy/*methods ; Female ; Humans ; Male ; Middle Aged ; Psychotherapy, Group ; Research Design ; Sensation Disorders/*therapy ; Treatment Outcome ; }, abstract = {BACKGROUND: Misophonia is a psychiatric disorder in which ordinary human sounds like smacking or chewing provoke intense anger and disgust. Despite the high burden of this condition, to date there is no evidence-based treatment available. In this study we evaluated the efficacy of cognitive behavioral therapy (CBT) and investigated whether clinical or demographic characteristics predicted treatment response.

METHODS: Ninety patients with misophonia received eight bi-weekly group CBT sessions. Treatment response was defined as a Clinical Global Impression - Improvement Scale (CGI-I) score at endpoint of 1 or 2 (very much or much improved) and a 30% or greater reduction on the Amsterdam Misophonia Scale (A-MISO-S), a measure of the severity of misophonia symptoms.

RESULTS: Following treatment 48% (N=42) of the patients showed a significant reduction of misophonia symptoms. Severity of misophonia and the presence of disgust were positive predictors of treatment response.

LIMITATIONS: The A-MISO-S is not a validated scale. Furthermore, this was an open-label study with a waiting list control condition.

CONCLUSIONS: This is the first treatment study for misophonia. Our results suggest that CBT is effective in half of the patients.}, } @article {pmid28162895, year = {2017}, author = {Kumar, S and Tansley-Hancock, O and Sedley, W and Winston, JS and Callaghan, MF and Allen, M and Cope, TE and Gander, PE and Bamiou, DE and Griffiths, TD}, title = {The Brain Basis for Misophonia.}, journal = {Current biology : CB}, volume = {27}, number = {4}, pages = {527-533}, pmid = {28162895}, issn = {1879-0445}, support = {/WT_/Wellcome Trust/United Kingdom ; 091593/WT_/Wellcome Trust/United Kingdom ; MR/J011207/1/MRC_/Medical Research Council/United Kingdom ; }, mesh = {Adult ; Anger/*physiology ; Anxiety Disorders/diagnostic imaging/*physiopathology ; Brain/diagnostic imaging/*physiopathology ; Cerebral Cortex/diagnostic imaging/*physiology ; Emotions/physiology ; Female ; Galvanic Skin Response ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Sound/*adverse effects ; Young Adult ; }, abstract = {Misophonia is an affective sound-processing disorder characterized by the experience of strong negative emotions (anger and anxiety) in response to everyday sounds, such as those generated by other people eating, drinking, chewing, and breathing [1-8]. The commonplace nature of these sounds (often referred to as "trigger sounds") makes misophonia a devastating disorder for sufferers and their families, and yet nothing is known about the underlying mechanism. Using functional and structural MRI coupled with physiological measurements, we demonstrate that misophonic subjects show specific trigger-sound-related responses in brain and body. Specifically, fMRI showed that in misophonic subjects, trigger sounds elicit greatly exaggerated blood-oxygen-level-dependent (BOLD) responses in the anterior insular cortex (AIC), a core hub of the "salience network" that is critical for perception of interoceptive signals and emotion processing. Trigger sounds in misophonics were associated with abnormal functional connectivity between AIC and a network of regions responsible for the processing and regulation of emotions, including ventromedial prefrontal cortex (vmPFC), posteromedial cortex (PMC), hippocampus, and amygdala. Trigger sounds elicited heightened heart rate (HR) and galvanic skin response (GSR) in misophonic subjects, which were mediated by AIC activity. Questionnaire analysis showed that misophonic subjects perceived their bodies differently: they scored higher on interoceptive sensibility than controls, consistent with abnormal functioning of AIC. Finally, brain structural measurements implied greater myelination within vmPFC in misophonic individuals. Overall, our results show that misophonia is a disorder in which abnormal salience is attributed to particular sounds based on the abnormal activation and functional connectivity of AIC.}, } @article {pmid27838888, year = {2017}, author = {Viziano, A and Micarelli, A and Alessandrini, M}, title = {Noise sensitivity and hyperacusis in patients affected by multiple chemical sensitivity.}, journal = {International archives of occupational and environmental health}, volume = {90}, number = {2}, pages = {189-196}, pmid = {27838888}, issn = {1432-1246}, mesh = {Adult ; Female ; Humans ; Hyperacusis/*epidemiology ; Male ; Middle Aged ; *Multiple Chemical Sensitivity ; Noise/*adverse effects ; Otoacoustic Emissions, Spontaneous/physiology ; Surveys and Questionnaires ; }, abstract = {PURPOSE: The aim of this study was to investigate the presence of noise sensitivity and hyperacusis in patients suffering from multiple chemical sensitivity (MCS), a chronic condition characterized by several symptoms following low-level chemical exposure. Moreover, distortion product otoacoustic emissions (DPOAE) were performed to further study cochlear function.

METHODS: A questionnaire-based survey was performed. Eighteen MCS patients, selected with strict diagnostic criteria, and 20 healthy age- and gender-matched subjects filled Weinstein's Noise Sensitivity Questionnaire (WNS) and Khalfa's Hyperacusis Questionnaire (HQ). Results were compared with scores from the quick Environmental Exposure Sensitivity Index (qEESI), a routinarily used questionnaire to screen MCS symptoms, and with DPOAE values. An analysis of variance (ANOVA) was performed between MCS and control subjects scores; moreover, Spearman's rank correlation test was performed between questionnaire results.

RESULTS: ANOVA testing on DPOAE values showed any significant difference between groups, while WNS, HQ and qEESI scores were significantly higher in MCS group compared to controls. Correlation analysis showed strong positive correlation between WNS, HQ and qEESI in MCS subjects.

CONCLUSIONS: For the first time, auditory-related perceptual disorders were studied in MCS. A strong association between WNS, HQ results and MCS symptoms severity has been highlighted. These findings suggest that decreased sound tolerance and noise sensitivity could be considered as possible new aspects of this syndrome, contributing to its peculiar phenotype. Furthermore, as DPOAE values did not differ from healthy subjects, present findings might suggest a 'central' source for such disorders in this group of patients.}, } @article {pmid27369067, year = {2016}, author = {Schelinski, S and Borowiak, K and von Kriegstein, K}, title = {Temporal voice areas exist in autism spectrum disorder but are dysfunctional for voice identity recognition.}, journal = {Social cognitive and affective neuroscience}, volume = {11}, number = {11}, pages = {1812-1822}, pmid = {27369067}, issn = {1749-5024}, mesh = {Acoustic Stimulation ; Adult ; Asperger Syndrome/physiopathology/psychology ; Autism Spectrum Disorder/*physiopathology/psychology ; Brain Mapping/*methods ; Communication ; Dominance, Cerebral/physiology ; Facial Recognition/physiology ; Female ; Humans ; Intelligence/physiology ; *Magnetic Resonance Imaging ; Male ; Middle Aged ; Recognition, Psychology/*physiology ; Speech Perception/*physiology ; Statistics as Topic ; Temporal Lobe/*physiopathology ; *Voice/physiology ; Young Adult ; }, abstract = {The ability to recognise the identity of others is a key requirement for successful communication. Brain regions that respond selectively to voices exist in humans from early infancy on. Currently, it is unclear whether dysfunction of these voice-sensitive regions can explain voice identity recognition impairments. Here, we used two independent functional magnetic resonance imaging studies to investigate voice processing in a population that has been reported to have no voice-sensitive regions: autism spectrum disorder (ASD). Our results refute the earlier report that individuals with ASD have no responses in voice-sensitive regions: Passive listening to vocal, compared to non-vocal, sounds elicited typical responses in voice-sensitive regions in the high-functioning ASD group and controls. In contrast, the ASD group had a dysfunction in voice-sensitive regions during voice identity but not speech recognition in the right posterior superior temporal sulcus/gyrus (STS/STG)-a region implicated in processing complex spectrotemporal voice features and unfamiliar voices. The right anterior STS/STG correlated with voice identity recognition performance in controls but not in the ASD group. The findings suggest that right STS/STG dysfunction is critical for explaining voice recognition impairments in high-functioning ASD and show that ASD is not characterised by a general lack of voice-sensitive responses.}, } @article {pmid27719856, year = {2016}, author = {Baguley, DM and Cope, TE and McFerran, DJ}, title = {Functional auditory disorders.}, journal = {Handbook of clinical neurology}, volume = {139}, number = {}, pages = {367-378}, doi = {10.1016/B978-0-12-801772-2.00032-1}, pmid = {27719856}, issn = {0072-9752}, mesh = {Auditory Perceptual Disorders/*diagnosis/*psychology ; Humans ; Psychophysiologic Disorders/*diagnosis ; Somatoform Disorders/*diagnosis ; }, abstract = {There are a number of auditory symptom syndromes that can develop without an organic basis. Some of these, such as nonorganic hearing loss, affect populations similar to those presenting with functional somatosensory and motor symptoms, while others, such as musical hallucination, affect populations with a significantly different demographic and require different treatment strategies. Many of these conditions owe their origin to measurably abnormal peripheral sensory pathology or brain network activity, but their pathological impact is often due, at least in part, to overamplification of the salience of these phenomena. For each syndrome, this chapter briefly outlines a definition, demographics, investigations, putative mechanisms, and treatment strategies. Consideration is given to what extent they can be considered to have a functional basis. Treatments are in many cases pragmatic and rudimentary, needing more work to be done in integrating insights from behavioral and cognitive psychology to auditory neuroscience. The audiology literature has historically equated the term functional with malingering, although this perception is, thankfully, slowly changing. These disorders transcend the disciplines of audiology, otorhinolaryngology, neurology and psychiatry, and a multidisciplinary approach is often rewarding.}, } @article {pmid27509398, year = {2016}, author = {Jesus, NO and Angrisani, RG and Maruta, EC and Azevedo, MF}, title = {Suppression effect of otoacoustic emissions in term and preterm infants.}, journal = {CoDAS}, volume = {28}, number = {4}, pages = {331-337}, doi = {10.1590/2317-1782/20162015153}, pmid = {27509398}, issn = {2317-1782}, mesh = {Acoustic Stimulation ; Auditory Threshold/physiology ; Cross-Sectional Studies ; Evoked Potentials, Auditory/*physiology ; Female ; Functional Laterality/*physiology ; Humans ; Infant, Newborn ; Infant, Premature ; Male ; Otoacoustic Emissions, Spontaneous/*physiology ; }, abstract = {PURPOSE: This research aims at verifying the occurrence and magnitude of suppression effect of otoacoustic emissions evoked by transient stimulus in term and preterm infants, setting a benchmark for clinical use.

METHODS: The study sample consisted of 40 infants, with a rage of age from five days to four months, without any risk indicators for hearing loss and otoacoustic emissions present at birth: the 20 term and 20 preterm infants spent more than five days in the Neonatal Intensive Care Unit. Linear click was presented at 65 dB Sound Pressure Level, in blocks of 15 seconds without noise, and with contralateral noise at 60 dB Sound Pressure Level. The reduced response in the presence of noise indicates positive suppression effect. Mean values of suppression were established and the comparison between the groups was analyzed statistically.

RESULTS: Suppression occurred in 100% of the children and did not vary as a function of ear side and between the groups.

CONCLUSION: All children presented suppression regardless of the group. The average suppression obtained on the total population was 0.85 dB. The minimum recommended criterion for clinical use was a reduction of 0.20 dB in the overall response.}, } @article {pmid26617171, year = {2015}, author = {Blegvad-Nissen, C and Thomsen, PH}, title = {[Misophonia is a neglected disorder].}, journal = {Ugeskrift for laeger}, volume = {177}, number = {48}, pages = {V04150309}, pmid = {26617171}, issn = {1603-6824}, mesh = {Adolescent ; Auditory Perceptual Disorders/*diagnosis ; Female ; Humans ; Obsessive-Compulsive Disorder/diagnosis ; Sound/adverse effects ; }, abstract = {A 14-year-old girl, who was diagnosed with OCD when she was 11-year-old, experienced emotional reactions and autonomic arousal in response to specific human-made sounds. At first she thought that these symptoms were part of her OCD, but it became clear to her that she suffered from misophonia - a disorder not yet classified.}, } @article {pmid26508801, year = {2016}, author = {Bruxner, G}, title = {'Mastication rage': a review of misophonia - an under-recognised symptom of psychiatric relevance?.}, journal = {Australasian psychiatry : bulletin of Royal Australian and New Zealand College of Psychiatrists}, volume = {24}, number = {2}, pages = {195-197}, doi = {10.1177/1039856215613010}, pmid = {26508801}, issn = {1440-1665}, mesh = {Anxiety Disorders/*psychology ; Depression/*psychology ; Hearing Disorders/*diagnosis/*psychology ; Humans ; *Mastication ; Obsessive-Compulsive Disorder/*psychology ; *Rage ; }, abstract = {OBJECTIVE: To explore the condition of misophonia, its definition, possible neurological correlates, its associated morbidity, its possible psychiatric relevance and potential treatment.

METHOD: Provision of an illustrative case vignette and a review of the limited literature.

RESULTS: Misophonia is a symptom associated with obsessive-compulsive disorder and anxiety disorders and may be a syndrome in itself associated with significant distress and avoidance. Treatments are not well validated.

CONCLUSION: Misophonia may be an under-recognised condition of psychiatric relevance.}, } @article {pmid26449104, year = {2015}, author = {Gédance, D}, title = {[Misophonia and contemporary psychiatry].}, journal = {Revue medicale suisse}, volume = {11}, number = {482}, pages = {1504-1505}, pmid = {26449104}, issn = {1660-9379}, mesh = {*Anxiety Disorders ; Female ; Humans ; *Sound ; }, } @article {pmid26422327, year = {2016}, author = {Parial, LL and Torres, GC and Macindo, JR}, title = {Family Presence During Resuscitation Benefits-Risks Scale (FPDR-BRS): Instrument Development and Psychometric Validation.}, journal = {Journal of emergency nursing}, volume = {42}, number = {3}, pages = {213-223}, doi = {10.1016/j.jen.2015.08.018}, pmid = {26422327}, issn = {1527-2966}, mesh = {Adult ; *Attitude of Health Personnel ; Emergency Nursing ; Family/*psychology ; Female ; Humans ; Male ; Personnel, Hospital/*psychology ; Psychometrics ; Reproducibility of Results ; Resuscitation/*psychology ; Risk Assessment ; Surveys and Questionnaires ; }, abstract = {UNLABELLED: Family presence during resuscitation (FPDR) is a growing health care practice; nevertheless, countless controversies surround this medical principle. Several studies have investigated the perceptions of health care professionals toward FPDR, yet psychometrically sound instruments assessing family members' perceptions of FPDR are scarce. Hence we aimed to develop and psychometrically validate the Family Presence During Resuscitation Benefits-Risks Scale (FPDR-BRS).

METHODS: Using a methodological design, an initial 27-item questionnaire was developed after extensive literature and theoretical review. Psychometric validation assessed content validity through a 2-step process involving expert nurses and doctors, basic item analysis, internal consistency using Cronbach's α, and construct validity via exploratory factor analysis. After acquiring Ethics Review Board approval, the FPDR-BRS was tested on 130 randomly selected eligible family members from a tertiary government hospital in the Philippines.

RESULTS: The initial 27-item questionnaire was reduced to 23 items after content validation, yielding an item content validity index and scale content validity index/Ave rage of 1.00. Basic item analysis revealed acceptable inter-item and item-scale correlations. Exploratory factor analysis extracted 4 factors, namely, personnel risks, personal risks, insight-building benefits, and connection-forming benefits. Cronbach's α for the entire scale was 0.90, with high subscale reliability coefficients.

DISCUSSION: The 23-item FPDR-BRS exhibited satisfactory psychometric properties and may be used to quantitatively measure a family member's perception towards witnessing the resuscitation of his or her significant other. Further comprehensive psychometric evaluations are warranted to ensure robust cross-cultural comparisons.}, } @article {pmid26316758, year = {2015}, author = {Cavanna, AE and Seri, S}, title = {Misophonia: current perspectives.}, journal = {Neuropsychiatric disease and treatment}, volume = {11}, number = {}, pages = {2117-2123}, pmid = {26316758}, issn = {1176-6328}, abstract = {Misophonia is characterized by a negative reaction to a sound with a specific pattern and meaning to a given individual. In this paper, we review the clinical features of this relatively common yet underinvestigated condition, with focus on co-occurring neurodevelopmental disorders. Currently available data on the putative pathophysiology of the condition can inform our understanding and guide the diagnostic process and treatment approach. Tinnitus retraining therapy and cognitive behavior therapy have been proposed as the most effective treatment strategies for reducing symptoms; however, current treatment algorithms should be validated in large population studies. At the present stage, competing paradigms see misophonia as a physiological state potentially inducible in any subject, an idiopathic condition (which can present with comorbid psychiatric disorders), or a symptomatic manifestation of an underlying psychiatric disorder. Agreement on the use of standardized diagnostic criteria would be an important step forward in terms of both clinical practice and scientific inquiry. Areas for future research include phenomenology, epidemiology, modulating factors, neurophysiological underpinnings, and treatment trials.}, } @article {pmid26118234, year = {2015}, author = {Stiefel, F and Michael, S}, title = {[Misophonia and contemporary psychiatry].}, journal = {Revue medicale suisse}, volume = {11}, number = {474}, pages = {1088}, pmid = {26118234}, issn = {1660-9379}, mesh = {*Anxiety Disorders ; Female ; Humans ; *Sound ; }, } @article {pmid26035184, year = {2015}, author = {McGuire, JF and Wu, MS and Storch, EA}, title = {Cognitive-behavioral therapy for 2 youths with misophonia.}, journal = {The Journal of clinical psychiatry}, volume = {76}, number = {5}, pages = {573-574}, doi = {10.4088/JCP.14cr09343}, pmid = {26035184}, issn = {1555-2101}, mesh = {Adolescent ; Auditory Perceptual Disorders/physiopathology/*therapy ; Child ; Cognitive Behavioral Therapy/*methods ; Female ; Humans ; Hyperacusis/physiopathology/therapy ; Implosive Therapy/methods ; *Sound ; }, } @article {pmid25938503, year = {2015}, author = {Phillips, SL and Richter, SJ and Teglas, SL and Bhatt, IS and Morehouse, RC and Hauser, ER and Henrich, VC}, title = {Feasibility of a bilateral 4000-6000 Hz notch as a phenotype for genetic association analysis.}, journal = {International journal of audiology}, volume = {54}, number = {10}, pages = {645-652}, pmid = {25938503}, issn = {1708-8186}, support = {R21 DC009296/DC/NIDCD NIH HHS/United States ; R21DC009296-01/DC/NIDCD NIH HHS/United States ; }, mesh = {Acoustic Stimulation ; Adolescent ; Adult ; Audiometry/*methods ; Auditory Threshold ; Case-Control Studies ; Feasibility Studies ; Female ; Gene Frequency ; Genetic Association Studies ; Genetic Predisposition to Disease ; Hearing/*genetics ; Hearing Loss, Noise-Induced/*diagnosis/*genetics/physiopathology ; Humans ; Male ; Noise/*adverse effects ; Phenotype ; Pilot Projects ; *Polymorphism, Single Nucleotide ; Predictive Value of Tests ; Risk Factors ; Young Adult ; }, abstract = {OBJECTIVE: Noise-induced hearing loss (NIHL) is a worldwide health problem and a growing concern among young people. Although some people appear to be more susceptible to NIHL, genetic association studies lack a specific phenotype. We tested the feasibility of a bilateral 4000-6000 Hz audiometric notch as a phenotype for identifying genetic contributions to hearing loss in young adults.

DESIGN: A case-control-control study was conducted to examine selected SNPs in 52 genes previously associated with hearing loss and/or expressed in the cochlea. A notch was defined as a minimum of a 15-dB drop at 4000-6000 Hz from the previous best threshold with a 5-dB 'recovery' at 8000 Hz.

STUDY SAMPLE: Participants were 252 individuals of European descent taken from a population of 640 young adults who are students of classical music. Participants were grouped as No-notch (NN), Unilateral Notch (UN), or Bilateral Notch (BN).

RESULTS: The strongest evidence of a genetic association with the 4000-6000 Hz notch was a nonsynonymous SNP variant in the ESRR- gene (rs61742642:C> T, P386S). Carriers of the minor allele accounted for 26% of all bilateral losses.

CONCLUSION: This study indicates that the 4000-6000 Hz bilateral notch is a feasible phenotype for identifying genetic susceptibility to hearing loss.}, } @article {pmid25915989, year = {2015}, author = {Jacot, CR and Eric, T and Sentissi, O}, title = {[Misophonia or aversion to human sound: a clinical illustration].}, journal = {Revue medicale suisse}, volume = {11}, number = {462}, pages = {466-469}, pmid = {25915989}, issn = {1660-9379}, mesh = {*Anxiety Disorders/diagnosis/etiology/therapy ; Female ; Humans ; Middle Aged ; *Sound ; }, abstract = {Misophonia, meaning hatred of sound, is a cluster of symptoms which is not completely included in anxiety disorders category as obsessive compulsive or as an impulsivity disorder. It is described as a chronic condition characterized by reactions, aversion to specific sounds that result in subsequent emotional. Indeed, this condition is relatively unknown and few psychiatrists have already faced this disorder causing in some individuals severe impairment. The investigation of a patient suffering of misophonia with severe impairment that we took into care in an outpatient psychiatric clinic in Geneva contributes to a better understanding of this condition and indicates potential factors that may co-occur and influence the clinical presentation. The good response in psychotherapy, has led us to carry out a brief review of the literature in order to better define and identify this disorder.}, } @article {pmid25886954, year = {2015}, author = {Webber, TA and Storch, EA}, title = {Toward a theoretical model of misophonia.}, journal = {General hospital psychiatry}, volume = {37}, number = {4}, pages = {369-370}, doi = {10.1016/j.genhosppsych.2015.03.019}, pmid = {25886954}, issn = {1873-7714}, mesh = {Auditory Perceptual Disorders/*psychology ; Humans ; Models, Psychological ; Models, Theoretical ; Obsessive-Compulsive Disorder/*psychology ; }, } @article {pmid25886953, year = {2015}, author = {Schneider, RL and Arch, JJ}, title = {Letter to the editor: potential treatment targets for misophonia.}, journal = {General hospital psychiatry}, volume = {37}, number = {4}, pages = {370-371}, doi = {10.1016/j.genhosppsych.2015.03.020}, pmid = {25886953}, issn = {1873-7714}, mesh = {Auditory Perceptual Disorders/*psychology ; Humans ; Obsessive-Compulsive Disorder/*psychology ; }, } @article {pmid25862626, year = {2015}, author = {Jastreboff, PJ}, title = {25 years of tinnitus retraining therapy.}, journal = {HNO}, volume = {63}, number = {4}, pages = {307-311}, pmid = {25862626}, issn = {1433-0458}, mesh = {Cognitive Behavioral Therapy/*methods ; Desensitization, Psychologic/*methods ; Evidence-Based Medicine ; Habituation, Psychophysiologic ; Hearing Loss/diagnosis/*psychology/*therapy ; Humans ; Tinnitus/diagnosis/*psychology/*therapy ; Treatment Outcome ; }, abstract = {This year marks 25 years of tinnitus retraining therapy (TRT), the approach that aims to eliminate tinnitus as a problem by extinguishing functional connections between the auditory and the limbic and autonomic nervous systems to achieve habituation of tinnitus-evoked reactions and subsequently habituation of perception. TRT addresses directly decreased sound tolerance (DST) as well as tinnitus. TRT consists of counseling and sound therapy, both based on the neurophysiological model of tinnitus. The main goal of retraining counseling is to reclassify tinnitus into the category of a neutral stimulus, while the main goal of sound therapy is to decrease the strength of tinnitus-related neuronal activity. A unique aspect of TRT is that because treatment is aimed to work above the tinnitus source, and at connections linking the auditory and other systems in the brain, the etiology of tinnitus is irrelevant. Any type of tinnitus, as well as somatosounds, can be successfully treated by TRT. Over 100 publications can be found on Medline when using "tinnitus retraining therapy" as a search term. The majority of these publications indicate TRT offers significant help for about 80 % of patients. A randomized clinical trial showing the effectiveness of TRT has been published and another large study is in progress. The principles of the neurophysiological model of tinnitus, and consequently TRT, have not changed in over 25 years of use, but a number of changes have been introduced in TRT implementation. These changes include the recognition of the importance of conditioned reflexes and the dominant role of the subconscious pathways; the introduction of the concept of misophonia (i.e., negative reactions to specific patterns of sound) and the implementation of specific protocols for its treatment; greater emphasis on the concurrent treatment of tinnitus, hyperacusis, misophonia, and hearing loss; extensive modification of counseling; and refinements in sound therapy. The effectiveness of TRT has increased significantly during the past 25 years, presumably due to changes incorporated in its implementation. The main improvement has been to shorten the average time until seeing clear improvement from 1 year to 1 month, with a statistically significant improvement seen at, and after, 3 months. Furthermore, there is a higher effectiveness and a shorter treatment time for DST and an increased extent of help for hearing loss.}, } @article {pmid25834771, year = {2015}, author = {Barratt, EL and Davis, NJ}, title = {Autonomous Sensory Meridian Response (ASMR): a flow-like mental state.}, journal = {PeerJ}, volume = {3}, number = {}, pages = {e851}, pmid = {25834771}, issn = {2167-8359}, abstract = {Autonomous Sensory Meridian Response (ASMR) is a previously unstudied sensory phenomenon, in which individuals experience a tingling, static-like sensation across the scalp, back of the neck and at times further areas in response to specific triggering audio and visual stimuli. This sensation is widely reported to be accompanied by feelings of relaxation and well-being. The current study identifies several common triggers used to achieve ASMR, including whispering, personal attention, crisp sounds and slow movements. Data obtained also illustrates temporary improvements in symptoms of depression and chronic pain in those who engage in ASMR. A high prevalence of synaesthesia (5.9%) within the sample suggests a possible link between ASMR and synaesthesia, similar to that of misophonia. Links between number of effective triggers and heightened flow state suggest that flow may be necessary to achieve sensations associated with ASMR.}, } @article {pmid25726280, year = {2015}, author = {Jastreboff, PJ and Jastreboff, MM}, title = {Decreased sound tolerance: hyperacusis, misophonia, diplacousis, and polyacousis.}, journal = {Handbook of clinical neurology}, volume = {129}, number = {}, pages = {375-387}, doi = {10.1016/B978-0-444-62630-1.00021-4}, pmid = {25726280}, issn = {0072-9752}, mesh = {Auditory Perceptual Disorders/diagnosis/epidemiology/*physiopathology ; Humans ; Hyperacusis/diagnosis/epidemiology/*physiopathology ; }, abstract = {Definitions, potential mechanisms, and treatments for decreased sound tolerance, hyperacusis, misophonia, and diplacousis are presented with an emphasis on the associated physiologic and neurophysiological processes and principles. A distinction is made between subjects who experience these conditions versus patients who suffer from them. The role of the limbic and autonomic nervous systems and other brain systems involved in cases of bothersome decreased sound tolerance is stressed. The neurophysiological model of tinnitus is outlined with respect to how it may contribute to our understanding of these phenomena and their treatment.}, } @article {pmid24804717, year = {2014}, author = {Aazh, H and McFerran, D and Salvi, R and Prasher, D and Jastreboff, M and Jastreboff, P}, title = {Insights from the First International Conference on Hyperacusis: causes, evaluation, diagnosis and treatment.}, journal = {Noise & health}, volume = {16}, number = {69}, pages = {123-126}, doi = {10.4103/1463-1741.132100}, pmid = {24804717}, issn = {1463-1741}, support = {DRF-2011-04-001/DH_/Department of Health/United Kingdom ; }, mesh = {Adult ; Anxiety/*psychology/therapy ; Auditory Cortex/*physiopathology ; Auditory Perception ; Child ; Cognitive Behavioral Therapy/*methods ; Humans ; *Hyperacusis/diagnosis/psychology/therapy ; *Noise ; Sound ; }, abstract = {The First International Conference on Hyperacusis gathered over 100 scientists and health care professionals in London, UK. Key conclusions from the conference included: (1) Hyperacusis is characterized by reduced tolerance of sound that has perceptual, psychological and social dimensions; (2) there is a growing awareness that children as well as adults experience symptoms of hyperacusis or misophonia; (3) the exact mechanisms that give rise to hyperacusis are not clear, but the available evidence suggests that functional changes within the central nervous system are important and in particular, hyperacusis may be related to increased gain in the central auditory pathways and to increased anxiety or emotional response to sound; (4) various counseling and sound therapy approaches seem beneficial in the management of hyperacusis, but the evidence base for these remains poor.}, } @article {pmid24782731, year = {2014}, author = {Schröder, A and van Diepen, R and Mazaheri, A and Petropoulos-Petalas, D and Soto de Amesti, V and Vulink, N and Denys, D}, title = {Diminished n1 auditory evoked potentials to oddball stimuli in misophonia patients.}, journal = {Frontiers in behavioral neuroscience}, volume = {8}, number = {}, pages = {123}, pmid = {24782731}, issn = {1662-5153}, abstract = {Misophonia (hatred of sound) is a newly defined psychiatric condition in which ordinary human sounds, such as breathing and eating, trigger impulsive aggression. In the current study, we investigated if a dysfunction in the brain's early auditory processing system could be present in misophonia. We screened 20 patients with misophonia with the diagnostic criteria for misophonia, and 14 matched healthy controls without misophonia, and investigated any potential deficits in auditory processing of misophonia patients using auditory event-related potentials (ERPs) during an oddball task. Subjects watched a neutral silent movie while being presented a regular frequency of beep sounds in which oddball tones of 250 and 4000 Hz were randomly embedded in a stream of repeated 1000 Hz standard tones. We examined the P1, N1, and P2 components locked to the onset of the tones. For misophonia patients, the N1 peak evoked by the oddball tones had smaller mean peak amplitude than the control group. However, no significant differences were found in P1 and P2 components evoked by the oddball tones. There were no significant differences between the misophonia patients and their controls in any of the ERP components to the standard tones. The diminished N1 component to oddball tones in misophonia patients suggests an underlying neurobiological deficit in misophonia patients. This reduction might reflect a basic impairment in auditory processing in misophonia patients.}, } @article {pmid24752915, year = {2014}, author = {Wu, MS and Lewin, AB and Murphy, TK and Storch, EA}, title = {Misophonia: incidence, phenomenology, and clinical correlates in an undergraduate student sample.}, journal = {Journal of clinical psychology}, volume = {70}, number = {10}, pages = {994-1007}, doi = {10.1002/jclp.22098}, pmid = {24752915}, issn = {1097-4679}, mesh = {Adolescent ; Adult ; Anger/physiology ; Anxiety/epidemiology ; Auditory Perceptual Disorders/diagnosis/*epidemiology/*physiopathology ; Comorbidity ; Depression/epidemiology ; Female ; Humans ; Incidence ; Male ; Middle Aged ; Obsessive-Compulsive Disorder/epidemiology ; Self Report ; Sensation Disorders/*epidemiology ; Students/statistics & numerical data ; Young Adult ; }, abstract = {OBJECTIVE: Individuals with misophonia display extreme sensitivities to selective sounds, often resulting in negative emotions and subsequent maladaptive behaviors, such as avoidance and anger outbursts. While there has been increasing interest in misophonia, few data have been published to date.

METHOD: This study investigated the incidence, phenomenology, correlates, and impairment associated with misophonia symptoms in 483 undergraduate students through self-report measures.

RESULTS: Misophonia was a relatively common phenomenon, with nearly 20% of the sample reporting clinically significant misophonia symptoms. Furthermore, misophonia symptoms demonstrated strong associations with measures of impairment and general sensory sensitivities, and moderate associations with obsessive-compulsive, anxiety, and depressive symptoms. Anxiety mediated the relationship between misophonia and anger outbursts.

CONCLUSION: This investigation contributes to a better understanding of misophonia and indicates potential factors that may co-occur and influence the clinical presentation of a person with misophonia symptoms.}, } @article {pmid24552574, year = {2014}, author = {Cavanna, AE}, title = {What is misophonia and how can we treat it?.}, journal = {Expert review of neurotherapeutics}, volume = {14}, number = {4}, pages = {357-359}, doi = {10.1586/14737175.2014.892418}, pmid = {24552574}, issn = {1744-8360}, mesh = {Acoustic Stimulation/*adverse effects ; Affective Symptoms/*complications/*diagnosis ; Autonomic Nervous System Diseases/*complications/*diagnosis ; Humans ; }, abstract = {Selective sound sensitivity syndrome or misophonia is a chronic condition characterized by unpleasant emotional experiences and autonomic arousal in response to specific sounds. Over the last few years there have been a few reports detailing the clinical features associated with this condition. These focused reports raise interesting questions about the nosological status of this potentially disabling clinical entity.}, } @article {pmid24431300, year = {2014}, author = {Kluckow, H and Telfer, J and Abraham, S}, title = {Should we screen for misophonia in patients with eating disorders? A report of three cases.}, journal = {The International journal of eating disorders}, volume = {47}, number = {5}, pages = {558-561}, doi = {10.1002/eat.22245}, pmid = {24431300}, issn = {1098-108X}, mesh = {Adolescent ; Adult ; Anorexia Nervosa/diagnosis/*psychology ; Bulimia Nervosa/diagnosis/*psychology ; Female ; Humans ; Hyperacusis/*complications ; Young Adult ; }, abstract = {In this case report, the authors describe three cases of misophonia in people with eating disorders. Misophonia is a condition where a specific trigger sound provokes an intense emotional reaction in an individual. Case 1 is a 29-year-old with childhood eating issues, anorexia nervosa and bulimia nervosa whose trigger was a high-pitched female voice. Case 2 is a 15-year-old diagnosed with anorexia nervosa after misophonia onset. Her trigger was people chewing and eating noisily. Case 3 is a 24-year-old woman who presented with anorexia nervosa prior to misophonia onset. Her trigger was the clinking and chewing of her mother and aunt eating cereal. All three cases identified an eating-related trigger sound with a violent aversive reaction and coping mechanisms involving eating avoidance or having a full mouth. Misophonia may be associated with presentations of eating disorders. This case report adds to the literature about the presentation of misophonia.}, } @article {pmid24398366, year = {2014}, author = {Prado-Barreto, VM and Salvatori, R and Santos Júnior, RC and Brandão-Martins, MB and Correa, EA and Garcez, FB and Valença, EH and Souza, AH and Pereira, RM and Nunes, MA and D'Avila, JS and Aguiar-Oliveira, MH}, title = {Hearing status in adult individuals with lifetime, untreated isolated growth hormone deficiency.}, journal = {Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery}, volume = {150}, number = {3}, pages = {464-471}, doi = {10.1177/0194599813517987}, pmid = {24398366}, issn = {1097-6817}, mesh = {Adult ; Audiometry, Pure-Tone ; Brazil/epidemiology ; Cross-Sectional Studies ; Dwarfism, Pituitary/complications/*physiopathology ; Female ; Hearing/*physiology ; Hearing Loss/epidemiology/etiology/*physiopathology ; Humans ; Incidence ; Male ; Middle Aged ; Otoacoustic Emissions, Spontaneous ; Surveys and Questionnaires ; }, abstract = {OBJECTIVE: To evaluate the hearing status of growth hormone (GH)-naive adults with isolated GH deficiency (IGHD) belonging to an extended Brazilian kindred with a homozygous mutation in the GH-releasing hormone receptor gene.

STUDY DESIGN: Cross-sectional.

SETTING: Divisions of Endocrinology and Otorhinolaryngology of the Federal University of Sergipe.

SUBJECTS AND METHODS: Twenty-six individuals with IGHD (age, 47.6 ± 15.1 years; 13 women) and 25 controls (age, 46.3 ± 14.3 years; 15 women) were administered a questionnaire on hearing complaints and hearing health history. We performed pure-tone audiometry, logoaudiometry, electroacoustic immittance, and stapedial reflex. To assess outer hair cell function in the cochlea, we completed transient evoked otoacoustic emissions (TEOAEs). To assess the auditory nerve and auditory brainstem, we obtained auditory brainstem responses (ABRs).

RESULTS: Misophonia and dizziness complaints were more frequent in those with IGHD than in controls (P = .011). Patients with IGHD had higher thresholds at 250 Hz (P = .005), 500 Hz (P = .006), 3 KHz (P = .008), 4 KHz (P = .038), 6 KHz (P = .008), and 8 KHz (P = .048) and mild high-tones hearing loss (P = .029). Stapedial reflex (P < .001) and TEOAEs (P = .025) were more frequent in controls. There were no differences in ABR latencies. Hearing loss in patients with IGHD occurred earlier than in controls (P < .001).

CONCLUSION: Compared with controls of the same area, subjects with untreated, congenital lifetime IGHD report more misophonia and dizziness, have predominance of mild high-tones sensorineural hearing loss, and have an absence of stapedial reflex and TEOAEs.}, } @article {pmid24333158, year = {2014}, author = {Webber, TA and Johnson, PL and Storch, EA}, title = {Pediatric misophonia with comorbid obsessive-compulsive spectrum disorders.}, journal = {General hospital psychiatry}, volume = {36}, number = {2}, pages = {231.e1-2}, doi = {10.1016/j.genhosppsych.2013.10.018}, pmid = {24333158}, issn = {1873-7714}, mesh = {Child ; Female ; Humans ; Mental Disorders/psychology ; Obsessive-Compulsive Disorder/*psychology ; *Sound ; Tourette Syndrome/*psychology ; }, abstract = {OBJECTIVE: Misophonia is a potentially debilitating condition characterized by increased sensitivity to specific sounds, which cause subsequent behavioral and emotional responses. The nature, clinical phenomenology and etiology of misophonia remain unclear, and misophonic clinical presentations are not currently accounted for by existing psychiatric or audiological disorders.

METHOD: We present a case of pediatric misophonia in the context of comorbid obsessive-compulsive disorder and Tourette's syndrome.

RESULTS: Given the interrelationships among obsessive-compulsive spectrum disorders and misophonia, these disorders may share underlying pathophysiology, particularly within the dopaminergic and serotonergic neural systems. Clinical (i.e., treatment) and theoretical implications are discussed.}, } @article {pmid24199217, year = {2013}, author = {Ferreira, GM and Harrison, BJ and Fontenelle, LF}, title = {Hatred of sounds: misophonic disorder or just an underreported psychiatric symptom?.}, journal = {Annals of clinical psychiatry : official journal of the American Academy of Clinical Psychiatrists}, volume = {25}, number = {4}, pages = {271-274}, pmid = {24199217}, issn = {1547-3325}, mesh = {Adult ; Anxiety Disorders/*classification ; Female ; Hearing Disorders/*classification ; Humans ; Hyperacusis/classification ; Male ; Middle Aged ; Obsessive-Compulsive Disorder/*classification ; Schizotypal Personality Disorder/*classification ; Tinnitus/classification ; }, abstract = {BACKGROUND: Misophonia, or selective sound sensitivity syndrome, is a preoccupation with or aversion to certain types of sounds that evokes feelings of irritability, disgust, or anger. Recently, it has been suggested that misophonia is a discrete clinical entity deserving of its own place in psychiatric diagnostic manuals. In this paper, we describe 3 patients whose misophonia could be attributed to different underlying primary psychiatric disorders.

METHODS: Case series report.

RESULTS: In these patients, we argue that misophonia is better described as a symptom of a) obsessive-compulsive disorder, b) generalized anxiety disorder, and c) schizotypal personality disorder.

CONCLUSIONS: The nosological status of misophonia remains a matter of debate. Patients who exhibit misophonia as a major complaint should be assessed for other conditions. Further studies on the prevalence, natural history, and additional features of misophonia are needed.}, } @article {pmid24029726, year = {2014}, author = {Palmquist, E and Claeson, AS and Neely, G and Stenberg, B and Nordin, S}, title = {Overlap in prevalence between various types of environmental intolerance.}, journal = {International journal of hygiene and environmental health}, volume = {217}, number = {4-5}, pages = {427-434}, doi = {10.1016/j.ijheh.2013.08.005}, pmid = {24029726}, issn = {1618-131X}, mesh = {Adult ; Aged ; Cross-Sectional Studies ; *Environmental Exposure ; Female ; Humans ; Male ; Middle Aged ; Multiple Chemical Sensitivity/*epidemiology ; Noise/adverse effects ; Prevalence ; Sick Building Syndrome/epidemiology ; Sweden/epidemiology ; }, abstract = {Environmental intolerance (EI) is characterized by attribution of several, multisystem symptoms to specific environmental exposures, such as exposure to odorous/pungent chemicals, certain buildings, electromagnetic fields (EMFs) and everyday sounds. The symptoms are medically unexplained, non-specific and the symptoms overlap between different types of EI. To approach the issue of underlying mechanisms the matter of overlap in prevalence between intolerances can provide valuable information. The aim of the study was to examine if the overlap between intolerance to odorous/pungent chemicals, certain buildings, EMFs and sounds is larger than the expected overlap if no association would exist between them. The study was using cross-sectional data from the Västerbotten Environmental Health Study in Sweden; a large questionnaire-based survey. 8520 adults (18-79 years) were randomly selected after stratification for age and sex, of whom 3406 (40%) participated. Individuals with the four types of intolerance were identified either through self-report, or by having been physician-diagnosed with a specific EI. The overlaps between the four EIs were greater than predictions based on coincidence for both self-reported and diagnosed cases (except for the overlap between diagnosed intolerance to sounds and EMFs). The results raise the question whether different types of EI share similar underlying mechanisms, or at least that the sufferers of EI share some predisposition to acquire the conditions.}, } @article {pmid23886569, year = {2014}, author = {Kerkhof, M and Boezen, HM and Granell, R and Wijga, AH and Brunekreef, B and Smit, HA and de Jongste, JC and Thijs, C and Mommers, M and Penders, J and Henderson, J and Koppelman, GH and Postma, DS}, title = {Transient early wheeze and lung function in early childhood associated with chronic obstructive pulmonary disease genes.}, journal = {The Journal of allergy and clinical immunology}, volume = {133}, number = {1}, pages = {68-76.e1-4}, doi = {10.1016/j.jaci.2013.06.004}, pmid = {23886569}, issn = {1097-6825}, support = {092731/WT_/Wellcome Trust/United Kingdom ; G0401540/MRC_/Medical Research Council/United Kingdom ; G9815508/MRC_/Medical Research Council/United Kingdom ; MC_PC_15018/MRC_/Medical Research Council/United Kingdom ; }, mesh = {Age of Onset ; Child ; Child, Preschool ; Female ; Genetic Predisposition to Disease ; Humans ; Infant ; Lung/growth & development/*physiopathology ; Male ; Netherlands ; Polymorphism, Single Nucleotide ; Pulmonary Disease, Chronic Obstructive/*epidemiology/*genetics ; Respiration/genetics ; Respiratory Function Tests ; Respiratory Sounds/*genetics/physiopathology ; Serpin E2/genetics/metabolism ; Tobacco Smoke Pollution/adverse effects ; }, abstract = {BACKGROUND: It has been hypothesized that a disturbed early lung development underlies the susceptibility to chronic obstructive pulmonary disease (COPD). Little is known about whether subjects genetically predisposed to COPD show their first symptoms or reduced lung function in childhood.

OBJECTIVE: We investigated whether replicated genes for COPD associate with transient early wheeze (TEW) and lung function levels in 6- to 8-year-old children and whether cigarette smoke exposure in utero and after birth (environmental tobacco smoke [ETS]) modifies these effects.

METHODS: The association of COPD-related genotypes of 20 single nucleotide polymorphisms in 15 genes with TEW, FEV1, forced vital capacity (FVC), and FEV1/FVC ratio was studied in the Prevention and Incidence of Asthma and Mite Allergy (PIAMA) birth cohort (n = 1996) and replicated in the Child, parents and health: lifestyle and genetic constitution (KOALA) and Avon Longitudinal Study of Parents and Children (ALSPAC) cohorts.

RESULTS: AGER showed replicated association with FEV1/FVC ratio. TNS1 associated with more TEW in PIAMA and lower FEV1 in ALSPAC. TNS1 interacted with ETS in PIAMA, showing lower FEV1 in exposed children. HHIP rs1828591 interacted with cigarette smoke exposure in utero in PIAMA and with ETS in ALSPAC, with lower lung function in nonexposed children. SERPINE2, FAM13A, and MMP12 associated with higher FEV1 and FVC, and SERPINE2, HHIP, and TGFB1 interacted with cigarette smoke exposure in utero in PIAMA only, showing adverse effects of exposure on FEV1 being limited to children with genotypes conferring the lowest risk of COPD.

CONCLUSION: Our findings indicate relevant involvement of at least 3 COPD genes in lung development and lung growth by demonstrating associations pointing toward reduced airway caliber in early childhood. Furthermore, our results suggest that COPD genes are involved in the infant's lung response to smoke exposure in utero and in early life.}, } @article {pmid23805089, year = {2013}, author = {Edelstein, M and Brang, D and Rouw, R and Ramachandran, VS}, title = {Misophonia: physiological investigations and case descriptions.}, journal = {Frontiers in human neuroscience}, volume = {7}, number = {}, pages = {296}, pmid = {23805089}, issn = {1662-5161}, abstract = {Misophonia is a relatively unexplored chronic condition in which a person experiences autonomic arousal (analogous to an involuntary "fight-or-flight" response) to certain innocuous or repetitive sounds such as chewing, pen clicking, and lip smacking. Misophonics report anxiety, panic, and rage when exposed to trigger sounds, compromising their ability to complete everyday tasks and engage in healthy and normal social interactions. Across two experiments, we measured behavioral and physiological characteristics of the condition. Interviews (Experiment 1) with misophonics showed that the most problematic sounds are generally related to other people's behavior (pen clicking, chewing sounds). Misophonics are however not bothered when they produce these "trigger" sounds themselves, and some report mimicry as a coping strategy. Next, (Experiment 2) we tested the hypothesis that misophonics' subjective experiences evoke an anomalous physiological response to certain auditory stimuli. Misophonic individuals showed heightened ratings and skin conductance responses (SCRs) to auditory, but not visual stimuli, relative to a group of typically developed controls, supporting this general viewpoint and indicating that misophonia is a disorder that produces distinct autonomic effects not seen in typically developed individuals.}, } @article {pmid23487200, year = {2013}, author = {Neal, M and Cavanna, AE}, title = {Selective sound sensitivity syndrome (misophonia) in a patient with Tourette syndrome.}, journal = {The Journal of neuropsychiatry and clinical neurosciences}, volume = {25}, number = {1}, pages = {E01}, doi = {10.1176/appi.neuropsych.11100235}, pmid = {23487200}, issn = {1545-7222}, mesh = {Auditory Perceptual Disorders/*etiology ; Humans ; Male ; Middle Aged ; Tourette Syndrome/*complications ; }, } @article {pmid23427903, year = {2013}, author = {Willems, P}, title = {Decision making in surgical treatment of chronic low back pain: the performance of prognostic tests to select patients for lumbar spinal fusion.}, journal = {Acta orthopaedica. Supplementum}, volume = {84}, number = {349}, pages = {1-35}, doi = {10.3109/17453674.2012.753565}, pmid = {23427903}, issn = {1745-3704}, mesh = {Adult ; Chronic Disease ; *Decision Making ; Female ; Humans ; Low Back Pain/*surgery ; Lumbar Vertebrae/*surgery ; Male ; Middle Aged ; Orthotic Devices ; Pain Measurement ; *Patient Selection ; Prognosis ; Restraint, Physical ; Spinal Fusion/*methods ; }, abstract = {Chronic low back pain (CLBP) is one of the main causes of disability in the western world with a huge economic burden to society. As yet, no specific underlying anatomic cause has been identified for CLBP. Imaging often reveals degenerative findings of the disc or facet joints of one or more lumbar motion segments. These findings, however, can also be observed in asymptomatic people. It has been suggested that pain in degenerated discs may be caused by the ingrowth of nerve fibers into tears or clefts of the annulus fibrosus or nucleus pulposus, and by reported high levels of pro-inflammatory mediators. As this so-called discogenic pain is often exacerbated by mechanical loading, the concept of relieving pain by spinal fusion to stabilise a painful spinal segment, has been developed. For some patients lumbar spinal fusion indeed is beneficial, but its results are highly variable and hard to predict for the individual patient. To identify those CLBP patients who will benefit from fusion, many surgeons rely on tests that are assumed to predict the outcome of spinal fusion. The three most commonly used prognostic tests in daily practice are immobilization in a lumbosacral orthosis, provocative discography and trial immobilization by temporary external transpedicular fixation. Aiming for consensus on the indications for lumbar fusion and in order to improve its results by better patient selection, it is essential to know the role and value of these prognostic tests for CLBP patients in clinical practice. The overall aims of the present thesis were: 1) to evaluate whether there is consensus among spine surgeons regarding the use and appreciation of prognostic tests for lumbar spinal fusion; 2) to verify whether a thoracolumbosacral orthosisis (TLSO) truly minimises lumbosacral motion; 3) to verify whether a TLSO can predict the clinical outcome of fusion for CLBP; 4) to assess whether provocative discography of adjacent segments actually predicts the long-term clinical outcome fusion; 5) to determine the incidence of postdiscography discitis, and whether there is a need for routine antibiotic prophylaxis; 6) to assess whether temporary external transpedicular fixation (TETF) can help to predict the outcome of spinal fusion; 7) to determine the prognostic accuracy of the most commonly used tests in clinical practice to predict the outcome of fusion for CLBP. The results of a national survey among spine surgeons in the Netherlands were presented in Study I. The surgeons were questioned about their opinion on prognostic factors and about the use of predictive tests for lumbar fusion in CLBP patients. The comments were compared with findings from the prevailing literature. The survey revealed a considerable lack of uniformity in the use and appreciation of predictive tests. Prognostic factors known from the literature were not consistently incorporated in the surgeons' decision making process either. This heterogeneity in strategy is most probably caused by the lack of sound scientific evidence for current predictive tests and it was concluded that currently there is not enough consensus among spine surgeons in the Netherlands to create national guidelines for surgical decision making in CLBP. In Study II, the hypothesized working mechanism of a pantaloon cast (i.e., minimisation of lumbosacral joint mobility) was studied. In patients who were admitted for a temporary external transpedicular fixation test (TETF), infrared light markers were rigidly attached to the protruding ends of Steinman pins that were fixed in two spinal levels. In this way three-dimensional motion between these levels could be analysed opto-electronically. During dynamic test conditions such as walking, a plaster cast, either with or without unilateral hip fixation, did not significantly decrease lumbosacral joint motion. Although not substantiated by sound scientific support, lumbosacral orthoses or pantaloon casts are often used in everyday practice as a predictor for the outcome of fusion. A systematic review of the literature supplemented with a prospective cohort study was performed (Study III) in order to assess the value of a pantaloon cast in surgical decision-making. It appeared that only in CLBP patients with no prior spine surgery, a pantaloon cast test with substantial pain relief suggests a favorable outcome of lumbar fusion compared to conservative treatment. In patients with prior spine surgery the test is of no value. It is believed by many spine surgeons that provocative discography, unlike plain radiographs or magnetic resonance imaging, is a physiologic test that can truly determine whether a disc is painful and relevant in a patient's pain syndrome, irrespective of the morphology of the disc. It has been suggested that in order to achieve a successful clinical outcome of lumbar fusion, suspect discs should be painful and adjacent control discs should elicit no pain on provocative discography. For this reason, a cohort of patients in whom the decision to perform lumbar fusion was based on an external fixation (TETF) trial, was analysed retrospectively in Study IV. The results of preoperative discography of solely the levels adjacent to the fusion were compared with the clinical results after spinal fusion. It appeared that in this select group of patients the discographic status of discs adjacent to a lumbar fusion did not have any effect on the clinical outcome. The most feared complication of lumbar discography is discitis. Although low in incidence, this is a serious complication for a diagnostic procedure and prevention by the use of prophylactic antibiotics has been advocated. In search for clinical guidelines, the risk of postdiscography discitis was assessed in Study V by means of a systematic literature review and a cohort of 200 consecutive patients. Without the use of prophylactic antibiotics, an overall incidence of postdiscography discitis of 0.25% was found. To prove that antibiotics would actually prevent discitis, a randomised trial of 9,000 patients would be needed to reach significance. Given the possible adverse effects of antibiotics, it was concluded that the routine use of prophylactic antibiotics in lumbar discography is not indicated. In Study VI, the middle- and long-term results of external fixation (TETF) as a test to predict the clinical outcome of lumbar fusion were studied in a group of back pain patients for whom there was doubt about the indication for surgery. The test included a placebo trial, in which the patients were unaware whether the lumbar segmental levels were fixed or dynamised. Using strict and objective criteria of pain reduction on a visual analogue scale, the TETF test failed to predict clinical outcome of fusion in this select group of patients. Pin track infection and nerve root irritation were registered as complications of this invasive test. It was concluded that in chronic low back pain patients with a doubtful indication for fusion, TETF is not recommended as a supplemental tool for surgical decision-making. In Study VII, a systematic literature review was performed regarding the prognostic accuracy of tests that are currently used in clinical practice and that are presumed to predict the outcome of lumbar spinal fusion for CLBP. The tests of interest were magnetic resonance imaging (MRI), TLSO immobilisation, TETF, provocative discography and facet joint infiltration. Only 10 studies reporting on three different index tests (discography, TLSO immobilisation and TETF) that truly reported on test qualifiers, such as sensitivity, specificity and likelihood ratios, could be selected. It appeared that the accuracy of all prognostic tests was low, which confirmed that in many clinical practices patients are scheduled for fusion on the basis of tests, of which the accuracy is insufficient or at best unknown. As the overall methodological quality of included studies was poor, higher quality trials that include negatively tested as well as positively tested patients for fusion, will be needed. It was concluded that at present, best evidence does not support the use of any prognostic test in clinical practice. No subset of patients with low back pain could be identified, for whom spinal fusion is a reliable and effective treatment. In literature, several studies have reported that cognitive behavioural therapy or intensive exercise programs have treatment results similar to those of spinal fusion, but with considerably less complications, morbidity and costs. As the findings of the present thesis show that the currently used tests do not improve the results of fusion by better patient selection, these tests should not be recommended for surgical decision making in standard care. Moreover, spinal fusion should not be proposed as a standard treatment for chronic low back pain. Causality of nonspecific spinal pain is complex and CLBP should not be regarded as a diagnosis, but rather as a symptom in patients with different stages of impairment and disability. Patients should be evaluated in a multidisciplinary setting or Spine Centre according to the so-called biopsychosocial model, which aims to identify underlying psychosocial factors as well as biological factors. Treatment should occur in a stepwise fashion starting with the least invasive treatment. The current approach of CLBP, in which emphasis is laid on self-management and empowerment of patients to take an active course of treatment in order to prevent long-term disability and chronicity, is recommended.}, } @article {pmid23413133, year = {2013}, author = {Alshaer, H and Levchenko, A and Bradley, TD and Pong, S and Tseng, WH and Fernie, GR}, title = {A system for portable sleep apnea diagnosis using an embedded data capturing module.}, journal = {Journal of clinical monitoring and computing}, volume = {27}, number = {3}, pages = {303-311}, pmid = {23413133}, issn = {1573-2614}, mesh = {Acoustics ; Algorithms ; Diagnosis, Computer-Assisted/instrumentation/statistics & numerical data ; Equipment Design ; Humans ; Monitoring, Ambulatory/*instrumentation/statistics & numerical data ; Polysomnography/*instrumentation/statistics & numerical data ; Reproducibility of Results ; Respiratory Sounds ; Signal-To-Noise Ratio ; Sleep Apnea Syndromes/*diagnosis ; }, abstract = {UNLABELLED: Sleep apnea (SA) is a very common disease with serious health consequences, yet is very under-diagnosed, partially because of the high cost and limited accessibility of in-laboratory polysomnography (PSG). The purpose of this work is to introduce a newly developed portable system for the diagnosis of SA at home that is both reliable and easy to use. The system includes personal devices for recording breath sounds and airflow during sleep and diagnostic algorithms to process the recorded data. The data capturing device consists of a wearable face frame with an embedded electronic module featuring a unidirectional microphone, a differential microphone preamplifier, a microcontroller with an onboard differential analogue to digital converter, and a microSD memory card. The device provides continuous data capturing for 8 h. Upon completion of the recording session, the memory card is returned to a location for acoustic analysis. We recruited 49 subjects who used the device independently at home, after which each subject answered a usability questionnaire. Random data samples were selected to measure the signal-to-noise ratio (SNR) as a gauge of hardware functionality. A subset of 11 subjects used the device on 2 different nights and their results were compared to examine diagnostic reproducibility. Independent of those, system's performance was evaluated against PSG in the lab environment in 32 subject. The overall success rate of applying the device in un-attended settings was 94 % and the overall rating for ease-of-use was 'excellent'. Signal examination showed excellent capturing of breath sounds with an average SNR of 31.7 dB. Nine of the 11 (82 %) subjects had equivalent results on both nights, which is consistent with reported inter-night variability. The system showed 96 % correlation with simultaneously performed in-lab PSG.

CONCLUSION: Our results suggest excellent usability and performance of this system and provide a strong rationale to further improve it and test its robustness in a larger study.}, } @article {pmid23372758, year = {2013}, author = {Schröder, A and Vulink, N and Denys, D}, title = {Misophonia: diagnostic criteria for a new psychiatric disorder.}, journal = {PloS one}, volume = {8}, number = {1}, pages = {e54706}, pmid = {23372758}, issn = {1932-6203}, mesh = {Adolescent ; Adult ; Child ; Child, Preschool ; Female ; Humans ; Male ; Mental Disorders/*diagnosis ; Psychiatric Status Rating Scales ; Young Adult ; }, abstract = {BACKGROUND: Some patients report a preoccupation with a specific aversive human sound that triggers impulsive aggression. This condition is relatively unknown and has hitherto never been described, although the phenomenon has anecdotally been named misophonia.

42 patients who reported misophonia were recruited by our hospital website. All patients were interviewed by an experienced psychiatrist and were screened with an adapted version of the Y-BOCS, HAM-D, HAM-A, SCL-90 and SCID II. The misophonia patients shared a similar pattern of symptoms in which an auditory or visual stimulus provoked an immediate aversive physical reaction with anger, disgust and impulsive aggression. The intensity of these emotions caused subsequent obsessions with the cue, avoidance and social dysfunctioning with intense suffering. The symptoms cannot be classified in the current nosological DSM-IV TR or ICD-10 systems.

CONCLUSIONS: We suggest that misophonia should be classified as a discrete psychiatric disorder. Diagnostic criteria could help to officially recognize the patients and the disorder, improve its identification by professional health carers, and encourage scientific research.}, } @article {pmid23285963, year = {2012}, author = {Zhu, X and Zhang, J and Li, M}, title = {[Decreased sound tolerance and tinnitus].}, journal = {Lin chuang er bi yan hou tou jing wai ke za zhi = Journal of clinical otorhinolaryngology, head, and neck surgery}, volume = {26}, number = {19}, pages = {909-912}, pmid = {23285963}, issn = {2096-7993}, mesh = {Humans ; *Hyperacusis ; *Tinnitus ; }, abstract = {Decreased sound tolerance includes hyperacusis and/or misphobia (phonophobia). As a commonly subjective symptom, tinnitus is defined to be a sound perceived in the ear or head without corresponding sound or electrical stimulus in the surrounding environment. It is usually occurred with or without hearing loss or harmful psychic reaction, which includes dyssomnia, annoy, rage, anxiety, depress, hard to concentrate, etc. Frequently, tinnitus is accompanied by decreased sound tolerance, while this text is aimed to review the correlated concepts of decreased sound tolerance,and focus on the hyperacusis which is a more common symptom.}, } @article {pmid23270666, year = {2012}, author = {Wu, T and Mohan, C}, title = {Lupus nephritis - alarmins may sound the alarm?.}, journal = {Arthritis research & therapy}, volume = {14}, number = {6}, pages = {129}, pmid = {23270666}, issn = {1478-6362}, mesh = {Female ; HMGB1 Protein/*urine ; Humans ; Lupus Erythematosus, Systemic/*diagnosis/*urine ; Lupus Nephritis/*diagnosis/*urine ; Male ; }, abstract = {A growing body of literature has documented the elevated levels of the alarmin HMGB1 in lupus skin and serum. Two recent reports highlight the increased expression of HMGB1 in lupus nephritis, within the diseased kidneys or in the urine. Taken together with previous reports, these findings suggest that the interaction of HMGB1 with a variety of receptors, including receptor for advanced glycation end products (RAGE) and Toll-like receptors, might play a role in the pathogenesis of lupus nephritis. These studies introduce urinary HMGB1 as a novel biomarker candidate in lupus nephritis. Whether alarmins would be effective in sounding the alarm at the incipience of renal damage remains to be ascertained.}, } @article {pmid22413649, year = {2011}, author = {Schwartz, P and Leyendecker, J and Conlon, M}, title = {Hyperacusis and misophonia: the lesser-known siblings of tinnitus.}, journal = {Minnesota medicine}, volume = {94}, number = {11}, pages = {42-43}, pmid = {22413649}, issn = {0026-556X}, mesh = {Adolescent ; Adult ; Cooperative Behavior ; Female ; Hearing Loss, Noise-Induced/diagnosis/*etiology/therapy ; Humans ; Hyperacusis/diagnosis/*etiology/therapy ; Interdisciplinary Communication ; Tinnitus/diagnosis/*etiology/therapy ; }, abstract = {Hyperacusis (decreased sound tolerance) and misophonia (fear of sound) are two conditions about which little is known. Consequently, physicians often struggle when they encounter patients who are affected by them. This article attempts to educate the medical community about hyperacusis and misophonia, both of which can have devastating effects on the lives of patients, and ways to manage them.}, } @article {pmid22179572, year = {2012}, author = {Erickson, MA and Niehoff, ML and Farr, SA and Morley, JE and Dillman, LA and Lynch, KM and Banks, WA}, title = {Peripheral administration of antisense oligonucleotides targeting the amyloid-β protein precursor reverses AβPP and LRP-1 overexpression in the aged SAMP8 mouse brain.}, journal = {Journal of Alzheimer's disease : JAD}, volume = {28}, number = {4}, pages = {951-960}, doi = {10.3233/JAD-2011-111517}, pmid = {22179572}, issn = {1875-8908}, support = {AG029839/AG/NIA NIH HHS/United States ; }, mesh = {Aging/*metabolism/pathology ; Amyloid beta-Protein Precursor/antagonists & inhibitors/*metabolism ; Animals ; Brain/drug effects/*metabolism/pathology ; Drug Delivery Systems ; *Gene Expression Regulation ; Low Density Lipoprotein Receptor-Related Protein-1 ; Male ; Mice ; Mice, Transgenic ; Oligonucleotides, Antisense/*administration & dosage ; Receptors, LDL/antagonists & inhibitors/*metabolism ; Tumor Suppressor Proteins/antagonists & inhibitors/*metabolism ; }, abstract = {The senescence accelerated mouse-prone 8 (SAMP8) mouse model of Alzheimer's disease has a natural mutation leading to age-related increases in the amyloid-β protein precursor (AβPP) and amyloid-β (Aβ) in the brain, memory impairment, and deficits in Aβ removal from the brain. Previous studies show that centrally administered antisense oligonucleotide directed against AβPP can decrease AβPP expression and Aβ production in the brains of aged SAMP8 mice, and improve memory. The same antisense crosses the blood-brain barrier and reverses memory deficits when injected intravenously. Here, we give 6 μg of AβPP or control antisense 3 times over 2 week intervals to 12 month old SAMP8 mice. Object recognition test was done 48 hours later, followed by removal of whole brains for immunoblot analysis of AβPP, low-density lipoprotein-related protein-1 (LRP-1), p-glycoprotein (Pgp), receptor for advanced glycation endproducts (RAGE), or ELISA of soluble Aβ(40). Our results show that AβPP antisense completely reverses a 30% age-associated increase in AβPP signal (p < 0.05 versus untreated 4 month old SAMP8). Soluble Aβ(40) increased with age, but was not reversed by antisense. LRP-1 large and small subunits increased significantly with age (147.7%, p < 0.01 and 123.7%, p < 0.05 respectively), and AβPP antisense completely reversed these increases (p < 0.05). Pgp and RAGE were not significantly altered with age or antisense. Antisense also caused improvements in memory (p < 0.001). Together, these data support the therapeutic potential of AβPP antisense and show a unique association between AβPP and LRP-1 expression in the SAMP8 mouse.}, } @article {pmid21864520, year = {2011}, author = {León-Justel, A and Mangas, MA and Infante Fontán, R and Castro Luque, J and Venegas Moreno, E and Madrazo Atutxa, A and Herrera del Rey, T and Martin-Rodriguez, JF and Soto-Moreno, A and Leal-Cerro, A}, title = {Budget impact of using midnight salivary cortisol in the diagnosis of hypercortisolism.}, journal = {Clinica chimica acta; international journal of clinical chemistry}, volume = {412}, number = {23-24}, pages = {2248-2253}, doi = {10.1016/j.cca.2011.08.013}, pmid = {21864520}, issn = {1873-3492}, mesh = {*Budgets ; Cushing Syndrome/*diagnosis ; Female ; Hospital Costs ; Humans ; Hydrocortisone/*analysis ; Male ; Middle Aged ; Reproducibility of Results ; Saliva/*chemistry ; Sensitivity and Specificity ; }, abstract = {BACKGROUND: A single midnight serum cortisol (MSC) test has been reported to possess the best sensitivity and specificity for diagnosing Cushing's syndrome (CS). However, this test requires patient hospitalization, making it costly. This paper aims to compare the hospital budget impact and accuracy of using midnight salivary cortisol (MSVC), as opposed to MSC, in the diagnosis of hypercortisolism.

METHODS: 77 patients with at least two high urinary free cortisol (UFC) values (>360 nmol/24 h) were selected from 611 patients with clinical symptoms of CS. The costs of the method to confirm the diagnosis of hypercortisolism was calculated comparing Option A using MSC (UFCx2, low-dose dexamethasone suppression test [LDDST]) that requires patient hospitalization versus Option B using MSVC (UFCx2, LDDST) in which the evaluation is done outside the Hospital. A budget impact analysis for one year was developed, and a sensitivity analysis in different scenarios was performed. Reproducibility and diagnostic performance of MSVC and MSC were also measured.

RESULTS: Salivary cortisol is a sound analytical method for evaluating free serum cortisol due to its classification accuracy, good imprecision, linearity, and stability. AUC(ROC) comparison between MSVC and MSC shows no significant differences. The substitution of the MSC for MSVC in our hospital could save between €16,762 and €132,804 in one year.

CONCLUSIONS: The use of MSVC in the diagnosis of hypercortisolism can result in a substantial decrease in the budget impact, without losing diagnosis accuracy and reliability, a significant advantage considering the current emphasis on reducing the financial burden of health care.}, } @article {pmid21810457, year = {2011}, author = {Weegerink, NJ and Schraders, M and Leijendeckers, J and Slieker, K and Huygen, PL and Hoefsloot, L and Oostrik, J and Pennings, RJ and Simon, A and Snik, A and Kremer, H and Kunst, HP}, title = {Audiometric characteristics of a Dutch family with Muckle-Wells syndrome.}, journal = {Hearing research}, volume = {282}, number = {1-2}, pages = {243-251}, doi = {10.1016/j.heares.2011.07.006}, pmid = {21810457}, issn = {1878-5891}, mesh = {Acoustic Stimulation ; Adolescent ; Adult ; *Audiometry, Pure-Tone ; *Audiometry, Speech ; Auditory Perception/*genetics ; Auditory Threshold ; Carrier Proteins/*genetics ; Child ; Child, Preschool ; Cryopyrin-Associated Periodic Syndromes/complications/drug therapy/*genetics ; DNA Mutational Analysis ; Disease Progression ; Female ; Genetic Predisposition to Disease ; Hearing Loss/*diagnosis/genetics/physiopathology/psychology/therapy ; Heredity ; Humans ; Interleukin 1 Receptor Antagonist Protein/therapeutic use ; Linear Models ; Loudness Perception ; Male ; Middle Aged ; *Mutation ; NLR Family, Pyrin Domain-Containing 3 Protein ; Netherlands ; Noise/adverse effects ; Otoscopy ; Pedigree ; Perceptual Masking ; Phenotype ; Predictive Value of Tests ; Reflex, Acoustic/genetics ; Reflex, Vestibulo-Ocular/genetics ; Speech Perception/genetics ; Vestibular Function Tests ; Young Adult ; }, abstract = {Description of the audiometric and vestibular characteristics of a Dutch family with Muckle-Wells syndrome (MWS). Examination of all family members consisted of pure tone audiometry, otoscopy and genetic analysis. In addition, a selected group underwent speech audiometry, vestibulo-ocular examination, acoustic reflex testing and tests assessing loudness scaling, gap detection, difference limen for frequency and speech perception in noise. Linear regression analyses were performed on the audiometric data. Six clinically affected family members participated in this study and all were carriers of a p.Tyr859His mutation in the NLPR3 gene. Most affected family members reported bilateral, slowly progressive hearing impairment since childhood. Hearing impairment started at the high frequencies and the low- and mid-frequency threshold values deteriorated with advancing age. Annual threshold deterioration (ATD) ranged from 1.3 to 1.9 dB/year with the highest values at the lower frequencies. Longitudinal linear regression analysis demonstrated significant progression for a number of frequencies in five individuals. Speech recognition scores were clearly affected. However, these individuals tended to have higher speech recognition scores than presbyacusis patients at similar PTA(1,2,4 kHz) levels. The loudness growth curves were steeper than those found in individuals with normal hearing, except for one family member (individual IV:6). Suprathreshold measurements, such as difference limen for frequency (DL(f)), gap detection and particularly speech perception in noise were within the normal range or at least close to data obtained in two groups of patients with a so-called conductive type of hearing loss, situated in the cochlea. Hearing impairment in MWS is variable and shows resemblance to previously described intra-cochlear conductive hearing impairment. This could be helpful in elucidating the pathogenesis of hearing impairment in MWS. Other associated symptoms of MWS were mild and nonspecific in the present family. Therefore, even without any obvious syndromic features, MWS can be the cause of sensorineural hearing impairment, especially when combined with (mild) skin rash and musculoskeletal symptoms. An early diagnosis of MWS is essential to prevent irreversible damage from amyloidosis. The effect of IL-1β inhibitors on hearing impairment is more controversial, but an early start of treatment seems to be essential. Therefore, our results are of importance in patient care and counselling.}, } @article {pmid21769998, year = {2011}, author = {Lebowitz, ER and Omer, H and Leckman, JF}, title = {Coercive and disruptive behaviors in pediatric obsessive-compulsive disorder.}, journal = {Depression and anxiety}, volume = {28}, number = {10}, pages = {899-905}, pmid = {21769998}, issn = {1520-6394}, support = {T32 MH018268/MH/NIMH NIH HHS/United States ; }, mesh = {Adult ; Attention Deficit and Disruptive Behavior Disorders/*diagnosis ; Child ; Child Behavior Disorders/*diagnosis ; *Coercion ; Female ; Humans ; Male ; Obsessive-Compulsive Disorder/*diagnosis ; Parents ; Psychiatric Status Rating Scales ; Psychometrics ; Severity of Illness Index ; Surveys and Questionnaires ; }, abstract = {BACKGROUND: This study explored the nature of disruptive and coercive behaviors in pediatric obsessive-compulsive disorder (OCD).

METHOD: Thirty children with OCD and a disruptive behavior disorder (DBD) were compared to 30 children with DBD alone using the Child Behavior Checklist and a novel 18-item questionnaire focused on distinctive coercive and disruptive behaviors seen in pediatric OCD (CD-POC).

RESULTS: Although youth with DBD alone had higher ratings of Externalizing Behaviors on the CBCL compared to the youth with OCD + DBD, their ratings on the CB-POC scale were lower. For example, 83% of OCD + DBD parents reported that their child "Imposes rules or behaviors on others due to tactile or other sensitivity and reacts to disobedience with rage or violence (e.g. forbids certain sounds, demands specific temperature settings)" compared to 23% of the parents of youth with DBD alone. Other highly discriminating behaviors included: "Demands special 'cuddling' or ritualized contact without regard for the will of others" and "Forbids the use of objects in his/her vicinity because of feelings of fear or disgust (e.g. knives, scissors, creams)." Total scores on the CD-POC were also correlated with OCD severity (P<.01).

CONCLUSION: The results suggest that the nature of DBD in pediatric OCD may be distinctive and worthy of further study.}, } @article {pmid21303290, year = {2011}, author = {}, title = {Fear of the yawning mother: a case study of misophonia.}, journal = {Australasian psychiatry : bulletin of Royal Australian and New Zealand College of Psychiatrists}, volume = {19}, number = {1}, pages = {88}, doi = {10.3109/10398562.2011.551934}, pmid = {21303290}, issn = {1440-1665}, } @article {pmid20732329, year = {2010}, author = {Kupniewska-Kozak, A and Gospodarska, E and Dadlez, M}, title = {Intertwined structured and unstructured regions of exRAGE identified by monitoring hydrogen-deuterium exchange.}, journal = {Journal of molecular biology}, volume = {403}, number = {1}, pages = {52-65}, doi = {10.1016/j.jmb.2010.08.027}, pmid = {20732329}, issn = {1089-8638}, mesh = {Amino Acid Sequence ; Deuterium/analysis ; Humans ; Hydrogen/analysis ; Mass Spectrometry ; Models, Molecular ; Molecular Sequence Data ; Protein Structure, Tertiary ; Receptor for Advanced Glycation End Products/*chemistry ; }, abstract = {Receptor for advanced glycation end products (RAGE) is a multiligand receptor that is engaged in many pathological processes. Potentially beneficial modification of its activity requires sound knowledge of its structural properties. However, up to now, only the structures of its separated domains have been published or deposited in databases. In this work, we used hydrogen-deuterium exchange and mass spectrometry to gain insight into the structural properties of exRAGE (extracellular region of RAGE)--the full extracellular part of the protein. The present work indicates the common and disparate features of full exRAGE as compared to the structural models of its separate domains. The highlight of the present study is the contrasting behavior of the different regions of the protein, with the protected regions neighboring fully exposed parts especially in the N-terminal V domain.}, } @article {pmid20136543, year = {2010}, author = {Collins, N}, title = {Fear of the yawning mother: a case of misophonia.}, journal = {Australasian psychiatry : bulletin of Royal Australian and New Zealand College of Psychiatrists}, volume = {18}, number = {1}, pages = {71-72}, doi = {10.3109/10398560903180133}, pmid = {20136543}, issn = {1440-1665}, mesh = {Adult ; Humans ; Male ; Mother-Child Relations ; Phobic Disorders/*diagnosis ; *Yawning ; }, } @article {pmid19560298, year = {2010}, author = {Sztuka, A and Pospiech, L and Gawron, W and Dudek, K}, title = {DPOAE in estimation of the function of the cochlea in tinnitus patients with normal hearing.}, journal = {Auris, nasus, larynx}, volume = {37}, number = {1}, pages = {55-60}, doi = {10.1016/j.anl.2009.05.001}, pmid = {19560298}, issn = {1879-1476}, mesh = {Adult ; Audiometry, Pure-Tone ; Cochlea/*physiopathology ; Female ; Hair Cells, Auditory, Outer/pathology ; Hearing/*physiology ; Humans ; Hyperacusis/diagnosis/physiopathology ; Male ; Otoacoustic Emissions, Spontaneous/*physiology ; Tinnitus/pathology/*physiopathology ; }, abstract = {OBJECTIVE: The most probable place generating tinnitus in the auditory pathway is the outer hair cells (OHCs) inside the cochlea. Otoacoustic emissions are used to assess their activity. The objective of the investigation was to measure the features of distortion product otoacoustic emissions (DPOAE) in a group of tinnitus patients without hearing loss, estimate the diagnostic value of the parameters for the analysis of cochlear function in the patients, emphasizing those most useful in localizing tinnitus generators, and determine the hypothetical influence of hyperacusis and misophony on DPOAE parameters in tinnitus patients.

PATIENTS AND METHODS: The material consisted of 44 patients with tinnitus and without hearing loss. In the control group were 33 patients without tinnitus with the same state of hearing. The tinnitus patients were divided into three subgroups: those with hyperacusis, those with misophonia, and those with neither. After collecting medical history and performing clinical examination of all the patients, tonal and impedance audiometry, ABR, and discomfort level were evaluated. Then DPOAE were measured using three procedures. First the amplitudes of two points per octave were assessed, second the "fine structure" method with 16-20 points per octave (f2/f1=1.22, L1=L2=70 dB), and the third procedure included recording the growth function in three series for input tones of f2=2002, 4004, and 6006Hz (f2/f1=1.22) and L1=L2 levels increasing by increments of 5 dB in each series.

RESULTS AND CONCLUSIONS: Hyperacusis was found in 63% and misophonia in 10% of the tinnitus patients with no hearing loss. DPOAE amplitudes in recordings with two points per octave and the fine structure method are very valuable parameters for estimating cochlear function in tinnitus patients with normal hearing. Function growth rate cannot be the only parameter in measuring DPOAE in tinnitus patients, including subjects with hyperacusis and misophonia. The markedly higher DPOAE amplitudes in the group of tinnitus patients without hearing loss suggest that tinnitus may be caused by increased motility of the OHCs induced by decreasing efferent fiber activity, and not by OHC failure. Hyperacusis significantly increases the amplitude of DPOAE in tinnitus patients with no hearing loss.}, } @article {pmid19380172, year = {2009}, author = {Wang, Y and Ma, L and Liu, P}, title = {Feature selection and syndrome prediction for liver cirrhosis in traditional Chinese medicine.}, journal = {Computer methods and programs in biomedicine}, volume = {95}, number = {3}, pages = {249-257}, doi = {10.1016/j.cmpb.2009.03.004}, pmid = {19380172}, issn = {1872-7565}, mesh = {*Algorithms ; *Artificial Intelligence ; *Decision Support Systems, Clinical ; Diagnosis, Computer-Assisted/*methods ; Humans ; Liver Cirrhosis/*diagnosis ; Medicine, Chinese Traditional/*methods ; Pattern Recognition, Automated/*methods ; Reproducibility of Results ; Sensitivity and Specificity ; Software ; Syndrome ; }, abstract = {Traditional Chinese medicine (TCM) treatment is one of the safe and effective methods for liver cirrhosis. In the process of its treatment, a very important step, syndrome prediction is generally performed by physicians at present, which actually hinders the application prospects of TCM. Based on the data mining algorithm, a novel method called TCMSP (traditional Chinese medicine syndrome prediction) is proposed, which consists of two phases. In the first phase, based on an improved information gain method in multi-view, the critical features are filtered from the original features. In the second phase, the class label of a new case is predicted automatically based on accuracy-weighted majority voting. The proposed method is evaluated by the liver cirrhosis dataset, 20 critical features are selected from original 105 features and the corresponding syndromes of 138 new cases are identified respectively. The critical features are in sound agreement with those used by the physicians in making their clinical decisions. Finally, this new method is also demonstrated on three standard datasets (SPECT Heart, Lung Cancer and Iris) and the results are compared with some other methods. The experimental results show that TCMSP method performs well in the field of TCM diagnosis.}, } @article {pmid18652730, year = {2008}, author = {Hess, EP and Thiruganasambandamoorthy, V and Wells, GA and Erwin, P and Jaffe, AS and Hollander, JE and Montori, VM and Stiell, IG}, title = {Diagnostic accuracy of clinical prediction rules to exclude acute coronary syndrome in the emergency department setting: a systematic review.}, journal = {CJEM}, volume = {10}, number = {4}, pages = {373-382}, doi = {10.1017/s148180350001040x}, pmid = {18652730}, issn = {1481-8035}, mesh = {Acute Coronary Syndrome/*diagnosis ; Angina, Unstable/diagnosis ; Chest Pain/*diagnosis ; *Decision Support Techniques ; Emergency Medical Services ; Humans ; Likelihood Functions ; Myocardial Infarction/diagnosis ; Research Design ; Sensitivity and Specificity ; }, abstract = {OBJECTIVE: We sought to determine the diagnostic accuracy of clinical prediction rules to exclude acute coronary syndrome (ACS) in the emergency department (ED) setting.

METHODS: We searched MEDLINE, EMBASE, Web of Science and the Cochrane Database of Systematic Reviews. We contacted content experts to identify additional articles for review. Reference lists of included studies were hand searched. We selected articles for review based on the following criteria: 1) enrolled consecutive ED patients; 2) incorporated variables from the history or physical examination, electrocardiogram and cardiac biomarkers; 3) did not incorporate cardiac stress testing or coronary angiography into prediction rule; 4) based on original research; 5) prospectively derived or validated; 6) did not require use of a computer; and 7) reported sufficient data to construct a 2 x 2 contingency table. We assessed study quality and extracted data independently and in duplicate using a standardized data extraction form.

RESULTS: Eight studies met inclusion criteria, encompassing 7937 patients. None of the studies verified the prediction rule with a reference standard on all or a random sample of patients. Six studies did not report blinding prediction rule assessors to reference standard results, and vice versa. Three prediction rules were prospectively validated. Sensitivities and specificities ranged from 94% to 100% and 13% to 57%, and positive and negative likelihood ratios from 1.1 to 2.2 and 0.01 to 0.17, respectively.

CONCLUSION: Current prediction rules for ACS have substantial methodological limitations and have not been successfully implemented in the clinical setting. Future methodologically sound studies are needed to guide clinical practice.}, } @article {pmid17263252, year = {2006}, author = {Sztuka, A and Pośpiech, L and Gawron, W and Dudek, K}, title = {[DPOAE in tinnitus patients with cochlear hearing loss considering hyperacusis and misophonia].}, journal = {Otolaryngologia polska = The Polish otolaryngology}, volume = {60}, number = {5}, pages = {765-772}, pmid = {17263252}, issn = {0030-6657}, mesh = {Adolescent ; Adult ; Aged ; Audiometry, Pure-Tone ; Auditory Threshold ; Female ; Hair Cells, Auditory, Outer/pathology/physiopathology ; Hearing Loss, Sensorineural/*physiopathology ; Humans ; Hyperacusis/*physiopathology ; Male ; Middle Aged ; *Otoacoustic Emissions, Spontaneous ; *Pitch Perception ; Predictive Value of Tests ; Tinnitus/*physiopathology ; }, abstract = {UNLABELLED: The most probable place generating tinnitus in auditory pathway are outer hair cells (OHC) inside cochlea. To asses their activity otoacoustic emission is used. The goal of the investigation was estimation the features of otoemission DPOAE in groups with tinnitus patients with cochlear hearing loss, estimation of diagnostic value of DPOAE parameters for analysis of function of the cochlea in investigated patients emphasizing DPOAE parameters most useful in localizing tinnitus generators and estimation of hypothetic influence of hyperacusis and misophony on parameters of DPOAE in tinnitus patients with cochlear hearing loss. The material of the study were 42 tinnitus patients with cochlear hearing loss. In the control group there were 21 patients without tinnitus with the same type of hearing loss. Then tinnitus patients were divided into three subgroups--with hyperacusis, misophony and without both of them, based on audiologic findings.

METHOD: after taking view on tinnitus and physical examination in all the patients pure tone and impedance audiometry, supratreshold tests, ABR and audiometric average and discomfort level were evaluated. Then otoemission DPOAE was measured in three procedures. First the amplitudes of two points per octave were assessed, in second--"fine structure" method-- 16-20 points per octave (f2/f1 = 1.2, L1 = L2 = 70 dB). Third procedure included recording of growth rate function in three series for input tones of value f2 = 2002, 4004, 6006 Hz (f2/f1= 1.22) and levels L1=L2, growing by degrees of 5dB in each series.

RESULTS: DPOAE amplitudes in recording of 2 points per octave and fine structure method are very valuable parameters for estimation of cochlear function in tinnitus patients with cochlear hearing loss. Decreasing of DPOAE amplitudes in patients with cochlear hearing loss and tinnitus suggests significant role of OHC pathology, unbalanced by IHC injury in generation of tinnitus in patients with hearing loss of cochlear localization. DPOAE fine structure provides us the additional information about DPOAE amplitude recorded in two points per octave, spreading the amount of frequencies f2, where differences are noticed in comparison of two groups--tinnitus patients and control. Function growth rate cannot be the only parameter in estimation of DPOAE in tinnitus patients with cochlear hearing loss, also including subjects with hyperacusis and misophony. Hyperacusis has important influence on DPOAE amplitude, increases essentially amplitude of DPOAE in the examined group of tinnitus patients.}, } @article {pmid16699064, year = {2006}, author = {Veale, D}, title = {A compelling desire for deafness.}, journal = {Journal of deaf studies and deaf education}, volume = {11}, number = {3}, pages = {369-372}, doi = {10.1093/deafed/enj043}, pmid = {16699064}, issn = {1081-4159}, mesh = {Adult ; Depression ; Female ; Hearing Loss/*psychology ; Humans ; Hyperacusis/*psychology ; Mental Disorders/*psychology ; Sign Language ; *Social Identification ; Social Isolation/psychology ; }, abstract = {A case is described of a patient who has a compelling and persistent desire to become deaf. She often kept cotton wool moistened with oil in her ears and was learning sign language. Living without sound appeared to be a severe form of avoidance behavior from hyperacusis and misophonia. She had a borderline personality disorder that was associated with a poor sense of self. Her desire to be deaf may be one aspect of gaining an identity for herself and to compensate for feeling like an alien and gaining acceptance in the Deaf community. Will a compelling desire for deafness ever become a recognized mental disorder one day for which hearing patients may be offered elective deafness after a period of assessment and living like a deaf person? Those working in the field of deafness should be aware that individuals may occasionally be seeking elective deafness or self-inflicting deafness to obtain a hearing aid.}, } @article {pmid16552774, year = {2006}, author = {Carey, J and Amin, N}, title = {Evolutionary changes in the cochlea and labyrinth: Solving the problem of sound transmission to the balance organs of the inner ear.}, journal = {The anatomical record. Part A, Discoveries in molecular, cellular, and evolutionary biology}, volume = {288}, number = {4}, pages = {482-489}, doi = {10.1002/ar.a.20306}, pmid = {16552774}, issn = {1552-4884}, mesh = {Animals ; Atmospheric Pressure ; *Biological Evolution ; Ear, Inner/abnormalities/anatomy & histology/*physiology ; Hearing/*physiology ; Humans ; Postural Balance/*physiology ; }, abstract = {This review article examines the evolutionary adaptations in the vertebrate inner ear that allow selective activation of auditory or vestibular hair cells, although both are housed in the same bony capsule. The problem of separating acoustic stimuli from the vestibular end organs in the inner ear has recently reemerged with the recognition of clinical conditions such as superior canal dehiscence syndrome and enlarged vestibular aqueduct syndrome. In these syndromes, anatomical defects in the otic capsule alter the functional separation of auditory and vestibular stimuli and lead to pathological activation of vestibular reflexes in response to sound. This review demonstrates that while the pars superior of the labyrinth (utricle and semicircular canals) has remained fairly constant throughout evolution, the pars inferior (saccule and other otolith, macular, and auditory end organs) has seen considerable change as many adaptations were made for the development of auditory function. Among these were a relatively rigid membranous labyrinth wall, a variably rigid otic capsule, immersion of the membranous labyrinth in perilymph, a perilymphatic duct to channel acoustic pressure changes away from the vestibular organs, and different operating frequencies for vestibular versus auditory epithelia. Even in normal human ears, acoustic sensitivity of the labyrinth to loud clicks or tones is retained enough to be measured in a standard clinical test, the vestibular-evoked myogenic potential test.}, } @article {pmid16514259, year = {2006}, author = {Jastreboff, PJ and Jastreboff, MM}, title = {Tinnitus retraining therapy: a different view on tinnitus.}, journal = {ORL; journal for oto-rhino-laryngology and its related specialties}, volume = {68}, number = {1}, pages = {23-9; discussion 29-30}, doi = {10.1159/000090487}, pmid = {16514259}, issn = {0301-1569}, mesh = {Acoustic Stimulation ; Conditioning, Classical/physiology ; *Habituation, Psychophysiologic ; Hearing Loss/complications ; Humans ; Hyperacusis/complications ; Tinnitus/complications/*psychology/*therapy ; Treatment Outcome ; }, abstract = {Tinnitus retraining therapy (TRT) is a method for treating tinnitus and decreased sound tolerance, based on the neurophysiological model of tinnitus. This model postulates involvement of the limbic and autonomic nervous systems in all cases of clinically significant tinnitus and points out the importance of both conscious and subconscious connections, which are governed by principles of conditioned reflexes. The treatments for tinnitus and misophonia are based on the concept of extinction of these reflexes, labeled as habituation. TRT aims at inducing changes in the mechanisms responsible for transferring signal (i.e., tinnitus, or external sound in the case of misophonia) from the auditory system to the limbic and autonomic nervous systems, and through this, remove signal-induced reactions without attempting to directly attenuate the tinnitus source or tinnitus/misophonia-evoked reactions. As such, TRT is effective for any type of tinnitus regardless of its etiology. TRT consists of: (1) counseling based on the neurophysiological model of tinnitus, and (2) sound therapy (with or without instrumentation). The main role of counseling is to reclassify tinnitus into the category of neutral stimuli. The role of sound therapy is to decrease the strength of the tinnitus signal. It is crucial to assess and treat tinnitus, decreased sound tolerance, and hearing loss simultaneously. Results from various groups have shown that TRT can be an effective method of treatment.}, } @article {pmid16340272, year = {2005}, author = {Kobs, G and Bernhardt, O and Kocher, T and Meyer, G}, title = {Oral parafunctions and positive clinical examination findings.}, journal = {Stomatologija}, volume = {7}, number = {3}, pages = {81-83}, pmid = {16340272}, issn = {1392-8589}, mesh = {Adult ; Bruxism/*complications ; Cross-Sectional Studies ; Facial Pain/etiology ; Female ; Humans ; Male ; Masticatory Muscles/physiopathology ; Middle Aged ; Muscle Contraction ; Muscle Fatigue ; Palpation ; Physical Examination ; Temporomandibular Joint Dysfunction Syndrome/*diagnosis/*etiology/physiopathology ; }, abstract = {STATEMENT OF PROBLEM: Oral parafunctional activity can be fatigued and painful masticatory muscles and/or pain in the temporomandibular joints. There is controversial discussion in the literature as to what role parafunctional activity plays in the multi-causal pathologic process.

PURPOSE: The purpose of this study was to determine any association between the level of parafunctional habits versus the level of mandibular dysfunction and to test the hypothesis that TMD/bruxer patients have significantly increased muscle tension and joint pain.

MATERIAL AND METHODS: There were 307 subjects (140 males und 167 females) selected for this investigation. 299 subjects were examined regarding any relationships between clenching and the incidence of muscle sensitivity. The age of subjects ranged from 20 to 54 years old, with a mean age of 35.4. 114 subjects had at least one sign of temporomandibular disorders (tenderness/pain on palpation of the joints or muscles, TMJ sounds, pain or deviation during maximum mouth opening (active/passive).

RESULTS: 81 subjects admitted to clenching, while 218 said they did not. Among the "non-clenchers", 68.8% had no sensitive muscles, 31.2% indicated sensitive masticatory muscles. Those who clenched their teeth were distributed as follows: 53.1% were diagnosed with bilateral masticatory muscle sensitivity, 46.9% showed no such indications. The two groups were not homogeneously divided, with regard to pain/discomfort (p = 0.001; Fisher's precision test).

CONCLUSION: This study found a statistically solid relationship between the incidence of "clenching" and muscle palpation findings, as well as between sensitivity in the mandibular joints from lateral and to cranial and dorsal with positive muscle palpation findings. The agreement between sensitivity of the masticatory musculature and the mandibular joint demonstrates that intensive clenching can predominantly lead to pathologic phenomena in the muscles or joints.}, } @article {pmid14658726, year = {2003}, author = {Bedenice, D and Heuwieser, W and Brawer, R and Solano, M and Rand, W and Paradis, MR}, title = {Clinical and prognostic significance of radiographic pattern, distribution, and severity of thoracic radiographic changes in neonatal foals.}, journal = {Journal of veterinary internal medicine}, volume = {17}, number = {6}, pages = {876-886}, doi = {10.1111/j.1939-1676.2003.tb02528.x}, pmid = {14658726}, issn = {0891-6640}, mesh = {Animals ; Animals, Newborn ; Cohort Studies ; Horse Diseases/*diagnostic imaging ; Horses ; Logistic Models ; Lung Diseases/*diagnostic imaging/*veterinary ; Observer Variation ; Predictive Value of Tests ; Radiography, Thoracic/methods/standards/*veterinary ; Retrospective Studies ; }, abstract = {A total of 207 thoracic radiographs obtained from 128 foals were evaluated to assess the impact of pulmonary radiographic pattern, distribution, and severity of pulmonary changes on short-term survival of neonatal foals. The association between selected clinical variables and the radiographic manifestation of neonatal respiratory disease was also investigated. The evaluation of interstitial and alveolar-interstitial radiographic patterns within the caudodorsal, caudoventral, and cranioventral lung regions proved to be highly reliable between viewers in the study. A diagnosis of systemic inflammatory response syndrome was related to increased pulmonary infiltrates within the caudodorsal lung region. Dyspneic foals had more extensive pulmonary infiltrates within the cranioventral lung, advanced respiratory disease, and lower survival rates. A fibrinogen concentration >400 mg/dL was associated with increased cranioventral radiographic abnormalities. In addition, tachypnea most consistently related to diffuse (caudodorsal, caudoventral, and cranioventral) pulmonary changes. Neutropenia, milk reflux from the nares, upper airway pathology, abnormal respiratory sounds, failure of transfer of passive immunity (IgG concentration <400 mg/dL), immaturity, or fever, however, were not related to radiographic pattern, distribution, or severity of radiographic changes. Sixty-five percent of foals with radiographic pulmonary disease were discharged alive from our referral hospital. Concurrent caudodorsal and caudoventral radiographic disease was most frequently observed in this foal population. Increased caudodorsal radiographic scores retained statistical significance as a prognostic indicator for nonsurvival in a multiple stepwise logistic regression analysis.}, } @article {pmid14527306, year = {2003}, author = {Friedman, TB and Griffith, AJ}, title = {Human nonsyndromic sensorineural deafness.}, journal = {Annual review of genomics and human genetics}, volume = {4}, number = {}, pages = {341-402}, doi = {10.1146/annurev.genom.4.070802.110347}, pmid = {14527306}, issn = {1527-8204}, mesh = {*Genetic Predisposition to Disease ; Hearing Loss, Sensorineural/diagnosis/*genetics/physiopathology ; Humans ; }, abstract = {Given the unique biological requirements of sound transduction and the selective advantage conferred upon a species capable of sensitive sound detection, it is not surprising that up to 1% of the approximately 30,000 or more human genes are necessary for hearing. There are hundreds of monogenic disorders for which hearing loss is one manifestation of a syndrome or the only disorder and therefore is nonsyndromic. Herein we review the supporting evidence for identifying over 30 genes for dominantly and recessively inherited, nonsyndromic, sensorineural deafness. The state of knowledge concerning their biological roles is discussed in the context of the controversies within an evolving understanding of the intricate molecular machinery of the inner ear.}, } @article {pmid11557246, year = {2001}, author = {Plebani, M}, title = {Biochemical markers of cardiac damage: from efficiency to effectiveness.}, journal = {Clinica chimica acta; international journal of clinical chemistry}, volume = {311}, number = {1}, pages = {3-7}, doi = {10.1016/s0009-8981(01)00551-4}, pmid = {11557246}, issn = {0009-8981}, mesh = {*Biomarkers ; Electrocardiography ; Heart Diseases/*blood/diagnosis ; Humans ; Troponin/blood ; }, abstract = {Testing for the diagnosis of acute myocardial infarction and other diseases included in the spectrum of the so-called "acute coronary syndrome" is rapidly changing from the traditional enzymatic assays to mass measurement of more specific and sensitive markers (cardiac troponins, CK-MB and myoglobin). Several questions have arisen since the introduction of these new markers into the clinical setting: the choice of strategies for optimizing the utilization of biochemical assays combining different (early and specific) markers, the rationale for sampling specimens and the identification of clinically useful turnaround times. The impressive clinical specificity and sensitivity assured by the measurement of cardiac troponins should be used for improving the effectiveness of patients' diagnosis and treatment. Troponins could be the paradigm of how a new diagnostic test and a therapeutic advance can be combined to the benefit of patients with acute coronary syndromes. In fact, in acute myocardial infarction (AMI) patients as well as in patients suffering from stable and unstable angina, the measurement of troponins alone, or combined to that of other biochemical markers, should be of practical value for the diagnosis, for the prognosis and for selecting the most effective therapeutic treatment. Limitations in cardiac markers should be classified into two groups: temporary and intrinsic limitations. Temporary limitations are: (a) current assays are not specific as to the analyte, (b) the limited standardization precludes a comparison between results obtained with different techniques. Intrinsic limitations are the elevation of troponins in the so-called "minor myocardial damage", which often cannot be confirmed by other techniques, the evidence that other heart diseases, such as congestive heart failure and myocarditis, can lead to an increase in troponin concentrations, and finally that troponin is not an early marker. A sound cooperation between cardiologists, physicians and laboratory specialists in explaining and understanding the advantages and limitations of current biochemical markers should allow us to move from efficiency to clinical effectiveness.}, } @article {pmid10849247, year = {2000}, author = {Lindberg, E and Elmasry, A and Janson, C and Gislason, T}, title = {Reported snoring--does validity differ by age?.}, journal = {Journal of sleep research}, volume = {9}, number = {2}, pages = {197-200}, doi = {10.1046/j.1365-2869.2000.00199.x}, pmid = {10849247}, issn = {0962-1105}, mesh = {Age Factors ; Aged ; Aging/*physiology ; Cardiovascular Diseases/complications ; Humans ; Male ; Middle Aged ; Population Surveillance ; Reproducibility of Results ; Sensitivity and Specificity ; Snoring/complications/*diagnosis ; Surveys and Questionnaires ; }, abstract = {Snoring is a major sign of obstructive sleep apnoea syndrome. Despite the frequent number of studies based on subjective reports of snoring, self-reported snoring has hardly been validated at all. In some previous epidemiological studies, a significant association between snoring and cardiovascular morbidity and mortality was found only below the age of 50-60 y. This study was performed to investigate whether this is due to a decrease in the validity of reported snoring with increasing age. In a population-based study, 2668 men aged 40-79 y answered a questionnaire including questions on snoring. Those who reported loud and disturbing snoring often or very often were regarded as habitual snorers. Without taking account of reported snoring, an age-stratified sample of these men was selected and their snoring was measured using a microphone for 1 night. Significant snoring was defined as recorded snoring sounds for >/= 10% of the night. The participants were divided into younger (age 40-59, mean +/- SD: 51.8 +/- 4.6 y, n=132) and older (age 60-79, 67.7 +/- 5.4 y, n=99) age groups. When analysing the validity of reported snoring, no significant differences were found between the younger and older age groups in terms of specificity [younger: 82% (95% CI 74-90%), older: 88% (81-95%)] or sensitivity [younger: 40% (26-54%), older: 35% (17-53%)]. These data indicate that, in men aged 40-79 y, the validity of reported snoring is similar in different age groups. The lack of an association between reported snoring and cardiovascular disease at higher ages can, therefore, not be explained by a decrease in the validity of reported snoring.}, } @article {pmid10604951, year = {2000}, author = {Snell, LD and Claffey, DJ and Ruth, JA and Valenzuela, CF and Cardoso, R and Wang, Z and Levinson, SR and Sather, WA and Williamson, AV and Ingersoll, NC and Ovchinnikova, L and Bhave, SV and Hoffman, PL and Tabakoff, B}, title = {Novel structure having antagonist actions at both the glycine site of the N-methyl-D-aspartate receptor and neuronal voltage-sensitive sodium channels: biochemical, electrophysiological, and behavioral characterization.}, journal = {The Journal of pharmacology and experimental therapeutics}, volume = {292}, number = {1}, pages = {215-227}, pmid = {10604951}, issn = {0022-3565}, support = {AA09930/AA/NIAAA NIH HHS/United States ; }, mesh = {Animals ; Anti-Anxiety Agents/pharmacology ; Ataxia/etiology ; Behavior, Animal/drug effects ; Binding Sites ; Binding, Competitive ; Cells, Cultured ; Cerebellum/cytology ; Dose-Response Relationship, Drug ; Ethanol/toxicity ; Glycine/metabolism ; Humans ; In Vitro Techniques ; Male ; Mice ; Mice, Inbred C57BL ; Mice, Inbred DBA ; Neurons/drug effects ; Oocytes/metabolism ; Phenylurea Compounds/chemical synthesis/*chemistry ; Protein Binding ; Quinolines/*chemical synthesis/*chemistry/*pharmacology ; Rats ; Receptors, Adrenergic, alpha/drug effects ; Receptors, Glutamate/drug effects ; Receptors, N-Methyl-D-Aspartate/*antagonists & inhibitors/chemistry ; Seizures/etiology ; *Sodium Channel Blockers ; Sodium Channels/chemistry ; Sound/adverse effects ; Strychnine/pharmacology ; Substance Withdrawal Syndrome/etiology ; Xenopus/genetics ; }, abstract = {A novel series of N-substituted 4-ureido-5,7-dichloro-quinolines were synthesized to contain pharmacophores directed at voltage-sensitive sodium channels (VSNaCs) and N-methyl-D-aspartate (NMDA) receptors. These compounds were shown to act in a use-dependent manner as antagonists of VSNaCs and to act as selective competitive antagonists at the strychnine-insensitive glycine recognition site of NMDA receptors. These agents had little or no effect on alpha-adrenergic receptors, other glutamate receptors, or sites other than the glycine site on the NMDA receptor, and did not block voltage-sensitive calcium channels in vitro. In vivo, the compounds were active in preventing or reducing the signs and symptoms of neurohyperexcitability and had anxiolytic properties. Unlike benzodiazepines, N-substituted 4-ureido-5, 7-dichloro-quinolines showed little interaction with the sedative effects of ethanol, but were effective in controlling ethanol withdrawal seizures. The combined actions of these compounds on VSNaCs and NMDA receptors also impart properties to these compounds that are important for preventing and reducing excitotoxic neurodegeneration, but these compounds lack the undesirable side effects of other agents used for these purposes.}, } @article {pmid9670216, year = {1998}, author = {Faingold, CL and N'Gouemo, P and Riaz, A}, title = {Ethanol and neurotransmitter interactions--from molecular to integrative effects.}, journal = {Progress in neurobiology}, volume = {55}, number = {5}, pages = {509-535}, doi = {10.1016/s0301-0082(98)00027-6}, pmid = {9670216}, issn = {0301-0082}, support = {NIAA 11628/AA/NIAAA NIH HHS/United States ; NS 21281/NS/NINDS NIH HHS/United States ; }, mesh = {Animals ; Brain/drug effects/metabolism ; Ethanol/adverse effects/*metabolism ; Excitatory Amino Acids/metabolism ; Humans ; Neural Inhibition/physiology ; Neurotransmitter Agents/*metabolism ; Seizures/chemically induced ; Substance Withdrawal Syndrome ; gamma-Aminobutyric Acid/physiology ; }, abstract = {There is extensive evidence that ethanol interacts with a variety of neurotransmitters. Considerable research indicates that the major actions of ethanol involve enhancement of the effects of gamma-aminobutyric acid (GABA) at GABAA receptors and blockade of the NMDA subtype of excitatory amino acid (EAA) receptor. Ethanol increases GABAA receptor-mediated inhibition, but this does not occur in all brain regions, all cell types in the same region, nor at all GABAA receptor sites on the same neuron, nor across species in the same brain region. The molecular basis for the selectivity of the action of ethanol on GaBAA receptors has been proposed to involve a combination of benzodiazepine subtype, beta 2 subunit, and a splice variant of the gamma 2 subunit, but substantial controversy on this issue currently remains. Chronic ethanol administration results in tolerance, dependence, and an ethanol withdrawal (ETX) syndrome, which are mediated, in part, by desensitization and/or down-regulation of GABAA receptors. This decrease in ethanol action may involve changes in subunit expression in selected brain areas, but these data are complex and somewhat contradictory at present. The sensitivity of NMDA receptors to ethanol block is proposed to involve the NMDAR2B subunit in certain brain regions, but this subunit does not appear to be the sole determinant of this interaction. Tolerance to ethanol results in enhanced EAA neurotransmission and NMDA receptor upregulation, which appears to involve selective increases in NMDAR2B subunit levels and other molecular changes in specific brain loci. During ETX a variety of symptoms are seen, including susceptibility to seizures. In rodents these seizures are readily triggered by sound (audiogenic seizures). The neuronal network required for these seizures is contained primarily in certain brain stem structures. Specific nuclei appear to play a hierarchical role in generating each stereotypical behavioral phases of the convulsion. Thus, the inferior colliculus acts to initiate these seizures, and a decrease in effectiveness of GABA-mediated inhibition in these neurons is a major initiation mechanism. The deep layers of superior colliculus are implicated in generation of the wild running behavior. The pontine reticular formation, substantia nigra and periaqueductal gray are implicated in generation of the tonic-clonic seizure behavior. The mechanisms involved in the recruitment of neurons within each network nucleus into the seizure circuit have been proposed to require activation of a critical mass of neurons. Achievement of critical mass may involve excess EAA-mediated synaptic neurotransmission due, in part, to upregulation as well as other phenomena, including volume (non-synaptic diffusion) neurotransmission. Effects of ETX on receptors observed in vitro may undergo amplification in vivo to allow the excess EAA action to be magnified sufficiently to produce synchronization of neuronal firing, allowing participation of the nucleus in seizure generation. GABA-mediated inhibition, which normally acts to limit excitation, is diminished in effectiveness during ETX, and further intensifies this excitation.}, } @article {pmid9627167, year = {1998}, author = {Wittmann, DH and Wittmann-Tylor, A}, title = {Scope and limitations of antimicrobial therapy of sepsis in surgery.}, journal = {Langenbeck's archives of surgery}, volume = {383}, number = {1}, pages = {15-25}, doi = {10.1007/s004230050087}, pmid = {9627167}, issn = {1435-2443}, mesh = {Anti-Bacterial Agents/pharmacokinetics/*therapeutic use ; Biological Availability ; Cephalosporins/pharmacokinetics/therapeutic use ; Clinical Trials as Topic ; Dose-Response Relationship, Drug ; Humans ; Microbial Sensitivity Tests ; Pancreatitis, Acute Necrotizing/drug therapy/microbiology ; Peritonitis/drug therapy/microbiology ; Shock, Septic/*drug therapy/microbiology/mortality ; Surgical Wound Infection/*drug therapy/microbiology/mortality ; Survival Rate ; Systemic Inflammatory Response Syndrome/*drug therapy/microbiology/mortality ; }, abstract = {OBJECTIVE: The goal of antibiotic therapy for surgical sepsis is to kill bacteria that intermittently or continuously reach the bloodstream from the residue of an operatively treated focus. While sepsis and conditions leading to sepsis compromise the immune system, antibiotics may become a fundamental determinant of the host's defense. No data from sound prospective randomized clinical antibiotic trials dealing with sepsis are available. Therefore we tested the hypothesis that treatment recommendations can be based on pharmacodynamics comparing in vitro activity of commonly used antimicrobials with concentrations sustained in vivo to provide for full coverage for bacteria of concern.

RESULTS: The application of strict criteria for antibiotic choice to avoid selection of primary resistant strains reveals that most commonly used antibiotics render insufficient activity to eliminate pathogens that commonly cause surgical sepsis. Antibiotics that sustain in vivo concentration exceeding fourfold the MIC100 (highest minimal inhibitory concentration for all (100%) species tested) of Escherichia coli, for example, are 400 mg ciprofloxacin IV (MIC100 of 1224 strains=0.06 mg/dl, in vivo concentration=1 mg/dl for 12 h), and 1000 mg imipenem/cilastatin (MIC100 of 3142 strains=0.14 mg/dl, in vivo concentration=2 mg/dl for 6 h). The third choice is one of the fourth- or, less convincingly, third-generation cephalosporins. Similar data for most pathogens causing sepsis are provided. First- and second-generation cephalosporins and penicillin beta-lactamase inhibitor combinations generally do not achieve sufficient concentrations to cover the most important pathogens of sepsis.

CONCLUSION: Sepsis is defined as a whole body's inflammatory response that is characterized by systemic signs and symptoms secondary to a focal infection. While many antibiotic trials have dealt with a focal infection, no prospective randomized antibiotic trial has dealt with sepsis per se. Antibiotic trials on focal infections generally exclude patients when their focal infection has progressed to sepsis. To circumvent the lack of controlled clinical trials we show that pharmacodynamics may provide sound foundation for antibiotic choice for sepsis.}, } @article {pmid9170052, year = {1997}, author = {Counter, SA and Olofsson, A and Grahn, HF and Borg, E}, title = {MRI acoustic noise: sound pressure and frequency analysis.}, journal = {Journal of magnetic resonance imaging : JMRI}, volume = {7}, number = {3}, pages = {606-611}, doi = {10.1002/jmri.1880070327}, pmid = {9170052}, issn = {1053-1807}, mesh = {Calibration ; Child ; Environmental Monitoring ; Fourier Analysis ; Hearing Loss, Noise-Induced/*etiology ; Humans ; Infant ; Magnetic Resonance Imaging/*adverse effects/instrumentation ; Models, Theoretical ; Phantoms, Imaging ; Pressure ; Risk Assessment ; }, abstract = {The large gradient coils used in MRI generate, simultaneously with the pulsed radiofrequency (RF) wave, acoustic noise of high intensity that has raised concern regarding hearing safety. The sound pressure levels (SPLs) and power spectra of MRI acoustic noise were measured at the position of the human head in the isocenter of five MRI systems and with 10 different pulse sequences used in clinical MR scanning. Each protocol, including magnetization-prepared rapid gradient echo (MP-RAGE; 113 dB SPL linear), fast gradient echo turbo (114 dB SPL linear), and spin echo T1/2 mm (117 dB SPL linear), was found to have the high SPLs, rapid pulse rates, amplitude-modulated pulse envelopes, and multipeaked spectra. Since thickness and SPL were inversely related, the T1-weighted images generated more intense acoustic noise than the proton-dense T2-weighted measures. The unfiltered linear peak values provided more accurate measurements of the SPL and spectral content of the MRI acoustic noise than the commonly used dB A-weighted scale, which filters out the predominant low frequency components. Fourier analysis revealed predominantly low frequency energy peaks ranging from .05 to approximately 1 kHz, with a steep high frequency cutoff for each pulse sequence. Ear protectors of known attenuation ratings are recommended for all patients during MRI testing.}, } @article {pmid9026741, year = {1996}, author = {Stam, J}, title = {[Consensus on diagnosis and treatment of the lumbosacral radicular syndrome. Dutch Society for Neurology].}, journal = {Nederlands tijdschrift voor geneeskunde}, volume = {140}, number = {52}, pages = {2621-2627}, pmid = {9026741}, issn = {0028-2162}, mesh = {Diagnostic Imaging ; Humans ; Intervertebral Disc Displacement/*diagnosis/*therapy ; Lumbosacral Region ; Nerve Compression Syndromes/diagnosis/therapy ; Patient Care Planning ; *Spinal Nerve Roots ; Spinal Stenosis/*diagnosis/*therapy ; Syndrome ; }, abstract = {A consensus development meeting concerning the treatment of lumbosacral radicular syndrome (LRS) by entrapment by a herniated disc or spinal stenosis was held on June 9th, 1995. It was observed that there is a lack of good evidence on many aspects of diagnosis and treatment of LRS. Agreement was reached on the thesis that the natural course of LRS is often benign. Diagnosis and treatment can usually be left to the primary care physician. Specialist consultation and ancillary investigations are only needed if an operation is indicated or in case of persistent diagnostic uncertainty. If imaging is needed MRI is preferred to CT or myelography. MRI is highly sensitive, but less specific, and may thus give false-positive results. Neurophysiologic testing may be informative in selected cases. Plain spinal X-rays are not useful in most cases. The traditional non-invasive treatments (such as bedrest, traction, physiotherapy, spinal manipulation) are not based upon convincing scientific evidence. Diagnostic imaging and invasive treatment should be considered in patients with a severe LRS that does not improve within a 4 to 8 week period. Both discectomy and chemonucleolysis are effective treatments. The principal indication is incapacitating radicular pain. There is no sound evidence that the prognosis of paresis is improved by operation. A cauda equina syndrome urgently needs surgical treatment. The efficacy of percutaneous interventions (nucleotomy, laser therapy) has not been proven. There are no strategies for the primary or secondary prevention of LRS that have demonstrated their efficacy. Psychological, social and financial factors probably contribute significantly to the occurrence of persisting symptoms after a LRS. Advice not to work after treatment for LRS may impede rehabilitation.}, } @article {pmid8872218, year = {1996}, author = {Holmlund, AB and Axelsson, S}, title = {Temporomandibular arthropathy: correlation between clinical signs and symptoms and arthroscopic findings.}, journal = {International journal of oral and maxillofacial surgery}, volume = {25}, number = {3}, pages = {178-181}, doi = {10.1016/s0901-5027(96)80024-5}, pmid = {8872218}, issn = {0901-5027}, mesh = {Adolescent ; Adult ; Aged ; Arthritis/diagnosis/pathology/physiopathology ; *Arthroscopy/statistics & numerical data ; Female ; Humans ; Male ; Middle Aged ; Osteoarthritis/diagnosis/pathology/physiopathology ; Predictive Value of Tests ; Range of Motion, Articular ; Sensitivity and Specificity ; Sound ; Synovitis/diagnosis/pathology/physiopathology ; Temporomandibular Joint/pathology/physiopathology ; Temporomandibular Joint Disc/pathology/physiopathology ; Temporomandibular Joint Disorders/*diagnosis/pathology/physiopathology ; Temporomandibular Joint Dysfunction Syndrome/diagnosis/pathology/physiopathology ; Tissue Adhesions/diagnosis/pathology/physiopathology ; }, abstract = {The clinical signs and symptoms of temporomandibular arthropathy were correlated with arthroscopic features of temporomandibular joint disease in 200 consecutive patients. The diagnostic accuracy of the selected clinical signs and symptoms was also tested with arthroscopy as the standard, and sensitivity (SE), specificity (SP), positive predictive value (PPV), and negative predictive value (NPV) were calculated. Pronounced osteoarthrosis was more frequently associated with joint crepitus (P < 0.001). Adhesions were more frequently associated with reduced maximum protrusion (P < 0.001). Crepitation was the only clinical sign that showed acceptable values for SE, SP, PPV, and NPV, and only in diagnosing advanced osteoarthrosis. The values for mild osteoarthrosis were low.}, } @article {pmid8792266, year = {1996}, author = {Bettison, S}, title = {The long-term effects of auditory training on children with autism.}, journal = {Journal of autism and developmental disorders}, volume = {26}, number = {3}, pages = {361-374}, pmid = {8792266}, issn = {0162-3257}, mesh = {*Acoustic Stimulation ; Adolescent ; Arousal ; Attention ; Auditory Perceptual Disorders/psychology/*therapy ; Autistic Disorder/psychology/*therapy ; Child ; Child, Preschool ; Female ; Follow-Up Studies ; Humans ; Intelligence ; Male ; *Music ; Personality Assessment ; }, abstract = {Eighty children, 3-17 years of age, with autism or Asperger syndrome and mild to severe distress in the presence of some sounds, were randomly allocated to two groups. The experimental group received auditory training and the control group listened to the same unmodified music under the same conditions. Significant improvements in behavior and severity of autism were maintained for 12 months by both groups. Informal data suggested that a range of abnormal responses to sound and other sensory abnormalities may also have improved. Verbal and performance IQ increased significantly 3 to 12 months after interventions. Findings suggest that some aspect of both auditory training and listening to selected unmodified music may have a beneficial effect on children with autism and sound sensitivity, and indicate a need for further research into the effects that led to these changes and the mechanisms involved in the sensory abnormalities commonly associated with autism.}, } @article {pmid8748784, year = {1995}, author = {Alesch, F and Armbruster, C and Budka, H}, title = {Diagnostic value of stereotactic biopsy of cerebral lesions in patients with AIDS.}, journal = {Acta neurochirurgica}, volume = {134}, number = {3-4}, pages = {214-219}, pmid = {8748784}, issn = {0001-6268}, mesh = {Acquired Immunodeficiency Syndrome/complications/*pathology ; Adult ; Biopsy ; Brain Diseases/complications/*pathology ; Female ; Frontal Lobe/pathology ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Tomography, X-Ray Computed ; }, abstract = {A neurological complication occurs in 40-60% of HIV infected patients during the course of the disease. In 10-20% the neurological complication is the first manifestation of the HIV infection. A reliable neuropathological diagnosis is a prerequisite for a specifically selected treatment. While modern computer-assisted imaging techniques, such as computed tomography or magnetic resonance imaging, do possess a high sensitivity, they do not as a rule permit an unambiguous diagnosis. Between October 1989 and July 1994 we biopsied 38 HIV infected patients stereotactically. The indication for the biopsy was determined by having radiologically detectable lesions with no regression tendency in patients under antitoxoplasmosis therapy. In 89% an unambiguous diagnosis was made based on the biopsy; 11% of the biopsies were not diagnostic. For the most part, toxoplasmosis (31%) and progressive multifocal leucoencephalopathy (29%) were involved. 18% of the patients suffered from a non-Hodgkin lymphoma. The foci were primarily frontal (47%), parietal (21%) or localised in the basal ganglia area (11%). The result of the biopsy led to a change in treatment for 52% of the patients. Morbidity and mortality of the operation were 0%. The results or our research series are similar to other groups. It was shown that stereotactic brain biopsy is a safe and effective method for establishing a sound basis for treating the frequently life-threatening cerebral complications of AIDS.}, } @article {pmid7877900, year = {1994}, author = {Burland, JA}, title = {Splitting as a consequence of severe abuse in childhood.}, journal = {The Psychiatric clinics of North America}, volume = {17}, number = {4}, pages = {731-742}, pmid = {7877900}, issn = {0193-953X}, mesh = {Adult ; Borderline Personality Disorder/diagnosis/psychology ; Child ; Child Abuse/*psychology ; Concept Formation ; Disruptive, Impulse Control, and Conduct Disorders/diagnosis/*psychology ; Humans ; Impulsive Behavior/diagnosis/psychology ; Object Attachment ; }, abstract = {Clinical data suggest that Kernberg's description of splitting as a defense mechanism is useful in conceptualizing the psychological consequences of abuse in childhood in certain patients. The splitting in these patients is similar to his description of splitting in borderline patients in that it compartmentalizes and sequesters certain overwhelming and painful ego states accompanying negative introjects of the betraying primary object and the betrayed self. These sequestered introjects, furthermore, act as automatons, generating behaviors that arbitrarily re-enact their content even though the patient remains consciously unaware of their historical meaning. Another consequence of the sequestration of these traumatic introjects is that their affects retain their initial power and primitive quality, unmodulated by the usual homogenizing process that is a part of the synthesis of part-object introjects into whole-object introjects; the sequestration, therefore, often painful in itself, must nevertheless be rigidly maintained lest traumatic anxiety in the face of overwhelming affects be re-experienced. Shengold calls the sequence of events that results in this brittle but stubborn painful constriction of the personality "soul murder." He borrowed the phrase from Freud who used it to refer to what Schreber had suffered at the hands of his sadistic father. That phrase--"soul murder"--may sound melodramatic, but it powerfully conveys what these patients communicate of their experience of themselves. As with Kernberg's patients, the defensive splitting serves to protect the positive introjects. These patients fear their negative introjects, even more than they feel uncomfortable about the split. They fear their desperate rage will destroy their love objects, and leave them feeling abandoned and hating themselves. As one of my patients put it: "I fear that my destructive anger will leave me all alone in a sea of rubble of my own making." In the transference, he feared destroying me and our positive bond. In these cases it would seem that the turning to splitting occurred at a later age than it does with Kernberg's borderline patients. His proposition is that the developmentally normal "splitting," related to the undifferentiation of the infantile ego, persists as a defensive splitting, perhaps as a consequence of a consistently derailed mother-child dialogue; whereas in my patients it would seem that the normal developmental splitting had waned as ego differentiation proceeded, but that in the face of overwhelming traumata at perhaps 3 or 4 years of age, the primitive defense was invoked regressively.(ABSTRACT TRUNCATED AT 400 WORDS)}, } @article {pmid7916235, year = {1994}, author = {Graeff, FG}, title = {Neuroanatomy and neurotransmitter regulation of defensive behaviors and related emotions in mammals.}, journal = {Brazilian journal of medical and biological research = Revista brasileira de pesquisas medicas e biologicas}, volume = {27}, number = {4}, pages = {811-829}, pmid = {7916235}, issn = {0100-879X}, mesh = {Acetylcholine/physiology ; Animals ; Anxiety/physiopathology ; Avoidance Learning/physiology ; Brain/drug effects/physiology ; Cats ; Corticotropin-Releasing Hormone/physiology ; *Defense Mechanisms ; Emotions/*drug effects/physiology ; Endorphins/physiology ; Escape Reaction/physiology ; Fear/physiology ; Neurotransmitter Agents/*physiology ; Norepinephrine/physiology ; Panic/physiology ; Rage/physiology ; Rats ; Serotonin/physiology ; gamma-Aminobutyric Acid/physiology ; }, abstract = {1. There is suggestive evidence that the septo-hippocampal system and the amygdala are involved in risk assessment behavior, a response to potential threat possibly related to anxiety. In addition, experimental results have been reported implicating the medial hypothalamus in coordinated escape, while the periaqueductal gray matter (PAG) and the median raphe nucleus serotonergic projection to the hippocampus seem to mediate freezing. The latter defensive behaviors are evoked by distal danger stimuli and may be viewed as manifestations of fear. Finally, there is a sound body of evidence indicating that the PAG commands primitive fight or flight reactions elicited by proximal threat, acute pain or asphyxia. These defense reactions may be related to rage and panic, respectively. In contrast, the lateral septal area and the bed nucleus of the stria terminalis have been shown to exert tonic inhibitory influence on defense. 2. Experimental evidence indicates that gamma-aminobutyric acid (GABA) tonically inhibits defensive behavior in the amygdala, hypothalamus and the PAG, an effect opposed by excitatory amino acids. Among monoamines, serotonin (5-HT) has been suggested to facilitate anxiety in the amygdala while inhibiting panic in the PAG. The role of noradrenaline in defense is less clear, although hypotheses implicating the locus coeruleus in anxiety and panic have been suggested. Among peptides, corticotropin-releasing factor (CRF) acting as a central neurotransmitter is thought to mediate behavioral and physiological effects of acute stress, while opioid peptides have been shown to inhibit defense in the amygdala and in the dorsal PAG. Finally, acetylcholine seems to facilitate defensive behavior in the hypothalamus and the PAG.}, } @article {pmid8468439, year = {1993}, author = {Dingemanse, J}, title = {An update of recent moclobemide interaction data.}, journal = {International clinical psychopharmacology}, volume = {7}, number = {3-4}, pages = {167-180}, doi = {10.1097/00004850-199300730-00008}, pmid = {8468439}, issn = {0268-1315}, mesh = {Adult ; Antiparkinson Agents/administration & dosage/pharmacokinetics/toxicity ; Benzamides/administration & dosage/pharmacokinetics/*toxicity ; Dose-Response Relationship, Drug ; Drug Therapy, Combination ; Ephedrine/administration & dosage/pharmacokinetics/toxicity ; Humans ; Moclobemide ; Monoamine Oxidase Inhibitors/administration & dosage/pharmacokinetics/*toxicity ; Selective Serotonin Reuptake Inhibitors/administration & dosage/pharmacokinetics/toxicity ; }, abstract = {The classical monoamine oxidase inhibitors (MAOIs) are believed to have serious risks because of interactions with other drugs and foodstuffs, although not with a sound scientific basis in all cases. However, moclobemide, a selective reversible inhibitor of MAO-A, has a low propensity for producing drug interactions. Interaction studies have been carried out in healthy volunteers in an attempt to answer some relevant practical questions related to therapy with moclobemide. In combination with therapeutic doses of either fluvoxamine or fluoxetine, moclobemide did not provide any indication of a serotoninergic syndrome, so that no wash-out period is needed when switching from a selective serotonin re-uptake inhibitor to moclobemide or vice versa. Since concomitant treatment with moclobemide and selegiline had a supra-additive effect on the sensitivity to intravenously administered tyramine, that combination therapy should only be considered when accompanied by dietary restrictions. Concomitant treatment with moclobemide and levodopa/benserazide, however, was well tolerated. When oral ephedrine was added to steady-state moclobemide treatment, the cardiovascular effects of the former were increased to about the same extent as for oral tyramine, i.e. a potentiation of 2-4.}, } @article {pmid1951814, year = {1991}, author = {Thomas, SB and Quinn, SC}, title = {The Tuskegee Syphilis Study, 1932 to 1972: implications for HIV education and AIDS risk education programs in the black community.}, journal = {American journal of public health}, volume = {81}, number = {11}, pages = {1498-1505}, pmid = {1951814}, issn = {0090-0036}, mesh = {Acquired Immunodeficiency Syndrome/*prevention & control ; *Black or African American ; Alabama ; Ethics, Medical/*history ; Federal Government ; Health Education ; History, 20th Century ; Human Experimentation/*history ; Humans ; Male ; Nontherapeutic Human Experimentation ; Patient Selection ; Prejudice ; Prospective Studies ; Research Subjects ; Syphilis/*history/therapy ; Trust ; United States ; United States Public Health Service/*history ; *Withholding Treatment ; }, abstract = {The Tuskegee study of untreated syphilis in the Negro male is the longest nontherapeutic experiment on human beings in medical history. The strategies used to recruit and retain participants were quite similar to those being advocated for HIV/AIDS prevention programs today. Almost 60 years after the study began, there remains a trail of distrust and suspicion that hampers HIV education efforts in Black communities. The AIDS epidemic has exposed the Tuskegee study as a historical marker for the legitimate discontent of Blacks with the public health system. The belief that AIDS is a form of genocide is rooted in a social context in which Black Americans, faced with persistent inequality, believe in conspiracy theories about Whites against Blacks. These theories range from the belief that the government promotes drug abuse in Black communities to the belief that HIV is a manmade weapon of racial warfare. An open and honest discussion of the Tuskegee Syphilis Study can facilitate the process of rebuilding trust between the Black community and public health authorities. This dialogue can contribute to the development of HIV education programs that are scientifically sound, culturally sensitive, and ethnically acceptable.}, } @article {pmid2261972, year = {1990}, author = {Stoohs, R and Guilleminault, C}, title = {Investigations of an automatic screening device (MESAM) for obstructive sleep apnoea.}, journal = {The European respiratory journal}, volume = {3}, number = {7}, pages = {823-829}, pmid = {2261972}, issn = {0903-1936}, mesh = {Electronics, Medical/instrumentation ; Heart Rate ; Humans ; Monitoring, Physiologic/*instrumentation ; Sleep Apnea Syndromes/*diagnosis ; Snoring/*physiopathology ; }, abstract = {A digital recording device developed to monitor heart rate (HR) and breathing sounds (snoring), and used to screen subjects for obstructive sleep apnoea syndrome (OSAS), was investigated. This device is called the MESAM and is currently commercially available in some western European countries. The computer-based automatic scoring systems provided with the equipment and a hand-scoring technique developed at Stanford and requiring 10-15 min to perform, were used. Polysomnography and MESAM recordings were performed simultaneously on two groups of 25 sleep disorder patients (each with respiratory disturbance index greater than or less than 10). Patients were randomly monitored and records were analysed by two teams blind to the initial clinical impression, to the events which occurred during the recordings, and to each other's findings. Specificity and sensitivity were calculated for each of the MESAM scoring techniques considered, with polysomnography being selected as the recording standard, With "automatic HR scoring" specificity was 12%, sensitivity 92%; with "automatic breathing sounds (snoring)" scoring, specificity was 8% and sensitivity 96%; with "hand-scoring" specificity was 72% and sensitivity 92%. If the three scoring techniques were combined, all patients with a respiratory disturbance index (RD) greater than 10 were recognized as having OSAS.}, } @article {pmid24222051, year = {1990}, author = {McKenna, JJ}, title = {Evolution and the sudden infant death syndrome (SIDS) : Part II: Why human infants?.}, journal = {Human nature (Hawthorne, N.Y.)}, volume = {1}, number = {2}, pages = {179-206}, pmid = {24222051}, issn = {1045-6767}, abstract = {Postnatal parent-infant physiological regulatory effects described in the previous paper (Part I) are viewed here as being biologically contiguous with events that occur prenatally, preparing and sensitizing the fetus to the average microenvironment into which the infant is expected, based on its evolutionary past, to be born. Following McKenna (1986), evidence (some of which is circumstantial) is presented concerning fetal hearing and fetal amniotic liquid breathing as they are affected both by maternal cardiovascular blood flow sounds in the uterus and by fluctuating maternal blood sugar levels. These data are linked in turn to the infant's postulated postnatal responsivity to parental sensory cues, including auditory and vestibular respiratory cues that may assist infants as they "learn" to breathe and, for some, to resist a SIDS event.Data on the respiratory and vocalizing behavior of normal and hearing-impaired persons are used to show that not all forms of human breathing are innate; some forms develop with experience. These data reveal how human infants learn, for example, to coordinate higher and lower brain respiratory nuclei in the context of learning initially to cry with intent and purpose and later to speak. Voluntary, cortex-based breathing emerges at the same time that infants are most likely to die from SIDS, between 2 and 4 months of age. This switch between voluntary and involuntary breathing during both sleep (while dreaming) and wake cycles, which depends on the integration of higher cortical and lower brain stem nuclei, is complex and is possibly the basis of the human species' unique susceptibility to SIDS-a syndrome as yet unrecognized in other species. These human infant vulnerabilities, including delayed maturity, can explain in part why natural selection ought to favor increased infant sensitivity to parental sensory cues provided by a caregiver-stimuli available in the evolving parental care environment that included parent-infant co-sleeping for more than 4-5 million years of human evolution.}, } @article {pmid3984502, year = {1985}, author = {Oniani, TN and Nachkebiia, NG}, title = {[Effect of electrocoagulation of the septum on the behavior and memory of the cat].}, journal = {Zhurnal vysshei nervnoi deiatelnosti imeni I P Pavlova}, volume = {35}, number = {1}, pages = {17-24}, pmid = {3984502}, issn = {0044-4677}, mesh = {Animals ; Behavior, Animal/*physiology ; Brain Mapping ; Cats ; Conditioning, Operant/physiology ; Electroencephalography ; Extinction, Psychological/physiology ; Female ; Food ; Male ; Memory/*physiology ; Septum Pellucidum/*physiology ; Theta Rhythm ; }, abstract = {Lesion effects of various areas of the septum on general behaviour, learning and memory were studied in cats. It appeared that electrocoagulation of the medial septum alone leading to the disappearance of the hippocampal theta rhythm does not result in the development of the septal syndrome signs; does not disturb the normal structure of the sleep-wakefulness cycle; does not delay the elaboration of instrumental alimentary reflexes (to approach two feeders) or their extinction, but does entirely disturb the delayed responses to conditioned stimuli. In cases when lesion involves also the lateral septum, it produces the development of all signs of the septal syndrome (hyperemotionality, hyperactivity, rage, hyperphagia, etc.), disturbance of the normal structure of the sleep-wakefulness cycle, delay of both the elaboration and extinction of instrumental alimentary reflexes, disturbance of pre-elaborated conditioned reactions with sound discrimination, entire disturbance of conditioned delayed responses. On the basis of these data, the specific significance of hippocampal theta-rhythm in the organization of learning and memory is rejected, and a more important role is attributed to the descending regulatory influence exerted by the hippocampus and other archipaleocortical structures on the activating and motivatiogenic structures of mesodiencephalon.}, } @article {pmid6718262, year = {1984}, author = {Watkins, JG and Watkins, HH}, title = {Hazards to the therapist in the treatment of multiple personalities.}, journal = {The Psychiatric clinics of North America}, volume = {7}, number = {1}, pages = {111-119}, pmid = {6718262}, issn = {0193-953X}, mesh = {*Dangerous Behavior ; Dependency, Psychological ; Dissociative Identity Disorder/psychology/*therapy ; Ego ; Ethics, Professional ; Female ; Humans ; Male ; *Professional-Patient Relations ; Psychotherapy/methods ; Rage ; Sexual Behavior ; *Violence ; }, abstract = {It is vitally important that the therapist be cognizant of the dangers inherent in treating some patients with multiple personality disorder. The authors offer sound, detailed advice on every facet of the clinician's interaction with the patient--from keeping on good terms with each ego state to guarding against physical violence and sexual seduction.}, } @article {pmid7180439, year = {1982}, author = {Mjøen, S and Langslet, A and Tangsrud, SE and Sundby, A}, title = {Auditory brainstem responses (ABR) in high-risk neonates.}, journal = {Acta paediatrica Scandinavica}, volume = {71}, number = {5}, pages = {711-715}, doi = {10.1111/j.1651-2227.1982.tb09508.x}, pmid = {7180439}, issn = {0001-656X}, mesh = {Age Factors ; *Audiometry ; *Audiometry, Evoked Response ; Brain Stem/*physiopathology ; Evoked Potentials, Auditory ; Gestational Age ; Hearing Loss, Central/diagnosis ; Humans ; Infant ; Infant, Newborn ; Infant, Newborn, Diseases/*physiopathology ; *Infant, Premature ; Intensive Care Units, Neonatal ; Risk ; }, abstract = {In the present study, auditory brainstem responses (ABR) were recorded in 60 high-risk neonates in the intensive care unit selected by the following criteria: Birth-weight less than 2000 g, hyperbilirubinemia requiring phototherapy or exchange transfusion, idiopathic respiratory distress syndrome, artificial ventilation, asphyxia, sepsis or meningitis, intracranial haemorrhage, neurological symptoms and potential ototoxic medication (aminoglycoides, furosemide). The infants tested ranged in gestational age from 27-44 weeks. The ABR testing was performed in a sound-proof room using the Madsen (ERA-74) equipment. Four infants did not reveal responses to 70 dB HL ("nonresponders"), and the total of 10 neonates (16.6%) had abnormal ABR-tests, when the physiological changes related to gestational age and conceptional age (gestational age plus the age after birth) were taken into account. The 10 neonates with abnormal tests were reexamined after discharge, and in six there were no improvement of threshold sensitivity. three of the "nonresponders" were retested several times within the two years after birth (one died at age 18 months of pertussis), and none of them revealed ABR at stimulus intensity of 70 dB HL. They all attend an audiological training program started at age of six months as a consequence of the early diagnosis of impaired auditory function. It is our opinion that a routine ABR-evaluation should be performed on high risk neonates (criteria mentioned above) in the newborn intensive care unit. Retesting of infants with abnormal responses within three months, and several times within the next two years if abnormal responses persist, is important. Transient impairment of auditory functions is not uncommon in these infants. However, the children with persisting hearing impairment should be discovered early to attend an early audiological training program.}, } @article {pmid7299031, year = {1981}, author = {Rudolph, J}, title = {Aggression in the service of the ego and the self.}, journal = {Journal of the American Psychoanalytic Association}, volume = {29}, number = {3}, pages = {559-579}, doi = {10.1177/000306518102900304}, pmid = {7299031}, issn = {0003-0651}, mesh = {Aggression/*psychology ; Child ; Child Behavior Disorders/*psychology ; *Ego ; Humans ; Male ; Narcissism ; Object Attachment ; Psychoanalytic Therapy ; }, abstract = {With Jay, as with other patients in psychoanalysis, the pathological has shed light on the normal. First, during symbiosis, physical illness markedly disrupted his sense of well-being. He did not develop sufficient reserves of narcissism and instead built up a superabundance of hostile aggression. In the differentiation subphase of separation-individuation, his aggression could not be used constructively in the service of differentiation. In the practicing subphase, still immobilized, he was unable to effect even physical separation, let alone psychic separation. These subphase inadequacies, of course, influenced the character of his rapprochement subphase. With functioning already impaired by earlier subphase experience, continuing emotional pain and frustration affected his ability to negotiate the rapprochement subphase. Missing for Jay were the contributions that an adequate rapprochement subphase furnishes the organizing function of the ego. Not only did the rapprochement subphase fail to correct the inadequacies of the earlier subphases, the failures of rapprochement represented the last and final blow to the development of even a semblance of self- and object constancy, so that borderline pathology was the result. We can follow the progress made by the analysand by his own statements: Early: "I don't have a reserve of self-love to carry me through." Later, "I'm at a stage when I feel I can organize things without great anxiety. Plan things. Going ahead and slipping back sometimes too, but feeling confident." It has been the aim of this paper to show how the most malignant narcissistic rage has been converted into constructive aggression. Despite the greatest intrinsic and environmental odds, this patient, because of his good endowment, and aided by psychoanalysis, succeeded in gradually converting destructive aggression into constructive aggression by amalgamating it with more and more libido. Along with this, he also developed a sound secondary narcissism, so that his prognosis at eighteen years of age is optimistic.}, } @article {pmid484028, year = {1979}, author = {Lomarev, MP}, title = {[Conditioned reactions elaborated on the basis of reinforcement by hypothalamic stimulation].}, journal = {Zhurnal vysshei nervnoi deiatelnosti imeni I P Pavlova}, volume = {29}, number = {4}, pages = {715-721}, pmid = {484028}, issn = {0044-4677}, mesh = {Animals ; Autonomic Nervous System/physiology ; Brain Mapping ; Conditioning, Classical/*physiology ; Electroshock ; Emotions/*physiology ; Fear/physiology ; Food ; Heart Rate ; Hypothalamus/*physiology ; Male ; Motor Cortex/*physiology ; Rage/physiology ; *Reinforcement, Psychology ; Respiration ; Somatosensory Cortex/*physiology ; }, abstract = {The possibility of elaboration of conditioned emotional reactions on the basis of the stimulation of the hypothalamus, was studied in cats. Reinforcement of a sound (500 c/s) by electrical stimulation of the hypothalamus, which produced reactions of undirected rage, of fear with avoidance, of food search, led to the formation of a conditioned passive defensive reaction, analogous to that based on pain reinforcement. Elaboration of conditioned emotional reactions were blocked by switching off of the sensorimotor cortex by cold. A conclusion is made that during stimulation of the hypothalamus, the state of fear serves as the reinforcing factor and that the sensorimotor neocortical areas participate in the estimation of biological significance of the conditioned signal.}, } @article {pmid4450816, year = {1974}, author = {Schwarz, A}, title = {Sound production and associated behavior in a cichlid fish, Cichlasoma centrarchus. I. Male-male interactions.}, journal = {Zeitschrift fur Tierpsychologie}, volume = {35}, number = {2}, pages = {147-156}, pmid = {4450816}, issn = {0044-3573}, mesh = {Animal Communication ; Animals ; Behavior, Animal ; Fishes/*physiology ; Male ; Nesting Behavior ; Rage ; Sex Factors ; *Vocalization, Animal ; }, }