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DanMalcore

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Dan
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Reply with quote  #1 
The American Tinnitus Association just posted this summary of a proceeds from the National Academy of Science.  Following this summary is a link in the Recent News portion of network website to the pdf. which draws this conclusion:

The ATA: 

Summary: Hyperacusis refers to a condition in which sounds that are uncomfortably loud to normal people are intolerably loud. This condition is prevalent and affects many people. However, its underlying mechanisms are still not clear and no effective treatments are available. Scientists and clinicians have been searching for the underlying mechanisms. Although there are multiple causes including acoustic trauma and ear infection, a very common theory points to increased central gain in the brain following decreased signal input from the cochlea. However, it remains unclear what special factor in the cochlea might contributes to hyperacusis. Recently, scientists at Johns Hopkins University School of Medicine think that they have discovered the possible role of type II nerve cells, which carry some form of acoustic information from the cochlea of the ear to the central nervous system, in hyperacusis.

Multiple types of nerve cells carry information from the cochlea of the ear to the central nervous system. The predominant type (~95%) is the type I fiber, which carries information about sound that is registered by the inner hair cells inside the cochlea. The sparser (~5%) is the type II fiber, which are activated, albeit weakly, by outer hair cells. Unlike type I cells, the role of type II cells, for decades now, has been somewhat unclear, especially since they have been shown not to be insensitive to sound. However, the recent work of Liu and colleagues may change that, by showing that these cells respond to damage to outer hair cells.

Moreover, they do so in a familiar way. Say you accidentally place your finger on a hot burner. You will recoil instantly, and remove your finger even before you become consciously aware of the pain, though the pain will eventually be perceived. The pathway that allows this to occur is via cells that carry information about temperature from your fingers to your spinal cord, which then activates other muscles in an effort to move the imperiled finger. Dr. Liu and colleagues think that a similar process may be at work in the auditory system, where loud sounds damaging outer hair cells triggers behavior to withdraw from the loud sound. In a cultured inner ear preparation, they found that when damaged outer hair cells release more molecules adenosine triphosphate (ATP) that serve as energy source for these cells to function. They also found that when more ATPs are released, the outer hair cells become more excited and send out more signals that are to be received by the brain. This suggests these nerve cells may act as the ear’s pain sensor and send pain-like signals to the brain that does not tolerate sounds in hyperacusis patients.

Key Outcomes: This study highlights the critical role of type II cells in acoustic damage, and suggests that they operate in a similar way to pain receptors in other parts of the body.

Relevance to tinnitus/hyperacusis: The heightened sensitivity to sound, and in some cases pain associated with sound, that is characteristic of hyperacusis may have a basis in a compromised type II cell system. If type II cells truly respond to acoustic damage, then hyper-sensitivity of these cells could lower the threshold for sounds that cause pain. This could be particularly important for those with hyperacusis, an extreme sensitivity to every day sounds. which in severe cases causes pain.

Study authors: Liu C, Glowatski E, Fuchs PA Proceeds of the National Academy of Science.

http://www.hyperacusis.net/hyperacusis/recent+news/default.asp



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Johnloudb

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Reply with quote  #2 
I think it is great that they are doing research on hyperacusis. But at the same time, when they make statements like there are no effective treatments for hyperacusis and the underlying mechanisms are not understood ... It really brings up the question, "do they have any clue at all about what they are doing?"

Why don't they do some researching on the topic or even talk to some people who've recovered before making such stupid remarks.
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saab1216

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Reply with quote  #3 
Not much motivation can project further research on hyperacusis if it is "permanent damage". What a devastating blow to those who need truth. I can attest that I am hearing quite normal in my damaged ears.
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jirimenzel

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Reply with quote  #4 
Quote:
Originally Posted by DanMalcore
The American Tinnitus Association just posted this summary of a proceeds from the National Academy of Science.  Following this summary is a link in the Recent News portion of network website to the pdf. which draws this conclusion:

The ATA: 

Summary: Hyperacusis refers to a condition in which sounds that are uncomfortably loud to normal people are intolerably loud. This condition is prevalent and affects many people. However, its underlying mechanisms are still not clear and no effective treatments are available. Scientists and clinicians have been searching for the underlying mechanisms. Although there are multiple causes including acoustic trauma and ear infection, a very common theory points to increased central gain in the brain following decreased signal input from the cochlea. However, it remains unclear what special factor in the cochlea might contributes to hyperacusis. Recently, scientists at Johns Hopkins University School of Medicine think that they have discovered the possible role of type II nerve cells, which carry some form of acoustic information from the cochlea of the ear to the central nervous system, in hyperacusis.

Multiple types of nerve cells carry information from the cochlea of the ear to the central nervous system. The predominant type (~95%) is the type I fiber, which carries information about sound that is registered by the inner hair cells inside the cochlea. The sparser (~5%) is the type II fiber, which are activated, albeit weakly, by outer hair cells. Unlike type I cells, the role of type II cells, for decades now, has been somewhat unclear, especially since they have been shown not to be insensitive to sound. However, the recent work of Liu and colleagues may change that, by showing that these cells respond to damage to outer hair cells.

Moreover, they do so in a familiar way. Say you accidentally place your finger on a hot burner. You will recoil instantly, and remove your finger even before you become consciously aware of the pain, though the pain will eventually be perceived. The pathway that allows this to occur is via cells that carry information about temperature from your fingers to your spinal cord, which then activates other muscles in an effort to move the imperiled finger. Dr. Liu and colleagues think that a similar process may be at work in the auditory system, where loud sounds damaging outer hair cells triggers behavior to withdraw from the loud sound. In a cultured inner ear preparation, they found that when damaged outer hair cells release more molecules adenosine triphosphate (ATP) that serve as energy source for these cells to function. They also found that when more ATPs are released, the outer hair cells become more excited and send out more signals that are to be received by the brain. This suggests these nerve cells may act as the ear’s pain sensor and send pain-like signals to the brain that does not tolerate sounds in hyperacusis patients.

Key Outcomes: This study highlights the critical role of type II cells in acoustic damage, and suggests that they operate in a similar way to pain receptors in other parts of the body.

Relevance to tinnitus/hyperacusis: The heightened sensitivity to sound, and in some cases pain associated with sound, that is characteristic of hyperacusis may have a basis in a compromised type II cell system. If type II cells truly respond to acoustic damage, then hyper-sensitivity of these cells could lower the threshold for sounds that cause pain. This could be particularly important for those with hyperacusis, an extreme sensitivity to every day sounds. which in severe cases causes pain.

Study authors: Liu C, Glowatski E, Fuchs PA Proceeds of the National Academy of Science.

http://www.hyperacusis.net/hyperacusis/recent+news/default.asp





In a paper on voluntary movement of tensor tympani, doctors found that only one or two of their patients could tense up their TT long enough for it to be measured on the tympanogram. Lib and Vasilia report that when Sismanis cured them of their sound sensitivity, they didn't show anything abnormal on the middle ear pressure tests. Movements of the tympanic membrane are difficult to spot and you have to know what you're looking for. How many ''hyperacusis'' patients have been put under local anesthesia to see if their sound pain goes away? Why do so many middle ear myoclonus patients have subjective hyperacusis and why do so many of them get cured by muscle relaxants or antispasmodics or cutting the muscles that are tetanically contracted? Why would I suffer the muscle spasm or pain at signal but not at noise, why would these nerves do so too? What tensed up muscles would be at the end of these nerve type II fibers anyways?

 
Maybe they should consider these possibilities instead.
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briann

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Reply with quote  #5 
I'm happy to see these nerves are being investigated. So far they look very suspicious. Definitely worth a deeper look.

-Brian
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Aplomado

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Reply with quote  #6 
I agree with John about the absurdity of saying there is no effective treatment.

However, other than that, the article makes a lot of sense.  Hyperacusis is not psychosomatic in my opinion.

Even if some hair cells are malfunctioning, sound therapy could cause your brain to compensate.
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Rick

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Reply with quote  #7 
The part that bothers me is the very first sentence in the Summary. Their basic definition of hyperacusis is wrong. It's not just sounds that are "uncomfortably loud to normal people" that are intolerably loud to us. It is sounds that are completely comfortable to normal people (even very soft quiet sounds) that are intolerably loud and painful for those afflicted with hyperacusis. Normal people don't even notice the sounds that kill us.

Shouldn't they have a good understanding of the severity of the condition they are trying to cure?

Still, of course, I am glad anyone in the medical community is doing research in this area. I have had the condition for over 40 years so it's nice to see it finally getting some attention.
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bobm

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Reply with quote  #8 
Rick,i agree with your comments,i to have had hyperacusis for 40 years.Back then they didnt know much about it.If any,of coarse things are looked into eventually.Over those years little has really been done.So we must just struggle along the best we can.Hoping that some miracle cure will happen.At my age i figure i will have this for my lifetime unfortunately.So going to sporting events,movies,social gatherings,concerts,busy restaurants,malls for any length of time,bowling,walks near busy roads etc etc.Will be a thing of the past.We just have to live with it.Yes there are days,weeks,months and years that go by with feelings of depression,pain,spiritless and many more secondary afflictions.Associated with this rare medical problem.Thats the problem it is a rare condition,this is why research has been slow in this area.Just scratching the surface of the problem.Better some research than none at all...   
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rodmccain

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Reply with quote  #9 
I am confused regarding the symptoms, and definition of hyperacusis.

I thought the primary symptom and definition of H was AMPLIFIED HEARING? Also picking up on frequencies you really didn't hear, or notice before?   It is also my understanding that SOME people, along with this amplified hearing, may also have tinnitus and even pain.

For me personally sound in general is amplified. If I expose myself to a normal environment, my T gets louder.  I have several different noises, so this is a real problem.  At the onset I did experience burning, severe pain, in my left ear, jaw and down the left side of my neck.  Currently the only "pain" I experience is a crawling sensation in my left ear with some soreness or a bit of discomfort.  The MAIN ISSUES are amplification and tinnitus.  It seems also to me, that my hearing gets even a bit more sensitive should I go out, as in loudness tolerance. 

If your hearing is NORMAL, and you have little or no tinnitus and only pain with sound, would Hyperacusis be an accurate diagnosis, or perhaps could there be another auditory issue going on?   I am wondering if others are confused as well?

Clarification would be much appreciated.

Thank you,
Kathy Mccain





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Rob

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Reply with quote  #10 
Kathy -

I am glad you are posting.  I hope you will do that more often.  If I'm being honest, I hope you will post from now on and that your husband will stop posting on your behalf.      

Many people with tinnitus find that it is exacerbated when exposed to sound.  That isn't a show stopper.  It is a pretty typical response and many people who experience it can still habituate tinnitus.  With hyperacusis, sound is louder.  You aren't confused about that one bit.  

Rob


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bellsareriging

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Reply with quote  #11 
Quote:
Originally Posted by Rob
Kathy -

I am glad you are posting.  I hope you will do that more often.  If I'm being honest, I hope you will post from now on and that your husband will stop posting on your behalf.      

Many people with tinnitus find that it is exacerbated when exposed to sound.  That isn't a show stopper.  It is a pretty typical response and many people who experience it can still habituate tinnitus.  With hyperacusis, sound is louder.  You aren't confused about that one bit.  

Rob




I  think  Rod  posts because he is trying  to help Kathy, and  I  hope he  continues  to post when ever he feels the need, and just maybe,  he does because  Kathy is so tired of the never ending  search  for a cure, and  from what Rod posts he will never give up.  Going in to my fifth year  with Hyperacusis  One  of my biggest problems  is educating My  family- to Quote  them, "this is all so confusing" !
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rodmccain

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Reply with quote  #12 
Rob,

I can not know just what you are hearing. The same holds true for you as well. 

I hate to bring this up,  but it needs to be said.  There are people that have had T so severely, they commit suicide. Granted, they are not in the majority, but it happens.  These people evidently had NO mental, or emotional history.

Take my word for it.  I  have tried to habituate to my situation.  Even the ear surgeon I spoke with said that TRT does not help people with my type of T.  There are several different siginals, all of which keep changing in volume and location.  I believe if I had H only, I would probably force myself to go out more, even though it's severe.  

I know from personal experience, there are certain T signals that you can live with more easily than others!   On a "good day" I feel like my old self. 

 I try to keep hope alive as well, but it is difficult.  I consider myself to be a very strong personality too.  I won't go into all the surgeries and difficulties I have managed to recovery from so I could move forward with my life.

This "beast" is different though.  It has knocked the wind out of my sails. 

Regards,
Kathy Mccain 


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Rob

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Reply with quote  #13 
Hi Kathy.

This is why I am glad you are posting.  No one can describe your experience better than you can.  

Have you looked into using cognitive behavioral therapy to help manage tinnitus?  Based on what you wrote, it might be helpful to you in a way that TRT is not.  

Rob
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rodmccain

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Reply with quote  #14 
My tinnitus and hyperacusis are related.   


It is my understanding that the new research suggests that both amplified hearing and tinnitus can be PERMANENT from noise trauma.    

You may be able to habituate to milder H and T, but not severe.  When the whole world is on high volume there is...NO just "getting used to it."  I don't believe you can habituate to pain either,  for those that have that symptom.

CBT does not work for me either.  I don't know if I mentioned this before, but my therapist diagnosed me with, believe it or not PTSD as well. 

In my case It was not irresponsible actions, nor inadequate hearing protection that ruined my hearing.  It was a medical procedure as I have posted several times before, that was way too loud. 

I personally believe Semens should be held accountable.

Regards,
Kathy Mccain


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Rob

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Reply with quote  #15 
You may be able to habituate to milder H and T, but not severe.  

This isn't true, Kathy.  I understand that you feel this way and I know you are hurting.  Both conditions, including pain, can be treated, no matter how severe.  You may view yourself as unfixable, but you are not unfixable. 

When the whole world is on high volume there is...NO just "getting used to it."  I don't believe you can habituate to pain either,  for those that have that symptom.

I had pain.  I no longer do.  I agree with you that if pain is severe, it can't be habituated.  I didn't habituate pain.  I no longer have it.  It didn't go away by itself, it wasn't mild, and I didn't get used to it.  I no longer have it.  The pain is gone.     

In my case It was not irresponsible actions, nor inadequate hearing protection that ruined my hearing.  It was a medical procedure as I have posted several times before, that was way too loud. 

I believe you.   

Rob
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Aplomado

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Reply with quote  #16 
Without hyperacusis, sound is perceived to be louder; you are not actually hearing things better.  Hyperacusis sometimes also involves pain with sound exposure as well.

My experience is similar to Rob's in that sound therapy is effective at reducing or eliminating the pain (it eliminated mine until I had a relapse- it is working again, though more slowly).
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