Clinical Findings That Differentiate Co-Occurrence of Hyperacusis and Tinnitus from Tinnitus Alone

Seung Ho Shin, Sung Wan Byun, Zoo Young Lee, Min Jee Kim, Eun Hye Kim, Ho Yun Lee

Research output: Contribution to journalArticlepeer-review

5 Scopus citations


Purpose: We aimed to assess the characteristics of patients with concurrent tinnitus and hyperacusis, determine the best audio-logical criteria for predicting hyperacusis, and confirm whether objective evidence of changes in the brain exists. Materials and Methods: The medical records of patients with tinnitus who visited the hospital between March 2020 and Decem-ber 2021 were reviewed. Data on accompanying hyperacusis, audiological profiles, and questionnaires including the Tinnitus Handicap Inventory (THI), Beck Depression Inventory, and numerical rating scale were analyzed. Resting-state quantitative elec-troencephalography (qEEG) using power spectral density (PSD) and event-related spectral perturbation (ERSP) were performed to objectively quantify changes in the brain. Results: A total of 194 patients were analyzed. Among them, 51 (26.3%) reported combined subjective hyperacusis with tinnitus. However, the proportions widely varied from 7.4% to 68.4% based on three audiological criteria for assessment. A higher score on the THI questionnaire was independently associated with the co-occurrence of tinnitus and hyperacusis. Fair agreement was observed between subjective hyperacusis and the audiological criterion based on a loudness discomfort level (LDL) of ≤90 dB at two or more frequencies for the diagnosis of hyperacusis. An increased beta-PSD and decreased levels of gamma-PSD, all-ERSP, and delta-ERSP were observed in patients with hyperacusis (p<0.05). Conclusion: Patients with co-occurring tinnitus and hyperacusis had more severe tinnitus distress. An LDL of ≤90 dB at two or more frequencies may be applicable to predict accompanying hyperacusis in subjects with tinnitus, and qEEG also provides more objective information.

Original languageEnglish
Pages (from-to)1035-1042
Number of pages8
JournalYonsei Medical Journal
Issue number11
StatePublished - Nov 2022

Bibliographical note

Funding Information:
This research was supported by a grant from the Korea Health Technology R&D Project through the Korea Health Industry Development Institute (KHIDI), funded by the Ministry of Health & Welfare, Republic of Korea (grant number: HI21C1574040021).

Publisher Copyright:
© Yonsei University College of Medicine 2022.


  • Tinnitus
  • electroencephalography
  • hyperacusis


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