Noise sensitivity is a
personality trait characteristic involving underlying attitudes towards noise
in general (Anderson 1971;
Stansfeld et al. 1993). It refers to the physiological and
psychological internal states of the individual, which affect the degree of
reactivity to noise (Job 1999). Noise sensitivity aggregates in families; the
presence/absence of noise sensitivity is higher for first-degree relatives than
for the general population, with heritability estimated as 36% (Heinonen-Guzejev
et al. 2005). Noise sensitivity is a predictor
of noise annoyance (Stansfeld 1992). Annoyance is a multifaceted psychological
concept, covering immediate behavioral effects of noise, such as disturbance of
concentration and interference with activities, and evaluative aspects like
“nuisance”, “disturbance”, “unpleasantness”, and “getting on one's nerves” (Guski et al.
Psychometric tools have been
designed to assess noise sensitivity and annoyance (Bregman &
Pearson 1972; Ekehammar & Dornic 1990; Kishikawa et al. 2006; Weinstein
1978). Examples include Weinstein’s noise
sensitivity scale (WNS) (Weinstein 1978) and the noise annoyance sensitivity scale (Bregman &
Although these questionnaires have been widely used in public health,
occupational health, and environmental research, they have not been used in
clinical settings for patients with hyperacusis. Most of the items on these
questionnaires were developed to assess the individual’s attitude towards
noise, with a focus on the impact of environmental noise as opposed to
assessment of the severity of sensitivity to sound and its impact on the
individuals’ quality of life; the latter are needed in the clinical assessment
of patients with hyperacusis. Nevertheless, it seems that individuals with high
noise sensitivity exhibit similar symptoms to patients with hyperacusis (Baliatsas et
al. 2016; Landon et al. 2012).
In some medical reports, mainly
in the literature related to traumatic brain injury and post-concussion
syndrome, the terms noise sensitivity and hyperacusis have been used
interchangeably to describe intolerance to sound (Attias et al.
2005; Landon et al. 2012). Viziano et al.
(2017) reported a strong correlation
between scores on the WNS and scores on the HQ for a group of patients affected
by multiple chemical sensitivity (r = 0.9, p<0.01).
(Department of Public Health, University of Helsinki, Finland) discussed
neurophysiological studies of noise sensitivity. Similar to hyperacusis, a
comprehensive model of the mechanisms underlying noise sensitivity is lacking.
Both psychological and biological factors may be involved. Noise-sensitive
individuals seem to exhibit less sensory gating than noise-resistant
individuals (Shepherd et al.
2016). Marja Heinonen-Guzejev discussed a
recent study conducted at the University of Helsinki that assessed neuronal
sound processing in relation to noise sensitivity using combined electro- and
magnetoencephalography (EEG and MEG) (Kliuchko et al.
2016). Subjects were tested using a fast
multifeature mismatch negativity (MMN) paradigm that included six types of
sound feature deviations from a reference sound (a piano tone). The MMN can be
used to assess sound discrimination accuracy (Naatanen 2001). Subjects with high noise sensitivity had
smaller P1 amplitudes than less noise-sensitive subjects, suggesting that the
former may have difficulties with sound feature encoding. Furthermore, their
MMN, a response that reflects deviance detection, was diminished. This was
especially apparent for a deviant with increased noisiness. Noise sensitivity
was specifically related to the processing of noise-like properties, but not
other features. The results of this study indicate that at least two stages of
pre-attentive cortical sound processing are affected by noise sensitivity. The
functional changes in the auditory system observed for noise sensitive
individuals could result from the susceptibility of their central auditory
system to detrimental noise effects. Studying the neuronal mechanisms of sound
processing may help in understanding the origin of noise sensitivity (Kliuchko et al.
Johan Paulin and Linus Andersson
(both from the Department of Psychology, Umeå University, Sweden) presented
preliminary results from an ongoing noise-exposure study, inspired by studies
of chemical intolerance (often referred to as odor hypersensitivity).
Individuals with chemical intolerance differ from healthy controls in how they
rate the perceptual properties of and react to odorous exposure, especially
after extended exposure (Andersson et
al. 2016; Andersson et al. 2017). Paulin and Andersson assessed
whether individuals with noise sensitivity react to extended white noise
exposure in a way that is comparable to how people with chemical intolerance
react to smells. Participants with and without self-reported noise sensitivity
were screened for hearing deficits, fitted with electrodes to register their
pulse, and seated inside a sound-attenuating chamber. Following 11 minutes of
silence, white noise was gradually increased in level for nine minutes and then
held constant at 60 dB SPL during the remaining 25 minutes of the session.
Gradually changing stimuli were used to remove the availability of perceptual anchors.
Without the possibility of anchoring ratings to an unchanging stimulus,
possible perceptual changes due to sensitization and habituation processes were
Paulin and Andersson discussed
two ways of analyzing the data. One method was to assign participants to high,
intermediate and low noise-sensitivity groups based on their self-reported
problems in daily life, as assessed with the WNS (Weinstein 1978). The high-sensitivity group rated the exposure
as more intense, unpleasant and symptom-eliciting than did the low sensitivity
group, with the intermediate sensitivity group giving intermediate ratings. The
high noise-sensitivity group had lower heart rate variability throughout the
session, which is an autonomic nervous system measure of distress (Thayer &
The other method of analysis involved assigning participants to three groups
according to the rated unpleasantness of the white noise. The outcomes were
similar to those found in the first analysis, but the effect sizes were
generally larger. Those who regarded the white noise as least unpleasant also
rated the noise as decreasing in magnitude over time, which can be interpreted
as a form of perceptual adaptation or habituation. This effect did not occur
for the other two groups. Finally, there was a tendency for those who rated the
noise as unpleasant to rate the smell inside the chamber as more intense than
did the other two groups.
In summary, the preliminary
analyses revealed considerable variability between individuals, not only in
terms of affective responses and symptoms but also in terms of the perceived
intensity of the noise exposure. However, assigning participants to different
groups in terms of noise sensitivity is not a trivial matter, and different
ways of assigning participants can lead to different outcomes. Given the
overlap between noise sensitivity and chemical intolerance (Palmquist et
al. 2014), the similarities in other measures
of distress (Paulin et al.
2016), and comparable responses to extended
exposure, Paulin and Andersson suggested that it may be fruitful to look for
intolerances other than to sound in hyperacusis patients.
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