Investigating the Phenomenology and Physiologic Underpinnings of Decreased Sound Tolerance in Adults with Autism Spectrum Disorder

调查患有自闭症谱系障碍的成人声音耐受性下降的现象学和生理学基础

基本信息

批准号：
10363654
负责人：
Zachary James Williams
金额：
$ 3.15万
依托单位：
VANDERBILT UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2021
资助国家：
美国
起止时间：
2021-07-01 至 2025-06-30
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10363654
关键词：
Acoustics Address Adult Adverse reactions Affect American Auditory Auditory Perception Auditory Physiology Auditory area Auditory system Behavior Behavioral Brain Stem Caregiver Burden Caregivers Categories Characteristics Child Classification Clinical Communities Data Development Diagnostic Dimensions Disease Distress Emotional Etiology Event-Related Potentials Evidence based treatment Exhibits Family Foundations Frequencies Fright Functional disorder Future General Population Growth Hyperacusis Individual Individual Differences Intervention Knowledge Loudness Loudness Perception Mastication Measures Mental disorders Meta-Analysis Pain Participant Patient Self-Report Perception Peripheral Persons Phenotype Physiological Physiology Population Population Group Prevalence Process Psychoacoustics Psychometrics Psychophysics Psychophysiology Pure-Tone Audiometry Questionnaires Reporting Research Research Personnel Safety Sampling Schools Self Administration Sensory Sensory Manifestations Severities Source Stimulus Subgroup Surveys Symptoms Syndrome Testing Tympanometry Ultrasonography Variant Work Workplace acoustic reflex adult with autism spectrum disorder associated symptom auditory processing autism spectrum disorder autistic children base behavioral impairment clinically significant comorbidity disabling symptom effective intervention emotional reaction experience functional disability improved indexing individuals with autism spectrum disorder insight meetings middle ear neurophysiology novel otoacoustic emission phenomenological models psychologic recruit relating to nervous system repetitive behavior research clinical testing response sensory stimulus social sound symptom cluster symptomatology

项目摘要

Project Summary Individuals with autism spectrum disorder (ASD) exhibit multiple differences in sensory perception, which have now been recognized as a core feature of the condition. Among these sensory differences, decreased sound tolerance (DST; i.e., an inability to cope with everyday sounds) is particularly salient, with a lifetime prevalence of 50–70% in the ASD population. Despite both first-person accounts and empirical studies indicating that DST is a major source of distress and functional impairment in ASD, little is known about the phenomenology or physiologic underpinnings of this symptom cluster, and no evidence-based treatments for DST in ASD are currently available. Some researchers have suggested that the adverse reactions seen in ASD are manifestations of hyperacusis, reflecting disordered loudness perception. However, others contend that exaggerated emotional responses to specific acoustic stimuli underlie these behaviors, indicating that DST in ASD could be a form of misophonia, a psychiatric disorder characterized by excessive emotional reactions to specific “trigger” sounds. To date, little empirical work has tested these hypotheses against one another, and it remains an open question whether DST in ASD reflects hyperacusis, misophonia, or a combination of the two. Furthermore, it remains unknown whether these symptoms are associated with alterations in the peripheral or central auditory system. The proposed study aims to answer these questions using a two-stage approach. In stage 1, we will construct a novel self-report questionnaire that assesses a wide range of DST symptoms spanning the four theoretical domains of loudness, pain, annoyance (i.e., misophonia), and fear. Available measures of DST typically assess only the loudness (hyperacusis) or annoyance (misophonia) dimensions, failing to address a number of other clinically significant symptoms. Utilizing large online samples of adults with and without ASD, we will refine and psychometrically validate our questionnaire for use as a quantitative measure of transdiagnostic DST symptoms. In stage 2, we will recruit adults with ASD (both with and without DST) and healthy controls from the community, characterizing their auditory function using a battery of psychoacoustic and physiological tests. Auditory perception will be assessed using pure tone audiometry, loudness discomfort level testing, and categorical loudness scaling. Underlying auditory physiology will be assessed from the middle ear to auditory cortex using a combination of tympanometry, acoustic reflex testing, otoacoustic emission suppression, brainstem/cortical auditory event-related potentials, and auditory steady-state responses. Objective auditory measures will be compared between diagnostic groups, and relationships between these measures and subjective DST symptomatology (based on established surveys and the novel self-report developed in stage 1) will be explored across the full stage 2 sample. This project will answer the fundamental question of whether DST in ASD represents a variant of hyperacusis, misophonia, or a combination of the two. Furthermore, by relating DST symptoms to underlying physiology, we will determine whether different dimensions of DST can be separated based on their physiologic correlates. Findings from this study are expected to elucidate the psychological and physiological mechanisms of DST in ASD, improving our understanding of this disabling symptom and guiding the development of targeted interventions for the ASD population.

项目概要患有自闭症谱系障碍 (ASD) 的个体在感官知觉方面表现出多种差异，这些差异现已在这些感官差异中，声音耐受性降低（DST；（即无法应对日常声音）尤为突出，自闭症谱系障碍 (ASD) 的终生患病率为 50-70% 尽管第一人称叙述和实证研究都表明 DST 是痛苦和痛苦的主要来源。自闭症谱系障碍（ASD）的功能障碍，但人们对这种症状的现象学或生理学基础知之甚少一些研究人员认为，目前尚无针对自闭症谱系障碍 (ASD) 的 DST 治疗方法。 ASD 中出现的不良反应是听觉过度的表现，反映了响度感知障碍。其他人则认为，这些行为的背后是对特定声音刺激的夸张情绪反应，这表明自闭症谱系障碍 (ASD) 中的 DST 可能是恐声症的一种形式，这是一种精神疾病，其特征是对事物的过度情绪反应。迄今为止，很少有实证工作对这些假设进行相互检验，而且它仍然是一种假设。自闭症谱系障碍 (ASD) 中的 DST 是否反映了听觉过敏、恐音症或两者的组合，这一问题尚待解决。目前尚不清楚这些症状是否与周围或中枢听觉系统的改变有关。本研究旨在通过两阶段方法来回答这些问题。在第一阶段，我们将构建一种新颖的方法。自我报告问卷，评估涵盖响度四个理论领域的广泛 DST 症状，疼痛、烦恼（即恐声症）和恐惧。现有的 DST 测量通常仅评估响度（听觉过敏）。或烦恼（恐音症）维度，未能解决许多其他临床显着症状。通过收集患有和不患有自闭症谱系障碍的成年人的大量在线样本，我们将完善并通过心理测量方法验证我们的调查问卷用作跨诊断 DST 症状的定量测量在第二阶段，我们将招募患有 ASD 的成年人（均患有 ASD）。和来自社区的健康控制，使用一系列特征来表征他们的听觉功能心理声学和生理测试将使用纯音测听、响度进行评估。不适水平测试和分类响度标度将从以下方面进行评估。结合鼓室导抗测试、声反射测试、耳声发射来检测中耳到听觉皮层抑制、脑干/皮质听觉事件相关电位和听觉稳态反应。将比较诊断组之间的测量值以及这些测量值与主观 DST 之间的关系将在整个范围内探索症状学（基于已开展的调查和第一阶段开发的新颖的自我报告）完整的第 2 阶段示例将回答 ASD 中的 DST 是否代表 ASD 的变体这一基本问题。此外，通过将 DST 症状与潜在的生理学联系起来，我们将确定 DST 的不同维度是否可以根据其生理相关性进行区分。这项研究有望阐明 DST 在 ASD 中的心理和生理机制，提高我们的认知能力。了解这种致残症状并指导针对 ASD 人群制定有针对性的干预措施。