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

• 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
• 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

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.

项目摘要 自闭症谱系障碍（ASD）的个体在感官感知中暴露了多个差异，这些差异 被认为是条件的核心特征。在这些感官差异中，声音耐受性降低（DST； 即，无法应付每天的声音）特别显着，ASD的终生患病率为50-70％ 人口。尽管第一人称账目和实证研究都表明DST是困扰和 ASD功能障碍，对此症状的现象学或生理基础知之甚少 目前可获得群集，并且没有对ASD中的DST进行循证治疗。一些研究人员建议 在ASD中看到的不良反应是Hyper Acusis的表现，反映了无序的响度感知。然而， 其他人则认为，对特定声学刺激的情感反应夸大了这些行为，表明 ASD中的DST可能是一种误解的一种形式，一种精神疾病，其特征是过度情绪反应 特定的“触发”声音。迄今为止，几乎没有实证工作已经对这些假设进行了互相检验，这仍然是 公开问题ASD中的DST是反映了HyperAcusis，Misophonia还是两者的组合。此外，它 这些符号是否与外围或中央听觉系统的变化有关。 拟议的研究旨在使用两阶段的方法回答这些问题。在第1阶段，我们将构建一本小说 自我报告调查表评估了跨越响度的四个理论领域的广泛的DST症状， 痛苦，烦恼（即误会）和恐惧。可用的DST措施通常仅评估响度（HyperAcusis） 或烦恼（误传）维度，无法解决许多其他临床上重要的症状。利用 有和没有ASD的成年人的大型在线样本，我们将完善和心理验证我们的问卷 用作转诊DST症状的定量度量。在第2阶段，我们将与ASD招募成年人 并且没有DST）和社区的健康控制 精神声音和身体测试。听觉感知将使用纯音调，响度评估 不舒服水平测试和分类响度缩放。基础听觉生理学将从 使用鼓声，声学测试，耳声发射的组合，中耳到听觉皮层 抑制作用，脑干/皮质听觉事件相关电位以及听觉稳态反应。客观听觉 将比较诊断组之间的措施，以及这些测量与主观DST之间的关系 症状学（基于既定的调查以及在第1阶段开发的新型自我报告）将在整个过程中探讨 完整的2阶段样本。该项目将回答ASD中DST是否代表变体的基本问题 超源，误传或两者的组合。此外，通过将DST症状与潜在生理学联系起来， 我们将根据其生理相关性确定DST的不同维度是否可以分离。发现 从这项研究中，预计将阐明ASD中DST的心理和身体机制，从而改善我们的 了解这种残疾症状并指导针对ASD人群的有针对性干预措施的发展。