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| Intervention | Ref | Study design | Sample size | Hyperacusis complaint | Aimed at treating hy | Outcome measures | Main findings |
| Primary | Secondary |
|
| CBT | Jüris et al. [18] | RCT | 60 | Primary | Yes | LDLs | HQ; HADS; TSK; QOLI | There were significant group effects for the treatment group (CBT) on all secondary outcome measures except for the anxiety subscale of the Hospital Anxiety and Depression Scale. There were both large significant between-group (treatment versus waiting list) and within-group effects for the CBT group on hyperacusis severity as measured by the HQ. LDLs were significantly reduced after treatment in CBT group compared to waiting list group for both ears. |
| CBT and pharma | Fioretti et al. [19] | Case report | 1 | Primary | Yes | HQ | LDLs, tonal audiometry | The patient reported improved mood and tolerance to sound with HQ scores below cut-off following second treatment. LDLs showed some improvement but were still below normal sound tolerance. |
| CBT and noise generators | Hiller and Haerkötter [20] | RCT | 136 | Secondary | No | Not stated, TQ | Not stated | At the 6-month follow-up, tinnitus education was shown to be more favourable. Improvements on TQ scores were observed for hyperacusis patients compared to all patients that completed the sessions. In the CBT group, similar results were shown with hyperacusis patients reporting improvements on TQ. More patients with hyperacusis than without were classified as responders for tinnitus education and CBT. |
| TRT | Formby et al. [21] | RCT | 40 | Primary | Yes | LDLs | Not stated | LDLs improved over the course of the intervention. These improvements were generally apparent within the first 4 months of the intervention, plateauing at around 6 months after the onset of full treatment (counselling and noise generators). Comfortable level speech scores improved from 50% to 80% after 6 months of full treatment. Treatment success rate was highest for the full treatment when compared to any of the partial treatments (counselling and placebo noise generator, noise generator only) or placebo noise generator group. |
| TRT | Gold et al. [22] | NRCT | 130 (ears) | Primary | Yes | LDLs | Effect of hyperacusis on the patient’s quality of life and daily activities questions | The patients self-reported an improved quality of life, with ability to comfortably participate in an increased number of activities after treatment. LDLs were significantly improved, at or near normal LDL thresholds for each frequency after treatment. Significant increases in DR at all test frequencies were also observed following treatment. |
| TRT | Wölk and Seefeld [23] | NRCT | 122 | Primary | Yes | LDLs, DR, Baltimore Questionnaire, VAS | Not specified | Patients reported that severity of hyperacusis was improved from a big problem to no longer a problem on the analogue scale. Regularly wearing maskers was associated with improved LDLs and DR, on average after treatment, indicating improved acceptance of ambient noise. |
| TRT | Hazell et al. [24] | Retro | 187 | Primary | Yes | LDLs, TRT questionnaire | Not specified | The number of life factors affected by hyperacusis was significantly reduced between the first and third visit after treatment. LDLs were significantly increased between each visit, with the majority of improvements experienced between the first and second visit. LDLs reached normal levels in 60% of patients by the fourth visit. |
| TRT | P. J. Jastreboff and M. M. Jastreboff [25] | Case series | 201 (56 hy) | Primary/secondary | Yes | LDLs (not reported) | Not specified | LDL results were not presented. 56 patients reported hyperacusis (with or without misophonia); of these, 45 patients (80%) showed significant improvement after treatment. Improvement was higher for the hyperacusis and concurrent misophonia group (33/39) than hyperacusis alone patients (13/17). |
| TRT | Forti et al. [26] | Case series | 40 (5 hy) | Secondary | No | Self-report | Not specified | No differences in difficulties with activities (relaxation, concentration, sleep, social relations, and work) were found in patients with hyperacusis following treatment. |
| TRT | Molini et al. [27] | Case series | 81 | Secondary | No | TRT interview | Not specified | 64 patients (79%) from categories 0 and 4 improved and achieved therapeutic success at the end of 18 months based on a decrease in symptom scale score of 2 or less (focused on tinnitus). Only nine out of the ten achieved therapeutic success in category 3. One patient (out of 1) in category IV improved. |
| TRT | Berry et al. [28] | Cohort | 32 | Secondary | No | Subjective presence or absence of hyperacusis | LDLs | In the nine patients that presented with hyperacusis and tinnitus, LDLs were significantly improved following treatment. |
| TRT | Suchova [29] | Cohort | 331 | Secondary | No | Self-report | Not stated | Only 8 patients of 53 patients with hyperacusis showed an improvement in hyperacusis. |
| TRT | Formby et al. [30] | RCT | 36 | Secondary | No | LDLs for pure tone, speech, and white noise | Uncomfortably loudness judgements | All treatment groups showed improvements of LDLs (10 dB or more at two consecutive follow-ups). LDLs and loudness judgments in the full treatment group (counselling and sound therapy with binaural sound generators) were consistently greater (averaged 15 and 10 dB) than those measured for the other groups ((2) counselling and placebo sound generators, (3) binaural sound generators only, and (4) placebo sound generators). 82% of individuals were classified as successfully treated following full treatment, 50% following the neutral control treatment, and 25% and 40% following partial treatment. |
| TRT | McKinney et al. [31] | NRCT | 182 | Secondary | No | LDLs | Not specified | Incidence of hyperacusis in the treatment group was significantly lower and LDLs were significantly increased after 12 months. Improved LDLs were greater for those patients who used noise generators in addition to directive counselling or amplification. LDLs of patients who complained of specific sounds as being uncomfortable were not significantly different from the rest of the treatment group. |
| TRT | Bartnik et al. [32] | Retro | 100 (40 hy) | Secondary | No | Author-developed questionnaire | Not specified | In category III, 55% of hyperacusis patients showed improvement (hyperacusis present, no prolonged noise exposure, and irrelevant or significant subjective hearing loss) and 60% in category IV (hyperacusis present, prolonged noise exposure, and irrelevant or significant subjective hearing loss) |
| TRT | Formby and Keaser [33] | Retro | 51 (18 hy) | Secondary | No | LDLs, DRs | Not specified | No significant treatment changes for the audiometric thresholds. LDLs were significantly increased at each frequency following treatment. LDLs were significantly increased after treatment in the audiometrically matched hyperacusis noise generator treatment group compared to the hearing aid treatment group. LDLs between Hearing aid group and LDL-matched hyperacusis noise generator treatment groups for the 1000-Hz condition were significantly different. |
| TRT | Formby and Gold [34] | Case series | 5 | Within symptom set | No | LDLs | Not specified | In all five cases, LDLs were increased at 6 months, exceeding normal tolerance levels after a year of treatment. In one case, LDLs were improved as much as 25 dB after a 3-week period. Self-reported noticeable improvement in sound tolerance and complaints of discomfort to loud sounds had resolved. |
| TRT | Hesse et al. [35] | Case report | 1 | Within symptom set | Yes | Self-report | Not stated | The patient self-reporting hyperacusis rarely occurred after successful treatment. |
| TRT and pharma | Westcott [36] | Case report | 1 | Within symptom set | No | Self-report | LDLs (after treatment only) | No LDLs were measured at the beginning of treatment. LDLs were markedly lower than normal levels (>100 dB) after desensitisation treatment. Despite this, the patient self-reported that all sounds had become more tolerable, with an improved ability to tolerate environmental sound and to cope with loud voices and reduced reactions to impact of sound. |
| Counselling and tinnitus habituation therapy | Ruth and Hamill-Ruth [37] | Case report | 1 | Within symptom set | No | Self-report | Not stated | The patient no longer experienced severe tinnitus or hyperacusis and reported improved pain symptoms and ability to sleep and socialise one year after treatment. |
| Directive counselling | Attri and Nagarkar [38] | Case report | 1 | Primary | Yes | Hyperacusis test | LDLs, Hamilton psychiatric rating scale | The patient reported less difficulty with sounds. An improvement in hyperacusis test scores and LDLs indicating close to normal sound tolerance. The patient also self-reported suffering less depression and difficulty with sounds only occurring during depressive episodes. |
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