# Evaluating Possible Auditory and Psychological Biomarkers of Sound Intolerance

> **NIH VA I01** · PORTLAND VA MEDICAL CENTER · 2022 · —

## Abstract

Hyperacusis and noise sensitivity are types of decreased sound tolerance (DST) disorders, and frequently
reported in patients with tinnitus and head injury respectively. When any degree of DST is seen in patients, it is
paramount to address the problems tolerating sounds because it negatively impacts every aspect of daily
functioning; severe DST manifests as everyday sounds being perceived as too loud, overwhelming, and
annoying. Due to the paucity of research on DST, limited knowledge exists pertaining to fundamental aspects
of its pathophysiology and how best to treat it. The overall objectives of this application are to test two
conceptual models of DST, an auditory model (Aim 1) and a psychological model (Aim 2) to determine the
etiology of severe DST.
When Veterans are seen in the clinic with complaints of sound intolerance (i.e., severe DST), health care
providers are uncertain how to help their patients. There are no objective tests to diagnose DST and the
commonly used behavioral assessment of loudness perception can result in exacerbating DST symptoms and
emotional distress. Additionally, the standard test battery does not provide any useful information as to the
underlying nature of the problem. This proposal is the first step to achieve our long-term goals of
understanding the etiology of DST and ultimately, provide clinicians the information they need to effectively
treat these disorders. To accomplish our goals, it is critical to use a behavioral measure of loudness perception
that does not cause unnecessary distress or exacerbate DST symptoms. Categorical Loudness Scaling (CLS)
is an automated procedure used to quantify loudness judgments. Part of this proposal will be to refine the CLS
procedure so that it meets this need.
The design of this study is to test multiple stages of the conceptual models using physiological measures of
auditory and psychological function. By examining the relationship between auditory and psychological
biomarkers, this study will provide clinically relevant information on where deficits exist in sensory and/or
neurological structures that lead to severe DST. This knowledge will guide future studies so that rehabilitative
treatments can be developed targeting the underlying mechanism that leads to severe DST. This research is
taking the necessary steps to provide an evidence-based approach to direct clinical decision-making for
Veterans with severe DST.
Outcomes of the proposed work have both theoretical and clinical impact. The experiments outlined in this
proposal will elucidate the underlying pathophysiology that leads to severe DST and result in valid and efficient
quantitative metrics that could become part of a standardized test battery for evaluating this health condition.
Additionally, by identifying risk factors, including the influence of mental health on degree of DST, outcomes of
this proposal will guide future studies on the development of a care path, one that will be interdisciplinary in it...

## Key facts

- **NIH application ID:** 10409682
- **Project number:** 5I01CX002149-03
- **Recipient organization:** PORTLAND VA MEDICAL CENTER
- **Principal Investigator:** Sarah Theodoroff
- **Activity code:** I01 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2022
- **Award amount:** —
- **Award type:** 5
- **Project period:** 2020-07-01 → 2024-12-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10409682

## Citation

> US National Institutes of Health, RePORTER application 10409682, Evaluating Possible Auditory and Psychological Biomarkers of Sound Intolerance (5I01CX002149-03). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10409682. Licensed CC0.

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