title: Noise sensitivity and hyperacusis in patients affected by multiple chemical sensitivity.
abstract: OBJECTIVE
  The aim of this study was to investigate the presence of noise sensitivity and hyperacusis in patients suffering from multiple chemical sensitivity (MCS), a chronic condition characterized by several symptoms following low-level chemical exposure. Moreover, distortion product otoacoustic emissions (DPOAE) were performed to further study cochlear function.
  
  
  METHODS
  A questionnaire-based survey was performed. Eighteen MCS patients, selected with strict diagnostic criteria, and 20 healthy age- and gender-matched subjects filled Weinstein's Noise Sensitivity Questionnaire (WNS) and Khalfa's Hyperacusis Questionnaire (HQ). Results were compared with scores from the quick Environmental Exposure Sensitivity Index (qEESI), a routinarily used questionnaire to screen MCS symptoms, and with DPOAE values. An analysis of variance (ANOVA) was performed between MCS and control subjects scores; moreover, Spearman's rank correlation test was performed between questionnaire results.
  
  
  RESULTS
  ANOVA testing on DPOAE values showed any significant difference between groups, while WNS, HQ and qEESI scores were significantly higher in MCS group compared to controls. Correlation analysis showed strong positive correlation between WNS, HQ and qEESI in MCS subjects.
  
  
  CONCLUSIONS
  For the first time, auditory-related perceptual disorders were studied in MCS. A strong association between WNS, HQ results and MCS symptoms severity has been highlighted. These findings suggest that decreased sound tolerance and noise sensitivity could be considered as possible new aspects of this syndrome, contributing to its peculiar phenotype. Furthermore, as DPOAE values did not differ from healthy subjects, present findings might suggest a 'central' source for such disorders in this group of patients.
authors.affiliation: Department of Clinical Sciences and Translational Medicine, 'Tor Vergata' University, Via Montpellier, 1, E sud Tower, 00133, Rome, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Viziano
authors.affiliation: Department of Clinical Sciences and Translational Medicine, 'Tor Vergata' University, Via Montpellier, 1, E sud Tower, 00133, Rome, Italy. alessandromicarelli@yahoo.it.|Department of Systems Medicine - Neuroscience Unit, 'Tor Vergata' University, Rome, Italy. alessandromicarelli@yahoo.it.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Micarelli
authors.affiliation: Department of Clinical Sciences and Translational Medicine, 'Tor Vergata' University, Via Montpellier, 1, E sud Tower, 00133, Rome, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Alessandrini
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D012001:Hyperacusis / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D018777:Multiple Chemical Sensitivity; D009622:Noise / Q000009:adverse effects*; D017084:Otoacoustic Emissions, Spontaneous / Q000502:physiology; D011795:Surveys and Questionnaires
keywords: Distortion product otoacoustic emissions; Hyperacusis; Idiopathic environmental intolerance; Multiple chemical sensitivity; Noise sensitivity