Loudness discomfort levels at extended high frequencies in young adults: A potential marker of hyperacusis.

Loudness discomfort levels (LDLs) are typically measured only at standard frequencies (0.25-8 kHz), which may limit their diagnostic utility in assessing loudness disorders such as hyperacusis. The aim of this study was to (1) establish normative LDL for extended high frequencies (EHFs, 9-16 kHz) in a non-hyperacusis population, (2) examine associations with participant audiological and demographic characteristics, and (3) explore EHFs LDLs in a small group of self-reported hyperacusis participants. We recruited 103 participants (52 female, 50 male, 1 non-binary) with a mean age of 27.5 years, divided into a non-hyperacusis group (n = 94) and a hyperacusis group (n = 9). Pure tone hearing thresholds (HTs) were measured from 0.25 to 16 kHz and LDLs were assessed at 0.5, 4, 9, 11.2, 12.5, 14 and 16 kHz. In non-hyperacusis participants, average EHF LDLs were of 74 dB HL (SD = 9.1-16.8; range = 10-100). LDLs showed small to medium negative correlations with the Hyperacusis Questionnaire (HQ), the Noise Sensitivity Scale (NSS) and the depression subscale of the Hospital Anxiety and Depression Scale, but no significant correlations with age or anxiety. Hyperacusis participants had significantly worse EHF average HTs, lower LDLs and reduced dynamic ranges across frequency ranges. This study provides the first report of LDLs for EHF in a large cohort and is a valuable reference for audiologists. These findings suggest that EHF measures could improve the diagnosis of loudness related disorders such as hyperacusis, supporting early identification and tailored interventions. Further research is needed to fully assess the clinical value of EHF LDL assessments.