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Several clinical populations show heightened sensitivity to sound—often described as phonophobia—which appears tied to abnormal cortical excitability.

• Migraine and pattern glare are both linked to cortical hyperexcitability and show lower sound discomfort thresholds, suggesting auditory discomfort may serve as a protective response against overstimulation.
• Williams syndrome also involves lower loudness discomfort levels and increased phonophobia, again associated with hyperexcitability.
• First-episode psychosis patients rate modulated sounds as more uncomfortable than controls, though they typically exhibit cortical hypoexcitability and report sensory flooding—indicating a different mechanism of sensory dysregulation.
• Panic disorder patients, whose limbic systems are hyper-responsive, find emotionally charged or distorted sounds (e.g., reversed songs) particularly aversive.
  Overall, these findings link perturbed sensory processing—whether due to hyper- or hypo-excitability—to increased auditory discomfort, though underlying neural mechanisms may differ across conditions. (Haigh et al., 2025)