The Kinetic Basis of Misophonia

DOI: https: //doi.org/10.1523/JNEUROSCI.0261-21.2021

Commentary

Misophonia is a disorder characterized by the experience of strong negative emotions of anger and anxiety in response to everyday sounds, such as the eating, drinking, and breathing of others.

These characteristics can be devastating to the patient and his or her family, and it is not even known what sounds trigger the disorder.

The researchers hypothesized that the mirror neuron system associated with oral-facial movements may underlie misophonia, since these trigger sounds are produced by chewing and other processes.

The study compared resting-state fMRI (rs-fMRI) connectivity (n = 33, 16 women) and sound-evoked fMRI responses (n = 42, 29 women) in misophonia patients with control controls.

Although the misophonia group showed no difference in auditory cortical response to triggered sounds, there was stronger functional connectivity between the auditory cortex and the orofacial motor cortex during the perception of common sounds, and we found features of stronger activation of the orofacial motor cortex in response to triggered sounds.

These results support a model of misophonia based on "hypermirroring" of the oral-facial actions of others, with sound being the "medium" through which the actions of others are excessively mirrored. Therefore, misophonia is not a de-reaction to sound per se, but it seems necessary to understand the manifestation of activity in the part of the motor system involved in the production of those sounds.