The Motor Basis for Misophonia

by May 25, 2021Research5 comments

Sukhbinder Kumar, Pradeep Dheerendra, Mercede Erfanian, Ester Benzaquén, William Sedley, Phillip E. Gander, Meher Lad, Doris E. Bamiou and Timothy D. Griffiths


“… we hypothesized that the mirror neuron system related to orofacial movements could underlie misophonia”


“We analysed resting state fMRI (rs-fMRI) connectivity (N=33, 16 females) and sound-evoked fMRI responses (N=42, 29 females) in misophonia sufferers and controls. We demonstrate that, compared to controls, the misophonia group show no difference in auditory cortex responses to trigger sounds, but do show: (i) stronger rs-fMRI connectivity between both auditory and visual cortex and the ventral pre-motor cortex responsible for orofacial movements; (ii) stronger functional connectivity between the auditory cortex and orofacial motor area during sound perception in general; (iii) stronger activation of the orofacial motor area, specifically, in response to trigger sounds. Our results support a model of misophonia based on ‘hyper-mirroring’ of the orofacial actions of others with sounds being the ‘medium’ via which action of others is excessively mirrored. Misophonia is therefore not an abreaction to sounds, per se, but a manifestation of activity in parts of the motor system involved in producing those sounds. This new framework to understand misophonia can explain behavioural and emotional responses and has important consequences for devising effective therapies.”

Significance Statement:

“Our data provide an alternative but complementary perspective on misophonia that emphasizes the action of the trigger-person rather than the sounds which are a by-product of that action. Sounds, in this new perspective, are only a ‘medium’ via which action of the triggering-person is mirrored onto the listener. This change in perspective has important consequences for devising therapies and treatment methods for misophonia. It suggests that instead of focussing on sounds, which many existing therapies do, effective therapies should target the brain representation of movement.”

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  1. CC

    I’m not 100% sure I resonate with this theory. If this were true, wouldn’t you need to look at the offending person for it to be an issue of mirroring? And I am often triggered even if I deliberately avoid looking at the person. Sounds like pouring or running water also trigger me, and those don’t involve people at all.

    Just wondering if anyone else feels similarly.

    • Sarah

      I agree, my triggers are mainly annoying birds who make the same call over and over. I live in the country side to get away from people who I don’t like in general as humans are dity, selfish morons, then I find I have this condition that makes me want to kill these birds and I’mvegan which shows how strong these feelings of hatred are…….towards the sounds…a cure??? Yes please.

  2. Christine Beckett

    I can identify with most of the things you mention .
    Beard pulling, the sound of swallowing liquid, slurping. Nails being filed, eating ( esp If I am not eating) all these things make me feel tense and angry. As a teenager I used to walk out of the room when my mother drank coffee because she kind of sucked it up. I couldn’t bear the noise.
    The beard pulling and stroking by my husband drives me crazy and makes me feel very angry. He can’t remember not to do it.
    I would be very interested to know if there is any treatment that could help me.

    • Jamie

      i feel exactly the same with my mom. im 16 and it all started when i was 12 and the sound of her sniffling started to drive me insane. Then other peoples started to bother me and now i cant even sit in class without earbuds because everyones sick. And its not their fault but it makes me so mad. I just dont want to be like this anymore and i feel like its not common enough for people to worry about

    • Judy Macartney

      I am really intolerant of people making noise behind me, especially if it is sudden and loud. I also hate rustling I really dislike people talking on their phones like it’s a walkie-talkie. I am irritated by jiggling feet and clicking pens. The irony is I am a bit deaf, but the prospect of a hearing aid rustling in my ear seems like torture. Anyone else like this?


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