Sukhbinder Kumar, Ph.D. and his associates at Newcastle University in collaboration with several other researchers recently had their misophonia brain imaging study published in Current Biology. Although this has created new excitement (and great publicity for misophonia awareness) we have been considering his work since he presented at the 2015 Misophonia Association Conference in Chicago. Dr. Kumar observed the brains on individuals being triggered with fMRI (functional magnetic resonance imaging). fMRI indicates brain activity by measuring blood flow. Where more blood is flowing, there is more neuronal activity. At the Misophonia Conference Dr. Kumar reported the results of his study that compared 22 people with misophonia vs. 20 without misophonia. In response to trigger sounds, the people with misophonia had higher activity in the anterior insula, which is known to be involved in sensing inside the body and external senses (taste, touch, hearing, smell, and sight). Other research indicates that the anterior insula is involved in subjective feelings of emotions.
No surprise here. We would all expect to see greater emotional brain activity for an individual with misophonia. The study also showed a connection between activity in the anterior insula and the vmPFC (ventromedial prefrontal cortex). This is very important because the vmPFC is known to be involved in associative learning (or learning from experience). Essentially, this research shows that the brain response to trigger stimuli is a conditioned (learned) emotional response (an involuntary emotional reflex response). An individual with misophonia hears/sees a trigger and “boom” there is an instant, involuntary emotion forced on the person. With misophonia, the person does not choose how to feel after a trigger, it just happens automatically.
Dr. Kumar concluded his presentation by saying, “In summary, our data provides evidence that ‘abnormal learning in vmPFC which in turn drives brain areas related to emotion processing’ is the neural bases of misophonia.”
The good news here is that the misophonic response develops through life experiences. As such, it is a result of brain plasticity (and not brain “hardwiring”). This means that it is hopeful that the brain “wiring” can be changed with proper treatment, which is what we are seeing in many cases.