Background and History: Sound sensitivities such as hyperacusis, phonophobia, and misophonia have long been reported but several models for misophonia have been suggested over the past decade. Through reviews of case and empirical studies, researchers are striving to reach consensus for a standard diagnostic paradigm.

Neurophysiology of Misophonia: Mechanisms involved in the likely neural pathway contributing to noise sensitivities, including the motor pathways, will be discussed. Evidence from electrophysiologhy and fMRI studies that describe abnormalities in the neural connections in the brains of individuals suffering from misophonia make important contributions to our understanding of this difficult set of clinical symptoms. Evidence of abnormalities in connections with networks responsible for regulating emotion provide insight into the emotional dysregulation experienced by many patients with misophonia.

Diagnosis and Treatment: Despite the contribution of several neural networks to the symptoms of misophonia, the audiologist is a critical member of the team involved in its diagnosis and treatment. A review of the neural networks and genetic characteristics involved in misophonia will be discussed.

Management: Cognitive-based therapies, others involving stress management and one study investigating pharmaceutical intervention with MDMA (ecstasy) will be reviewed. Cases involving parent reports of effects in children will also be included.

Learning Objectives

After attending this session, participants will be able to

• identify patients with characteristics of misophonia.
• counsel patients on the neurophysiologic underpinnings of misophonia and help them understand it’s not something they are imagining
• engage in team-based treatment for misophonia symptoms and monitor outcomes