Properties (13)
Year 2024
Abstract
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- purpleRed
Aliases
- (Neacsiu et al., 2024)
Import Date 09-22-2024
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Dv Initial Source >
Dv Status #status/complete
Dv Limitations • Small sample size lacking racial/ethnic diversity • Potential cumulative effects of repeated rTMS • Differences in stimulation intensity between conditions
Dv Future Directions • Replicate with larger, more diverse sample • Examine full factorial design of stimulation parameters • Investigate long-term effects of combined neurostimulation and emotion regulation interventions
Dv Relevance • This study examines the effects of neurostimulation and cognitive restructuring on emotional distress in individuals with misophonia and emotional dysregulation, finding that a top-down approach targeting emotion regulation is more effective in reducing distress than a bottom-up approach targeting sound reactivity. • shows the combined CR and TMS approach worked best, but each approach alone had strengths for either self reported distress( CR) or tonic arousal (TMS) • the authors discuss the idea that Misophonics are sensitized to triggers such that they self report greater distress then is evident from physiological measures
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An experimental examination of neurostimulation and cognitive restructuring as potential components for Misophonia interventions
Status:: #status/complete
Metadata
- Item Type: #journalArticle
- Authors: Andrada D. Neacsiu, Lysianne Beynel, Nimesha Gerlus, Kevin S. LaBar, Noreen Bukhari-Parlakturk, M. Zachary Rosenthal,
- Date Added: January 18, 2024
- URL: https://linkinghub.elsevier.com/retrieve/pii/S0165032724001368
- DOI: 10.1016/j.jad.2024.01.120
- Cite Key: neacsiuExperimentalExaminationNeurostimulation2024
- Tags: #clinical, #Emotion-dysregulation, #intervention, #Misophonia, #neuroscience, #neurostimulation, #treatment, #Fmri
- PDF Attachments
Abstract
| Background/Purpose | Background- • Misophonia is a recently defined disorder with limited existing treatment evidence • Emerging neuroscientific findings suggest misophonia may involve hyperactivity of the anterior insular cortex and altered prefrontal activity/connectivity • Similarities with emotional dysregulation disorders warrant comparison and examination of emotion regulation interventions Purpose- • Compare adults with misophonia to clinical controls with high emotion dysregulation • Examine whether interventions should target sound reactivity reduction or emotion regulation improvement • Compare neurostimulation, cognitive restructuring, and their combination as potential misophonia interventions and investigate whether a bottom-up or top-down approach is best suited for a misophonia intervention. (page 2) |
| Participants/samples | - 29 adults with moderate-severe misophonia - 30 clinical controls with high emotion dysregulation - Matched groups |
| Measures | - Subjective units of distress (SUDS) - Skin conductance response (SCR) and level (SCL) - High-frequency heart rate variability (HF-HRV) |
| Procedures | - Personalized aversive, misophonic, and neutral sounds - Three neurostimulation conditions: 1. Inhibitory 1 Hz rTMS over medial prefrontal cortex (mPFC) 2. Excitatory 10 Hz rTMS over dorsolateral prefrontal cortex (dlPFC) 3. Sham stimulation - Participants listened to or cognitively downregulated emotions to sounds during stimulation |
| Results | - Misophonia group reported higher distress to misophonic sounds compared to controls - Both types of neurostimulation reduced distress more than sham, with excitatory rTMS providing most benefit - Excitatory rTMS enhanced regulation of misophonic emotions in both groups - Combined cognitive restructuring and excitatory rTMS led to lowest misophonic distress |
| Discussion/Limits | Conclusion- - Few psychophysiological differences between misophonia and clinical emotional dysregulation - Self-reported distress differentiates misophonia from other clinical conditions - Top-down regulation approach superior to bottom-up reactivity inhibition for misophonia intervention - Combined neurostimulation and emotion regulation training most promising for misophonia treatment • The results suggest that a neurostimulation-based treatment might be optimal for intervention for misophonia as well as emotional dysregulation. (page 12) • The results showed that participants with misophonia reported higher distress when listening to and downregulating misophonic distress compared to controls. Both types of neurostimulation reduced distress significantly more than sham stimulation, with excitatory rTMS providing the most benefit. R, and SCL more than sham neurostimulation. Additionally, the study found that HF-rTMS decreased SUDS ratings more than LF-rTMS or sham when participants listened to misophonic sounds. • The study found that HF-rTMS reduced SCL significantly more than sham when listening to either aversive or misophonic sounds and when downregulating misophonic sounds. Additionally, the study found that the top-down approach targeting emotion regulation was more effective in reducing distress than the bottom-up approach targeting sound reactivity. • The results showed that both neurostimulation and emotion regulation training reduced distress when compared to no intervention, with the combined intervention leading to the biggest decrease in distress. (page 2) |
| Limitations:: | • Small sample size lacking racial/ethnic diversity • Potential cumulative effects of repeated rTMS • Differences in stimulation intensity between conditions |
| Future Directions:: | • Replicate with larger, more diverse sample • Examine full factorial design of stimulation parameters • Investigate long-term effects of combined neurostimulation and emotion regulation interventions |
| Relevance:: | • This study examines the effects of neurostimulation and cognitive restructuring on emotional distress in individuals with misophonia and emotional dysregulation, finding that a top-down approach targeting emotion regulation is more effective in reducing distress than a bottom-up approach targeting sound reactivity. • shows the combined CR and TMS approach worked best, but each approach alone had strengths for either self reported distress( CR) or tonic arousal (TMS) • the authors discuss the idea that Misophonics are sensitized to triggers such that they self report greater distress then is evident from physiological measures |
Notes
key terms and concepts
- Misophonia-- Decreased tolerance for certain aversive, repetitive common sounds or stimuli associated with these sounds, characterized by intense distress and heightened physiological reactions
- Repetitive transcranial magnetic stimulation (rTMS) - Non-invasive brain stimulation technique that uses magnetic fields to modulate neural activity in targeted brain regions
- Cognitive restructuring - Emotion regulation skill involving identifying and modifying maladaptive thought patterns
my engagement notes
misc
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Misophonia may be comparable to other DSM disorders
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Additional biomarkers needed to capture unique misophonic distress
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Existing emotion regulation interventions may benefit misophonia sufferers
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Coil-to-cortex distance and headaches should be controlled in future neurostimulation studies
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Alternative neurostimulation techniques (e.g., tDCS, tACS) warrant investigation for misophonia
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possible sensitization in Misophonia
the authors propose that their finding that Misophonics showed greater distress when trying to regulate the Misophonic response, in contrast to the physiological responses, suggests sensitization in Misophonics. that is to say, that Misophonics may report higher distress then is evident from physiological measures. (page 11)
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- The study had a limited sample size and did not investigate the long-term effects of the interventions.
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The study had a small sample size and did not include a control group without misophonia or emotional dysregulation. Additionally, the study did not examine the long-term effects of the interventions.
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The study notes that SCL/SCR/HF-HRV may not be appropriate measures to capture the difference in response between groups, and that other objective measures should be tested to differentiate misophonia from clinical distress. (page 12)
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- the authors suggest that Misophonia can be compared to other DSM disorders, and that new biomarkers to distinguish Misophonia from other issues are still needed. (page 12)
zettelkasten
possible role of dlPFC in Misophonia suggested by by stop signal task and demonstrated in TMS study