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In a 2026 study, Roy examined whether misophonia affects spatial auditory processing by administering ITD and ILD threshold tasks and a virtual acoustic spatial identification test (VASI) to 20 individuals with misophonia and 20 normal-hearing controls, along with the A-MISO-S severity questionnaire. They found that the misophonic group had elevated ITD thresholds and reduced overall VASI accuracy (particularly at R45 and L45 positions), while ILD thresholds did not differ between groups; misophonia severity negatively correlated with VASI accuracy, and ITD and VASI together classified group membership with high accuracy. from this the authors suggest that ITD and VASI accuracy are robust diagnostic markers for spatial processing deficits in misophonia , and could be used as diagnostic markers for Misophonia (Roy et al., 2026).

additional discussion on the logic behind ITD and VASI as predictors

Explaining ITD

the authors link the high ability of ITD to predict spatial localization ability to its role in the localization of low frequency sound s( in this case below ~1,500Hz), which they go onto say also encompasses the frequency range of many Misophonia triggers.
they further suggest the observed heightened ITD thresholds may reflect altered temporal resolution/ binaural temporal interaction, perhaps due to the previously reported hyperconnectivity between auditory and limbic areas in Misophonia.

explaining VASI

the authors note that the observed poor performance on VASI for the Misophonic group suggests issues with spatial mapping and auditory scene analysis, critical aspects of sound source identification, aligning with the existing evidence of source ambiguity moderating the emotional responses to sounds (page 11)

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