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Anterior Insula Hyperactivation and Abnormal Salience Attribution to Trigger Sounds

A 2017 study by Kumar and colleagues investigated structural and functional brain abnormalities in individuals with misophonia by exposing participants to three classes of sounds (trigger, generally aversive, and neutral) while collecting fMRI, heart rate, galvanic skin response, and subjective ratings. fMRI analyses revealed a significant group × sound interaction in bilateral anterior insular cortex, driven by greater BOLD responses to trigger sounds in misophonic participants, with AIC activity correlating linearly with reported distress. The authors conclude that misophonia is characterized by abnormal salience attribution to specific sounds, arising from atypical activation and functional connectivity between the AIC and medial frontal, medial parietal, and temporal regions. (Kumar et al., 2017)