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      Misophonia: physiological investigations and case descriptions

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          Abstract

          Misophonia is a relatively unexplored chronic condition in which a person experiences autonomic arousal (analogous to an involuntary “fight-or-flight” response) to certain innocuous or repetitive sounds such as chewing, pen clicking, and lip smacking. Misophonics report anxiety, panic, and rage when exposed to trigger sounds, compromising their ability to complete everyday tasks and engage in healthy and normal social interactions. Across two experiments, we measured behavioral and physiological characteristics of the condition. Interviews (Experiment 1) with misophonics showed that the most problematic sounds are generally related to other people's behavior (pen clicking, chewing sounds). Misophonics are however not bothered when they produce these “trigger” sounds themselves, and some report mimicry as a coping strategy. Next, (Experiment 2) we tested the hypothesis that misophonics' subjective experiences evoke an anomalous physiological response to certain auditory stimuli. Misophonic individuals showed heightened ratings and skin conductance responses (SCRs) to auditory, but not visual stimuli, relative to a group of typically developed controls, supporting this general viewpoint and indicating that misophonia is a disorder that produces distinct autonomic effects not seen in typically developed individuals.

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          Most cited references29

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          Misophonia: Diagnostic Criteria for a New Psychiatric Disorder

          Background Some patients report a preoccupation with a specific aversive human sound that triggers impulsive aggression. This condition is relatively unknown and has hitherto never been described, although the phenomenon has anecdotally been named misophonia. Methodology and Principal Findings 42 patients who reported misophonia were recruited by our hospital website. All patients were interviewed by an experienced psychiatrist and were screened with an adapted version of the Y-BOCS, HAM-D, HAM-A, SCL-90 and SCID II. The misophonia patients shared a similar pattern of symptoms in which an auditory or visual stimulus provoked an immediate aversive physical reaction with anger, disgust and impulsive aggression. The intensity of these emotions caused subsequent obsessions with the cue, avoidance and social dysfunctioning with intense suffering. The symptoms cannot be classified in the current nosological DSM-IV TR or ICD-10 systems. Conclusions We suggest that misophonia should be classified as a discrete psychiatric disorder. Diagnostic criteria could help to officially recognize the patients and the disorder, improve its identification by professional health carers, and encourage scientific research.
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            Electrodermal responses: what happens in the brain.

            Electrodermal activity (EDA) is now the preferred term for changes in electrical conductance of the skin, including phasic changes that have been referred to as galvanic skin responses (GSR), that result from sympathetic neuronal activity. EDA is a sensitive psychophysiological index of changes in autonomic sympathetic arousal that are integrated with emotional and cognitive states. Until recently there was little direct knowledge of brain mechanisms governing generation and control of EDA in humans. However, studies of patients with discrete brain lesions and, more recently, functional imaging techniques have clarified the contribution of brain regions implicated in emotion, attention, and cognition to peripheral EDA responses. Moreover, such studies enable an understanding of mechanisms by which states of bodily arousal, indexed by EDA, influence cognition and bias motivational behavior.
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              Increased structural connectivity in grapheme-color synesthesia.

              Diffusion tensor imaging allowed us to validate for the first time the hypothesis that hyperconnectivity causes the added sensations in synesthesia. Grapheme-color synesthetes (n = 18), who experience specific colors with particular letters or numbers (for example, 'R is sky blue'), showed greater anisotropic diffusion compared with matched controls. Greater anisotropic diffusion indicates more coherent white matter. Anisotropy furthermore differentiated subtypes of grapheme-color synesthesia. Greater connectivity in the inferior temporal cortex was particularly strong for synesthetes who see synesthetic color in the outside world ('projectors') as compared with synesthetes who see the color in their 'mind's eye' only ('associators'). In contrast, greater connectivity (as compared with non-synesthetes) in the superior parietal or frontal cortex did not differentiate between subtypes of synesthesia. In conclusion, we found evidence that increased structural connectivity is associated with the presence of grapheme-color synesthesia, and has a role in the subjective nature of synesthetic color experience.
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                Author and article information

                Journal
                Front Hum Neurosci
                Front Hum Neurosci
                Front. Hum. Neurosci.
                Frontiers in Human Neuroscience
                Frontiers Media S.A.
                1662-5161
                25 June 2013
                2013
                : 7
                : 296
                Affiliations
                [1] 1Department of Psychology, Center for Brain and Cognition, University of California, San Diego San Diego, CA, USA
                [2] 2Department of Psychology, Northwestern University Evanston, IL, USA
                [3] 3Department of Psychology, University of Amsterdam Amsterdam, Netherlands
                Author notes

                Edited by: Peter G. Enticott, Monash University, Australia

                Reviewed by: Kate Hoy, Monash University, Australia; Arjan Schröder, Academic Medical Center, Netherlands

                *Correspondence: Miren Edelstein, Department of Psychology, University of California, San Diego, 9500 Gilman Dr. #0109, La Jolla, CA 92093-0109, USA e-mail: mhedelstein@ 123456ucsd.edu
                Article
                10.3389/fnhum.2013.00296
                3691507
                23805089
                55d3dbb4-3b48-42f0-a987-3c62f2ffaab2
                Copyright © 2013 Edelstein, Brang, Rouw and Ramachandran.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in other forums, provided the original authors and source are credited and subject to any copyright notices concerning any third-party graphics etc.

                History
                : 01 April 2013
                : 05 June 2013
                Page count
                Figures: 5, Tables: 1, Equations: 0, References: 32, Pages: 11, Words: 7744
                Categories
                Neuroscience
                Original Research Article

                Neurosciences
                misophonia,sound sensitivity,skin conductance response,auditory processing,aversive sounds,case reports,autonomic response

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