In-fact, Dr. Brout was an advocate for misophonia before the name even existed! Disappointed by her own experiences with the state of the field when seeking help for her own child, Dr. has dedicated herself to advocating for the establishment of better mental health research practice, improved diagnosis, and innovative clinical practice for the past 18 years. Her focus has been on the relationship between auditory  over-responsivity and psychological functioning. Dr. Brout continues to, bring together multi-disciplinary teams of highly esteemed academic researchers and clinicians in order to share resources, eventually culminating in research papers, academic conferences, and innovative treatment. Currently we are involved in the following studies on sensory disorders. Below that, we will list studies that we are interested in.

Our Programs & Studies

New York University LeDoux Lab

The goal of this research is to explore how the processing of auditory stimuli in the brain can go awry (leading some people to have aversive reactions to stimuli that most people consider innocuous).

To gain a better understanding of how these averse reactions are controlled by the brain, we are building on our research over the past 30 years.  We have shown that the brain region called the amygdala is key to such responses.

One area of the amygdala , the lateral nucleus, is involved in receiving sensory inputs and another, the central nucleus, controls the expression of responses. Over-reactivity to auditory stimuli could be due to a hypersensitive lateral amygdala or an over-reactive central amygdala.

We will study animals that show exaggerated responses to auditory stimuli and will record activity in the lateral or central nucleus to try to determine whether the problem is due to hyper-sensitivity or hyper-reactivity.

 

 

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Duke University Sensory Processing and Emotion Regulation

The Sensory Processing and Emotion Regulation Program is the longest standing research program involved with The International Misophonia Research Network. Founded by Jennifer Jo Brout in 2008 and led by Dr. Zach Rosenthal, research conducted within this program investigates the relationship between auditory over-responsivity/misophonia, emotions, cognition and behavior.

Previous studies from this program have examined the effects of meclizine on pre-pulse inhibition (Levin et al., 2014) and the relationship between sensory over-responsivity and emotions in adult psychopathology (Rosenthal et al., 2011; Rosenthal et al., in press).

In addition to research, we are dedicated to developing, evaluating, and establishing best practices for providers working with patients who report having misophonia. The approach we are developing is multi-disciplinary and is done in tandem with patients and their families. The self-help component to this approach is a practical combination of proactive coping skills designed to help individuals identify aversive stimuli, and learn different ways to help calm the physiological and emotional over-arousal associated with that stimuli. The program also seeks to help individuals reevaluate and change ways of thinking about aversive stimuli that may act to acerbate.  The program teaches how to help calm the physiological and emotional responses to these aversive stimuli. Updates about this program will be posted periodically.

Current Studies

Sensory Processing and Mental Health Study

Some people respond to sensory cues in their daily environments differently than others. Problem with processing sensory information (e.g., getting angry when hearing certain sounds) can be associated with various behavioral health problems.

This study was funded by the Wallace Research Foundation and is no longer active. The study examines the relationship between self-reported responses to sensory cues (during childhood and adulthood) and various mental health problems.

Generalization of Emotion Regulation

This is a study about the ways in which people cope with emotional distress in their lives. We will be looking at ways to understand how to help people calm down easier after they become emotionally distressed. We are interested in how to do this both inside the clinic and also outside in the real world.

Investigating Antihistamine Treatment to Reduce Sensory Over-responsiveness 

Histamine, in addition to being a chemical that controls nasal and stomach acid secretions and itch responses also serves as a transmitter between neurons in the brain. We have found that brain histamine systems play important roles in sensory responsivity. In preclinical studies we have shown that a certain type of antihistamine treatment can help reverse sensory gating impairments. In an initial clinical study with people who have difficulty modulating their sensory responsiveness, antihistamine treatment improved sensory screening without producing sedation. This initial study was in people with general sensory over-responsiveness.

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The Polyvagal Theory – Stephen Porges

Polyvagal Theory makes predictions based on acoustic properties. The Polyvagal Theory proposes that subjective responses to sounds are initially (before associative learning) based on two features of the acoustic signal: pitch and variation in pitch. The theory articulates that for mammals there is a frequency band of perceptual advantage in which social communication occurs. It is within this frequency band that acoustic “safety” cues are conveyed.
Consistent with the theory, safety is signaled when the pitch of the acoustic signal is modulated within this band. Thus, a monotone within this band is not sufficient to signal safety. Moreover, the theory proposes that low frequency monotone sounds (e.g., dog’s bark, lion’s roar, large truck, and thunder) are inherent signals of predator and high frequency monotone sounds are inherent signals of pain and danger (e.g., shrill cries of babies or someone who is being injured).

 

The Brain Basis for Misophonia – Dr. Sukhbinder Kumar

Dr. Sukhbinder Kumar and colleagues from the Institute of Neuroscience at New Castle University published a groundbreaking misophonia study in Current Biology (February, 2017). The research team measured three sets of sounds that were presented to both misophonics and to controls while they were in an MRI scanner.  Sounds included typical misophonia “trigger sounds”, typically unpleasant sounds, as well as neutral sounds. Measurements of brain activity and autonomic responses (heart rate and galvanic skin response) were recorded in the MRI scanner. After presentation of each sound, misophonic and control subjects rated their level of distress. Common trigger sounds evoked a strong reaction in misophonic subjects, while the typically unpleasant sounds were reported as “annoying”. Notably, the typically unpleasant sounds did not result in heightened reactions in misophonics.

Brain imaging data showed greatly exaggerated activation of the anterior insular cortex (AIC) in people with misophonia, but not in controls. In addition, the heightened reactivity in misophonic subjects was specific to trigger sounds. For controls there was no difference between reactions to unpleasant versus trigger sounds.

The AIC detects personally relevant stimuli in the environment and directs attention to that stimulus. Stronger activation of AIC to trigger sounds demonstrates that misophonic subjects assign higher salience to trigger sounds.

In addition, analysis of functional connectivity of AIC showed hyper-connectivity, which was again specific to trigger sounds and to default mode network (DMN) in misophonic subjects. The DMN is active during internally directed thoughts and recall of memories.

Finally, analysis of structural brain data demonstrated that misophonics have greater myelination in the gray matter of ventromedial prefrontal cortex (vmPFC). This structural difference may account for the abnormal functional connectivity of AIC to DMN in misophonics. Overall, Kumar et al. showed abnormal activation and functional connectivity of AIC underlying the symptoms of misophonia.