The Motor Basis for Misophonia.
The Motor Basis for Misophonia.
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DOI：
10.1523/jneurosci.0261-21.2021
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发表时间：
2021-06-30
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影响因子：
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通讯作者：
Griffiths TD
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作者：
Kumar S;Dheerendra P;Erfanian M;Benzaquén E;Sedley W;Gander PE;Lad M;Bamiou DE;Griffiths TD
失语症是一种常见的疾病，其特征是对某些日常声音，如其他人吃、喝和呼吸产生的声音，产生强烈的愤怒和焦虑的负面情绪。这些“扳机”声音的常见性质使失语症对患者及其家人来说是一种毁灭性的疾病。这种无伤大雅的声音是如何触发这种反应的，目前尚不清楚。由于大多数触发声音是由其他人的口面部运动(例如，咀嚼)产生的，我们假设与口面部运动相关的镜像神经系统可能是失音的基础。我们分析了失语症患者和对照组的静息状态fMRI(rs-fMRI)连接性(N=33，16女性)和声诱发fMRI反应(N=42，29女性)。我们证明，与对照组相比，失语症组在听觉皮质对触发声音的反应上没有差异，但确实显示：(1)听觉和视觉皮质以及负责口面部运动的腹侧运动前皮质之间更强的rs-fMRI连接；(2)在声音感知过程中，听觉皮质和口面部运动区之间更强的功能连接；以及(3)口面部运动区更强的激活，特别是对触发声音的反应。我们的研究结果支持了一种错音症模型，该模型建立在对他人的口部动作进行“超级镜像”的基础上，声音是过度反映他人动作的“媒介”。因此，错音症本身并不是对声音的发泄，而是运动系统中与产生声音有关的部分活动的表现。这个理解失语症的新框架可以解释行为和情感反应，并对设计有效的治疗方法具有重要的影响。意义陈述传统上，厌音症被认为是一种声音情绪加工的障碍，即别人发出的简单的进食和咀嚼的声音会引起负面的情绪反应。我们的数据为失语症提供了另一种但互补的视角，强调了触发者的行动，而不是作为该行动的副产品的声音。在这个新的视角下，声音只是一个“媒介”，通过它，触发者的行动被反射到听者身上。这种观点的改变对设计治疗失语症的方法和方法具有重要影响。它表明，与许多现有疗法不同，有效的疗法应该针对大脑运动的表征，而不是专注于声音。
Misophonia is a common disorder characterized by the experience of strong negative emotions of anger and anxiety in response to certain everyday sounds, such as those generated by other people eating, drinking, and breathing. The commonplace nature of these “trigger” sounds makes misophonia a devastating disorder for sufferers and their families. How such innocuous sounds trigger this response is unknown. Since most trigger sounds are generated by orofacial movements (e.g., chewing) in others, we hypothesized that the mirror neuron system related to orofacial movements could underlie misophonia. We analyzed resting state fMRI (rs-fMRI) connectivity (N = 33, 16 females) and sound-evoked fMRI responses (N = 42, 29 females) in misophonia sufferers and controls. We demonstrate that, compared with controls, the misophonia group show no difference in auditory cortex responses to trigger sounds, but do show: (1) stronger rs-fMRI connectivity between both auditory and visual cortex and the ventral premotor cortex responsible for orofacial movements; (2) stronger functional connectivity between the auditory cortex and orofacial motor area during sound perception in general; and (3) stronger activation of the orofacial motor area, specifically, in response to trigger sounds. Our results support a model of misophonia based on “hyper-mirroring” of the orofacial actions of others with sounds being the “medium” via which action of others is excessively mirrored. Misophonia is therefore not an abreaction to sounds, per se, but a manifestation of activity in parts of the motor system involved in producing those sounds. This new framework to understand misophonia can explain behavioral and emotional responses and has important consequences for devising effective therapies. SIGNIFICANCE STATEMENT Conventionally, misophonia, literally “hatred of sounds” has been considered as a disorder of sound emotion processing, in which “simple” eating and chewing sounds produced by others cause negative emotional responses. Our data provide an alternative but complementary perspective on misophonia that emphasizes the action of the trigger-person rather than the sounds which are a byproduct of that action. Sounds, in this new perspective, are only a “medium” via which action of the triggering-person is mirrored onto the listener. This change in perspective has important consequences for devising therapies and treatment methods for misophonia. It suggests that, instead of focusing on sounds, which many existing therapies do, effective therapies should target the brain representation of movement.