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Misophonia in Chinese Medicine

This Friday I will make a special lecture on how to treat misophonia (恐音症)in Chinese Medicine. It looks like a very new topic in CM. After I read some research paper on misophonia, I found it’s possible to treat misophonia as Er Ming (tinnitus) and psychological disorders e.g. anxiety, depression.

In the filed of psychology, misophonia is a new condition. Current understanding on its mechanism is largely limited. There is no reports on the use of acupuncture to treat misophonia yet. Anyhow the current research can enlighten our thinking on how to use acupuncture to treat misophonia.

I listed some useful research on this topic.

Misophonia is associated with altered brain activity in the auditory cortex and salience network​(Schröder et al. 2019)​

Misophonia is characterized by intense rage and disgust provoked by hearing specific human sounds resulting in social isolation due to avoidance. We exposed patients with symptom provoking audiovisual stimuli to investigate brain activity of emotional responses. 21 patients with misophonia and 23 matched healthy controls were recruited at the psychiatry department of the Amsterdam UMC. Participants were presented with three different conditions, misophonia related cues (video clips with e.g. lip smacking and loud breathing), aversive cues (violent or disgusting clips from movies), and neutral cues (video clips of e.g. someone meditating) during fMRI. Electrocardiography was recorded to determine physiological changes and self-report measures were used to assess emotional changes. Misophonic cues elicited anger, disgust and sadness in patients compared to controls. Emotional changes were associated with increases in heart rate. The neuroimaging data revealed increased activation of the right insula, right anterior cingulate cortex and right superior temporal cortex during viewing of the misophonic video clips compared to neutral clips. Our results demonstrate that audiovisual stimuli trigger anger and physiological arousal in patients with misophonia, associated with activation of the auditory cortex and salience network.

Treatments for Decreased Sound Tolerance (Hyperacusis and Misophonia)​(Jastreboff and Jastreboff 2014)​

Decreased sound tolerance (DST) is an underappreciated condition that affects the lives of a significant portion of the general population. There is lack of agreement regarding definitions, specific components, prevalence, methods of evaluation, and methods of treatment. Limited data are available on the results of treatments. Research is scant and constrained by the lack of an animal model. This article proposes a definition of DST and its division into hyperacusis and misophonia. The potential mechanisms of these phenomena are outlined, and the results of treatment performed at Emory University are presented. Out of 201 patients with DST, 165 (82%) showed significant improvement. Of 56 patients with hyperacusis (with or without misophonia), 45 (80%) showed significant improvement. This proportion was higher for the group with hyperacusis and concurrent misophonia (33 of 39, or 85%) and lower for patients with hyperacusis only (13 of 17, or 76%). Effectiveness of treatment for misophonia with or without hyperacusis was identical (152 of 184, 83% and 139 of 167, 83%, respectively, for misophonia accompanied by hyperacusis and for misophonia only). Even with current limited knowledge of DST, it is possible to propose specific mechanisms of hyperacusis and misophonia and, based on these mechanisms, to offer treatments in accordance with the neurophysiological model of tinnitus. These treatments are part of Tinnitus Retraining Therapy (TRT), which is aimed at concurrently treating tinnitus and DST and alleviating the effects of hearing loss. High effectiveness of the proposed treatments support the postulated mechanisms.

free full-text

Jastreboff, Margaret, and Pawel Jastreboff. 2014. “Treatments for Decreased Sound Tolerance (Hyperacusis and Misophonia).” Seminars in Hearing, April, 105–20.

Schröder, Arjan, Guido van Wingen, Nadine Eijsker, Renée San Giorgi, Nienke C. Vulink, Collin Turbyne, and Damiaan Denys. 2019. “Misophonia Is Associated with Altered Brain Activity in the Auditory Cortex and Salience Network.” Scientific Reports, May.

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