Misophonia is a condition in which specific ordinary sounds provoke disproportionately strong negative affect and physiological arousal. Evidence for neurobiological abnormalities underlying misophonia is scarce. Since many psychiatric disorders show white matter (WM) abnormalities, we tested for both macro and micro-structural WM differences between misophonia patients and healthy controls.

We collected T1-weighted and diffusion-weighted magnetic resonance images from 24 patients and 25 matched controls. We tested for group differences in WM volume using whole-brain voxel-based morphometry and used the significant voxels from this analysis as seeds for probabilistic tractography. After calculation of diffusion tensors, we compared group means for fractional anisotropy, mean diffusivity, and directional diffusivities, and applied tract-based spatial statistics for voxel-wise comparison.

Compared to controls, patients had greater left-hemispheric WM volumes in the inferior fronto-occipital fasciculus, anterior thalamic radiation, and body of the corpus callosum connecting bilateral superior frontal gyri. Patients also had lower averaged radial and mean diffusivities and voxel-wise comparison indicated large and widespread clusters of lower mean diffusivity.

We found both macro and microstructural WM abnormalities in our misophonia sample, suggesting misophonia symptomatology is associated with WM alterations. These biological alterations may be related to differences in social-emotional processing, particularly recognition of facial affect, and to attention for affective information.

恐音症是一种特定的普通声音会引起不成比例的强烈负面影响和生理唤醒的情况。恐音症背后的神经生物学异常的证据很少。由于许多精神疾病表现出白质 (WM) 异常，我们测试了恐音症患者和健康对照者之间宏观和微观结构的 WM 差异。

我们收集了来自 24 名患者和 25 名匹配对照的 T1 加权和弥散加权磁共振图像。我们使用基于全脑体素的形态测量法测试了 WM 体积的组间差异，并将该分析中的重要体素用作概率纤维束成像的种子。在计算扩散张量后，我们比较了分数各向异性、平均扩散率和方向扩散率的组均值，并应用基于区域的空间统计进行体素比较。

与对照组相比，患者在下额枕束、前丘脑辐射和连接双侧额上回的胼胝体体中的左半球 WM 体积更大。患者还具有较低的平均径向和平均扩散系数，体素方面的比较表明较低平均扩散系数的大而广泛的簇。

我们在恐音症样本中发现了宏观和微观结构的 WM 异常，表明恐音症症状与 WM 改变有关。这些生物学改变可能与社会情感处理的差异有关，尤其是面部情感的识别，以及对情感信息的关注。