Evaluation of extended high frequency thresholds in individuals with misophonia

Abstract Background Misophonia is a condition characterized by strong emotional and physiological responses to specific auditory or visual stimuli, often leading to distress and functional impairment. It commonly co-occurs with disorders such as OCD, ADHD, and tinnitus, yet its underlying auditory mechanisms remain poorly understood. Traditional audiometry may not fully capture the auditory sensitivities reported in misophonia, suggesting a need to explore extended high-frequency hearing thresholds. Previous studies have indicated atypical neural activation patterns in misophonic individuals, pointing toward altered auditory processing. This study aimed to compare extended high-frequency thresholds between individuals with misophonia and typical adults to better understand auditory sensitivity in this population and enhance diagnostic precision. Methods Thirty participants aged 18–54 years (mean age 32.01, SD = 11.3) were divided into two groups: 15 with misophonia and 15 controls. All the participants had normal hearing sensitivity, Type-A tympanograms with acoustic reflexes at 1000 Hz, and presence of transient-evoked otoacoustic emissions. Misophonia symptoms were assessed using the Revised Amsterdam Misophonia Scale (A-MISO-S). Extended High-Frequency Audiometry (EHFA) was performed in a sound-treated environment. Results A paired t-tests showed no significant inter-ear differences; thus, bilateral data were pooled. Independent t-tests revealed significantly better extended high-frequency thresholds in the misophonia group compared to controls, with no significant age differences between groups. Conclusion This study found significantly enhanced extended high-frequency thresholds in individuals with misophonia, indicating increased auditory sensitivity possibly due to altered auditory processing mechanisms. These findings support incorporating EHFA into clinical assessments, aiding targeted management strategies for misophonia. Additional research is needed to strengthen these observations.