An interview with Dr. Heather Hansen on her misophonia research. #
Posted September 8, 2026
Reviewed by Monica Vilhauer Ph.D.
Key points
- Misophonia's neural signature is different than what we see in anxiety and other disorders.
- This adds important evidence to the notion that misophonia is a standalone disorder.
- The anterior insula, part of the salience network, is highly involved in misophonia.
- In the study, the more connectivity from the anterior insula is associated with more severe misophonia.
I had the privilege of interviewing Dr. Heather Hansen about her latest work, which adds support to the notion that misophonia is a stand-alone disorder. Dr. Hansen runs the Cognition and Auditory Perception of Everyday Sounds (CAPES) Lab in the Department of Psychological Sciences at William & Mary College. For her recent study, Hansen and colleagues analyzed the brain connectivity of 162 adults as a function of misophonia severity. Their findings highlight numerous important issues about misophonia, bringing us further in our understanding of misophonia as a disorder that crosses disciplines but is simultaneously a unique disorder.
Jennifer Brout: I am very excited to speak to you about your findings! To me, the finding that misophonia has a very specific neural signature adds important evidence to the idea that it is a standalone disorder. Am I understanding that correctly?
Heather Hansen: Yes, this neural signature is different than what we see in anxiety and other disorders. Our main finding is that the anterior insula, part of the salience network, is highly involved in misophonia.
JB: Then, point one gives us more evidence that misophonia involves the anterior insula?
HH: Yes, but in addition, we found that the anterior insula gets more connected the more severe your misophonia is. So that connectivity changes or increases as a function of misophonia level.
JB: Are you saying that if you have more severe misophonia, the connectivity of the insula will appear greater?
HH: Yes. Correct. Plus, the idea that more connectivity is associated with more severe misophonia may lead us to characterize the disorder as being on a spectrum rather than a binary diagnosis of ‘you have it’ or ‘you don’t.’
JB: Are these connections a result of having misophonia, or does the greater connectivity cause more severe misophonia?
HH: We don't know yet. FMRI does not show directionality. I can just say that those things are associated in some way. Keep in mind, however, that measuring the insula and its connectivity is not a perfect science. Researchers use different equipment and define brain areas in different ways.
JB: Thank you for pointing that out. That is something we don't think about very much!
HH: So that's an important nuance—in a lot of the neuroimaging papers we have currently out, we all locate brain regions slightly differently. In addition, because the anterior insula is involved in so many different things, different sections of it belong to many different brain networks. It's part of a salience network that helps us attend to the things that are important. But it also has sections that are part of networks linked to motor processing and sensations, and the default mode (which is what your brain is doing when you don't have a specific task).
JB: I see.
HH: All of this is to say, I wanted to investigate the specificity of the anterior insula a little bit more to figure out what part of it is the crucial part in misophonia. Therefore, I divided the insula in a couple of different ways so that I could test the parts out – the part of the insula involved in the salience network, the part involved in the default mode network, etc. Turns out there is only increased connectivity from the part of the insula that belongs to the salience network in misophonia.
JB: How does this compare to previous studies?
HH: One of the things that I learned, which adds evidence to some of the earlier neuroimaging work (like Schroeder et al. and Kumar et al.’s work), is that the salience network definitely seems to be involved. This paper basically adds some specific data to their earlier hypotheses and says, yes. It seems to be that it's the salience part of the anterior insula that's important in misophonia.
JB: Would you sum this up a little?
HH: The anterior insula is a part of the brain that communicates with other brain regions more in misophonia. It communicates with higher-level auditory regions to understand what a complex sound is. It communicates with attention regions to determine if one should pay attention to a particular sound. It communicates with an integration region that helps compare sounds to prior experiences. It's a higher-level region that communicates with a lot of other regions in the brain, regions that seem particularly relevant for misophonia. And this communication happens more in folks with more severe misophonia.
JB: Misophonia, then, has to do with various brain areas, and the anterior insula (part of the salience network) is highly important. The more this anterior insula connects to other areas may determine the severity of the disorder.
HH: Yes.
JB: Thank you very much for taking the time to do this interview and for all of your great work on misophonia! I am looking forward to your next study!
References
Hansen HA, Norris JE, Bain CM, Ethridge LE, Tardif CL. Selective Disruption of Salience-Network Anterior Insula Connectivity in Misophonia: A Disorder-Specific Neural Signature. Hum Brain Mapp. 2026 Feb 15;47(3):e70468. doi: 10.1002/hbm.70468. PMID: 41676968; PMCID: PMC12895373.