Body

Dheerendra & Ramesh 2025 Iron dysregulation model of Misophonia

in a 2025 hypothesis, article Dheerendra & Ramesh proposes a novel model of Misophonia suggesting that misophonia arises from a self-perpetuating cycle of iron dysregulation in the mirror motor cortex. Chronic hyperactivity in this region, particularly the orofacial area involved in action mirroring, leads to increased metabolic demand and elevated cerebral blood flow, facilitating excessive iron accumulation. This iron buildup induces oxidative stress and low-grade neuroinflammation, which in turn promotes maladaptive long-term potentiation and reduces inhibitory control. The resulting disinhibition enhances connectivity with sensory cortices, reinforcing pathological hyper-mirroring and involuntary mimicry of trigger sounds. This cycle sustains and exacerbates misophonic symptoms. The authors propose that targeting this loop through neuroimaging, iron-modulating treatments, or neural modulation could offer promising therapeutic interventions. (Dheerendra & Ramesh, 2025)