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Insula-Sensorimotor Connectivity Beyond the Mirror-Neuron Account: Neural Evidence for Non-Orofacial Triggers

in there 2022 fMRI study, Hansen  challenge the “motor basis” account of misophonia proposed by Kumar et al. (2021) by demonstrating that altered connectivity in misophonia is not specific to ventral premotor cortex (PMv), the region typically associated with mirror neurons. Instead, they found increased insula connectivity across multiple sensorimotor regions, including primary motor (M1), primary somatosensory (S1), and dorsal premotor cortex (PMd), suggesting that the effect is not confined to a mirror-neuron mechanism. Moreover, by functionally defining finger-related motor and somatosensory regions, they showed that individuals with higher misophonia scores also exhibit differential insula connectivity with finger representations, providing neural evidence for non-orofacial triggers. This broader pattern of sensorimotor–insula connectivity undermines the claim that misophonia is primarily driven by orofacial mirroring and instead supports a more distributed neural account that includes direct representation of non-oral triggers rather than their acquisition solely through associative learning. (Hansen et al., 2022)