A case of acquired amusia and misophonia following right temporal resection

Emily R Dappen ¹, Joel I Berger ², Amy M Belfi ³

⁰Department of Neurosurgery, The University of Iowa, Iowa City, IA 52242, USA; Iowa Neuroscience Institute, The University of Iowa, Iowa City, IA 52242, USA.

Hearing Research +

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November 28, 2025

View abstract on PubMed

Summary

A patient developed music perception deficits (amusia) and sound sensitivity (misophonia) after brain surgery. This case is the first report of acquired misophonia following epilepsy treatment.

Area Of Science

Neuroscience
Auditory Perception
Clinical Neurology

Background

Auditory perception is crucial for music enjoyment and communication.
Disruptions can lead to amusia (music perception deficits) and misophonia (sound sensitivity).
Acquired amusia and misophonia are rare conditions, particularly when occurring concurrently.

Purpose Of The Study

To describe a unique case of acquired, concurrent amusia and misophonia.
To investigate the neurological basis of these auditory processing deficits.
To characterize the patient's post-surgical auditory impairments.

Main Methods

A 21-year-old female patient underwent resection of right posterior insula, temporal, supramarginal, and sensory cortex for epilepsy.
Post-resection, the patient completed interviews and an extensive testing battery.
Assessments focused on music processing, auditory perception, and misophonia symptom severity.

Main Results

The patient exhibited significant deficits in music processing domains (scale, key, contour, interval).
Clinically elevated misophonia symptom severity and impairment were observed.
Normal performance was noted in speech-in-babble perception and music reward, despite self-reported impairments.

Conclusions

Resected brain regions (insula, temporal, supramarginal, sensory cortex) significantly contribute to normal music perception.
This case represents the first documented instance of acquired misophonia.
The findings underscore the complex neural basis of auditory processing and its susceptibility to neurosurgical intervention.

Keywords:

Auditory perception Cortex Epilepsy Lesion Music Neurosurgery Posterior insula

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