Objective measures of sensory gating capacity do not predict the severity of misophonia symptoms

Misophonia is characterized by intense negative emotional responses to specific trigger sounds. Given that repetitive sounds are frequently endorsed as triggers, we investigated whether impaired preattentive sensory gating contributes to misophonia pathophysiology. Forty-eight participants (36 female; aged 18-64) completed self-report measures of misophonia severity (MisoQuest) and sensory gating ability (Sensory Gating Inventory-Brief), alongside an objective measure of sensory gating capacity (suppression of the P50 component in a paired-pulse paradigm). Resting-state beta and gamma power were also examined as potential markers of inhibitory capacity. A dimensional approach was employed, examining relationships across the spectrum of symptom severity rather than discrete diagnostic groups. Participants showed normal P50 suppression overall (mean S2/S1 ratio = 0.40 ± 0.34). Despite significant correlation between self-reported misophonia severity and sensory gating difficulties (τ = 0.51, p < .001), no significant associations emerged between P50 suppression ratios and either misophonia severity (τ = -0.05, p = .652) or self-reported gating difficulties (τ = 0.14, p = .198). Similarly, resting-state beta and gamma power showed, at best, weak evidence of a relationship with misophonia symptoms. These findings suggest that misophonia may not arise from deficits in early, automatic sensory filtering mechanisms. Rather, the characteristic hypersensitivity to trigger sounds likely emerges from alterations in higher-order auditory processing networks, consistent with neuroimaging evidence of altered salience network activity. These results help constrain theoretical models that seek to understand the patterns of atypical neural activity that underlie the experience of misophonia.