Misophonia, Autistic Traits, and Obsessive-Compulsive Symptoms in Migraine: A Controlled Comparative Study

This study examined misophonia severity and triggers in adolescents with migraine versus controls and their associations with autistic traits and obsessive-compulsive symptoms.

This cross-sectional case-control study included 80 adolescents aged 15-18 years (40 with migraine; 40 age- and sex-matched controls). Participants completed the Amsterdam Misophonia Scale-Revised (AMISOS-R) and the Obsessive-Compulsive Inventory-Child Version (OCI-CV); parents completed the Autism Spectrum Screening Questionnaire (ASSQ-TR).

Adolescents with migraine had higher AMISOS-R scores than controls (20.70 ± 8.59 vs. 13.65 ± 8.69, p < 0.001) and a higher prevalence of misophonia (85.0% vs. 62.5%, p = 0.022). Repetitive clicking and ambient background sounds were more frequently reported as triggers in the migraine group (p = 0.003 and p = 0.001, respectively). ASSQ total scores were higher in migraine (p = 0.022), whereas OCI-CV total scores did not differ, despite higher doubting/checking scores (p = 0.024). Within the migraine group, headache intensity correlated with misophonia severity (r = 0.329, p = 0.038). In regression analysis, migraine status, female sex, and ASSQ scores independently predicted misophonia severity (adjusted R² = 0.362).

Misophonia was more prevalent and severe in adolescents with migraine and was associated with headache severity and autistic traits. These findings suggest that misophonia may be a sensory feature of adolescent migraine and highlight the need for longitudinal studies to elucidate the common sensory processing pathways linking migraine and misophonia.