ASMR, from Theory to Therapeutics: Exploring the neural mechanism and clinical potential of Autonomous Sensory Meridian Response

Autonomous Sensory Meridian Response (ASMR) is a sensory-affective phenomenon in
which specific auditory cues, such as whispering, brushing, or tapping, elicit pleasant tingling sensations, felt across the scalp and neck in listeners, along with parasympathetic calm. Despite its widespread popularity and self-reported benefits to anxiety, sleep, and pain, its underlying neural mechanisms and therapeutic potential remain relatively underexplored. This thesis develops and empirically tests the Proximity Prediction Hypothesis (PPH), a novel predictive coding model proposing that near-ear auditory cues engage the brain’s Peripersonal Space network, generating top-down expectations of affective touch in ASMR. When these predictions are instantiated, the model predicts beta-band desynchronisation (reflecting sensorimotor disinhibition), gamma-band enhancement (reflecting precision-weighted sensory integration), and a cascade towards parasympathetic calm. Study 1 formulated the PPH theory, integrating evidence from affective touch physiology, Peripersonal Space activation, and interoceptive predictive coding. Illustrative behavioural data (N = 64) confirmed that pleasantness, rather than arousal, drives the likelihood and intensity of ASMR tingling, supporting the model’s valence-based mechanism. Study 2 used cross-modal EEG (N = 64) and MEG (N = 30) experiments to test these predictions empirically; here, ASMR sounds evoked robust beta-band desynchronisation and gamma-band enhancement relative to controls, providing the first cross-modal neurophysiological evidence for ASMR’s oscillatory signature and support for its proposed hierarchical predictive coding cascade. Study 3, a preregistered, two week longitudinal trial in a chronic pain sample (N = 64), demonstrated that daily ASMR exposure significantly reduced fatigue and produced near-significant improvements in pain interference, consistent with affective-autonomic recalibration hypotheses. Together, these studies establish ASMR as a reproducible oscillatory and physiological state arising from predictive simulation of affiliative touch. The findings advance a unified account linking perception, emotion, and bodily regulation, and position ASMR as a scalable, non-pharmacological means of modulating vagal tone, as well as highlighting its potential to improve affective-autonomic balance in chronic pain.