Rhythmic Sensory Stimulation Research Articles

An integrated review of music cognition and rhythmic stimuli in sensorimotor neurocognition and neurorehabilitation.

This work reviews the growing body of interdisciplinary research on music cognition, using biomechanical, kinesiological, clinical, psychosocial, and sociological methods. The review primarily examines the relationship between temporal elements in music and motor responses under varying contexts, with considerable relevance for clinical rehabilitation. After providing an overview of the terminology and approaches pertinent to theories of rhythm and meter from the musical-theoretical and cognitive fields, this review focuses on studies on the effects of rhythmic sensory stimulation on gait, rhythmic cues' effect on the motor system, reactions to rhythmic stimuli attempting to synchronize mobility (i.e., musical embodiment), and the application of rhythm for motor rehabilitation for individuals with Parkinson's disease, stroke, mild cognitive impairment, Alzheimer's disease, and other neurodegenerative or neurotraumatic diseases. This work ultimately bridges the gap between the musical-theoretical and cognitive science fields to facilitate innovative research in which each discipline informs the other.

Altering stimulus timing via fast rhythmic sensory stimulation induces STDP-like recall performance in human episodic memory

Episodic memory provides humans with the ability to mentally travel back to the past,1 where experiences typically involve associations between multimodal information. Forming a memory of the association is thought to be dependent on modification of synaptic connectivity.2,3 Animal studies suggest that the strength of synaptic modification depends on spike timing between pre- and post-synaptic neurons on the order of tens of milliseconds, which is termed "spike-timing-dependent plasticity" (STDP).4 Evidence found in human invitro studies suggests different temporal scales in long-term potentiation (LTP) and depression (LTD), compared with the critical time window of STDP in animals.5,6 In the healthy human brain, STDP-like effects have been shown in the motor cortex, visual perception, and face identity recognition.7,8,9,10,11,12,13 However, evidence in human episodic memory is lacking. We investigated this using rhythmic sensory stimulation to drive visual and auditory cortices at 37.5Hz with four phase offsets. Visual relative to auditory cued recall accuracy was significantly enhanced in the 90° condition when the visual stimulus led at the shortest delay (6.67ms). This pattern was reversed in the 270° condition when the auditory stimulus led at the shortest delay. Within cue modality, recall was enhanced when a stimulus of the corresponding modality led the shortest delay (6.67ms) compared with the longest delay (20ms). Our findings provide evidence for STDP in human episodic memory, which builds an important bridge from invitro studies in animals to human memory behavior.

Cross-modal attentional effects of rhythmic sensory stimulation

Temporal regularities are ubiquitous in our environment. The theory of entrainment posits that the brain can utilize these regularities by synchronizing neural activity with external events, thereby, aligning moments of high neural excitability with expected upcoming stimuli and facilitating perception. Despite numerous accounts reporting entrainment of behavioural and electrophysiological measures, evidence regarding this phenomenon remains mixed, with several recent studies having failed to provide confirmatory evidence. Notably, it is currently unclear whether and for how long the effects of entrainment can persist beyond their initiating stimulus, and whether they remain restricted to the stimulated sensory modality or can cross over to other modalities. Here, we set out to answer these questions by presenting participants with either visual or auditory rhythmic sensory stimulation, followed by a visual or auditory target at six possible time points, either in-phase or out-of-phase relative to the initial stimulus train. Unexpectedly, but in line with several recent studies, we observed no evidence for cyclic fluctuations in performance, despite our design being highly similar to those used in previous demonstrations of sensory entrainment. However, our data revealed a temporally less specific attentional effect, via cross-modally facilitated performance following auditory compared with visual rhythmic stimulation. In addition to a potentially higher salience of auditory rhythms, this could indicate an effect on oscillatory 3-Hz amplitude, resulting in facilitated cognitive control and attention. In summary, our study further challenges the generality of periodic behavioural modulation associated with sensory entrainment, while demonstrating a modality-independent attention effect following auditory rhythmic stimulation.

The efficacy of sensory neural entrainment on acute and chronic pain: A systematic review and meta-analysis.

Changes to the power of neural oscillations in cortical and sub-cortical structures can change pain perception. Rhythmic sensory stimulation is a non-invasive method that can increase power in specific frequencies of neural oscillations. If the stimulation frequency targets those frequencies related to pain perception, such as alpha or theta frequencies, there can be a reduction in perceived pain intensity. Thus, sensory neural entrainment may provide an alternative to pharmacological intervention for acute and chronic pain. This review aimed to identify and critically appraise the evidence on the effectiveness of sensory entrainment methods for pain perception. We undertook a systematic search across Medline, Embase, PsycInfo, Web of Science and Scopus in November 2020 to identify studies investigating the efficacy of sensory entrainment on adults. We assessed studies for their quality using the PRISMA checklist. A random-effects model was used in a meta-analysis to measure the effect of entrainment on pain perception. Our systematic review yielded nine studies fitting the search criteria. Studies investigated the effect of visual and auditory entrainment on pain intensity rating, electrophysiological markers of pain and amount of analgesia needed during surgery. The meta-analysis suggests that alpha (8-13Hz) sensory entrainment is effective for acute pain perception, whereas theta (4-7Hz) entrainment is effective for chronic pain. Although there is heterogeneity in the current evidence, our review highlights the potential use of sensory entrainment to affect acute and chronic pain. Further research is required regarding the timing, duration and frequency of the stimulation to determine the best application for maximum efficacy.

Modelling neural entrainment and its persistence: influence of frequency of stimulation and phase at the stimulus offset

Neural entrainment, the synchronization of brain oscillations to the frequency of an external stimuli, is a key mechanism that shapes perceptual and cognitive processes. Objective. Using simulations, we investigated the dynamics of neural entrainment, particularly the period following the end of the stimulation, since the persistence (reverberation) of neural entrainment may condition future sensory representations based on predictions about stimulus rhythmicity. Methods. Neural entrainment was assessed using a modified Jansen-Rit neural mass model (NMM) of coupled cortical columns, in which the spectral features of the output resembled that of the electroencephalogram (EEG). We evaluated spectro-temporal features of entrainment as a function of the stimulation frequency, the resonant frequency of the neural populations comprising the NMM, and the coupling strength between cortical columns. Furthermore, we tested if the entrainment persistence depended on the phase of the EEG-like oscillation at the time the stimulus ended. Main Results. The entrainment of the column that received the stimulation was maximum when the frequency of the entrainer was within a narrow range around the resonant frequency of the column. When this occurred, entrainment persisted for several cycles after the stimulus terminated, and the propagation of the entrainment to other columns was facilitated. Propagation also depended on the resonant frequency of the second column, and the coupling strength between columns. The duration of the persistence of the entrainment depended on the phase of the neural oscillation at the time the entrainer terminated, such that falling phases (from π/2 to 3π/2 in a sine function) led to longer persistence than rising phases (from 0 to π/2 and 3π/2 to 2π). Significance. The study bridges between models of neural oscillations and empirical electrophysiology, providing insights to the mechanisms underlying neural entrainment and the use of rhythmic sensory stimulation for neuroenhancement.

Investigating the Effects of Auditory and Vibrotactile Rhythmic Sensory Stimulation on Depression: An EEG Pilot Study.

BackgroundMajor depressive disorder (MDD) is a persistent psychiatric condition and one of the leading causes of global disease burden. In a previous study, we investigated the effects of a five-week intervention consisting of rhythmic gamma frequency (30-70 Hz) vibroacoustic stimulation in 20 patients formally diagnosed with MDD. In that study, the findings suggested a significant clinical improvement in depression symptoms as measured using the Montgomery-Asberg Depression Rating Scale (MADRS), with 37% of participants meeting the criteria for clinical response. The goal of the present research was to examine possible changes from baseline to posttreatment in resting-state electroencephalography (EEG) recordings using the same treatment protocol and to characterize basic changes in EEG related to treatment response.Materials and methodsThe study sample consisted of 19 individuals aged 18-70 years with a clinical diagnosis of MDD. The participants were assessed before and after a five-week treatment period, which consisted of listening to an instrumental musical track on a vibroacoustic device, delivering auditory and vibrotactile stimulus in the gamma-band range (30-70 Hz, with particular emphasis on 40 Hz). The primary outcome measure was the change in Montgomery-Asberg Depression Rating Scale (MADRS) from baseline to posttreatment and resting-state EEG.ResultsAnalysis comparing MADRS score at baseline and post-intervention indicated a significant change in the severity of depression symptoms after five weeks (t = 3.9923, df = 18, p = 0.0009). The clinical response rate was 36.85%. Resting-state EEG power analysis revealed a significant increase in occipital alpha power (t = -2.149, df = 18, p = 0.04548), as well as an increase in the prefrontal gamma power of the responders (t = 2.8079, df = 13.431, p = 0.01442).ConclusionsThe results indicate that improvements in MADRS scores after rhythmic sensory stimulation (RSS) were accompanied by an increase in alpha power in the occipital region and an increase in gamma in the prefrontal region, thus suggesting treatment effects on cortical activity in depression. The results of this pilot study will help inform subsequent controlled studies evaluating whether treatment response to vibroacoustic stimulation constitutes a real and replicable reduction of depressive symptoms and to characterize the underlying mechanisms.

Improvement of Gait in Patients with Stroke Using Rhythmic Sensory Stimulation: A Case-Control Study.

Patients with stroke suffer from impaired locomotion, exhibiting unstable walking with increased gait variability. Effects of rhythmic sensory stimulation on unstable gait of patients with chronic stroke are unclear. This study aims to determine the effects of rhythmic sensory stimulation on the gait of patients with chronic stroke. Twenty older adults with stroke and twenty age- and gender-matched healthy controls walked 60 m under four conditions: normal walking with no stimulation, walking with rhythmic auditory stimulation (RAS) through an earphone in the ear, walking with rhythmic somatosensory stimulation (RSS) through a haptic device on the wrist of each participant, and walking with rhythmic combined stimulation (RCS: RAS + RSS). Gait performance in the stroke group significantly improved during walking with RAS, RSS, and RCS compared to that during normal walking (p < 0.008). Gait variability significantly decreased under the RAS, RSS, and RCS conditions compared to that during normal walking (p < 0.008). Rhythmic sensory stimulation is effective in improving the gait of patients with chronic stroke, regardless of the type of rhythmic stimuli, compared to healthy controls. The effect was greater in patients with reduced mobility, assessed by the Rivermead Mobility Index (RMI).

Phase entrainment by periodic stimuli in silico: A quantitative study

We present a quantitative study of phase entrainment by periodic visual stimuli in a biologically inspired neural network. The objective is to understand the neuronal population dynamics that underlie phase entrainment of brain oscillations by external stimuli, which is used for therapeutic treatment in neurological disorders, for example in Parkinsonian tremor. Yet, the neuronal dynamics underpinning such entrainment is not fully understood. Rhythmic sensory stimulation is one way of studying phase synchronisation in the brain. A recent experimental study has reported phase entrainment of brain oscillations during steady state visually evoked potentials (SSVEP), which are scalp electroencephalogram corresponding to periodic stimuli. We have simulated SSVEP-like signals corresponding to periodic pulse input to our in silico model. We have used phase locking values, normalised Shannon entropy and conditional probability as synchronisation indices to show phase synchrony in the neuronal populations. Our experiment demonstrates that the phase synchronisation disappears with jitter in the input inter-pulse intervals, and this would not be the case if the output signal were to be the superposition of the responses to the different input signals. Thus, the phase synchronisation implies entrainment of the network response by the periodic input. Overall, our study shows the plausibility of using biologically inspired in silico models, validated by experimental works, to understand and make testable predictions on brain entrainment as a therapeutic treatment in specific neurological disorders.

No effects of rhythmic visual stimulation on target discrimination: An online alpha entrainment experiment.

Previous research established that rhythmic sensory stimulation can affect subsequent stimulus perception, possibly through ‘entrainment’ of oscillations in the brain. Alpha frequency is a natural target for visual entrainment, because fluctuations in posterior alpha oscillations have been linked to visual target detection or discrimination. On the other hand, alpha oscillations also relate to attentional mechanisms, such as attentional orienting or selection. Previous visual alpha entrainment studies focused on differential processing of targets presented in‐phase with the preceding rhythmic stimulation relative to out‐of‐phase targets (an ‘SOA effect’), putatively related to the phase of entrained neuronal alpha oscillations. Fewer studies probed the consequences of rhythmic alpha stimulation for attention mechanisms related to alpha power. Here, we asked whether alpha stimulation of one hemifield has similar effects on reaction times as we see for increased alpha synchronization in magneto/electroencephalography (M/EEG) studies (i.e., more alpha means impaired processing and functional inhibition). We implemented a task inspired by attention studies, assessing reaction times to ipsilateral vs. contralateral visual targets, with and without concurrent presentation of distractors. Yet, in place of any attention cues, we presented a rhythmic, vs. arrhythmic, alpha‐frequency train of visual flashes to one hemifield, in a large sample size (N = 115) in an online experiment. We found clear evidence that flash train rhythmicity did not impact task performance. We also found that the spatial congruence between the unilateral flash train and the subsequent visual target did impact response times but only in the presence of contralateral distractor stimuli. We discuss implications, limitations and future directions.

No Evidence for Entrainment: Endogenous Gamma Oscillations and Rhythmic Flicker Responses Coexist in Visual Cortex.

Over the past decades, numerous studies have linked cortical gamma oscillations (∼30–100 Hz) to neurocomputational mechanisms. Their functional relevance, however, is still passionately debated. Here, we asked whether endogenous gamma oscillations in the human brain can be entrained by a rhythmic photic drive >50 Hz. Such a noninvasive modulation of endogenous brain rhythms would allow conclusions about their causal involvement in neurocognition. To this end, we systematically investigated oscillatory responses to a rapid sinusoidal flicker in the absence and presence of endogenous gamma oscillations using magnetoencephalography (MEG) in combination with a high-frequency projector. The photic drive produced a robust response over visual cortex to stimulation frequencies of up to 80 Hz. Strong, endogenous gamma oscillations were induced using moving grating stimuli as repeatedly done in previous research. When superimposing the flicker and the gratings, there was no evidence for phase or frequency entrainment of the endogenous gamma oscillations by the photic drive. Unexpectedly, we did not observe an amplification of the flicker response around participants' individual gamma frequencies (IGFs); rather, the magnitude of the response decreased monotonically with increasing frequency. Source reconstruction suggests that the flicker response and the gamma oscillations were produced by separate, coexistent generators in visual cortex. The presented findings challenge the notion that cortical gamma oscillations can be entrained by rhythmic visual stimulation. Instead, the mechanism generating endogenous gamma oscillations seems to be resilient to external perturbation.SIGNIFICANCE STATEMENT We aimed to investigate to what extent ongoing, high-frequency oscillations in the gamma-band (30–100 Hz) in the human brain can be entrained by a visual flicker. Gamma oscillations have long been suggested to coordinate neuronal firing and enable interregional communication. Our results demonstrate that rhythmic visual stimulation cannot hijack the dynamics of ongoing gamma oscillations; rather, the flicker response and the endogenous gamma oscillations coexist in different visual areas. Therefore, while a visual flicker evokes a strong neuronal response even at high frequencies in the gamma-band, it does not entrain endogenous gamma oscillations in visual cortex. This has important implications for interpreting studies investigating the causal and neuroprotective effects of rhythmic sensory stimulation in the gamma-band.

Using fast visual rhythmic stimulation to control inter-hemispheric phase offsets in visual areas

Spike timing dependent plasticity (STDP) is believed to be important for neural communication and plasticity in human episodic memory, but causal evidence is lacking due to technical challenges. Rhythmic sensory stimulation that has been used to investigate causal relations between oscillations and cognition may be able to address this question. The challenge, however, is that the frequency corresponding to the critical time window for STDP is gamma (~40 Hz), yet the application of rhythmic sensory stimulation has been limited primarily to lower frequencies (<30 Hz). It remains unknown whether this method can be applied to precisely control the activation time delay between distant groups of neurons at a millisecond scale. To answer this question and examine the role of STDP in human episodic memory, we simulated the STDP function by controlling the activation time delay between the left and right visual cortices during memory encoding. This was achieved by presenting flickering (37.5 Hz) movie pairs in the left and right visual fields with a phase lag of either 0, 90, 180 or 270°. Participants were asked to memorize the two movies within each pair and the association was later tested. Behavioral results revealed no significant difference in memory performance across conditions with different degrees of gamma phase synchrony. Yet importantly, our study showed for the first time, that oscillatory activity can be driven with a precision of 6.67 ms delay between neuronal groups. Our method hereby provides an approach to investigate relations between precise neuronal timing and cognitive functions.

Sustained neural rhythms reveal endogenous oscillations supporting speech perception.

Rhythmic sensory or electrical stimulation will produce rhythmic brain responses. These rhythmic responses are often interpreted as endogenous neural oscillations aligned (or "entrained") to the stimulus rhythm. However, stimulus-aligned brain responses can also be explained as a sequence of evoked responses, which only appear regular due to the rhythmicity of the stimulus, without necessarily involving underlying neural oscillations. To distinguish evoked responses from true oscillatory activity, we tested whether rhythmic stimulation produces oscillatory responses which continue after the end of the stimulus. Such sustained effects provide evidence for true involvement of neural oscillations. In Experiment 1, we found that rhythmic intelligible, but not unintelligible speech produces oscillatory responses in magnetoencephalography (MEG) which outlast the stimulus at parietal sensors. In Experiment 2, we found that transcranial alternating current stimulation (tACS) leads to rhythmic fluctuations in speech perception outcomes after the end of electrical stimulation. We further report that the phase relation between electroencephalography (EEG) responses and rhythmic intelligible speech can predict the tACS phase that leads to most accurate speech perception. Together, we provide fundamental results for several lines of research-including neural entrainment and tACS-and reveal endogenous neural oscillations as a key underlying principle for speech perception.

Assessing Rhythmic Visual Entrainment and Reinstatement of Brain Oscillations to Modulate Memory Performance.

The human brain’s ability to store information and remember past events is thought to be orchestrated by the synchronization of neuronal oscillations in various frequency bands. A vast amount of research has found that neural oscillations in the theta (∼4–7 Hz) and alpha (∼8–12 Hz) bands play an important role in memory formation. More specifically, it has been suggested that memory performance benefits if the same oscillatory pattern is present during encoding and retrieval. However, the causal relevance of these oscillations is not well understood. Rhythmic sensory stimulation is thought to entrain ongoing brain oscillations and modulate associated functions (e.g., memory formation). In the present study, we used rhythmic visual stimulation at 6 and 10 Hz to experimentally modulate the memory encoding process in a recognition memory task. In addition, we reinstated oscillatory activity from the encoding episode during retrieval, which has been hypothesized to result in memory performance improvements compared to non-reinstated conditions and incongruent reinstatement. Contrary to our hypothesis, we find no effect of neural entrainment during encoding on subsequent memory performance. Likewise, memory retrieval does not benefit from neural reinstatement. The results are discussed with respect to methodological challenges of rhythmic sensory stimulation as a means to alter cognitive processes and induce context-dependent memory effects.

Modulation of gamma oscillations as a possible therapeutic tool for neuropsychiatric diseases: A review and perspective

Gamma oscillations (30–80 Hz) are well-known for their role in cortical signal transmission and cognitive brain functions. Aberrant gamma activity has been observed in various neuropsychiatric disorders, but the clinical potential of restoring gamma oscillations via noninvasive brain stimulation has been widely neglected. Only recently, therapeutic effects of gamma entrainment were documented in mouse models of Alzheimer's dementia (AD) using rhythmic sensory stimulation. In the present review, we first summarize the current status of the research on gamma entrainment in mouse models of AD and human AD patients. Then, we suggest transcranial alternating current stimulation (tACS) as an alternative brain stimulation technique and review the recent literature on the effects of gamma tACS in healthy volunteers and neuropsychiatric diseases to document the efficacy of gamma tACS in improving cognitive functions. We discuss several advantages of tACS compared to rhythmic sensory stimulation for the entrainment of gamma oscillations in the human brain and emphasize the need for more clinical studies applying tACS to drive gamma oscillations and, in turn, to improve cognitive functioning not only in AD but also in patients suffering from other neuropsychiatric disorders.

Retraction: A parallel randomized controlled trial examining the effects of rhythmic sensory stimulation on fibromyalgia symptoms.

Retraction: A parallel randomized controlled trial examining the effects of rhythmic sensory stimulation on fibromyalgia symptoms.

A Pilot Study Investigating the Effect of Music-Based Intervention on Depression and Anhedonia.

This study investigated the effect of a music-based intervention on depression and associated symptoms. Twenty individuals formally diagnosed with Major Depressive Disorder and in a current Major Depressive Episode (11 females and 8 males; aged between 26 and 65 years) undertook a 5 weeks intervention consisting of music listening combined with rhythmic sensory stimulation. Participants listened to a set of designed instrumental music tracks embedded with low-frequency sounds (30–70 Hz). The stimuli were delivered for 30 min, 5 times per week, using a portable consumer device with built-in stereo speakers and a low-frequency transducer, which allowed the low-frequency sounds embedded in the music to be experienced as a mild vibrotactile sensation around the lower back. Changes from baseline to post-intervention in measures of depression symptoms, sleep quality, quality of life, anhedonia, and music-reward processing were assessed with clinician-based assessments as well as self-reports and a monetary incentive behavioral task. The study results indicated that there were significant changes from baseline in measures of depression and associated symptoms, including sleep quality, quality of life, and anhedonia. However, individual differences in treatment response need to be considered. These findings corroborate previous evidence that music-based intervention, when added to standard care, is a promising adjunctive treatment for Major Depressive Disorder, and open new avenues to investigate the effect of music-based therapy to ameliorate anhedonia-specific dysfunction in major depressive disorder and other neuropsychiatric disorders.

A parallel randomized controlled trial examining the effects of rhythmic sensory stimulation on fibromyalgia symptoms.

This double-blind, two-arm parallel randomized controlled trial investigated the effects of gamma-frequency rhythmic sensory stimulation on fibromyalgia. We were interested in whether rhythmic sensory stimulation would promote significant changes in fibromyalgia and associated symptoms, and whether treatment effects would differ between two distinct treatment parameters. Fifty patients with a formal diagnosis of fibromyalgia were randomly assigned to two test groups. One group received vibrotactile stimulation from a continuous sine wave single-frequency stimulation (40 Hz) for 30 minutes, five days per week, over five weeks, concomitant with usual care. The second group completed the same treatment protocol but received a different stimulation, consisting of random and intermittent complex wave gamma-range vibrotactile stimulation. Fibromyalgia symptoms, pain severity and interference, depression symptoms, quality of life and sleep quality were assessed at baseline and post-intervention. Results indicated that there were statistically significant changes from baseline to post-treatment in measures of fibromyalgia symptom severity, pain interference, depression, and sleep quality. However, treatment outcomes did not differ significantly between groups. These findings provide preliminary evidence that gamma-frequency rhythmic vibroacoustic stimulation may decrease fibromyalgia symptoms and ease associated comorbidities, opening new avenues for further investigation of the effects of rhythmic sensory stimulation on chronic pain conditions.

Stimulus-Driven Brain Rhythms within the Alpha Band: The Attentional-Modulation Conundrum.

Two largely independent research lines use rhythmic sensory stimulation to study visual processing. Despite the use of strikingly similar experimental paradigms, they differ crucially in their notion of the stimulus-driven periodic brain responses: one regards them mostly as synchronized (entrained) intrinsic brain rhythms; the other assumes they are predominantly evoked responses [classically termed steady-state responses (SSRs)] that add to the ongoing brain activity. This conceptual difference can produce contradictory predictions about, and interpretations of, experimental outcomes. The effect of spatial attention on brain rhythms in the alpha band (8–13 Hz) is one such instance: alpha-range SSRs have typically been found to increase in power when participants focus their spatial attention on laterally presented stimuli, in line with a gain control of the visual evoked response. In nearly identical experiments, retinotopic decreases in entrained alpha-band power have been reported, in line with the inhibitory function of intrinsic alpha. Here we reconcile these contradictory findings by showing that they result from a small but far-reaching difference between two common approaches to EEG spectral decomposition. In a new analysis of previously published human EEG data, recorded during bilateral rhythmic visual stimulation, we find the typical SSR gain effect when emphasizing stimulus-locked neural activity and the typical retinotopic alpha suppression when focusing on ongoing rhythms. These opposite but parallel effects suggest that spatial attention may bias the neural processing of dynamic visual stimulation via two complementary neural mechanisms.SIGNIFICANCE STATEMENT Attending to a visual stimulus strengthens its representation in visual cortex and leads to a retinotopic suppression of spontaneous alpha rhythms. To further investigate this process, researchers often attempt to phase lock, or entrain, alpha through rhythmic visual stimulation under the assumption that this entrained alpha retains the characteristics of spontaneous alpha. Instead, we show that the part of the brain response that is phase locked to the visual stimulation increased with attention (as do steady-state evoked potentials), while the typical suppression was only present in non-stimulus-locked alpha activity. The opposite signs of these effects suggest that attentional modulation of dynamic visual stimulation relies on two parallel cortical mechanisms—retinotopic alpha suppression and increased temporal tracking.

Sensory Electrical Stimulation Cueing May Reduce Freezing of Gait Episodes in Parkinson's Disease.

Introduction Freezing of gait (FoG) is a movement abnormality that presents with advancing Parkinson's disease (PD) and is one of the most debilitating symptoms of the disease. The mainstay of nonpharmacological management of FoG is typically through external cueing techniques designed to relieve or prevent the freezing episode. Previous work shows that electrical stimulation may prove useful as a gait guidance technique, but further evidence is required. The main objective of this study was to determine whether a “fixed” rhythmic sensory electrical stimulation (sES) cueing strategy would significantly (i) reduce the time taken to complete a walking task and (ii) reduce the number of FoG episodes occurring when performing the task. Methods 9 participants with idiopathic PD performed a self-identified walking task during both control (no cue) and cueing conditions. The self-identified walking task was a home-based daily walking activity, which was known to result in FoG for that person. A trained physiotherapist recorded the time taken to complete the walking task and the number of FoG episodes which occurred during the task. Data were analyzed by paired t-tests for both the time to complete a walking task and the number of FoG episodes occurring. Results sES cueing resulted in a reduction in the time taken to complete a walking task and in the number of FoG episodes occurring during performance of this task by 14.23 ± 11.15% (p=0.009) and 58.28 ± 33.89% (p=0.002), respectively. Conclusions This study shows a positive effect of “fixed” rhythmic sES on the time taken to complete a walking task and on the number of FoG episodes occurring during the task. Our results provide evidence that sES cueing delivered in a “fixed” rhythmic manner has the potential to be an effective cueing mechanism for FoG prevention.

High-density EEG characterization of brain responses to auditory rhythmic stimuli during wakefulness and NREM sleep

Auditory rhythmic sensory stimulation modulates brain oscillations by increasing phase-locking to the temporal structure of the stimuli and by increasing the power of specific frequency bands, resulting in Auditory Steady State Responses (ASSR). The ASSR is altered in different diseases of the central nervous system such as schizophrenia. However, in order to use the ASSR as biological markers for disease states, it needs to be understood how different vigilance states and underlying brain activity affect the ASSR. Here, we compared the effects of auditory rhythmic stimuli on EEG brain activity during wake and NREM sleep, investigated the influence of the presence of dominant sleep rhythms on the ASSR, and delineated the topographical distribution of these modulations. Participants (14 healthy males, 20-33 years) completed on the same day a 60 min nap session and two 30 min wakefulness sessions (before and after the nap). During these sessions, amplitude modulated (AM) white noise auditory stimuli at different frequencies were applied. High-density EEG was continuously recorded and time-frequency analyses were performed to assess ASSR during wakefulness and NREM periods. Our analysis revealed that depending on the electrode location, stimulation frequency applied and window/frequencies analysed the ASSR was significantly modulated by sleep pressure (before and after sleep), vigilance state (wake vs. NREM sleep), and the presence of slow wave activity and sleep spindles. Furthermore, AM stimuli increased spindle activity during NREM sleep but not during wakefulness. Thus, (1) electrode location, sleep history, vigilance state and ongoing brain activity needs to be carefully considered when investigating ASSR and (2) auditory rhythmic stimuli during sleep might represent a powerful tool to boost sleep spindles.