Pilot feasibility study of binaural auditory beats for reducing symptoms of inattention in children and adolescents with attention-deficit/hyperactivity disorder

Role of visual brainwave entrainment on the resting state brainwaves of children with and without attention-deficit/hyperactivity disorder

The relationship between brainwave oscillations and Attention-Deficit/Hyperactivity Disorder (ADHD)-related cognitive challenges is a trending proposition in the field of Cognitive Neuroscience. Studies suggest the role of brainwave oscillations in the symptom expressions of ADHD-diagnosed children. Intervention studies have further suggested the scope of brain stimulation techniques in improving cognition. The current manuscript explored the effect of changes in the brainwaves post-sensory entrainment on cognitive performance of children. We calculated each participant's brainwave difference and ratios of theta, alpha, and beta power after the entrainment sessions. Further, we explored possible correlations between these values and the psychometric scores. The beta resting state showed the strongest association with selective attention performance of all participants. Theta-beta ratio (TBR) showed an inverse correlation with selective attention and working memory performances. The theta frequency was associated with decreased working performance in children without ADHD. Our findings also suggest a predominant role of TBR than the theta-alpha ratio in determining the cognitive performance of children with ADHD. The individual differences in the entrainment reception were attributed to the participant's age, IQ, and their innate baseline frequencies. The implications of our findings can initiate substantiating brainwave-based entrainment sessions as a therapeutic modality to improve cognition among children.

Effects of Fast-Tempo and Binaural Beat Therapy Music during Warm-Up on Repeated Sprint Ability Test Performance among Young Soccer Players

This prospective crossover study aimed to investigate the effect of binaural beat therapy music on soccer player performance. Between July 2023 and December 2023, 45 athletes (31 females/14 males, mean age = 20.47 ± 0.99) wore Bluetooth earphones through which one of the following was given during initial 20 min warm-up exercises before undergoing repeated sprint ability tests: no music/fast-tempo music/fast-tempo music with background binaural beat therapy music. Heart rate change after warm-up exercises/repeated sprint ability (RSA) tests and the time to finish RSA tests were recorded. Despite no significant difference in heart rate increase after warm-up between the two genders regardless of intervention, larger increases after RSA tests were found in males following any of the three interventions (all p < 0.01) with the most notable difference observed after fast-tempo music (p < 0.0001). A significant effect size (r = 0.2) correlated with fast-tempo music during warm-up in either gender. Binaural beat therapy music during warm-up reached a significant effect size only when all participants were considered, suggesting limited benefits.

Potential of binaural beats intervention for improving memory and attention: insights from meta-analysis and systematic review

Binaural beats (BB) entrainment is an auditory perceptual occurrence that exists when two tones of separate frequencies are simultaneously presented to each ear. Research on BB entrainment has gained attention due to its ability to treat various conditions like anxiety, attention-deficit/hyperactivity (ADHD), etc. Even though research on BB entrainment suggests its efficiency in improving cognition among individuals, existing literature indicates mixed results in the cognitive domains of attention and memory. Thus, we conducted meta-analysis to examine the effect of BB intervention on memory and attention, respectively, in the current paper. We further performed a systematic review on the selected studies to report their variables, demographic characteristics of the participants, and outcomes to comprehensively position the research on BB intervention exclusively in the areas of memory and attention. Fifteen studies met our inclusion criteria. Based on 31 effect sizes, the results indicated an overall medium and significant effect size (g = 0.40). Findings from systematic review reveal conflicting results, especially concerning theta and beta's efficacy on memory (recall and recognition tasks) and attention-related tasks. The findings of the current paper add to the growing evidence that BB intervention improves attention and memory in humans. Since the findings suggest a near-moderate effect of BB interventions and mixed results in the systematic review, more research with robust study designs must explore its guiding principle and the expanding role of brainwaves in improving memory and attention in individuals. Such an intervention has important implications in both clinical and non-clinical settings.

Effects of gamma frequency binaural beats on attention and anxiety

Binaural beats (BB) are an auditory phenomenon produced from a combination of two sine waves with slightly different frequencies presented to each ear. Previous research has implicated the role of BBs through brainwave entrainment in potentially giving rise to benefits ranging from enhanced memory and attention to reduced anxiety and stress. Here, we investigated the effect of gamma (40-Hz) BBs on attention using the attention network test (ANT), a previously unused task that assesses three subtypes of attention: Alerting, Orienting, and Executive Control. Fifty-eight healthy adults performed the ANT remotely under the exposure of 340-Hz BBs and a 380-Hz control tone. All completed a rating scale for levels of anxiety before and after each exposure. Performance on the ANT task (reaction time and error rates) between BB and control groups was evaluated using Wilcoxon signed-rank tests. We found no significant differences in Reaction Time (RT), Error Rate (ER), or the efficacy of the Attention Networks (AN) between the experimental and control conditions (p > 0.05). We found no effect of BB on self-rated measures of anxiety. Our findings do not provide evidence for improvement in attention with gamma BB.

Supplementary Information

The online version contains supplementary material available at 10.1007/s12144-023-04681-3.

Binaural beats to entrain the brain? A systematic review of the effects of binaural beat stimulation on brain oscillatory activity, and the implications for psychological research and intervention

Binaural beats are an auditory phenomenon that occurs when two tones of different frequencies, which are presented separately to each ear, elicit the sensation of a third tone oscillating at the difference frequency of the two tones. Binaural beats can be perceived in the frequency range of about 1-30 Hz, a range that coincides with the main human EEG frequency bands. The brainwave entrainment hypothesis, which assumes that external stimulation at a certain frequency leads to the brain's electrocortical activity oscillating at the same frequency, provides the basis for research on the effects of binaural beat stimulation on cognitive and affective states. Studies, particularly in more applied fields, usually refer to neuroscientific research demonstrating that binaural beats elicit systematic changes in EEG parameters. At first glance, however, the available literature on brainwave entrainment effects due to binaural beat stimulation appears to be inconclusive at best. The aim of the present systematic review is, thus, to synthesize existing empirical research. A sample of fourteen published studies met our criteria for inclusion. The results corroborate the impression of an overall inconsistency of empirical outcomes, with five studies reporting results in line with the brainwave entrainment hypothesis, eight studies reporting contradictory, and one mixed results. What is to be noticed is that the fourteen studies included in this review were very heterogeneous regarding the implementation of the binaural beats, the experimental designs, and the EEG parameters and analyses. The methodological heterogeneity in this field of study ultimately limits the comparability of research outcomes. The results of the present systematic review emphasize the need for standardization in study approaches so as to allow for reliable insight into brainwave entrainment effects in the future.

Wired for sound: The effect of sound on the epileptic brain

Sound waves are all around us resonating at audible and inaudible frequencies. Our ability to hear is crucial in providing information and enabling interaction with our environment. The human brain generates neural oscillations or brainwaves through synchronised electrical impulses. In epilepsy these brainwaves can change and form rhythmic bursts of abnormal activity outwardly appearing as seizures. When two waveforms meet, they can superimpose onto one another forming constructive, destructive or mixed interference. The effects of audible soundwaves on epileptic brainwaves has been largely explored with music. The Mozart Sonata for Two Pianos in D major, K. 448 has been examined in a number of studies where significant clinical and methodological heterogeneity exists. These studies report variable reductions in seizures and interictal epileptiform discharges. Treatment effects of Mozart Piano Sonata in C Major, K.545 and other composer interventions have been examined with some musical exposures, for example Hayden's Symphony No. 94 appearing pro-epileptic. The underlying anti-epileptic mechanism of Mozart music is currently unknown, but interesting research is moving away from dopamine reward system theories to computational analysis of specific auditory parameters. In the last decade several studies have examined inaudible low intensity focused ultrasound as a neuro-modulatory intervention in focal epilepsy. Whilst acute and chronic epilepsy rodent model studies have consistently demonstrated an anti-epileptic treatment effect this is yet to be reported within large scale human trials. Inaudible infrasound is of concern since at present there are no reported studies on the effects of exposure to infrasound on epilepsy. Understanding the impact of infrasound on epilepsy is critical in an era where sustainable energies are likely to increase exposure.

Effects of the Alpha, Beta, and Gamma Binaural Beat Brain Stimulation and Short-Term Training on Simultaneously Assessed Visuospatial and Verbal Working Memories, Signal Detection Measures, Response Times, and Intrasubject Response Time Variabilities: A Within-Subject Randomized Placebo-Controlled Clinical Trial

Introduction

Binaural beats (BBs) are phantom sound illusions perceived when two sounds of slightly different frequencies are separately transmitted to the ears. It is suggested that some BB frequencies might entrain the brain and enhance certain cognitive functions such as working memory or attention. Nevertheless, studies in this regard are very scarce, quite controversial, and merely covering a very small portion of this vast field of research (e.g., testing only a few BB frequencies), not to mention adopting some limited methodologies (e.g., no assessment of the loudness of the BB sound, adopting only between-subject analyses, and testing only one perceptual modality). Hence, we aimed to assess the potential effects of alpha, beta, and gamma BBs on cognitive-behavioral parameters of working memory and attention examined simultaneously in two different modalities (visuospatial and auditory-verbal).

Methods

This within-subject five-arm randomized placebo-controlled clinical trial included 155 trials in 31 healthy right-handed subjects (17 women, 14 men, 30.84 ± 6.16 years old). Each subject listened to 8-minute sessions of 10 Hz, 16 Hz, and 40 Hz binaural beats versus 240 Hz pure tone and silence (in random orders). In each 8-minute block, they played a dual 2-back task with feedback enabled. Their cognitive-behavioral parameters (working memory capacities, signal detection measures (hit rate, false alarm rate, sensitivity, and response bias), and reaction speed measures (response time and intrasubject response time variability)) were calculated. The effects of the sound interventions and short-term training on these working memory and attention measures were assessed statistically using mixed-model linear regressions, repeated-measures ANOVAs and ANCOVAs, Bonferroni post hoc tests, and one-sample t-tests (α = 0.05).

Results

The following are some major statistically significant findings (P ≤ 0.05): In the visuospatial modality, the 10 Hz BB reduced the response time and intrasubject response time variability and reduced the extent of decline over time in the case of visuospatial working memory, sensitivity, and hit rate. In the auditory-verbal modality, the 10 Hz intervention reduced the hit rate, false alarm rate, and sensitivity. The 10 Hz intervention also caused the lowest intermodality discrepancies in hit rates and false alarm rates, the highest response time discrepancies, and negative discrepancies in working memories and sensitivities (indicating the superiority of the visuospatial modality). The response biases tended to be liberal-to-neutral in the verbal modality and rather conservative in the visuospatial modality. Reactions were faster in the visuospatial modality than the auditory-verbal one, while the intrasubject variability of reaction times was smaller in the auditory-verbal modality. Short-term training can increase the hit rate, working memory, and sensitivity and can decrease the false alarm rate and response time. Aging and reduced sound intervention volume may slow down responses and increase the intrasubject variability of response time. Faster reactions might be correlated with greater hit rates, working memories, and sensitivities and also with lower false alarm rates.

Conclusions

The 8-minute alpha-band binaural beat entrainment may have a few, slight enhancing effects within the visuospatial modality, but not in both modalities combined. Short-term training can improve working memory and some cognitive parameters of attention. Some BB interventions can affect the intermodality discrepancies. There may be differences between the two modalities in terms of the response speeds and intrasubject response time variabilities. Aging can slow down the response, while increasing the volume of audio interventions may accelerate it.

The effects of music & auditory beat stimulation on anxiety: A randomized clinical trial

Background and objectives

Music and auditory beat stimulation (ABS) in the theta frequency range (4–7 Hz) are sound-based anxiety treatments that have been independently investigated in prior studies. Here, the anxiety-reducing potential of calm music combined with theta ABS was examined in a large sample of participants.

Methods

An open-label randomized controlled trial was conducted with participants taking anxiolytics (n = 163). Participants were randomly assigned using the Qualtrics randomizer algorithm, to a single session of sound-based treatment in one of four parallel arms: combined (music & ABS; n = 39), music-alone (n = 36), ABS-alone (n = 41), or pink noise (control; n = 47). Pre- and post-intervention somatic and cognitive state anxiety measures were collected along with trait anxiety, personality measures and musical preferences. The study was completed online using a custom application.

Results

Based on trait anxiety scores participants were separated into moderate and high trait anxiety sub-groups. Among participants with moderate trait anxiety, we observed reductions in somatic anxiety that were greater in combined and music-alone conditions than in the pink noise condition; and reductions in cognitive state anxiety that were greater in the combined condition than in the music-alone, ABS-alone, and pink noise conditions. While we also observed reductions in somatic and cognitive state anxiety in participants with high trait anxiety, the conditions were not well differentiated.

Conclusions

Sound-based treatments are effective in reducing somatic and cognitive state anxiety. For participants with moderate trait anxiety, combined conditions were most efficacious.

Binaural sound therapy for tinnitus treatment: A psychometric and neurophysiological evaluation

INTRODUCTION

Tinnitus is an annoying buzz that manifests itself in many ways. In addition, it can provoke anxiety, stress, depression, and fatigue. The acoustic therapies have become the most commonly applied treatment for tinnitus, either self-administered or clinically prescribed. Binaural Sound Therapy (BST) and Music Therapy (MT) aim to reverse the neuroplasticity phenomenon related to tinnitus by adequately stimulating the auditory path-way. The goal of this research is to evaluate the feasibility of applying BST for tinnitus treatment by comparing its effect with MT effect.

MATERIALS AND METHODS

34 patients with tinnitus from 29 to 60 years were informed about the experimental procedure and consented their participation. Patients were divided into two groups: 1) MT and 2) BST. They applied their sound-based treatment for one hour every day along eight weeks. Each treatment was adjusted to Hearing Loss (HL) and tinnitus characteristics of each participant. To record EEG data, a bio-signal amplifier with sixteen EEG channels was used. The system recorded data at a sampling frequency of 256 Hz within a bandwidth between 0.1 and 100 Hz.

RESULTS

The questionnaire-monitoring reported that MT increased tinnitus perception in 30% of the patients, and increased anxiety and stress in 8% of them. Regarding EEG-monitoring, major neural synchronicity over the frontal lobe was found after the treatment. In the case of BST reduced stress in 23% of patients. Additionally, BST reduced tinnitus perception similar to MT (15% of patients). With respect to EEG-monitoring, slightly major neural synchronicity over the right frontal lobe was found after the treatment.

CONCLUSIONS

MT should be applied with caution since it could be worsening the tinnitus sufferer condition. On the other hand, BST is recommended for tinnitus sufferers who have side effects concerning stress but no anxiety.

Understanding the neurological mechanism involved in enhanced memory recall task following binaural beat: a pilot study

Binaural beat (BB) is a promising technique for memory improvement in elderly or people with neurological conditions. However, the related modulation of cortical networks followed by behavioral changes has not been investigated. The objective of this study is to establish a relationship between BB oscillatory brain activity evoked by stimulation and a behavioral response in a short term memory task. Three Groups A, B, and C of 20 participants each received alpha (10 Hz), beta (14 Hz), and gamma (30 Hz) BB, respectively, for 15 min. Their EEG was recorded in pre, during, and post BB states. Participants performed a digit span test before and after a BB session. A significant increase in the cognitive score was found only for Group A while a significant decrease in reaction time was noted for Groups A and C. Group A had a significant decrease of theta and increase of alpha power, and a significant increase of theta and decrease of gamma imaginary coherence (ICH) post BB. Group C had a significant increase in theta and gamma power accompanied by the increase of theta and gamma ICH post BB. The effectiveness of BB depends on the frequency of stimulation. A putative neural mechanism involves an increase in theta ICH in parieto-frontal and interhemispheric frontal networks.

A randomized controlled study examining a novel binaural beat technique for treatment of preoperative anxiety in a group of women undergoing elective caesarean section

IMPORTANCE

Attention is being focused on improving mothers' positive experiences of childbirth while reducing the negative ones. Cesarean section is a known factor able to increase maternal anxiety.

OBJECTIVE

To determine whether a new binaural beat-based technique can reduce the preoperative discomfort of the elective surgical patient.

METHODS

Prospective, randomized double-blind controlled study: 60 women scheduled to undergo elective cesarean section. Women with a low risk pregnancy were recruited and enrolled at the time of the "37 weeks" visit. Exclusion criteria were: psychiatric disorders, neurological impairment, epilepsy, deafness, use of drugs/alcohol during pregnancy, insufficient reading level. Participants will be contestually allocated to one of three groups according to a predetermined computer-generated random sequence: (1) "binaural" group, (2) "normal music" group, and (3) "control" group. Participants of groups 1 and 2 will be unaware of the type of audio heard.

INTERVENTION

According to the allocation arm, participants were asked to listen an engineered audio track (binaural beat arm) created with the novel algorithm "Dynamic Spectrum Phase Shift" (DMSPS), or an identical soundtrack without DMSPS in it (music arm), or no specific intervention, representing standard practice. The feeling of anxiety has been measured by the State-Trait Anxiety Inventory (STAI-Y) questionnaire.Conclusions and Relevance: Binaural beat audio created with DMSPS algorithm provides superior changes in reported anxiety in comparison to normal music and above all to standard care.This technique does not need extra staff or extra staying time for the patients, so it could be a cost-effective way to manage preoperative anxiety in women undergoing elective cesarean section, with a potential impact to the mother's positive experiences and care of the newborn. The EudraCT number: 2019-000743-27.

The effect of binaural beat stimulation on sustained attention

Binaural beats have been used as a way of modifying cognition via auditory stimulation. A recent meta-analysis suggests that binaural beat stimulation can have a positive effect on attention (Garcia-Argibay et al., Psychologische Forschung 83:1124-1136, 2019a, Psychological Research Psychologische Forschung 83:357-372, 2019b), with the sample-weighted average effect size being about .58. This is an intriguing and potentially useful finding, both theoretically and practically. In this study, we focus on sustained attention. We delivered beta-frequency (16 Hz) binaural beat stimulation during a sustained attention task. In "Experiment 1", reaction times were faster under beat stimulation than control stimulation in a between-subjects design. However, the effect was modest in magnitude, and model comparisons using Bayes Factors were indiscriminate between including and excluding the effect from the model. We followed this initial experiment with two concurrently administered follow-up experiments. In "Experiment 2", we added thought probes to measure any changes in task engagement associated with binaural beat stimulation. "Experiment 2" revealed a different effect from "Experiment 1": participants in the binaural beat condition exhibited a shallower vigilance decrement. However, the beat stimulation did not affect the thought probes responses. Combining data across the two experiments indicated rather strong evidence against the hypothesis that beta-frequency binaural beats can augment sustained attention, either via a general speeding of responding or a mitigation of the vigilance decrement. Finally, in "Experiment 3", we investigated whether pupillary measures of arousal and/or task engagement would be affected by binaural beat stimulation. There was no evidence for such effects. Overall, we did not observe any consistent evidence that binaural beat stimulation can augment sustained attention or its subjective and physiological correlates.

Reduced pain and analgesic use after acoustic binaural beats therapy in chronic pain - A double-blind randomized control cross-over trial

BACKGROUND

Binaural Beats (BB) consist of two artificial acoustic stimuli with different frequency, presented simultaneously but independently to each ear. The human brain perceives and synchronizes to this frequency difference (entrainment). Aim of this study was to test the hypothesis that brain entrainment to a lower function rhythm, with BB application, can decrease pain perception and analgesic medication use, in chronic pain patients.

METHODS

In a double blind, randomized, cross-over trial, BB at 5Hz (theta rhythm) were applied for 30 minutes, under simultaneous electroencephalogram recordings, followed by liberal, on demand use by chronic pain patients for a week, compared to sham stimulation (SS). Pain as the main outcome (numeric scale, NRS), stress (STAI) and medication usage (defined daily doses, DDD) were assessed at baseline, 30 minutes and week's end.

RESULTS

Perceived pain (NRS) was significantly reduced in BB intervention (5.6±2.3 to 3.4±2.6, p<0.001), compared to SS (5.2±2.1 to 4.8±2.3, p=0.78), during the first 30-minute phase, as well as at the week's end (to 3.9±2.5 compared to 5.5±2.6 respectively, p<0.001). The mean EEG theta power at 5Hz was significantly increased only during BB application. Stress was significantly reduced at 30 minutes in both interventions but remained reduced only in the BB group at the week's end. Analgesic medication consumption (DDD, g) during the week was significantly less in the BB intervention (3.9±3.7 vs. 4.6±4.1, p<0.05), while reporting equal to SS mean levels of pain.

CONCLUSIONS

Acoustic BB reduced pain intensity, stress and analgesic use, compared to SS, in chronic pain patients.

SIGNIFICANCE

This study provides evidence that theta rhythm binaural beats can alleviate pain intensity, both after a brief 30 minute and a longer one week on-demand intervention. The subsequent significant reduction in analgesic medication consumption in chronic pain patients' daily living could offer a valuable tool, augmenting the effect of existing pain therapies.

The Effects of Binaural and Monoaural Beat Stimulation on Cognitive Functioning in Subjects with Different Levels of Emotionality

Today, binaural and monaural beats are offered over the Internet or by mental health institutes to improve wellbeing or cognitive functioning. This improvement is explained by the assumption that the brain adapts its brainwave frequency to the frequency of the auditory beat. The present study examined the effects of binaural and monaural beat stimulation on attention and working memory in high and low emotional participants. A group of 24 participants (16 females, 8 males) between 19 and 31 years old (M = 22.33, SD = 3.42) performed a Flanker task to measure attention and a Klingberg task to measure working memory while listening to white noise (WN), 40 Hz gamma binaural beat (BB) and 40 Hz gamma monaural beat (MB). Speed of performance on all three levels of difficulty of the Flanker attention task was faster under the BB and MB condition than under WN. No differences were found between BB and MB conditions. With respect to the quality of performance on the Flanker attention task and the Klingberg working memory task no significant differences under the WN, MB, and BB condition were found. Finally, as participants with low or high emotionality did not respond differently to BB and MB under any of the conditions, effects of BB and MB seem similar in high and low emotional participants. The present study supports the notion that faster attention processing may equally be attributed to the influence of BB and MB. Further research is recommended to gain more insight in the role of factors such as duration of stimulation of BB and MB, frequency range, most appropriate carrier tones, and the role of personality traits.

40-Hz Binaural beats enhance training to mitigate the attentional blink

This study investigated whether binaural beat stimulation could accelerate the training outcome in an attentional blink (AB) task. The AB refers to the lapse in detecting a target T2 in rapid serial visual presentation (RSVP) after the identification of a preceding target T1. Binaural beats (BB) are assumed to entrain neural oscillations and support cognitive function. Participants were assigned into two groups and presented with BB sounds while performing the AB task on three subsequent days in a cross-over design. Group A was presented with 40-Hz BB during the first day and 16 Hz during the second day, while the order of beat frequencies was reversed in Group B. No sound was presented on the third day. MEG recordings confirmed a strong entrainment of gamma oscillations during 40-Hz BB stimulation and smaller gamma entrainment with 16-Hz BB. The rhythm of the visual stimulation elicited 10-Hz oscillations in occipital MEG sensors which were of similar magnitude for both BB frequencies. The AB performance did not increase within a session. However, participants improved between sessions, with overall improvement equal in both groups. Group A improved more after the first day than the second day. In contrast, group B gained more from the 40 Hz stimulation on the second day than from 16-Hz stimulation on the first day. Taken together, 40-Hz BB stimulation during training accelerates the training outcome. The improvement becomes evident not immediately, but after consolidation during sleep. Therefore, auditory beats stimulation is a promising method of non-invasive brain stimulation for enhancing training and learning which is well-suited to rehabilitation training.

Temperament, Executive Functioning, and Anxiety in School-Age Children Who Stutter

The purpose of this study was to examine temperament dimensions, executive functioning ability, and anxiety levels in school-age children who stutter and their non-stuttering peers. Participants were 100 Portuguese children aged 7 to 12 years (M = 9.13; SD = 1.70), including 50 children who stutter and 50 children who do not stutter. Analyses, which were performed separately for younger and older participants, sought to identify correlations between key variables. Temperament was evaluated through a parent questionnaire, executive functioning was evaluated through children’s responses on a performance test, and anxiety level was assessed through a self-perception scale. On the temperament measure, comparisons between children who stutter and their non-stuttering peers revealed that older children who stutter exhibited significantly higher scores on the Anger/Frustration, Impulsivity, and Sadness subscales, and lower averages on the Attention/Focusing, Perceptual sensitivity, and Soothability/Falling Reactivity subscales. On the executive functioning task, comparisons revealed that the group of younger children who stutter exhibited significantly higher average execution times than their non-stuttering peers. There were no statistically significant differences in anxiety between children who stutter and children who do not stutter, and there were no statistically significant correlations between temperament factors and measures of executive functioning. Children who stutter experienced lower ability to orient attention and greater emotional reactivity compared with their non-stuttering peers. Significant correlations were found between executive functioning and age and among the temperament factors themselves. These results, which support the need for a multidimensional view of stuttering, were interpreted in the context of the Dual Diathesis – Stressor model. Findings indicate that temperament and executive functioning abilities may contribute to the development of stuttering.

Efficacy of binaural auditory beats in cognition, anxiety, and pain perception: a meta-analysis

Binaural auditory beats are a perceptual phenomenon that occurs when presenting separately to each ear two tones that slightly differ in their frequency. It has been suggested that binaural beats can influence cognition and mental states among others. The objective of this meta-analysis was to study the effect of binaural beats on memory, attention, anxiety, and analgesia. Twenty-two studies met our inclusion criteria for this meta-analysis. The results, based on 35 effect sizes, showed an overall medium, significant, consistent effect size (g = 0.45). Meta-regression results indicated that it does not seem to be necessary to mask binaural beats with white noise or pink noise in terms of effectiveness, obtaining similar effects with unmasked binaural beats. Moreover, the findings suggest that binaural-beat exposure before, and before and during the task produces superior results than exposure during the task. Time under exposure contributed significantly to the model indicating that longer periods are advisable to ensure maximum effectiveness. Our meta-analysis adds to the growing evidence that binaural-beat exposure is an effective way to affect cognition over and above reducing anxiety levels and the perception of pain without prior training, and that the direction and the magnitude of the effect depends upon the frequency used, time under exposure, and the moment in which the exposure takes place.

The Impact of Monaural Beat Stimulation on Anxiety and Cognition

Application of auditory beat stimulation has been speculated to provide a promising new tool with which to alleviate symptoms of anxiety and to enhance cognition. In spite of reportedly similar EEG effects of binaural and monaural beats, data on behavioral effects of monaural beats are still lacking. Therefore, we examined the impact of monaural beat stimulation on anxiety, mood and memory performance. We aimed to target states related to anxiety levels and general well-being, in addition to long-term and working memory processes, using monaural beats within the range of main cortical rhythms. Theta (6 Hz), alpha (10 Hz) and gamma (40 Hz) beat frequencies, as well as a control stimulus were applied to healthy participants for 5 min. After each stimulation period, participants were asked to evaluate their current mood state and to perform cognitive tasks examining long-term and working memory processes, in addition to a vigilance task. Monaural beat stimulation was found to reduce state anxiety. When evaluating responses for the individual beat frequencies, positive effects on state anxiety were observed for all monaural beat conditions compared to control stimulation. Our results indicate a role for monaural beat stimulation in modulating state anxiety and are in line with previous studies reporting anxiety-reducing effects of auditory beat stimulation.

Auditory beat stimulation and its effects on cognition and mood States

Auditory beat stimulation may be a promising new tool for the manipulation of cognitive processes and the modulation of mood states. Here, we aim to review the literature examining the most current applications of auditory beat stimulation and its targets. We give a brief overview of research on auditory steady-state responses and its relationship to auditory beat stimulation (ABS). We have summarized relevant studies investigating the neurophysiological changes related to ABS and how they impact upon the design of appropriate stimulation protocols. Focusing on binaural-beat stimulation, we then discuss the role of monaural- and binaural-beat frequencies in cognition and mood states, in addition to their efficacy in targeting disease symptoms. We aim to highlight important points concerning stimulation parameters and try to address why there are often contradictory findings with regard to the outcomes of ABS.

A normative study of the Children's Color Trails Test (CCTT) in the Cypriot population

BACKGROUND

The Children's Color Trails Test (CCTT) is a neuropsychological test that measures attention, divided attention, and speed of mental processing. It has been increasingly used in the assessment of children in cross-cultural environments for neurological and psychiatric disorders such as seizures and closed head injuries, learning and/or language disabilities, attention deficit/hyperactivity disorder, children with manganese exposure, and children diagnosed with HIV virus. However, there is a paucity of studies presenting normative data. The aim of the present study was to provide normative data for the CCTT in the Cypriot population.

METHODS

A total of 709 native Cypriot children aged 7-16 years, recruited from various public schools across the island, took part in the study. Exclusion criteria involved the existence of neurological, psychiatric, cardiological, and metabolic diseases, premature birth, history of maternal alcohol and drug abuse during pregnancy, low birth weight, hearing loss, visual problems, native language other than Greek, and abnormality in fine-motor movements.

RESULTS

Age and gender were found to be important factors for the interpretation of scores in all CCTT variables. Older children required less time and exhibited fewer errors, near misses, and prompts compared to younger children. There was a consistent pattern of a 3-4 seconds improvement (less time in seconds) in the CCTT completion time as age increased.

CONCLUSIONS

CCTT is a promising tool for the measurement of attention in the native Cypriot population. Further research is needed in children diagnosed with various neurological and psychiatric diseases in order to estimate validity of the CCTT in clinical populations.