Binaural Beat Technology in Humans: A Pilot Study To Assess Psychologic and Physiologic Effects

Investigating the effectiveness of music therapy combined with binaural beats on chronic tinnitus: A randomized controlled trial

BACKGROUND

Binaural beat stimulation (BBS) involve presenting two sinusoidal waves with specific frequency differences to induce neural changes in the brain, often used for mental state induction and symptom reduction. However, there are limited studies on its effectiveness for tinnitus. This study aimed to assess the effectiveness of combining binaural beats with music containing nature sounds for chronic tinnitus.

METHODS

A total of 30 men, aged 45.87 on average (SD = 8.09), who had chronic tinnitus and symmetrical mild to moderate hearing loss, were included in this study. The participants were randomly assigned to two groups: MT group (Music therapy; n = 15), which received relaxing music containing the sound of sea waves, and MT + BBS group (Music therapy plus binaural beats; n = 15), which received the same music combined with alpha frequency (8 Hz) binaural beats. The therapy sessions were conducted twice a day for 15 min, over a period of 4 weeks. Outcome measures, including the Tinnitus Handicap Inventory (THI), Tinnitus Functional Index (TFI), Hospital Anxiety and Depression Scale (HADS), Visual Analog Scale (VAS) and the pitch and loudness of tinnitus were administered before, immediately after, and during the three-month follow-up period.

RESULTS

The findings revealed improvements in loudness and annoyance VAS, as well as THI total and all subscale scores in both groups (p < 0.001). Additionally, TFI total score showed improvement in both groups (MT: p = 0.001; MT + BBS: p < 0.001) except for the sense of control subscale in both groups and the cognitive subscale in the MT group after the treatment and during the three-month follow-up period. Furthermore, both groups exhibited a decrease in scores for both subscales of HADS. However, there were no significant differences between the two groups in any of the measurement outcomes (p > 0.05), except for the emotional subscale scores of TFI (p = 0.049) and the functional subscale scores of THI (p = 0.034). In other words, during the follow-up period, the MT + BBS group exhibited lower scores in these two subscales compared to the MT group.

CONCLUSION

Although our study failed to demonstrate the superiority of combining binaural beats with music, both groups experienced significant improvements. This suggest that there are potential benefits to be gained from these types of stimuli. Given the sustained effect of both methods and the even greater improvements in follow-up observed in the binaural beats group for some scales, it seems that the changes in neural response and brain waves caused by our stimulations are persistent. This necessitates further research involving brain mapping, especially with longer follow-up durations.

Comparing the Effectiveness of Cognitive Rehabilitation and Binaural Beats on Craving and Comorbidities of Sexual Hyperactivity: A Pilot, Exploratory Quasi-Experimental Study

Sexual hyperactivity, often linked with substantial psychological and social disturbances, remains under-researched, particularly in contexts like Iran where cultural and social norms may influence the reporting and treatment of such conditions. This study explores the therapeutic potential of cognitive rehabilitation (CR) and binaural beats (BB) in addressing this issue. The primary objective was to compare the effectiveness of CR and BB in reducing symptoms of sexual hyperactivity and associated comorbid conditions, with a focus on fluctuations in sexual desire and overall mental health. Utilizing a quasi-experimental design, the study involved pretest, posttest, and follow-up assessments to evaluate the interventions' impacts. Recruitment through social media yielded 45 participants from a larger pool, who were then assigned to either the CR group, the BB group, or a control group. The CR and BB interventions were administered over a period of 10 sessions, each lasting 20 min, 3 times a week. Significant improvements were observed in both intervention groups compared to the control group. The CR group showed a marked reduction in Sexual Addiction Screening Test (SAST) scores from an initial average of 24.87 to 6.80 at follow-up, indicating a reduction in symptoms of sexual hyperactivity. The BB group also showed improvement, with SAST scores decreasing from 19.93 to 9.57. In terms of mental health comorbidities, the Depression, Anxiety, and Stress Scale (DASS-21) scores decreased notably in the CR group from a baseline of 8.53 to 3.07 post-intervention, and in the BB group from 10.33 to 5.80. Both interventions showed similar effectiveness in reducing anxiety and stress, with no statistically significant differences between the groups for most of the outcomes studied, affirming their potential for clinical application.

Outcome measures of brainwave entrainment using delta wave stimulation in individuals with tinnitus having normal hearing sensitivity

OBJECTIVE

The current study aimed to evaluate the efficacy of delta frequency binaural beats stimulation in treatment of individuals with tinnitus having normal hearing sensitivity.

METHOD

Twenty-four individuals who reported bothersome tinnitus in the presence of clinically normal hearing were grouped into two (I and II). The group was provided with delta frequency binaural beats and II was provided with white noise stimulation (both of 20 min duration) for 30 days. Post 30 days, the re-assessment of tinnitus handicap, depression, anxiety, and quality of life parameters were performed and compared with that of pre-treatment scores.

RESULTS

A considerable reduction of tinnitus handicap scores, depression and anxiety levels were observed for both the groups, except for the quality-of-life parameters. However, few of the participants showed limited or negligible improvement post-treatment. On comparison of reduction of scores observed across the groups, there was a higher reduction of scores observed for group I when compared to group II.

CONCLUSION

The current study was an initial attempt to study the efficacy of binaural beats in treatment of individuals with tinnitus having normal hearing. Apart from a few individuals, the delta wave stimulation acted as a helpful tool in improving tinnitus borne distress symptoms in such patients with normal hearing. The results of the present study put forward the scope of adapting binaural beats stimulation for the treatment of individuals presenting with tinnitus having normal hearing sensitivity. This technique could be adopted into clinical practice after extensive research involving an extended treatment duration on a larger population.

Examining the effects of binaural beat music on sleep quality, heart rate variability, and depression in older people with poor sleep quality in a long-term care institution: A randomized controlled trial

OBJECTIVE

This study aimed to examine the effects of binaural beat music (BBM) on sleep quality, heart rate variability, and depression in older people with poor sleep quality in a long-term care institution.

METHODS

A single-blind randomized controlled trial design was employed, and 64 older participants with poor sleep quality were recruited from a long-term care institution in Taiwan. Participants were randomized into the BBM group or control group and received 14 days of intervention. During the intervention period, participants in the experimental group listened to 20 min of Taiwanese Hokkien oldies embedded with BBM once in the morning and afternoon three times a week. Participants in the control group only listened to Taiwanese Hokkien oldies. Questionnaires and heart rate variability analysis were used to assess participants' sleep quality, heart rate variability, and depressive symptoms.

RESULTS

Significant improvements were observed in sleep quality, along with an increase in heart rate variability means of heart rate and normal sinus beats, and a decrease in low-frequency normalized units and depression severity in the BBM group after the intervention. In the control group, effects on sleep quality were inconsistent, heart rate variability showed significant improvements in some autonomic nervous function regulation, and depression severity was significantly decreased. Furthermore, the BBM group showed a significant improvement in sleep quality and a significant reduction in sympathetic nervous activity compared with the control group.

CONCLUSION

This study demonstrates that 14 days of BBM intervention, a non-invasive intervention, could improve sleep quality and depression in older people with poor sleep quality in long-term care institutions. Geriatr Gerontol Int 2024; 24: 297-304.

Effects of inaudible binaural beats on visuospatial memory

OBJECTIVES

Binaural beats are auditory beat stimulation that produces sounds and induces a specific state of brain wave based on the difference in the frequency of stimulation. This study aimed to investigate the effects of inaudible binaural beats on visuospatial memory at 18 000 Hz reference and 10 Hz difference frequencies.

METHODS

Eighteen adult subjects in their twenties were enrolled, including 12 males (mean age: 23.8 ± 1.2) and 6 females (mean age: 22.8 ± 0.8). An auditory stimulator providing 10 Hz binaural beats stimulation via 18 000 Hz to the left and 18 010 Hz to the right ears was used. The experiment consisted of two 5-min phases, including a rest phase and a task phase involving task performance without (Task-only) and with binaural beats stimulation (Task+BB). A 3-back task was used to measure visuospatial memory. Cognitive ability measured by task performance (accuracy and reaction time) with and without binaural beats, as well as variations in alpha power across different brain domains, were compared using paired t-tests.

RESULTS

Compared to the Task-only condition, the Task+BB condition had significantly higher accuracy and significantly shorter reaction time. The electroencephalogram analysis showed that the reduction level in alpha power for the task performance under the Task+BB condition was significantly lower in all brain areas except the frontal, compared to that under the Task-only condition.

CONCLUSION

The significance of this study lies in having verified the independent effects of binaural beats stimulation without any auditory influence, based on visuospatial memory.

Virtually Augmented Self-Hypnosis in Peripheral Vascular Intervention: A Randomized Controlled Trial

PURPOSE

Hypnosis is useful for diminishing distress during medical procedures. This study investigated the efficacy of virtually augmented self-hypnosis as an adjunctive non-pharmacological method for procedural pain and anxiety relief during endovascular interventions (EVI).

METHODS

We compared an immersive distraction experience (clinicaltrials.gov identifier NCT04561596) featuring virtual reality (VR) using a head-mounted display versus treatment as usual (TAU). Patients followed the "Aqua" module (Oncomfort™) consisting of a scuba dive and breathing exercises. They experienced a self-induced dissociative state similar to clinical hypnosis without direct intervention of a professional. Enrollment followed a 1:1 randomized open study (VR or TAU). Patients' feelings were evaluated just before and after the procedure, and 3 months following intervention. Anxiety was evaluated using the State Trait Anxiety Inventory (STAI) and pain (sensory, emotional, and memory) with a visual analogue scale (VAS).

RESULTS

This study included 100 patients. Mean anxiety (pre-post) was significantly reduced within groups and between groups (difference of 4.2 points, p = 0.016). The percentage of responders to anxiety lowering were 76 and 46% for VR and TAU, respectively (p = 0.004). The two groups did not significantly differ in mean sensory-intensity and affective emotional pain (pre-post) using VAS, in negative memories concerning remembered pain at 3 months (difference > 1 from immediate post-procedural reported pain intensity), mean procedural time, or the need for analgesic or sedative drugs.

CONCLUSIONS

VR self-hypnosis has the potential to improve the management of patients' distress during radiological procedures. It is safe and effective for reducing anxiety during EVI.

An increase in the auditory steady-state response amplitudes after a period of listening to binaural beat stimuli in tinnitus patients: a pilot study

Background

Tinnitus impact on persons’ lifestyle, function, and emotion is of significant importance that has been the leader for conducting an increasing amount of research in the field of tinnitus pathophysiology, assessment, and management. Binaural beats (BB) are one of acoustic neuromodulation approaches used in psychological disorders, such as distress and anxiety. Thus, we hypothesized that binaural beat could be helpful in the relief of tinnitus distress and annoyance.

Methods

Seventeen chronic tinnitus subjects participated in this quasi-experimental (quantitative research) study. In this study, the effect of binaural beat stimuli was evaluated subjectively using the tinnitus handicap inventory (THI) scores, the visual analog scale for loudness and annoyance (VAS_L, VAS_A), and objectively by the 40-Hz ASSR after 1 month of listening to binaural beats, and the correlation between these two assessments was evaluated.

Results

After 1 month of binaural beat stimuli listening, all of the subjective findings were significantly improved, and the amplitude of 40-Hz ASSR was increased in the right auditory and anterior frontal regions at 2000-Hz carrier frequency. Besides, there was a high correlation between the decreasing of the subjective scores with the rising of the amplitude of 40-Hz ASSR.

Conclusion

The use of binaural beat as an acoustic neuromodulation method for tinnitus management may be recommended according to the current study findings. However, more investigations on the effectiveness supported by data from controlled clinical trials and more correlations with ASSR alteration are highly suggested.

The effect of alpha binaural beat music on orthodontic pain after initial archwire placement: A randomized controlled trial

OBJECTIVE

The objective of this article was to evaluate the effect of alpha binaural beat music on pain level after initial placement of a maxillary fixed appliance, compared to music without binaural beats (placebo) and no music (control).

METHODS

60 patients undergoing maxillary fixed orthodontic appliance and initial archwire placement were randomly allocated into the three aforementioned groups. The pain level experienced was monitored for the following seven days, using the short-form McGill pain questionnaire (SF-MPQ).

RESULTS / DESCRIPTORS

Intensity of both sensory and psychological aspects of pain reduced significantly in the binaural beat music (BBM) group, compared to the control, after the 5th day. Statistically significant lower affective and total pain scores were also found on day 6 for the placebo group, compared to the control. Present Pain Intensity (PPI): Statistically significant lower scores were found between the BBM group and the control group from days 3 to 7. Statistically significant lower scores were also found between the placebo and the control groups on days 4, 5 and 6. Visual Analog Scale (VAS): Compared to the control group, the placebo group had a lower VAS score on day 4, and the BBM group had lower scores on days 6 and 7.

CONCLUSIONS

There was a significant reduction of pain demonstrated in the BBM group, compared to the control, toward the end of the first week of treatment. There was no difference in reported pain between the BBM and placebo groups for any of the scores.

Advances in the Cognitive Management of Chronic Pain in Children through the Use of Virtual Reality Combined with Binaural Beats: A Pilot Study

Chronic pain affects the quality of life of those affected. The need to investigate alternative and complementary methods to the pharmacological one to alleviate chronic pain is evident, so virtual reality and binaural tones have become a topic of interest in this field in recent years. This study aims to analyze the contributions of the combination of these two techniques in pediatric patients with chronic pain. For this, data on psychophysiological responses (heart rate and galvanic skin response) and pain perception are collected during and after interaction with this technology using a mixed pre- and posttest experimental methodology. The physiological data and answers in the Pediatric Pain Questionnaire (PPQ) have been collected in a sample of n = 13 healthy participants and n = 9 pediatric patients with chronic pain. The results show a significant difference between baseline and after applying virtual reality and binaural beats, md = 1.205 (t = 3.32; $p<0.05$ ). There are great effects on the perception of chronic pain if virtual reality and binaural beats are combined, even greater than with virtual reality alone, making this combination of technologies a very useful tool to be exploited for the management of chronic pain in pediatric patients with rheumatic diseases.

Comparison of autonomous sensory meridian response and binaural auditory beats effects on stress reduction: a pilot study

This study aimed to compare the effects of Autonomous sensory meridian response (ASMR) and binaural beat (BB) on stress reduction, and to determine whether ASMR and BB can induce changes in quantitative electroencephalography (QEEG). A double-blind randomized trial was conducted. Subjects with stress were recruited considering their perceived stress scale (PSS), Beck depression inventory-II (BDI-II), insomnia severity index (ISI), and state-trait anxiety inventory-state anxiety (STAI-S) scores. Subjects listened to ASMR or BB with music (8 Hz for daytime, 5 Hz for nighttime) for 15 min in daytime and 30 min before going to sleep for 3 weeks. QEEG was measured before and after the intervention. Seventy-six participants (57 female, mean age = 46.12 ± 12.01) finished the trial. After the intervention, PSS, BDI-II, ISI, STAI-S, and PSQI scores improved significantly in both groups. BDI-II and ISI mean scores were normalized in both groups after the intervention. Changes of absolute beta and high beta power in the ASMR group were larger than those in the BB group (p = 0.026, p = 0.040, respectively). Both ASMR and BB are equally effective in reducing stress levels. Unlike BB, ASMR can lead to an increase in beta and high beta waves associated with cortical arousal.

The Effect of Binaural Beat Audio on Operative Pain and Anxiety in Cataract Surgery under Topical Anaesthesia: A Randomized Controlled Trial

Background: The aim of this paper was to examine the analgesic and anxiolytic effects of binaural beat audio in patients undergoing cataract surgery under topical anaesthesia. Methods: This was a prospective, randomized controlled trial of 61 patients undergoing cataract surgery under topical anaesthesia. They were divided into two research conditions; the binaural beat audio group, and a sham-control group (ear phones with no music). Patients completed the State-Trait Anxiety Inventory questionnaire (STAI), and their blood pressure (BP) and heart rate (HR) were measured pre- and post-intervention. Intraoperative pain levels were ascertained using a visual analog scale (VAS) completed immediately after the surgery. Results: The binaural beat group had significantly lower pain scores (p < 0.001), HR (p < 0.001), diastolic BP (p = 0.003), mean arterial pressure (p = 0.007) and anxiety (p = 0.009) than the control group. Within the binaural beat group, subjects experienced a statistically significant reduction in HR (p = 0.004) and anxiety (p < 0.001) levels compared to baseline values, while all parameters, except anxiety, increased significantly in the control group. Conclusions: Binaural beat audio decreases operative pain and anxiety in cataract surgery under topical anaesthesia. It may have additional benefits in modulating the tachycardic response to stress.

Effect of binaural beat in the inaudible band on EEG (STROBE)

This study aimed to determine the effects of the binaural beat (BB) on brainwave induction using an inaudible baseline frequency outside the audible frequency range. Experiments were conducted on 18 subjects (11 males [mean age: 25.7 ± 1.6 years] and 7 females [mean age: 24.0 ± 0.6 years]). A BB stimulation of 10 Hz was exerted by presenting frequencies of 18,000 Hz and 18,010 Hz to the left and right ears, respectively. A power spectrum analysis was performed to estimate the mean of the absolute power of the alpha frequency range (8-13 Hz). The variation in the mean alpha power during the rest and stimulation phases in each brain area was compared using the Wilcoxon signed-rank test. Compared to the rest phase, the stimulation phase with BB showed an increasing trend in the mean alpha power across all 5 brain areas. Notably, a significant increase was found in the frontal, central, and temporal areas. This is a significant study in that it determines the effects of only BB without the influence of auditory perception, which has been overlooked in previous studies.

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.

Entrapment of Binaural Auditory Beats in Subjects with Symptoms of Insomnia

Binaural beat (BB) stimulation, which has two different frequencies for each ear, is reportedly effective in reducing anxiety and controlling mood. This study aimed to evaluate the brain wave entrainment effect of binaural beats and to propose an effective and safe supplementary therapy for relieving the symptoms of insomnia. Subjects between 20 and 59 years of age with subclinical symptoms of insomnia were recruited from the community. Quantitative electroencephalography was measured twice, before and two weeks after the BB intervention. Participants used the apparatus with or without 6 Hz BB for 30 min before going to bed for two weeks. When music with BB was played, the relative theta power increased (occipital, p = 0.009). After two weeks of intervention with music, the theta power increased when listening to music with BB (parietal, p = 0.009). After listening to music with BB for two weeks, the decrease in the beta power was more noticeable than after using music-only devices when participants listened to music in the laboratory (occipital, p = 0.035). When BB were played, the entrapment of the theta wave appeared. Therefore, exposure to music with BB is likely to reduce the hyper-arousal state and contribute to sleep induction.

The effect of auditory stimulation using delta binaural beat for a better sleep and post-sleep mood: A pilot study

Background

Although previous evidence confirms the effects of sleep deprivation on mental health and wellbeing, due to the interaction effects of sleep and mood on each other, the influence of sleep improvement has received less attention.

Objective

This study aimed to find whether binaural beat technology can enhance sleep quality and thus post-sleep mood.

Methods

Twenty healthy students participated in this pilot study. All subjects were investigated for two weeks (a baseline week and an experimental week). In the first week, there was no intervention, but in the second week, all subjects were exposed to a 90 min binaural beat in the delta frequency range. The individuals’ sleep was monitored for two weeks using a sleep diary form, and a Profile of Mood State questionnaire was employed to assess their mood at the end of the first and second weeks.

Results

Auditory stimulation with delta binaural beat enhanced sleep parameters such as sleep failure, the number of awakenings, real duration of sleep, sleep quality, and feeling following the waking of the individuals. Finally, students’ moods improved by reducing anxiety and anger, but other mood parameters did not indicate a significant difference.

Conclusion

The findings of this study confirmed that auditory stimulation with a delta binaural beat seems to be a low-cost and alternative method for medicine and other treatment methods with side effects.

Application

This study demonstrates the use of technology with a neuroergonomics approach to improve sleep and mood disorders.

A Brief Study of Binaural Beat: A Means of Brain-Computer Interfacing

The human brain tends to follow a rhythm. Sound has a significant impact on our physical and mental health. This sound technology uses binaural beat by generating two tones of marginally different frequencies in each individual ear to facilitate the improved focus of attention, emotion, calming, and sensory organization. Binaural beat helps in memory boosting, relaxation, and work performance. Again because of hearing a binaural beat sound, brainwave stimuli can be diagnosed to pick up a person’s sensitive information. Using this technology in brain-computer interfacing, it is possible to establish a communication between the brain and the computer. Thus, it enables us to go beyond our potential. The aim of this study is to assess the impact and explore the potential contribution of binaural beat to enhancement of human brain performance.

Using Heartfulness Meditation and Brainwave Entrainment to Improve Teenage Mental Wellbeing

Teenagers are highly susceptible to mental health issues and this problem has been exacerbated by the quarantine restrictions of COVID-19. This study evaluated the use of Heartfulness Meditation and Audio Brainwave Entrainment to help teenagers cope with mental health issues. It used 30-min Heartfulness meditation and 15-min brainwave entrainment sessions with binaural beats and isochronic tones three times a week for 4 weeks. Using a pretest-posttest methodology, participants were asked to complete a survey battery including the Pittsburgh Quality of Sleep Index, Perceived Stress Scale, Patient Health Question-9, Profile of Mood States, and Cambridge Brain Health assessment. Participants (n = 40) were divided into four experimental groups: the control group (n = 9), Audio Brainwave Entrainment group (n = 9), Heartfulness Meditation group (n = 10), and a combined group (n = 12), for a 4-week intervention. Data were analyzed with paired t-tests. The singular Audio Brainwave Entrainment group did not see statistically significant improvements, nor did any of the intervention groups for brain health (p > 0.05). This study, however, proved the efficacy of a 4-week Heartfulness Meditation program to regulate overall mood (p = 0.00132), stress levels (p = 0.0089), state depression (POMS; p = 0.0037), and anger (p = 0.002). Results also suggest adding Audio Brainwave Entrainment to Heartfulness Meditation may improve sleep quality (p = 0.0377) and stress levels (p = 0.00016).

Effects of binaural and monaural beat stimulation on attention and EEG

Nowadays a popular technique to improve mood and cognition is auditory beat stimulation (ABS), which is thought to induce a frequency-following response of brainwaves. The main types of ABS are monaural beats (MB) and binaural beats (BB). BB involves the presentation of a specific frequency to one ear and another frequency to the other ear which may induce neural entrainment. A difference between the frequencies of 40 Hz is assumed to improve cognition. The present study examined the effect of 40 Hz binaural beats (BB) and monaural beats (MB) on attention and electroencephalography (EEG). A total of 25 first-year psychology students (11 males, 14 females) performed a Flanker task while EEG was recorded during the 5 min-presentation of pink noise (PN), MB and BB. With respect to attention, as measured by the Flanker task, the number of false responses in the BB condition was smaller than that in the PN condition while the number of false responses in the MB condition was larger as compared to the PN condition. As there was no association of BB with a consistent increase in absolute 40 or 45 Hz power compared to PN or MB, EEG recordings could not confirm the hypothesized neural entrainment in the brain. Overall, the current findings show that listening to 40 Hz BB improves attention but do not show the occurrence of neural entrainment. Future research is recommended to include a larger sample, to use a broader cognitive test battery and to present auditory beats with a longer duration.

Shannon entropy measures for EEG signals in tinnitus

BACKGROUND AND AIM

Tinnitus is known as a common clinical symptom, and it comprehensively is essential to understand the underlying mechanisms. Time-varying EEG is considered an appropriate technique to explore brain regions and related activities, and nonlinear methods may extract the irregularities in the EEG signal and gather more expanded information. Therefore, we studied Shannon Entropy in EEG raw data obtained from normal subjects and compared it to data from chronic tinnitus sufferers before and after an intervention.

METHODS

From the qEEG database of Iran University of Medical Sciences, the School of Rehabilitation Sciences, we have selected 23 healthy and 24 chronic tinnitus subjects. Nineteen subjects of the tinnitus group had benefited from a complete course of sound therapy (binaural beat for a month). QEEGs were measured with a 27-channel EEG amplifier in the sitting and eye-closed position for 3 min. Shannon entropy was investigated for all electrodes separately and compared among groups using a one-way ANOVA statistical test.

FINDINGS

Our results revealed a significant difference between healthy and tinnitus subjects (p < 0.05). Post-hoc comparisons using the Bonferroni test showed increased entropy in the tinnitus group for all electrodes (p < 0.05) at low frequencies and most electrodes at mid frequencies. In addition, after the intervention, paired t-test showed a reduction in entropy to somehow above normal control levels for all electrodes at low-frequencies. Such results were accompanying clinical improvement after the intervention.

CONCLUSION

The increased entropy in tinnitus patients might reflect the chaotic behavior of the brain. Nonlinear methods in EEG studies (Entropy) could be of great importance in understanding tinnitus neurophysiology and might potentially be a suitable criterion for clinical practice.

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.

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.

Binaural Beats through the Auditory Pathway: From Brainstem to Connectivity Patterns

Binaural beating is a perceptual auditory illusion occurring when presenting two neighboring frequencies to each ear separately. Several controversial claims have been attributed to binaural beats regarding their ability to entrain human brain activity and mood, in both the scientific literature and the marketing realm. Here, we sought to address those questions in a robust fashion using a single-blind, active-controlled protocol. To do so, we compared the effects of binaural beats with a control beat stimulation (monaural beats, known to entrain brain activity but not mood) across four distinct levels in the human auditory pathway: subcortical and cortical entrainment, scalp-level functional connectivity and self-reports. Both stimuli elicited standard subcortical responses at the pure tone frequencies of the stimulus [i.e., frequency following response (FFR)], and entrained the cortex at the beat frequency [i.e., auditory steady state response (ASSR)]. Furthermore, functional connectivity patterns were modulated differentially by both kinds of stimuli, with binaural beats being the only one eliciting cross-frequency activity. Despite this, we did not find any mood modulation related to our experimental manipulation. Our results provide evidence that binaural beats elicit cross frequency connectivity patterns, but weakly entrain the cortex when compared with monaural beat stimuli. Whether binaural beats have an impact on cognitive performance or other mood measurements remains to be seen and can be further investigated within the proposed methodological framework.

Efficacy of Binaural Beat Meditation Technology for Treating Anxiety Symptoms: A Pilot Study

The objective of this study was to examine the efficacy of a novel binaural beat meditation technology for the treatment of anxiety symptoms in both psychiatric outpatients and nonpatients. Twenty psychiatric outpatients with anxiety disorder and eight individuals (nonpatients) in the healing professions were given the opportunity to use this meditation technology over the course of 2 weeks to 2 months. The State-Trait Anxiety Inventory scores were measured in all participants over the course of the study. Of the 20 outpatients who took part in the study, nine used the meditations as planned, whereas 11 did not for various reasons (could not download, forgot, did not have time, etc.), resulting in the formation of three treatment groups: psychiatry + meditation (n = 8), psychiatry only (n = 10), and meditation only (n = 8). The psychiatry + meditation group showed a 13.5-point (26.5%) decrease in State-Anxiety (t = 5.28, p = 0.001), a 14.1-point (24.7%) decrease in Trait-Anxiety (t = -5.12, p = 0.001), and a 27.6-point (25.6%) decrease in Total Anxiety (t = 7.63, p ≤ 0.001). The psychiatry-only group showed a 4.2-point (8.4%) decrease in State-Anxiety (t = -2.20, p = 0.05) and a 7.0-point (6.9%) decrease in Total Anxiety (t = -2.61, p = 0.02). The meditation only showed a 3.5-point (9.8%) decrease in Trait-Anxiety (t = -2.47, p = 0.04). In a multiple regression analysis controlling for sociodemographic factors, medications, and treatment-related variables, the only statistically significant improvement in anxiety was seen in the psychiatry + meditation group for the Total Anxiety score (p < 0.01). These findings suggest that use of this meditation technology may exhibit a positive effect on self-reported measures of anxiety in the context of a psychiatry/psychotherapy practice. However, larger-scale randomized, placebo-controlled trials are needed to confirm our findings.

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 Treatment of Autism Spectrum Disorder With Auditory Neurofeedback: A Randomized Placebo Controlled Trial Using the Mente Autism Device

Introduction: Children affected by autism spectrum disorder (ASD) often have impairment of social interaction and demonstrate difficulty with emotional communication, display of posture and facial expression, with recognized relationships between postural control mechanisms and cognitive functions. Beside standard biomedical interventions and psychopharmacological treatments, there is increasing interest in the use of alternative non-invasive treatments such as neurofeedback (NFB) that could potentially modulate brain activity resulting in behavioral modification.

Methods: Eighty-three ASD subjects were randomized to an Active group receiving NFB using the Mente device and a Control group using a Sham device. Both groups used the device each morning for 45 minutes over a 12 week home based trial without any other clinical interventions. Pre and Post standard ASD questionnaires, qEEG and posturography were used to measure the effectiveness of the treatment.

Results: Thirty-four subjects (17 Active and 17 Control) completed the study. Statistically and substantively significant changes were found in several outcome measures for subjects that received the treatment. Similar changes were not detected in the Control group.

Conclusions: Our results show that a short 12 week course of NFB using the Mente Autism device can lead to significant changes in brain activity (qEEG), sensorimotor behavior (posturography), and behavior (standardized questionnaires) in ASD children.

Short-Term Effects of Binaural Beats on EEG Power, Functional Connectivity, Cognition, Gait and Anxiety in Parkinson’s Disease

We applied rhythmic binaural sound to Parkinson’s Disease (PD) patients to investigate its influence on several symptoms of this disease and on Electrophysiology (Electrocardiography and Electroencephalography (EEG)). We conducted a double-blind, randomized controlled study in which rhythmic binaural beats and control were administered over two randomized and counterbalanced sessions (within-subjects repeated-measures design). Patients ([Formula: see text], age [Formula: see text], stage I–III Hoehn & Yahr scale) participated in two sessions of sound stimulation for 10[Formula: see text]min separated by a minimum of 7 days. Data were collected immediately before and after both stimulations with the following results: (1) a decrease in theta activity, (2) a general decrease in Functional Connectivity (FC), and (3) an improvement in working memory performance. However, no significant changes were identified in the gait performance, heart rate or anxiety level of the patients. With regard to the control stimulation, we did not identify significant changes in the variables analyzed. The use of binaural-rhythm stimulation for PD, as designed in this study, seems to be an effective, portable, inexpensive and noninvasive method to modulate brain activity. This influence on brain activity did not induce changes in anxiety or gait parameters; however, it resulted in a normalization of EEG power (altered in PD), normalization of brain FC (also altered in PD) and working memory improvement (a normalizing effect). In summary, we consider that sound, particularly binaural-rhythmic sound, may be a co-assistant tool in the treatment of PD, however more research is needed to consider the use of this type of stimulation as an effective therapy.

Binaural Beat: A Failure to Enhance EEG Power and Emotional Arousal

When two pure tones of slightly different frequencies are delivered simultaneously to the two ears, is generated a beat whose frequency corresponds to the frequency difference between them. That beat is known as acoustic beat. If these two tones are presented one to each ear, they still produce the sensation of the same beat, although no physical combination of the tones occurs outside the auditory system. This phenomenon is called binaural beat. In the present study, we explored the potential contribution of binaural beats to the enhancement of specific electroencephalographic (EEG) bands, as previous studies suggest the potential usefulness of binaural beats as a brainwave entrainment tool. Additionally, we analyzed the effects of binaural-beat stimulation on two psychophysiological measures related to emotional arousal: heart rate and skin conductance. Beats of five different frequencies (4.53 Hz -theta-, 8.97 Hz -alpha-, 17.93 Hz -beta-, 34.49 Hz -gamma- or 57.3 Hz -upper-gamma) were presented binaurally and acoustically for epochs of 3 min (Beat epochs), preceded and followed by pink noise epochs of 90 s (Baseline and Post epochs, respectively). In each of these epochs, we analyzed the EEG spectral power, as well as calculated the heart rate and skin conductance response (SCR). For all the beat frequencies used for stimulation, no significant changes between Baseline and Beat epochs were observed within the corresponding EEG bands, neither with binaural or with acoustic beats. Additional analysis of spectral EEG topographies yielded negative results for the effect of binaural beats in the scalp distribution of EEG spectral power. In the psychophysiological measures, no changes in heart rate and skin conductance were observed for any of the beat frequencies presented. Our results do not support binaural-beat stimulation as a potential tool for the enhancement of EEG oscillatory activity, nor to induce changes in emotional arousal.

Effects of Singing Bowl Sound Meditation on Mood, Tension, and Well-being: An Observational Study

Poor mood and elevated anxiety are linked to increased incidence of disease. This study examined the effects of sound meditation, specifically Tibetan singing bowl meditation, on mood, anxiety, pain, and spiritual well-being. Sixty-two women and men (mean age 49.7 years) participated. As compared with pre-meditation, following the sound meditation participants reported significantly less tension, anger, fatigue, and depressed mood (all Ps <.001). Additionally, participants who were previously naïve to this type of meditation experienced a significantly greater reduction in tension compared with participants experienced in this meditation ( P < .001). Feeling of spiritual well-being significantly increased across all participants ( P < .001). Tibetan singing bowl meditation may be a feasible low-cost low technology intervention for reducing feelings of tension, anxiety, and depression, and increasing spiritual well-being. This meditation type may be especially useful in decreasing tension in individuals who have not previously practiced this form of meditation.

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.

Intra-Auditory Integration Improves Motor Performance and Synergy in an Accurate Multi-Finger Pressing Task

Humans detect changes in the air pressure and understand the surroundings through the auditory system. The sound humans perceive is composed of two distinct physical properties, frequency and intensity. However, our knowledge is limited how the brain perceives and combines these two properties simultaneously (i.e., intra-auditory integration), especially in relation to motor behaviors. Here, we investigated the effect of intra-auditory integration between the frequency and intensity components of auditory feedback on motor outputs in a constant finger-force production task. The hierarchical variability decomposition model previously developed was used to decompose motor performance into mathematically independent components each of which quantifies a distinct motor behavior such as consistency, repeatability, systematic error, within-trial synergy, or between-trial synergy. We hypothesized that feedback on two components of sound as a function of motor performance (frequency and intensity) would improve motor performance and multi-finger synergy compared to feedback on just one component (frequency or intensity). Subjects were instructed to match the reference force of 18 N with the sum of all finger forces (virtual finger or VF force) while listening to auditory feedback of their accuracy. Three experimental conditions were used: (i) condition F, where frequency changed; (ii) condition I, where intensity changed; (iii) condition FI, where both frequency and intensity changed. Motor performance was enhanced for the FI conditions as compared to either the F or I condition alone. The enhancement of motor performance was achieved mainly by the improved consistency and repeatability. However, the systematic error remained unchanged across conditions. Within- and between-trial synergies were also improved for the FI condition as compared to either the F or I condition alone. However, variability of individual finger forces for the FI condition was not significantly decreased as compared to I condition alone. This result indicates an improvement in motor performance is consistent with Bayesian estimation, and changes in multi-finger interaction mostly result in the enhanced motor performance. These findings provide evidence that the central nervous system can take advantage of the intra-auditory integration in a statistically optimal (Bayesian) fashion to enhance motor performance by improving multi-finger synergy.

Short-term effects of relaxation music on patients suffering from primary open-angle glaucoma

Purpose

To evaluate whether additive relaxation music (RM) has an adjuvant short-term effect on physiological and psychological parameters in patients with primary open-angle glaucoma.

Methods

Prospective, randomized clinical trial. Patients in the therapy group (TG) received a 30-minute RM via headphones, whereas members of the control group (CG) did not. Best corrected visual acuity, intraocular pressure, visual field testing, short- and long-term mental states, and blood levels of different stress hormones were analyzed and compared.

Results

A total of 25 (61%)/16 (39%) patients were assigned to the TG/CG. Best corrected visual acuity, daily intraocular pressure, and short-term mental state (KAB) development were significantly better in the TG in comparison to controls. Visual field testing, long-term mental well-being (profile of mood states), and adrenalin, cortisol, and endothelin-I blood levels did not differ significantly between both groups.

Conclusion

Additive RM applied on a daily basis can positively impact various physiological and psychological parameters in the short term.

Finding a depression app: a review and content analysis of the depression app marketplace

Background

Depression is highly prevalent and causes considerable suffering and disease burden despite the existence of wide-ranging treatment options. Mobile phone apps offer the potential to help close this treatment gap by confronting key barriers to accessing support for depression.

Objectives

Our goal was to identify and characterize the different types of mobile phone depression apps available in the marketplace.

Methods

A search for depression apps was conducted on the app stores of the five major mobile phone platforms: Android, iPhone, BlackBerry, Nokia, and Windows. Apps were included if they focused on depression and were available to people who self-identify as having depression. Data were extracted from the app descriptions found in the app stores.

Results

Of the 1054 apps identified by the search strategy, nearly one-quarter (23.0%, 243/1054) unique depression apps met the inclusion criteria. Over one-quarter (27.7%, 210/758) of the excluded apps failed to mention depression in the title or description. Two-thirds of the apps had as their main purpose providing therapeutic treatment (33.7%, 82/243) or psychoeducation (32.1%, 78/243). The other main purpose categories were medical assessment (16.9%, 41/243), symptom management (8.2%, 20/243), and supportive resources (1.6%, 4/243). A majority of the apps failed to sufficiently describe their organizational affiliation (65.0%, 158/243) and content source (61.7%, 150/243). There was a significant relationship (χ²₅=50.5, P<.001) between the main purpose of the app and the reporting of content source, with most medical assessment apps reporting their content source (80.5%, 33/41). A fifth of the apps featured an e-book (20.6%, 50/243), audio therapy (16.9%, 41/243), or screening (16.9%, 41/243) function. Most apps had a dynamic user interface (72.4%, 176/243) and used text as the main type of media (51.9%, 126/243), and over a third (14.4%, 35/243) incorporated more than one form of media.

Conclusion

Without guidance, finding an appropriate depression app may be challenging, as the search results yielded non-depression–specific apps to depression apps at a 3:1 ratio. Inadequate reporting of organization affiliation and content source increases the difficulty of assessing the credibility and reliability of the app. While certification and vetting initiatives are underway, this study demonstrates the need for standardized reporting in app stores to help consumers select appropriate tools, particularly among those classified as medical devices.

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 high-density EEG investigation into steady state binaural beat stimulation

Binaural beats are an auditory phenomenon that has been suggested to alter physiological and cognitive processes including vigilance and brainwave entrainment. Some personality traits measured by the NEO Five Factor Model have been found to alter entrainment using pulsing light stimuli, but as yet no studies have examined if this occurs using steady state presentation of binaural beats for a relatively short presentation of two minutes. This study aimed to examine if binaural beat stimulation altered vigilance or cortical frequencies and if personality traits were involved. Thirty-one participants were played binaural beat stimuli designed to elicit a response at either the Theta (7 Hz) or Beta (16 Hz) frequency bands while undertaking a zero-back vigilance task. EEG was recorded from a high-density electrode cap. No significant differences were found in vigilance or cortical frequency power during binaural beat stimulation compared to a white noise control period. Furthermore, no significant relationships were detected between the above and the Big Five personality traits. This suggests a short presentation of steady state binaural beats are not sufficient to alter vigilance or entrain cortical frequencies at the two bands examined and that certain personality traits were not more susceptible than others.

Efficacy of guided imagery with theta music for advanced cancer patients with dyspnea: a pilot study

BACKGROUND

Dyspnea is a frequent and devastating symptom among advanced cancer patients for which improved and low-cost palliative techniques are needed.

METHODS

A one-group repeated measures research design investigated the efficacy of guided imagery (GI) with theta music (M) on dyspnea in advanced cancer patients. The intervention consisted of four periods: (a) pretest; (b) intervention with peaceful non-M; (c) intervention with 10 min of GI with M (GI/M), with the first and last 3 min being M only (i.e., the middle 4 min was GI/M); and (d) posttest. Dyspnea outcome was measured with the Modified Borg Scale (MBS) for self-reported evaluation of dyspneic symptoms. Physiological parameters measured were pulse oxygen saturation (SpO(2)), end-tidal CO( 2) (EtCO(2)), heart rate (HR), and respiratory rate (RR). Posttest qualitative data were obtained via interview for subjective patient experience.

RESULTS

Participants included 53 patients, 33% with lung cancer. GI/M produced a significant decrease in MBS scores; 90% of the subjects gave positive qualitative reviews of GI/M. SpO(2) did not change significantly over time. GI/M significantly increased EtCO(2), decreased RR, and decreased HR.

DISCUSSION

This study demonstrates that GI/M is a useful intervention for palliative care of patients with dyspnea. M alone was demonstrated to be effective, while soothing non-M was not effective. GI/M was more effective than M alone. GI/M should be considered low-cost end-of-life palliative care for dyspnea.