Possible Effect of Binaural Beat Combined With Autonomous Sensory Meridian Response for Inducing Sleep

Enhancing Deep Sleep Induction Through a Wireless In-Ear EEG Device Delivering Binaural Beats and ASMR: A Proof-of-Concept Study

This study presents the development of a wireless in-ear EEG device designed to monitor brain activity during sleep and deliver auditory stimuli aimed at enhancing deep sleep. The device records EEG signals and plays a combined auditory stimulus consisting of autonomous sensory meridian response (ASMR) and 3 Hz binaural beats at a 60:30 dB ratio, intended to promote delta wave activity and non-rapid eye movement (NREM) stage 3 sleep. Fifteen participants completed this study, which included two consecutive nights: a baseline night and a testing night. Participants were divided into an experimental group, which received the combined ASMR and binaural beat stimulus, and a control group, which received only ASMR. The combined stimulus was delivered upon entering NREM stage 2 and replaced by ASMR when NREM stage 3 was reached. Results showed that the experimental group experienced an increase in NREM 3 sleep, a decrease in NREM 2 sleep, and a slight increase in NREM 3 latency compared to the baseline night. Although the findings are promising, further testing with a larger sample size is required to confirm the device's potential to enhance sleep quality and promote delta activity in the brain.

Binaural beats at 0.25 Hz shorten the latency to slow-wave sleep during daytime naps

Binaural beats can entrain neural oscillations and modulate behavioral states. However, the effect of binaural beats, particularly those with slow frequencies (< 1 Hz), on sleep remains poorly understood. We hypothesized that 0.25-Hz beats can entrain neural oscillations and enhance slow-wave sleep by shortening its latency or increasing its duration. To investigate this, we included 12 healthy participants (six women; mean age, 25.4 ± 2.6 years) who underwent four 90-min afternoon nap sessions, comprising a sham condition (without acoustic stimulation) and three binaural-beat conditions (0, 0.25, or 1 Hz) with a 250-Hz carrier tone. The acoustic stimuli, delivered through earphones, were sustained throughout the 90-min nap period. Both N2- and N3- latencies were shorter in the 0.25-Hz binaural beats condition than in the sham condition. We observed no significant results regarding neural entrainment at slow frequencies, such as 0.25 and 1 Hz, and the modulation of sleep oscillations, including delta and sigma activity, by binaural beats. In conclusion, this study demonstrated the potential of binaural beats at slow frequencies, specifically 0.25 Hz, for inducing slow-wave sleep in generally healthy populations.

Effect of dynamic binaural beats on sleep quality: a proof-of-concept study with questionnaire and biosignals

Binaural beat (BB) has been investigated as a potential modality to enhance sleep quality. In this study, we introduce a new form of BB, referred to as dynamic BB (DBB), which incorporates dynamically changing carrier frequency differences between the left and right ears. Specifically, the carrier frequency of the right ear varied between 100 and 103 Hz over a period, while the left ear remained fixed at 100 Hz, yielding a frequency difference range of 0 to 3 Hz. The objective of this study was to examine the effect of DBB on sleep quality. Ten healthy participants were included in a cross-over design, where they experienced both DBB and a SHAM (absence of sound) condition across two consecutive nights, with polysomnography evaluation. DBB was administrated during pre-sleep initiation, sleep onset, and transition from rapid eye movement (REM) to non-REM stage. DBB significantly reduced sleep latency compared to the SHAM condition. Electrocardiogram analysis revealed that exposure to DBB led to diminished heart rate variability during the pre-sleep initiation and sleep onset periods, accompanied by a decrease in low-frequency power of heart rate during the sleep onset period. DBB might be effective in improving sleep quality, suggesting its possible application in insomnia treatments.

Predicting tingling sensations induced by autonomous sensory meridian response (ASMR) videos based on sound texture statistics: a comparison to pleasant feelings

Sound serves as a potent medium for emotional well-being, with phenomena like the autonomous sensory meridian response (ASMR) showing a unique capacity for inducing relaxation and alleviating stress. This study aimed to understand how tingling sensations (and, for comparison, pleasant feelings) that such videos induce relate to acoustic features, using a broader range of ASMR videos as stimuli. The sound texture statistics and their timing predictive of tingling and pleasantness were identified through L1-regularized linear regression. Tingling was well-predicted (r = 0.52), predominantly by the envelope of frequencies near 5 kHz in the 1500 to 750 ms period before the response: stronger tingling was associated with a lower amplitude around the 5 kHz frequency range. This finding was further validated using an independent set of ASMR sounds. The prediction of pleasantness was more challenging (r = 0.26), requiring a longer effective time window, threefold that for tingling. These results enhance our understanding of how specific acoustic elements can induce tingling sensations, and how these elements differ from those that induce pleasant feelings. Our findings have potential applications in optimizing ASMR stimuli to improve quality of life and alleviate stress and anxiety, thus expanding the scope of ASMR stimulus production beyond traditional methods. This article is part of the theme issue 'Sensing and feeling: an integrative approach to sensory processing and emotional experience'.

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.

Pentatonic sequences and monaural beats to facilitate relaxation: an EEG study

Introduction

In two studies we investigated if specific acoustic stimulations could be more effective to induce a relaxation response in comparison to silence. Acoustic stimulations included monaural beats and musical sequences based on a pentatonic scale.

Methods

In the first study, 47 participants evaluated monaural beats and pentatonic sequences presented through loudspeakers and varying along three frequencies (0.2, 2, 4 Hz). In the second study, 31 participants relaxed with their eyes closed for 10 min during a passive listening of monaural beats and a pentatonic sequence presented through loudspeakers. A silence condition was introduced as control. All auditory stimuli were designed with a temporal modulation of 0.2 Hz. Concomitant EEG was recorded with a 64-channel system and spectral analysis was performed on delta, theta, alpha, beta, and gamma oscillations to test if each of the three auditory stimulations had a significant effect on EEG spectral power in comparison to silence.

Results

In the first study, pentatonic sequences were evaluated as more pleasant and more relaxing than monaural beats. Pleasantness and relaxation were inversely related to frequency. Visual imagery and emotion induction had higher frequency and were rated with a more positive valence in pentatonic sequences than in monaural beats. In the second study monaural beats in comparison to silence strongly decreased beta and gamma oscillations in the first three minutes and strongly increased theta oscillations in the last three minutes. Pentatonic sequences increased delta, theta, and alpha oscillations in the last three minutes while decreasing beta, and gamma oscillations for the whole auditory stimulation.

Discussion

The results show that auditory signals with a very low temporal modulation (0.2 Hz) could be more effective than silence in inducing a relaxation response. Although 0.2 Hz monaural beats were effective in inducing a relaxation response, they tended to be perceived as unpleasant. Pentatonic sequences could be considered as a better alternative to promote relaxation by auditory stimulation.

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.

A Review of Binaural Bates and the Brain

Binaural beat (BB), as a non-invasive auditory beat stimulation type, has found its potential applications in cognitive domains. This review presents a proper summary to deepen our understanding of the soundness of the BB technique by looking into its applications, possible mechanisms of action, effectiveness, limitations, and potential side effects. BB has been claimed to improve cognitive and psychological functions such as memory, attention, stress, anxiety, motivation, and confidence. We have also looked into preclinical and clinical research studies that have been performed using BB and proposed changes in the brain following the application of BB stimulations, including EEG changes. This review also presents applications outside the cognitive domain and evaluates BB as a possible treatment method.

Neural consequences of binaural beat stimulation on auditory sentence comprehension: an EEG study

A growing literature has shown that binaural beat (BB)-generated by dichotic presentation of slightly mismatched pure tones-improves cognition. We recently found that BB stimulation of either beta (18 Hz) or gamma (40 Hz) frequencies enhanced auditory sentence comprehension. Here, we used electroencephalography (EEG) to characterize neural oscillations pertaining to the enhanced linguistic operations following BB stimulation. Sixty healthy young adults were randomly assigned to one of three listening groups: 18-Hz BB, 40-Hz BB, or pure-tone baseline, all embedded in music. After listening to the sound for 10 min (stimulation phase), participants underwent an auditory sentence comprehension task involving spoken sentences that contained either an object or subject relative clause (task phase). During the stimulation phase, 18-Hz BB yielded increased EEG power in a beta frequency range, while 40-Hz BB did not. During the task phase, only the 18-Hz BB resulted in significantly higher accuracy and faster response times compared with the baseline, especially on syntactically more complex object-relative sentences. The behavioral improvement by 18-Hz BB was accompanied by attenuated beta power difference between object- and subject-relative sentences. Altogether, our findings demonstrate beta oscillations as a neural correlate of improved syntactic operation following BB stimulation.

The relaxation effect of autonomous sensory meridian response depends on personal preference

Background

Autonomous sensory meridian response (ASMR) is a sensory response such as tingling and pleasantness from audiovisual stimuli. ASMR videos come in a wide variety of types, and personal preferences are biased. There are many reports of the effects os ASMR on sleep onset, anxiety relief, and other relaxation effects. However, prior task-oriented studies have used ASMR videos provided by the experimenter. We hypothesized that ASMR movies of a personal preference would show significantly increased activity in the nucleus accumbens, frontal cortex, and insular cortex, which are brain areas associated with relaxation. Therefore, the purpose of this study was to elucidate the neuroscientific basis for the relaxation effects of ASMR videos that match someone's personal preferences.

Methods

This study included 30 healthy individuals aged ≥18 years. ASMR enthusiasts were included as the target population due to the need to have a clear preference for ASMR videos. A control video (1 type) and ASMR videos (20 types) were used as the stimulus tasks. Among the ASMR videos, those with high and low evaluation scores were considered liked and dislikedASMR videos, respectively. Functional magnetic resonance imaging was performed while the participants viewed a block design with a resting task in between. The data were analyzed using Statistical Parametric Mapping 12 to identify the areas activated by control, disliked, and liked ASMR videos.

Results

Emotion-related areas (the amygdala, frontal cortex, and insular cortex) not activated by control and unliked ASMR videos were activated only by liked ASMR videos.

Conclusion

The amygdala, frontal cortex, and insular cortex may be involved in the limbic dopamine circuits of the amygdala and middle frontal gyrus and the autonomic balance of the left and right insular cortices. This suggests the potential of positive mood and its use as a treatment for patients with anxiety and depression. These results suggest that the use of ASMR videos to match individual preferences may induce relaxation and have beneficial effects on depression and other disorders, and also support the introduction of ASMR videos in mental health care.

A 2022 Survey of Commercially Available Smartphone Apps for Sleep: Most Enhance Sleep

Commercially available smartphone apps represent an ever-evolving and fast-growing market. Our review systematically surveyed currently available commercial sleep smartphone apps to provide details to inform both providers and patients alike, in addition to the healthy consumer market. Most current sleep apps offer a free version and are designed to be used while awake, prior to sleep, and focus on the enhancement of sleep, rather than measurement, by targeting sleep latency using auditory stimuli. Sleep apps could be considered a possible strategy for patients and consumers to improve their sleep, although further validation of specific apps is recommended.

SeriesSleepNet: an EEG time series model with partial data augmentation for automatic sleep stage scoring

Introduction: We propose an automatic sleep stage scoring model, referred to as SeriesSleepNet, based on convolutional neural network (CNN) and bidirectional long short-term memory (bi-LSTM) with partial data augmentation. We used single-channel raw electroencephalography signals for automatic sleep stage scoring. Methods: Our framework was focused on time series information, so we applied partial data augmentation to learn the connected time information in small series. In specific, the CNN module learns the time information of one epoch (intra-epoch) whereas the bi-LSTM trains the sequential information between the adjacent epochs (inter-epoch). Note that the input of the bi-LSTM is the augmented CNN output. Moreover, the proposed loss function was used to fine-tune the model by providing additional weights. To validate the proposed framework, we conducted two experiments using the Sleep-EDF and SHHS datasets. Results and Discussion: The results achieved an overall accuracy of 0.87 and 0.84 and overall F1-score of 0.80 and 0.78 and kappa value of 0.81 and 0.78 for five-class classification, respectively. We showed that the SeriesSleepNet was superior to the baselines based on each component in the proposed framework. Our architecture also outperformed the state-of-the-art methods with overall F1-score, accuracy, and kappa value. Our framework could provide information on sleep disorders or quality of sleep to automatically classify sleep stages with high performance.

Does ASMR propensity reflect a mentally flexible mindset? Exploring the relationship between ASMR propensity, transliminality, emotional contagion, schizotypal traits, roleplaying ability, and creativity

Autonomous Sensory Meridian Response (ASMR) is an alternative state of consciousness characterised by changes in affect, feelings of relaxation, and tingling sensations on the body. Online videos designed to stimulate ASMR in viewers have become increasingly popular. Although there is evidence that ASMR may improve sleep, emotion regulation, and relaxation, the current understanding of ASMR propensity remains limited. This study examined whether a mentally flexible cognitive style may underlie the ability to experience ASMR. Undergraduate students (N = 376) completed an online survey involving a series of self-report questionnaires and two performance-based creative ability tasks. Findings did not provide support for an overall mentally flexible mindset, however, transliminality, emotional contagion susceptibility, positive schizotypal traits, and roleplaying ability all significantly positively predicted ASMR propensity. These findings suggest that ASMR propensity represents several possible underlying cognitive styles relating to enhanced imagination and perceptual ability, and cannot be simply characterised by mental flexibility.

Reverse effect of home-use binaural beats brain stimulation

Binaural beats brain stimulation is a popular strategy for supporting home-use cognitive tasks. However, such home-use brain stimulation may be neutral to cognitive processes, and any intellectual improvement may be only a placebo effect. Thus, without belief in it, it may bring no benefits. Here we test 1000 individuals at their homes as they perform a two-part fluid intelligence test. Some took the second part listening to binaural beats, while others took it in silence or listening to other sounds. The binaural beats group was divided into three subgroups. The first one was informed that they would listen to sounds that improve the brain's work, the second that neutral sounds, and the third that some sounds the nature of which was not defined. We found that listening to binaural beats was not neutral, as it dramatically deteriorated the score irrespective of the condition. Silence or other sounds had no effect. Thus, home-use binaural beats brain stimulation brings reverse effects to those assumed: instead of supporting the effectiveness of cognitive activities, it may weaken them.

Autonomous sensory meridian response is associated with a larger heartbeat-evoked potential amplitude without differences in interoceptive awareness

Autonomous sensory meridian response (ASMR) describes the experience of a pleasant body sensation accompanied by a feeling of well-being and relaxation in response to specific audiovisual stimuli, such as whispers and personal attention. Previous work suggests a relationship between this experience with the processing of affective and body states; however, no research has explored differences in interoception between people experiencing ASMR and those who do not. We hypothesized that the ASMR experience is based on interoception processing. To test this, we assessed group differences across different dimensions of interoception: Interoceptive sensibility (IS), measured using the multidimensional assessment of interoceptive awareness (MAIA); Interoceptive accuracy score (IAS), measured by calculating performance in a heartbeat counting task (HCT), and the electrophysiological index of interoception, the heartbeat evoked potential (HEP), which was calculated during the HCT and an ASMR tingle reporting task (ASMR-TRT). Our results showed that IS and IAS, dimensions requiring conscious awareness, showed no differences between groups. However, HEP amplitude was larger in the ASMR group in both tasks. We concluded that the ASMR experience is based on an unconscious interoceptive mechanism, reflected by HEP, where exteroceptive social-affective stimuli are integrated to represent a body state of positive affective feelings and relaxation, as has been described for affective touch. The relevance of this finding relies on that interoceptive function, body regulation, and emotional/affective experiences are fundamental for well-being, and the relationship between ASMR and interoception opens the way to future research exploring the causal relationship between them and their potential clinical applications.

Brain function effects of autonomous sensory meridian response (ASMR) video viewing

Background

Autonomous sensory meridian response (ASMR) is the sensation of tingling from audiovisual stimuli that leads to positive emotions. ASMR is used among young people to relax, induce sleep, reduce stress, and alleviate anxiety. However, even without experiencing tingling, ASMR is used by many young people to seek relaxation. Auditory stimulation in ASMR is thought to play the most important role among its triggers, and previous studies have used a mixture of auditory and visual stimulation and auditory stimulation. This is the first study to approach the differences between the effects of direct audiovisual and auditory stimulation from the perspective of brain function using functional magnetic resonance imaging (fMRI) and to clarify the effects of ASMR, which attracts many young people.

Methods

The subjects were 30 healthy subjects over 19 years old or older who had not experienced tingling. Brain function was imaged by fMRI while watching ASMR videos or listening to the sound files only. We administered a questionnaire based on a Likert scale to determine if the participants felt a "relaxed mood" and "tingling mood" during the task.

Results

Significant activation was found in the visual cortex for audiovisual stimulation and in the visual and auditory cortex for auditory stimulation. In addition, activation of characteristic sites was observed. The specific sites of activation for audiovisual stimulation were the middle frontal gyrus and the left nucleus accumbens, while the specific sites of activation for auditory stimulation were the bilateral insular cortices. The questionnaire showed no significant differences in either "relaxed mood" or "tingling mood" in response to auditory and visual stimulation or auditory stimulation alone.

Conclusion

The results of this study showed that there was a clear difference between auditory and audiovisual stimulation in terms of the areas of activation in the brain, but the questionnaire did not reveal any difference in the subjects' mood. Audiovisual stimulation showed activation of the middle frontal gyrus and the nucleus accumbens, whereas auditory stimulation showed activation of the insular cortex. This difference in brain activation sites suggests a difference in mental health effects between auditory and audiovisual stimulation. However, future research on comparisons between those who experience tingling and those who do not, as well as investigations of physiological indices, and examination of the relationship with activated areas in the brain may show that ASMR is useful for mental health.

Effects of Nursing Care Using Binaural Beat Music on Anxiety, Pain, and Vital Signs in Surgery Patients

PURPOSE

This study investigated the effects of binaural beat music on anxiety, pain, and vital signs in Korean surgical patients.

DESIGN

This study used a non-equivalent control group pre-and post-test design.

METHODS

This study included 54 patients who underwent spinal nerve plastic surgery under local anesthesia. The experimental group listened to binaural beat music twice, using headphones (20 minutes before surgery and 30 minutes after surgery). We measured the participants' pain and anxiety levels using a visual analog scale for pain and anxiety. In addition, we checked the participants' systolic and diastolic blood pressure and heart rate using a blood pressure monitor.

FINDINGS

The experimental group displayed significantly lower anxiety and pain scores than the control group after the intervention. Meanwhile, systolic and diastolic blood pressure did not show any statistically significant differences between the groups. However, the experimental group had a significantly lower pulse rate than the control group.

CONCLUSION

Our research findings showed that using binaural beat music in the nursing care of surgical patients under local anesthesia can effectively reduce postoperative pain and anxiety, contributing to improved mental health and physical well-being after surgery.

Reduction of psychological cravings and anxiety in women compulsorily isolated for detoxification using autonomous sensory meridian response (ASMR)

OBJECTIVE

To explore the effects of the autonomous sensory meridian response (ASMR) on the psychological cravings and anxiety of women compulsorily isolated for detoxification.

METHOD

Around 122 women were recruited in a female drug detoxification center. Except for the 12-week training of ASMR, the experimental conditions of the experimental group (n = 60) were the same as those of the control group (n = 62). The addiction Stroop task was used to assess the level of psychological cravings and the State-Trait Anxiety Inventory was used to assess the level of anxiety.

RESULTS

After the training, the decrease in state anxiety of the experimental group was larger than that of the control group, and the reaction time of the experimental group in the Stroop was also significantly lower than before the training.

CONCLUSIONS

ASMR could thus reduce to a certain extent the state anxiety and attentional bias for drug-related clues under signaling psychological cravings among women compulsorily isolated for detoxification.

HIGHLIGHTS

Intervention effects on psychological cravings and anxiety of women isolated for detoxification Basis for role of ASMR in regulating psychological cravings and anxiety in forced abstainers ASMR intervention reduced forced abstainers' attentional bias to drug-related clues.

Digital Addiction and Sleep

In 2020, the World Health Organization formally recognized addiction to digital technology (connected devices) as a worldwide problem, where excessive online activity and internet use lead to inability to manage time, energy, and attention during daytime and produce disturbed sleep patterns or insomnia during nighttime. Recent studies have shown that the problem has increased in magnitude worldwide during the COVID-19 pandemic. The extent to which dysfunctional sleep is a consequence of altered motivation, memory function, mood, diet, and other lifestyle variables or results from excess of blue-light exposure when looking at digital device screens for long hours at day and night is one of many still unresolved questions. This article offers a narrative overview of some of the most recent literature on this topic. The analysis provided offers a conceptual basis for understanding digital addiction as one of the major reasons why people, and adolescents in particular, sleep less and less well in the digital age. It discusses definitions as well as mechanistic model accounts in context. Digital addiction is identified as functionally equivalent to all addictions, characterized by the compulsive, habitual, and uncontrolled use of digital devices and an excessively repeated engagement in a particular online behavior. Once the urge to be online has become uncontrollable, it is always accompanied by severe sleep loss, emotional distress, depression, and memory dysfunction. In extreme cases, it may lead to suicide. The syndrome has been linked to the known chronic effects of all drugs, producing disturbances in cellular and molecular mechanisms of the GABAergic and glutamatergic neurotransmitter systems. Dopamine and serotonin synaptic plasticity, essential for impulse control, memory, and sleep function, are measurably altered. The full spectrum of behavioral symptoms in digital addicts include eating disorders and withdrawal from outdoor and social life. Evidence pointing towards dysfunctional melatonin and vitamin D metabolism in digital addicts should be taken into account for carving out perspectives for treatment. The conclusions offer a holistic account for digital addiction, where sleep deficit is one of the key factors.

Validation of Continuous Monitoring System for Epileptic Users in Outpatient Settings

Epilepsy is a chronic disease with a significant social impact, given that the patients and their families often live conditioned by the possibility of an epileptic seizure and its possible consequences, such as accidents, injuries, or even sudden unexplained death. In this context, ambulatory monitoring allows the collection of biomedical data about the patients’ health, thus gaining more knowledge about the physiological state and daily activities of each patient in a more personalized manner. For this reason, this article proposes a novel monitoring system composed of different sensors capable of synchronously recording electrocardiogram (ECG), photoplethysmogram (PPG), and ear electroencephalogram (EEG) signals and storing them for further processing and analysis in a microSD card. This system can be used in a static and/or ambulatory way, providing information about the health state through features extracted from the ear EEG signal and the calculation of the heart rate variability (HRV) and pulse travel time (PTT). The different applied processing techniques to improve the quality of these signals are described in this work. A novel algorithm used to compute HRV and PTT robustly and accurately in ambulatory settings is also described. The developed device has also been validated and compared with other commercial systems obtaining similar results. In this way, based on the quality of the obtained signals and the low variability of the computed parameters, even in ambulatory conditions, the developed device can potentially serve as a support tool for clinical decision-taking stages.

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.

Induction of Relaxation by Autonomous Sensory Meridian Response

Background: Autonomous sensory meridian response (ASMR) is used by young people to induce relaxation and sleep and to reduce stress and anxiety; it comprises somatosensation caused by audiovisual stimuli (triggers) that lead to positive emotions. Auditory stimuli play the most important role among the triggers involved in ASMR and have been reported to be more triggering than visual stimuli. On the other hand, classical music is also known to have a relaxing effect. This is the first study to clarify the difference in brain activation associated with relaxation effects between ASMR and classical music by limiting ASMR to auditory stimulation alone.

Methods: Thirty healthy subjects, all over 20 years of age, underwent fMRI while listening to ASMR and classical music. We compared the differences in brain activation associated with classical music and ASMR stimulation. After the experiment, the subjects were administered a questionnaire on somatosensation and moods. After the experiment, the participants were asked whether they experienced ASMR somatosensation or frisson. They were also asked to rate the intensity of two moods during stimulation: “comfortable mood,” and “tingling mood”.

Result: The results of the questionnaire showed that none of the participants experienced any ASMR somatosensation or frisson. Further, there was no significant difference in the ratings given to comfort mood, but there was a significant difference in those given to tingling mood. In terms of brain function, classical music and ASMR showed significant activation in common areas, while ASMR showed activation in more areas, with the medial prefrontal cortex being the main area of activation during ASMR.

Conclusion: Both classical music and the ASMR auditory stimulus produced a pleasant and relaxed state, and ASMR involved more complex brain functions than classical music, especially the activation of the medial prefrontal cortex. Although ASMR was limited to auditory stimulation, the effects were similar to those of listening to classical music, suggesting that ASMR stimulation can produce a pleasant state of relaxation even if it is limited to the auditory component, without the somatic sensation of tingling. ASMR stimulation is easy to use, and appropriate for wellness purposes and a wide range of people.

Personalized Theta and Beta Binaural Beats for Brain Entrainment: An Electroencephalographic Analysis

Binaural beats (BB) consist of two slightly distinct auditory frequencies (one in each ear), which are differentiated with clinical electroencephalographic (EEG) bandwidths, namely, delta, theta, alpha, beta, or gamma. This auditory stimulation has been widely used to module brain rhythms and thus inducing the mental condition associated with the EEG bandwidth in use. The aim of this research was to investigate whether personalized BB (specifically those within theta and beta EEG bands) improve brain entrainment. Personalized BB consisted of pure tones with a carrier tone of 500 Hz in the left ear together with an adjustable frequency in the right ear that was defined for theta BB (since f_c for theta EEG band was 4.60 Hz ± 0.70 SD) and beta BB (since f_c for beta EEG band was 18.42 Hz ± 2.82 SD). The adjustable frequencies were estimated for each participant in accordance with their heart rate by applying the Brain-Body Coupling Theorem postulated by Klimesch. To achieve this aim, 20 healthy volunteers were stimulated with their personalized theta and beta BB for 20 min and their EEG signals were collected with 22 channels. EEG analysis was based on the comparison of power spectral density among three mental conditions: (1) theta BB stimulation, (2) beta BB stimulation, and (3) resting state. Results showed larger absolute power differences for both BB stimulation sessions than resting state on bilateral temporal and parietal regions. This power change seems to be related to auditory perception and sound location. However, no significant differences were found between theta and beta BB sessions when it was expected to achieve different brain entrainments, since theta and beta BB induce relaxation and readiness, respectively. In addition, relative power analysis (theta BB/resting state) revealed alpha band desynchronization in the parieto-occipital region when volunteers listened to theta BB, suggesting that participants felt uncomfortable. In conclusion, neural resynchronization was met with both personalized theta and beta BB, but no different mental conditions seemed to be achieved.

A role for music in cataract surgery: a systematic review

PURPOSE

There have been several studies that explore the anxiolytic effects of music during cataract surgery. This is the first systematic review of literature highlighting the effects of music on patients undergoing cataract surgery without pharmacological anxiolytics.

METHODS

A systematic review of literature using PRISMA methodology identified randomized controlled trials involving patients undergoing cataract surgery with music as an intervention during the procedure with outcomes measured using at least one assessment of anxiety level, pain score, satisfaction, or vital sign measurements. Studies using pharmacological anxiolytics or additional pain-relieving medications besides local anesthetic were excluded.

RESULTS

Three studies, involving 523 patients, were included with patients undergoing cataract surgery with music intervention. Music intervention during cataract surgery has demonstrated use in reducing perceived pain, reducing anxiety, and improving vitals with increased benefit of reduced heart rate and blood pressures with binaural beat embedded music.

CONCLUSIONS

The clinical implications of this review identify non-traditional approaches to reducing anxiety intraoperatively for cataract surgeries, offering clinicians alternatives to minimizing benzodiazepine and medication use risks.

Autonomous Sensory Meridian Response self-reporters showed higher scores for cognitive reappraisal as an emotion regulation strategy

Background

Autonomous Sensory Meridian Response (ASMR) describes the experience of a pleasant tingling sensation along the back of the head, accompanied with a feeling of well-being and relaxation, in response to specific audio-visual stimuli, such as whispers, soft sounds, and personal attention. Previous works have assessed individual variations in personality traits associated with ASMR, but no research to date has explored differences in emotion regulation associated with ASMR. This omission occurred even when ASMR, a sensory-emotional experience, has been proposed to be located in a sound sensitivity spectrum as the opposite end of misophonia, a phenomenon associated with difficulties regulating emotions. The present work aimed to assess group differences between ASMR self-reporters and non-ASMR controls associated with emotion regulation strategies.

Methods

We used the validated Spanish version of the Emotion Regulation Questionnaire to assess individual differences in the use of cognitive reappraisal and expressive suppression.

Results

Our results showed that participants who experience ASMR had higher scores in the cognitive reappraisal subscale of the emotion regulation questionnaire than the non-ASMR group.

Conclusions

Individuals who experience ASMR reported higher use of cognitive reevaluation of emotionally arousing situations, suggesting more effectiveness in regulating emotions. Our finding further elucidates individual differences related to this experience, supporting that ASMR is a real psychophysiological phenomenon associated with other psychological constructs and has remarkable consequences in affective/emotional dimensions and general well-being.

Alcoholic EEG signal classification with Correlation Dimension based distance metrics approach and Modified Adaboost classification

The basic function of the brain is severely affected by alcoholism. For the easy depiction and assessment of the mental condition of a human brain, Electroencephalography (EEG) signals are highly useful as it can record and measure the electrical activities of the brain much to the satisfaction of doctors and researchers. Utilizing the standard conventional techniques is quite hectic to derive the useful information as these signals are highly non-linear and non-stationary in nature. While recording the EEG signals, the activities of the neurons are recorded from various scalp regions which has varied characteristics and has a very low magnitude. Therefore, human interpretation of such signals is very difficult and consumes a lot of time. Hence, with the advent of Computer Aided Diagnosis (CAD) Techniques, identifying the normal versus alcoholic EEG signals has been of great utility in the medical field. In this work, we perform the initial clustering of the alcoholic EEG signals by means of using Correlation Dimension (CD) for easy feature extraction and then the suitable features are selected in it by means of employing various distance metrics like correlation distance, city block distance, cosine distance and chebyshev distance. Proceeding in such a methodology aids and assures that a good discrimination could be achieved between normal and alcoholic EEG signals using non-linear features. Finally, classification is then carried out with the suitable classifiers chosen such as Adaboost.RT classifier, the proposed Modified Adaboost.RT classifier by means of introducing Ridge and Lasso based soft thresholding technique, Random Forest with bootstrap resampling technique, Artificial Neural Networks (ANN) such as Radial Basis Functions (RBF) and Multi-Layer Perceptron (MLP), Support Vector Machine (SVM) with Linear, Polynomial and RBF Kernel, Naïve Bayesian Classifier (NBC), K-means classifier, and K Nearest Neighbor (KNN) Classifier and the results are analyzed. Results report a comparatively high classification accuracy of about 98.99% when correlation distance metrics are utilized with CD and the proposed Modified Adaboost.RT classifier using Ridge based soft thresholding technique.

Effects of Autonomous Sensory Meridian Response on the Functional Connectivity as Measured by Functional Magnetic Resonance Imaging

Autonomous sensory meridian response (ASMR) is a sensory phenomenon in which audio-visual stimuli evoke a tingling sensation and is accompanied by a feeling of calm and relaxation. Therefore, there has been an increasing interest in using stimuli that elicit ASMR in cognitive and clinical neuroscience studies. However, neurophysiological basis of sensory-emotional experiences evoked by ASMR remain largely unexplored. In this study, we investigated how functional connectivity is changed while watching ASMR video, compared to resting state, and assessed its potential association with affective state induced by ASMR. 28 subjects participated in fMRI experiment consisting of 2 sessions (resting-state and task of viewing ASMR-eliciting video). Using a seed-based correlation analysis, we found that functional connections between the posterior cingulate cortex, and superior/middle temporal gyri, cuneus, and lingual gyrus were significantly increased during ASMR compared to resting state. In addition, we found that with the pregenual anterior cingulate cortex seed region, functional connectivity of the medial prefrontal cortex was increased during ASMR condition, relative to resting state. These results imply that ASMR can be elicited and maintained by ongoing interaction between regional activity that are mainly involved in the mentalizing and self-referential processing. We also found that ASMR-induced affective state changes (high activation negative and high activation positive state) were negatively correlated with functional connectivity involved in visual information processing, suggesting that visual information processing in response to high arousal states can be weakened by ASMR-eliciting stimuli.

End-to-End Automatic Sleep Stage Classification Using Spectral-Temporal Sleep Features

Sleep disorder is one of many neurological diseases that can affect greatly the quality of daily life. It is very burdensome to manually classify the sleep stages to detect sleep disorders. Therefore, the automatic sleep stage classification techniques are needed. However, the previous automatic sleep scoring methods using raw signals are still low classification performance. In this study, we proposed an end-to-end automatic sleep staging framework based on optimal spectral-temporal sleep features using a sleep-edf dataset. The input data were modified using a bandpass filter and then applied to a convolutional neural network model. For five sleep stage classification, the classification performance 85.6% and 91.1% using the raw input data and the proposed input, respectively. This result also shows the highest performance compared to conventional studies using the same dataset. The proposed framework has shown high performance by using optimal features associated with each sleep stage, which may help to find new features in the automatic sleep stage method.Clinical Relevance- The proposed framework would help to diagnose sleep disorders such as insomnia by improving sleep stage classification performance.