Non-invasive brain stimulation applied to Heschl's gyrus modulates pitch discrimination

Perceptual and cognitive effects of focal tDCS of auditory cortex in tinnitus

OBJECTIVES

Noninvasive brain stimulation continues to grow as an effective, low-risk way of improving the symptoms of brain conditions. Transcranial direct current stimulation (tDCS) is particularly well-tolerated, with benefits including low cost and potential portability. Nevertheless, continued study of perceptual and cognitive side effects is warranted, given the complexity of functional brain organization. This paper describes the results of a brief battery of tablet-based tasks used in a recent pilot study of auditory-cortex tDCS in people with chronic tinnitus.

METHODS

Volunteers with chronic tinnitus (n=20) completed two hearing tasks (pure-tone thresholds, Words In Noise) and two cognitive tasks (Flanker, Dimension Change Card Sort) from the NIH Toolbox. Volunteers were randomized to active or sham 4×1 Ag/AgCl tDCS of auditory cortex, and tasks were completed immediately before and after the first tDCS session, and after the fifth/final tDCS session. Statistics included linear mixed-effects models for change in task performance over time.

RESULTS

Before tDCS, performance on both auditory tasks was highly correlated with clinical audiometry, supporting the external validity of these measures (r2>0.89 for all). Although overall auditory task performance did not change after active or sham tDCS, detection of right-ear Words in Noise stimuli modestly improved after five active tDCS sessions (t(34)=-2.07, p=0.05). On cognitive tasks, reaction times were quicker after sham tDCS, reflecting expected practice effects (e.g., t(88)=3.22, p=0.002 after 5 sessions on Flanker task). However, reaction times did not improve over repeated sessions in the active group, suggesting that tDCS interfered with learning these practice effects.

CONCLUSIONS

Repeated sessions of auditory-cortex tDCS does not appear to adversely affect hearing or cognition, but may modestly improve hearing in noisy environments and interfere with some types of motor learning. Low-burden cognitive/perceptual test batteries could be a powerful way to identify adverse effects and new treatment targets in brain stimulation research.

The use of non-invasive brain stimulation in auditory perceptual learning: A review

Auditory perceptual learning is an experience-dependent form of auditory learning that can improve substantially throughout adulthood with practice. A key mechanism associated with perceptual learning is synaptic plasticity. In the last decades, an increasingly better understanding has formed about the neural mechanisms related to auditory perceptual learning. Research in animal models found an association between the functional organization of the primary auditory cortex and frequency discrimination ability. Several studies observed an increase in the area of representation to be associated with improved frequency discrimination. Non-invasive brain stimulation techniques have been related to the promotion of plasticity. Despite its popularity in other fields, non-invasive brain stimulation has not been used much in auditory perceptual learning. The present review has discussed the application of non-invasive brain stimulation methods in auditory perceptual learning by discussing the mechanisms, current evidence and challenges, and future directions.

Modulation of auditory temporal processing, speech in noise perception, auditory-verbal memory, and reading efficiency by anodal tDCS in children with dyslexia

Dyslexia is a neurodevelopmental disorder that is prevalent in children. It is estimated that 30-50% of individuals diagnosed with dyslexia also manifest an auditory perceptual deficit characteristic of auditory processing disorder (APD). Some studies suggest that defects in basic auditory processing can lead to phonological defects as the most prominent cause of dyslexia. Thus, in some cases, there may be interrelationships between dyslexia and some of the aspects of central auditory processing. In recent years, transcranial direct current stimulation (tDCS) has been used as a safe method for the modulation of central auditory processing aspects in healthy adults and reading skills in children with dyslexia. Therefore, the objectives of our study were to investigate the effect of tDCS on the modulation of different aspects of central auditory processing, aspects of reading, and the relationship between these two domains in dyslexic children with APD. A within-subjects design was employed to investigate the effect of two electrode arrays (the anode on the left STG (AC)/cathode on the right shoulder and anode on the left STG/cathode on the right STG) on auditory temporal processing; speech-in-noise perception, short-term auditory memory; and high-frequency word, low-frequency word, pseudoword, and text reading. The results of this clinical trial showed the modulation of the studied variables in central auditory processing and the accuracy and speed of reading variables compared to the control and sham statuses in both electrode arrays. Our results also showed that the improvement of the accuracy and speed of text reading, as well as the accuracy of pseudoword reading were related to the improvement of speech in noise perception and temporal processing. The results of this research can be effective in clarifying the basis of the neurobiology of dyslexia and, in particular, the hypothesis of the role of basic auditory processing and subsequently the role of the auditory cortex in dyslexia. These results might provide a framework to facilitate behavioral rehabilitation in dyslexic children with APD.

Transcranial Direct Current Stimulation Combined With Listening to Preferred Music Alters Cortical Speech Processing in Older Adults

Emerging evidence suggests transcranial direct current stimulation (tDCS) can improve cognitive performance in older adults. Similarly, music listening may improve arousal and stimulate subsequent performance on memory-related tasks. We examined the synergistic effects of tDCS paired with music listening on auditory neurobehavioral measures to investigate causal evidence of short-term plasticity in speech processing among older adults. In a randomized sham-controlled crossover study, we measured how combined anodal tDCS over dorsolateral prefrontal cortex (DLPFC) paired with listening to autobiographically salient music alters neural speech processing in older adults compared to either music listening (sham stimulation) or tDCS alone. EEG assays included both frequency-following responses (FFRs) and auditory event-related potentials (ERPs) to trace neuromodulation-related changes at brainstem and cortical levels. Relative to music without tDCS (sham), we found tDCS alone (without music) modulates the early cortical neural encoding of speech in the time frame of ∼100-150 ms. Whereas tDCS by itself appeared to largely produce suppressive effects (i.e., reducing ERP amplitude), concurrent music with tDCS restored responses to those of the music+sham levels. However, the interpretation of this effect is somewhat ambiguous as this neural modulation could be attributable to a true effect of tDCS or presence/absence music. Still, the combined benefit of tDCS+music (above tDCS alone) was correlated with listeners' education level suggesting the benefit of neurostimulation paired with music might depend on listener demographics. tDCS changes in speech-FFRs were not observed with DLPFC stimulation. Improvements in working memory pre to post session were also associated with better speech-in-noise listening skills. Our findings provide new causal evidence that combined tDCS+music relative to tDCS-alone (i) modulates the early (100-150 ms) cortical encoding of speech and (ii) improves working memory, a cognitive skill which may indirectly bolster noise-degraded speech perception in older listeners.

Using Transcranial Electrical Stimulation in Audiological Practice: The Gaps to Be Filled

The effects of transcranial electrical stimulation (tES) approaches have been widely studied for many decades in the motor field, and are well known to have a significant and consistent impact on the rehabilitation of people with motor deficits. Consequently, it can be asked whether tES could also be an effective tool for targeting and modulating plasticity in the sensory field for therapeutic purposes. Specifically, could potentiating sensitivity at the central level with tES help to compensate for sensory loss? The present review examines evidence of the impact of tES on cortical auditory excitability and its corresponding influence on auditory processing, and in particular on hearing rehabilitation. Overall, data strongly suggest that tES approaches can be an effective tool for modulating auditory plasticity. However, its specific impact on auditory processing requires further investigation before it can be considered for therapeutic purposes. Indeed, while it is clear that electrical stimulation has an effect on cortical excitability and overall auditory abilities, the directionality of these effects is puzzling. The knowledge gaps that will need to be filled are discussed.

The influence of anodal transcranial direct current stimulation over the right auditory cortex on interference effects in memory for melodies

The study investigates how transcranial direct current stimulation (tDCS) over the auditory cortex (AC) modulates memory for melodies under different noise conditions, whilst also considering cumulative disruptive interference effects. Forty-one participants completed a continuous recognition melody task, as well as a visual control task, which included four noise conditions for which noise was either present only during encoding (N-C), only during retrieval (C-N), during both (N-N) or not at all (C-C) and completed the tasks after receiving anodal or sham tDCS over the right AC. The results of the sham session replicate previous findings by revealing that memory for melodies is worse when noise in added to the encoding phase (N-C) whereas the N-N condition shows good performance, highlighting a context effect, and that cumulative disruptive interference is not present in memory for melodies except in the N-C condition. After anodal stimulation the memory pattern differs such as that memory performance is best in the C-C condition and furthermore the cumulative disruptive interference effect in the N-C condition is diminished. In sum, the study highlights the involvement of the right AC for memory for melodies and the results indicate an association of the AC for creating context effects.

Causal Relationship between the Right Auditory Cortex and Speech-Evoked Envelope-Following Response: Evidence from Combined Transcranial Stimulation and Electroencephalography

Speech-evoked envelope-following response (EFR) reflects brain encoding of speech periodicity that serves as a biomarker for pitch and speech perception and various auditory and language disorders. Although EFR is thought to originate from the subcortex, recent research illustrated a right-hemispheric cortical contribution to EFR. However, it is unclear whether this contribution is causal. This study aimed to establish this causality by combining transcranial direct current stimulation (tDCS) and measurement of EFR (pre- and post-tDCS) via scalp-recorded electroencephalography. We applied tDCS over the left and right auditory cortices in right-handed normal-hearing participants and examined whether altering cortical excitability via tDCS causes changes in EFR during monaural listening to speech syllables. We showed significant changes in EFR magnitude when tDCS was applied over the right auditory cortex compared with sham stimulation for the listening ear contralateral to the stimulation site. No such effect was found when tDCS was applied over the left auditory cortex. Crucially, we further observed a hemispheric laterality where aftereffect was significantly greater for tDCS applied over the right than the left auditory cortex in the contralateral ear condition. Our finding thus provides the first evidence that validates the causal relationship between the right auditory cortex and EFR.

Modulating short-term auditory memory with focal transcranial direct current stimulation applied to the supramarginal gyrus

Previous studies have shown that transcranial direct current stimulation (tDCS) can affect performance by decreasing regional excitability in a brain region that contributes to the task of interest. To our knowledge, no research to date has found both enhancing and diminishing effects on performance, depending upon which polarity of the current is applied. The supramarginal gyrus (SMG) is an ideal brain region for testing tDCS effects because it is easy to identify using the 10-20 electroencephalography coordinate system, and results of neuroimaging studies have implicated the left SMG in short-term memory for phonological and nonphonological sounds. In the present study, we found that applying tDCS to the left SMG affected pitch memory in a manner that depended upon the polarity of stimulation: cathodal tDCS had a negative impact on performance whereas anodal tDCS had a positive impact. These effects were significantly different from sham stimulation, which did not influence performance; they were also specific to the left hemisphere - no effect was found when applying cathodal stimulation to the right SMG - and were unique to pitch memory as opposed to memory for visual shapes. Our results provide further evidence that the left SMG is a nodal point for short-term auditory storage and demonstrate the potential of tDCS to influence cognitive performance and to causally examine hypotheses derived from neuroimaging studies.

Inhibitory effect of tDCS on auditory evoked response: Simultaneous MEG-tDCS reveals causal role of right auditory cortex in pitch learning

A body of literature has demonstrated that the right auditory cortex (AC) plays a dominant role in fine pitch processing. However, our understanding is relatively limited about whether this asymmetry extends to perceptual learning of pitch. There is also a lack of causal evidence regarding the role of the right AC in pitch learning.  We addressed these points with anodal transcranial direct current stimulation (tDCS), adapting a previous behavioral study in which anodal tDCS over the right AC was shown to block improvement of a microtonal pitch pattern learning task over 3 days. To address the physiological changes associated with tDCS, we recorded MEG data simultaneously with tDCS on the first day, and measured behavioral thresholds on the following two consecutive days. We tested three groups of participants who received anodal tDCS over their right or left AC, or sham tDCS, and measured the N1m auditory evoked response before, during, and after tDCS. Our data show that anodal tDCS of the right AC disrupted pitch discrimination learning up to two days after its application, whereas learning was unaffected by left-AC or sham tDCS. Although tDCS reduced the amplitude of the N1m ipsilaterally to the stimulated hemisphere on both left and right, only right AC N1m amplitude reductions were associated with the degree to which pitch learning was disrupted. This brain-behavior relationship confirms a causal link between right AC physiological responses and fine pitch processing, and provides neurophysiological insight concerning the mechanisms of action of tDCS on the auditory system.

Investigating the effects of tDCS on Visual Orientation Discrimination Task Performance: 'The possible influence of placebo'

The non-invasive neuromodulation technique tDCS offers the promise of a low cost tool for both research and clinical applications in psychology, psychiatry and neuroscience. However, findings regarding its efficacy are often equivocal. A key issue is that the clinical and cognitive applications studied are often complex and thus effects of tDCS are difficult to predict given its known effects on the basic underlying neurophysiology, namely alterations in cortical inhibition-excitation balance. As such, it may be beneficial to assess the effects of tDCS in tasks whose performance has a clear link to cortical inhibition-excitation balance such as the visual orientation discrimination task (ODT). In prior studies in our laboratory no practise effects were found during 2 consecutive runs of the ODT, thus in the current investigation, to examine the effects of tDCS, subjects received 10 minutes of 2mA occipital tDCS (sham, anode, cathode) between a first and second run of ODT. Surprisingly, subjects' performance significantly improved in the second run of ODT compared to the first one regardless of the tDCS stimulation type they received (anodal, cathodal, or sham-tDCS). Possible causes for such an improvement could have been due to either a generic 'placebo' effect of tDCS (as all subjects received some form of tDCS) or an increased delay period between the two runs of ODT of the current study compared to our previous work (10 minutes duration required to administer tDCS as opposed to ~2 minutes in previous studies as a 'break'). As such, we tested these two possibilities with a subsequent experiment in which subjects received 2 minutes or 10 minutes delay between the 2 runs (with no tDCS) or 10 minutes of sham-tDCS. Only sham-tDCS resulted in improved performance thus these data add to a growing literature suggesting that tDCS has powerful placebo effect that may occur even in the absence of active cortical modulation.

Transcranial direct current stimulation of posterior temporal cortex modulates electrophysiological correlates of auditory selective spatial attention in posterior parietal cortex

Speech perception in "cocktail-party" situations, in which a sound source of interest has to be extracted out of multiple irrelevant sounds, poses a remarkable challenge to the human auditory system. Studies on structural and electrophysiological correlates of auditory selective spatial attention revealed critical roles of the posterior temporal cortex and the N2 event-related potential (ERP) component in the underlying processes. Here, we explored effects of transcranial direct current stimulation (tDCS) to posterior temporal cortex on neurophysiological correlates of auditory selective spatial attention, with a specific focus on the N2. In a single-blind, sham-controlled crossover design with baseline and follow-up measurements, monopolar anodal and cathodal tDCS was applied for 16 min to the right posterior superior temporal cortex. Two age groups of human subjects, a younger (n = 20; age 18-30 yrs) and an older group (n = 19; age 66-77 yrs), completed an auditory free-field multiple-speakers localization task while ERPs were recorded. The ERP data showed an offline effect of anodal, but not cathodal, tDCS immediately after DC offset for targets contralateral, but not ipsilateral, to the hemisphere of tDCS, without differences between groups. This effect mainly consisted in a substantial increase of the N2 amplitude by 0.9 μV (SE 0.4 μV; d = 0.40) compared with sham tDCS. At the same point in time, cortical source localization revealed a reduction of activity in ipsilateral (right) posterior parietal cortex. Also, localization error was improved after anodal, but not cathodal, tDCS. Given that both the N2 and the posterior parietal cortex are involved in processes of auditory selective spatial attention, these results suggest that anodal tDCS specifically enhanced inhibitory attentional brain processes underlying the focusing onto a target sound source, possibly by improved suppression of irrelevant distracters.

Bihemispheric anodal transcranial direct-current stimulation over temporal cortex enhances auditory selective spatial attention

The capacity to selectively focus on a particular speaker of interest in a complex acoustic environment with multiple persons speaking simultaneously-a so-called "cocktail-party" situation-is of decisive importance for human verbal communication. Here, the efficacy of single-dose transcranial direct-current stimulation (tDCS) in improving this ability was tested in young healthy adults (n = 24), using a spatial task that required the localization of a target word in a simulated "cocktail-party" situation. In a sham-controlled crossover design, offline bihemispheric double-monopolar anodal tDCS was applied for 30 min at 1 mA over auditory regions of temporal lobe, and the participant's performance was assessed prior to tDCS, immediately after tDCS, and 1 h after tDCS. A significant increase in the amount of correct localizations by on average 3.7 percentage points (d = 1.04) was found after active, relative to sham, tDCS, with only insignificant reduction of the effect within 1 h after tDCS offset. Thus, the method of bihemispheric tDCS could be a promising tool for enhancement of human auditory attentional functions that are relevant for spatial orientation and communication in everyday life.

The Montreal Protocol for Identification of Amusia

The Montreal Battery for the Evaluation of Amusia (MBEA; Peretz, Champod, & Hyde Annals of the New York Academy of Sciences, 999, 58-75, 2003) is an empirically grounded quantitative tool that is widely used to identify individuals with congenital amusia. The use of such a standardized measure ensures that the individuals tested will conform to a specific neuropsychological profile, allowing for comparisons across studies and research groups. Recently, a number of researchers have published credible critiques of the usefulness of the MBEA as a diagnostic tool for amusia. Here we argue that the MBEA and its online counterpart, the AMUSIA tests (Peretz et al. Music Perception, 25, 331-343, 2008), should be considered steps in a screening process for amusia, rather than standalone diagnostic tools. The goal of this article is to present, in detailed and easily replicable format, the full protocol through which congenital amusics should be identified. In providing information that has often gone unreported in published articles, we aim to clarify the strengths and limitations of the MBEA and to make recommendations for its continued use by the research community as part of the Montreal Protocol for Identification of Amusia.

No Effect of Transcranial Direct Current Stimulation of the Auditory Cortex on Auditory-Evoked Potentials

Transcranial direct current stimulation (tDCS) is a non-invasive brain stimulation technique to change cortical excitability. Its effects are shown for cognitive processing, and behavior in the motor and perceptual domains. However, evidence of tDCS effects in the perceptual domain particularly for auditory processing is rare. Therefore, and in the context of disturbances in auditory processing in psychiatric populations, e.g., in patients with auditory verbal hallucinations, we aimed to investigate the potential modulatory effect of tDCS on the excitability of left posterior temporal cortex in detail. We included 24 healthy participants in a crossover design, applying sham and anodal stimulation in two measurement sessions 1 week apart. Electroencephalography (EEG) was recorded while participants listened to tones before, during, and after stimulation. Amplitudes and latencies of P50, N100, and P200 auditory-evoked potentials (AEP) were compared between anodal and sham stimulation, and between time points before, during, and after tDCS. In contrast to previous studies, results demonstrate no significant differences between stimulation types or time points for any of the investigated AEP amplitudes or latencies. Furthermore, a topographical analysis did not show any topographical differences during peak time periods of the investigated AEP for stimulation types and time points besides a habituation effect. Thus, our results suggest that tDCS modulation of excitability of the left posterior temporal cortex, targeting the auditory cortex, does not have any effect on AEP. This is particularly interesting in the context of tDCS as a potential treatment for changed electrophysiological parameters and symptoms of psychiatric diseases, e.g., lower N100 or auditory verbal hallucinations in schizophrenia.

Insights Into Auditory Cortex Dynamics From Non-invasive Brain Stimulation

Non-invasive brain stimulation (NIBS) has been widely used as a research tool to modulate cortical excitability of motor as well as non-motor areas, including auditory or language-related areas. NIBS, especially transcranial magnetic stimulation (TMS) and transcranial direct current stimulation, have also been used in clinical settings, with however variable therapeutic outcome, highlighting the need to better understand the mechanisms underlying NIBS techniques. TMS was initially used to address causality between specific brain areas and related behavior, such as language production, providing non-invasive alternatives to lesion studies. Recent literature however suggests that the relationship is not as straightforward as originally thought, and that TMS can show both linear and non-linear modulation of brain responses, highlighting complex network dynamics. In particular, in the last decade, NIBS studies have enabled further advances in our understanding of auditory processing and its underlying functional organization. For instance, NIBS studies showed that even when only one auditory cortex is stimulated unilaterally, bilateral modulation may result, thereby highlighting the influence of functional connectivity between auditory cortices. Additional neuromodulation techniques such as transcranial alternating current stimulation or transcranial random noise stimulation have been used to target frequency-specific neural oscillations of the auditory cortex, thereby providing further insight into modulation of auditory functions. All these NIBS techniques offer different perspectives into the function and organization of auditory cortex. However, further research should be carried out to assess the mode of action and long-term effects of NIBS to optimize their use in clinical settings.

Motor facilitation during observation of implied motion: Evidence for a role of the left dorsolateral prefrontal cortex

The phenomenon of motor resonance (the increase in motor cortex excitability during observation of actions) has been previously described. Transcranial magnetic stimulation (TMS) studies have demonstrated a similar effect during perception of implied motion (IM). The left dorsolateral prefrontal cortex (DLPFC) seems to be activated during action observation. Furthermore, the role of this brain area in motor resonance to IM is yet to be investigated. Fourteen healthy volunteers were enrolled into the study. We used transcranial direct current stimulation (tDCS) to stimulate DLPFC aiming to investigate whether stimulation with different polarities would affect the amplitude of motor evoked potential collected during observation of images with and without IM. The results of our experiment indicated that Cathodal tDCS over the left DLPFC prevented motor resonance during observation of IM. On the contrary, anodal and sham tDCS did not significantly modulate motor resonance to IM. The current study expands the understanding of the neural circuits engaged during observation of IM. Our results are consistent with the hypothesis that action understanding requires the interaction of large networks and that the left DLPFC plays a crucial role in generating motor resonance to IM.

Reverse Engineering Tone-Deafness: Disrupting Pitch-Matching by Creating Temporary Dysfunctions in the Auditory-Motor Network

Perceiving and producing vocal sounds are important functions of the auditory-motor system and are fundamental to communication. Prior studies have identified a network of brain regions involved in pitch production, specifically pitch matching. Here we reverse engineer the function of the auditory perception-production network by targeting specific cortical regions (e.g., right and left posterior superior temporal (pSTG) and posterior inferior frontal gyri (pIFG)) with cathodal transcranial direct current stimulation (tDCS)—commonly found to decrease excitability in the underlying cortical region—allowing us to causally test the role of particular nodes in this network. Performance on a pitch-matching task was determined before and after 20 min of cathodal stimulation. Acoustic analyses of pitch productions showed impaired accuracy after cathodal stimulation to the left pIFG and the right pSTG in comparison to sham stimulation. Both regions share particular roles in the feedback and feedforward motor control of pitched vocal production with a differential hemispheric dominance.

Modulating transcallosal and intra-hemispheric brain connectivity with tDCS: Implications for interventions in Aphasia

BACKGROUND/OBJECTIVE

Transcranial direct current stimulation (tDCS) can enhance or diminish cortical excitability levels depending on the polarity of the stimulation. One application of non-invasive brain-stimulation has been to modulate a possible inter-hemispheric disinhibition after a stroke. This disinhibition model has been developed mainly for the upper extremity motor system, but it is not known whether the language/speech-motor system shows a similar inter-hemispheric interaction. We aimed to examine physiological evidence of inter- and intra-hemispheric connectivity changes induced by tDCS of the right inferior frontal gyrus (IFG) using arterial-spin labeling (ASL) MRI.

METHODS

Using an MR-compatible DC-Stimulator, we applied anodal stimulation to the right IFG region of nine healthy adults while undergoing non-invasive cerebral blood flow imaging with arterial-spin labeling (ASL) before, during, and after the stimulation. All ASL images were then normalized and timecourses were extracted in regions of interest (ROIs), which were the left and right IFG regions, and the right supramarginal gyrus (SMG) in the inferior parietal lobule. Two additional ROIs (the right occipital lobe and the left fronto-orbital region) were taken as control regions.

RESULTS

Using regional correlation coefficients as a surrogate marker of connectivity, we could show that inter-hemispheric connectivity (right IFG with left IFG) decreased significantly (p < 0.05; r-scores from 0.67 to 0.53) between baseline and post-stimulation, while the intra-hemispheric connectivity (right IFG with right SMG) increased significantly (p < 0.05;r-scores from 0.74 to 0.81). A 2 × 2 ANOVA found a significant main effect of HEMISPHERE (F(8) = 6.83, p < 0.01) and a significant HEMISPHERE-by-TIME interaction (F(8) = 4.24, p < 0.05) in connectivity changes. The correlation scores did not change significantly in the control region pairs (right IFG with right occipital and right IFG with left fronto-orbital) over time.

CONCLUSION

Using an MR-compatible DC stimulator we showed that ASL-MRI can detect tDCS-induced modulation of brain connectivity within and between hemispheres. These findings might affect trial designs focusing on modulating the non-dominant hemisphere to enhance language/speech-motor functions.

Low intensity transcranial electric stimulation: Safety, ethical, legal regulatory and application guidelines

Low intensity transcranial electrical stimulation (TES) in humans, encompassing transcranial direct current (tDCS), transcutaneous spinal Direct Current Stimulation (tsDCS), transcranial alternating current (tACS), and transcranial random noise (tRNS) stimulation or their combinations, appears to be safe. No serious adverse events (SAEs) have been reported so far in over 18,000 sessions administered to healthy subjects, neurological and psychiatric patients, as summarized here. Moderate adverse events (AEs), as defined by the necessity to intervene, are rare, and include skin burns with tDCS due to suboptimal electrode-skin contact. Very rarely mania or hypomania was induced in patients with depression (11 documented cases), yet a causal relationship is difficult to prove because of the low incidence rate and limited numbers of subjects in controlled trials. Mild AEs (MAEs) include headache and fatigue following stimulation as well as prickling and burning sensations occurring during tDCS at peak-to-baseline intensities of 1-2mA and during tACS at higher peak-to-peak intensities above 2mA. The prevalence of published AEs is different in studies specifically assessing AEs vs. those not assessing them, being higher in the former. AEs are frequently reported by individuals receiving placebo stimulation. The profile of AEs in terms of frequency, magnitude and type is comparable in healthy and clinical populations, and this is also the case for more vulnerable populations, such as children, elderly persons, or pregnant women. Combined interventions (e.g., co-application of drugs, electrophysiological measurements, neuroimaging) were not associated with further safety issues. Safety is established for low-intensity 'conventional' TES defined as <4mA, up to 60min duration per day. Animal studies and modeling evidence indicate that brain injury could occur at predicted current densities in the brain of 6.3-13A/m2 that are over an order of magnitude above those produced by tDCS in humans. Using AC stimulation fewer AEs were reported compared to DC. In specific paradigms with amplitudes of up to 10mA, frequencies in the kHz range appear to be safe. In this paper we provide structured interviews and recommend their use in future controlled studies, in particular when trying to extend the parameters applied. We also discuss recent regulatory issues, reporting practices and ethical issues. These recommendations achieved consensus in a meeting, which took place in Göttingen, Germany, on September 6-7, 2016 and were refined thereafter by email correspondence.

Neural Correlates of Early Sound Encoding and their Relationship to Speech-in-Noise Perception

Speech-in-noise (SIN) perception is a complex cognitive skill that affects social, vocational, and educational activities. Poor SIN ability particularly affects young and elderly populations, yet varies considerably even among healthy young adults with normal hearing. Although SIN skills are known to be influenced by top-down processes that can selectively enhance lower-level sound representations, the complementary role of feed-forward mechanisms and their relationship to musical training is poorly understood. Using a paradigm that minimizes the main top-down factors that have been implicated in SIN performance such as working memory, we aimed to better understand how robust encoding of periodicity in the auditory system (as measured by the frequency-following response) contributes to SIN perception. Using magnetoencephalograpy, we found that the strength of encoding at the fundamental frequency in the brainstem, thalamus, and cortex is correlated with SIN accuracy. The amplitude of the slower cortical P2 wave was previously also shown to be related to SIN accuracy and FFR strength; we use MEG source localization to show that the P2 wave originates in a temporal region anterior to that of the cortical FFR. We also confirm that the observed enhancements were related to the extent and timing of musicianship. These results are consistent with the hypothesis that basic feed-forward sound encoding affects SIN perception by providing better information to later processing stages, and that modifying this process may be one mechanism through which musical training might enhance the auditory networks that subserve both musical and language functions.

Cortical Correlates of the Auditory Frequency-Following and Onset Responses: EEG and fMRI Evidence

The frequency-following response (FFR) is a measure of the brain's periodic sound encoding. It is of increasing importance for studying the human auditory nervous system due to numerous associations with auditory cognition and dysfunction. Although the FFR is widely interpreted as originating from brainstem nuclei, a recent study using MEG suggested that there is also a right-lateralized contribution from the auditory cortex at the fundamental frequency (Coffey et al., 2016b). Our objectives in the present work were to validate and better localize this result using a completely different neuroimaging modality and to document the relationships between the FFR, the onset response, and cortical activity. Using a combination of EEG, fMRI, and diffusion-weighted imaging, we show that activity in the right auditory cortex is related to individual differences in FFR-fundamental frequency (f₀) strength, a finding that was replicated with two independent stimulus sets, with and without acoustic energy at the fundamental frequency. We demonstrate a dissociation between this FFR-f₀-sensitive response in the right and an area in left auditory cortex that is sensitive to individual differences in the timing of initial response to sound onset. Relationships to timing and their lateralization are supported by parallels in the microstructure of the underlying white matter, implicating a mechanism involving neural conduction efficiency. These data confirm that the FFR has a cortical contribution and suggest ways in which auditory neuroscience may be advanced by connecting early sound representation to measures of higher-level sound processing and cognitive function.

SIGNIFICANCE STATEMENT

The frequency-following response (FFR) is an EEG signal that is used to explore how the auditory system encodes temporal regularities in sound and is related to differences in auditory function between individuals. It is known that brainstem nuclei contribute to the FFR, but recent findings of an additional cortical source are more controversial. Here, we use fMRI to validate and extend the prediction from MEG data of a right auditory cortex contribution to the FFR. We also demonstrate a dissociation between FFR-related cortical activity from that related to the latency of the response to sound onset, which is found in left auditory cortex. The findings provide a clearer picture of cortical processes for analysis of sound features.

Modulation of Illusory Auditory Perception by Transcranial Electrical Stimulation

The aim of the present study was to test whether transcranial electrical stimulation can modulate illusory perception in the auditory domain. In two separate experiments we applied transcranial Direct Current Stimulation (anodal/cathodal tDCS, 2 mA; N = 60) and high-frequency transcranial Random Noise Stimulation (hf-tRNS, 1.5 mA, offset 0; N = 45) on the temporal cortex during the presentation of the stimuli eliciting the Deutsch's illusion. The illusion arises when two sine tones spaced one octave apart (400 and 800 Hz) are presented dichotically in alternation, one in the left and the other in the right ear, so that when the right ear receives the high tone, the left ear receives the low tone, and vice versa. The majority of the population perceives one high-pitched tone in one ear alternating with one low-pitched tone in the other ear. The results revealed that neither anodal nor cathodal tDCS applied over the left/right temporal cortex modulated the perception of the illusion, whereas hf-tRNS applied bilaterally on the temporal cortex reduced the number of times the sequence of sounds is perceived as the Deutsch's illusion with respect to the sham control condition. The stimulation time before the beginning of the task (5 or 15 min) did not influence the perceptual outcome. In accordance with previous findings, we conclude that hf-tRNS can modulate auditory perception more efficiently than tDCS.

Effects of an NMDA antagonist on the auditory mismatch negativity response to transcranial direct current stimulation

Transcranial direct current stimulation (tDCS) is a non-invasive form of brain stimulation which uses a weak constant current to alter cortical excitability and activity temporarily. tDCS-induced increases in neuronal excitability and performance improvements have been observed following anodal stimulation of brain regions associated with visual and motor functions, but relatively little research has been conducted with respect to auditory processing. Recently, pilot study results indicate that anodal tDCS can increase auditory deviance detection, whereas cathodal tDCS decreases auditory processing, as measured by a brain-based event-related potential (ERP), mismatch negativity (MMN). As evidence has shown that tDCS lasting effects may be dependent on N-methyl-D-aspartate (NMDA) receptor activity, the current study investigated the use of dextromethorphan (DMO), an NMDA antagonist, to assess possible modulation of tDCS's effects on both MMN and working memory performance. The study, conducted in 12 healthy volunteers, involved four laboratory test sessions within a randomised, placebo and sham-controlled crossover design that compared pre- and post-anodal tDCS over the auditory cortex (2 mA for 20 minutes to excite cortical activity temporarily and locally) and sham stimulation (i.e. device is turned off) during both DMO (50 mL) and placebo administration. Anodal tDCS increased MMN amplitudes with placebo administration. Significant increases were not seen with sham stimulation or with anodal stimulation during DMO administration. With sham stimulation (i.e. no stimulation), DMO decreased MMN amplitudes. Findings from this study contribute to the understanding of underlying neurobiological mechanisms mediating tDCS sensory and memory improvements.

Probing neural mechanisms underlying auditory stream segregation in humans by transcranial direct current stimulation (tDCS)

One hypothesis concerning the neural underpinnings of auditory streaming states that frequency tuning of tonotopically organized neurons in primary auditory fields in combination with physiological forward suppression is necessary for the separation of representations of high-frequency A and low-frequency B tones. The extent of spatial overlap between the tonotopic activations of A and B tones is thought to underlie the perceptual organization of streaming sequences into one coherent or two separate streams. The present study attempts to interfere with these mechanisms by transcranial direct current stimulation (tDCS) and to probe behavioral outcomes reflecting the perception of ABAB streaming sequences. We hypothesized that tDCS by modulating cortical excitability causes a change in the separateness of the representations of A and B tones, which leads to a change in the proportions of one-stream and two-stream percepts. To test this, 22 subjects were presented with ambiguous ABAB sequences of three different frequency separations (∆F) and had to decide on their current percept after receiving sham, anodal, or cathodal tDCS over the left auditory cortex. We could confirm our hypothesis at the most ambiguous ∆F condition of 6 semitones. For anodal compared with sham and cathodal stimulation, we found a significant decrease in the proportion of two-stream perception and an increase in the proportion of one-stream perception. The results demonstrate the feasibility of using tDCS to probe mechanisms underlying auditory streaming through the use of various behavioral measures. Moreover, this approach allows one to probe the functions of auditory regions and their interactions with other processing stages.

Individual Differences in the Frequency-Following Response: Relation to Pitch Perception

The scalp-recorded frequency-following response (FFR) is a measure of the auditory nervous system’s representation of periodic sound, and may serve as a marker of training-related enhancements, behavioural deficits, and clinical conditions. However, FFRs of healthy normal subjects show considerable variability that remains unexplained. We investigated whether the FFR representation of the frequency content of a complex tone is related to the perception of the pitch of the fundamental frequency. The strength of the fundamental frequency in the FFR of 39 people with normal hearing was assessed when they listened to complex tones that either included or lacked energy at the fundamental frequency. We found that the strength of the fundamental representation of the missing fundamental tone complex correlated significantly with people's general tendency to perceive the pitch of the tone as either matching the frequency of the spectral components that were present, or that of the missing fundamental. Although at a group level the fundamental representation in the FFR did not appear to be affected by the presence or absence of energy at the same frequency in the stimulus, the two conditions were statistically distinguishable for some subjects individually, indicating that the neural representation is not linearly dependent on the stimulus content. In a second experiment using a within-subjects paradigm, we showed that subjects can learn to reversibly select between either fundamental or spectral perception, and that this is accompanied both by changes to the fundamental representation in the FFR and to cortical-based gamma activity. These results suggest that both fundamental and spectral representations coexist, and are available for later auditory processing stages, the requirements of which may also influence their relative strength and thus modulate FFR variability. The data also highlight voluntary mode perception as a new paradigm with which to study top-down vs bottom-up mechanisms that support the emerging view of the FFR as the outcome of integrated processing in the entire auditory system.

Cortical contributions to the auditory frequency-following response revealed by MEG

The auditory frequency-following response (FFR) to complex periodic sounds is used to study the subcortical auditory system, and has been proposed as a biomarker for disorders that feature abnormal sound processing. Despite its value in fundamental and clinical research, the neural origins of the FFR are unclear. Using magnetoencephalography, we observe a strong, right-asymmetric contribution to the FFR from the human auditory cortex at the fundamental frequency of the stimulus, in addition to signal from cochlear nucleus, inferior colliculus and medial geniculate. This finding is highly relevant for our understanding of plasticity and pathology in the auditory system, as well as higher-level cognition such as speech and music processing. It suggests that previous interpretations of the FFR may need re-examination using methods that allow for source separation.

Auditory brainstem response (ABR) is used to study temporal encoding of auditory information in music and language. This study utilizes magnetoencephalography to localize both cortical and subcortical origins of the sustained frequency following response (FFR), the ABR component that encodes the periodicity of sound.

Modulating Human Auditory Processing by Transcranial Electrical Stimulation

Transcranial electrical stimulation (tES) has become a valuable research tool for the investigation of neurophysiological processes underlying human action and cognition. In recent years, striking evidence for the neuromodulatory effects of transcranial direct current stimulation, transcranial alternating current stimulation, and transcranial random noise stimulation has emerged. While the wealth of knowledge has been gained about tES in the motor domain and, to a lesser extent, about its ability to modulate human cognition, surprisingly little is known about its impact on perceptual processing, particularly in the auditory domain. Moreover, while only a few studies systematically investigated the impact of auditory tES, it has already been applied in a large number of clinical trials, leading to a remarkable imbalance between basic and clinical research on auditory tES. Here, we review the state of the art of tES application in the auditory domain focussing on the impact of neuromodulation on acoustic perception and its potential for clinical application in the treatment of auditory related disorders.

Changed categorical perception of consonant-vowel syllables induced by transcranial direct current stimulation (tDCS)

Background

Speech-related disorders may refer to impairment of temporal analysis in the human auditory system. By the advance of non-invasive brain stimulation new forms of therapy arise. In the present study, we examined the neuromodulatory effect of auditory tDCS on the perception of temporal modulated speech syllables. In three experimental sessions we assessed phonetic categorization of consonant–vowels (CV)-syllables (/da/,/ta/) with varying voice onset times (VOT) during sham, anodal, and cathodal tDCS delivered bilateral to the auditory cortex (AC). Subsequently, we recorded auditory evoked potentials (AEP) in response to voiced (/ba/,/da/,/ga/) and voiceless (/pa/,/ta/,/ka/) CV-syllables.

Results

In result, we demonstrate that bilateral tDCS of the AC can modulate CV-syllable perception. Behaviorally, cathodal tDCS improved phonetic categorization abilities in a VOT continuum accompanied by an elevation of the P50 amplitude of the AEP to CV-syllables during the anodal tDCS after effect.

Conclusions

The present study demonstrates the ability of bilateral tDCS over the AC to ameliorate speech perception. The results may have clinical implications by fostering potential approaches for a treatment of speech-related pathologies with a deficit of temporal processing.

Modulation of human auditory spatial scene analysis by transcranial direct current stimulation

Localizing and selectively attending to the source of a sound of interest in a complex auditory environment is an important capacity of the human auditory system. The underlying neural mechanisms have, however, still not been clarified in detail. This issue was addressed by using bilateral bipolar-balanced transcranial direct current stimulation (tDCS) in combination with a task demanding free-field sound localization in the presence of multiple sound sources, thus providing a realistic simulation of the so-called "cocktail-party" situation. With left-anode/right-cathode, but not with right-anode/left-cathode, montage of bilateral electrodes, tDCS over superior temporal gyrus, including planum temporale and auditory cortices, was found to improve the accuracy of target localization in left hemispace. No effects were found for tDCS over inferior parietal lobule or with off-target active stimulation over somatosensory-motor cortex that was used to control for non-specific effects. Also, the absolute error in localization remained unaffected by tDCS, thus suggesting that general response precision was not modulated by brain polarization. This finding can be explained in the framework of a model assuming that brain polarization modulated the suppression of irrelevant sound sources, thus resulting in more effective spatial separation of the target from the interfering sound in the complex auditory scene.

Stimulating somatosensory psychophysics: a double-blind, sham-controlled study of the neurobiological mechanisms of tDCS

The neuromodulation technique transcranial direct current stimulation (tDCS) is thought to produce its effects on behavior by altering cortical excitability. Although the mechanisms underlying the observed effects are thought to rely on the balance of excitatory and inhibitory neurotransmission, the physiological principles of the technique are not completely understood. In this study, we examine the influence of tDCS on vibrotactile adaptation, using a simple amplitude discrimination paradigm that has been shown to exhibit modifications in performance due to changes in inhibitory neurotransmission. Double-blind tDCS (Anodal/Sham) of 1 mA was delivered for 600 s to electrodes positioned in a somatosensory/contralateral orbit montage. Stimulation was applied as part of a pre/post design, between blocks of the behavioral tasks. In accordance with previous work, results obtained before the application of tDCS indicated that amplitude discrimination thresholds were significantly worsened during adaptation trials, compared to those achieved at baseline. However, tDCS failed to modify amplitude discrimination performance. Using a Bayesian approach, this finding was revealed to constitute substantial evidence for the null hypothesis. The failure of DC stimulation to alter vibrotactile adaptation thresholds is discussed in the context of several factors that may have confounded the induction of changes in cortical plasticity.

Development and validation of a novel tool for assessing pitch discrimination

OBJECTIVE

To develop and validate a tool for pitch discrimination that can be easily applied in otolaryngology clinics.

METHODS

Twenty healthy subjects performed three psychoacoustic tasks for assessing pitch discrimination thresholds, which were compared among the three tasks. In the pitch direction discrimination (PDirD) task, the subjects judged the pitch of two tones as higher or lower. In the pitch difference discrimination (PDiffD) task, the subjects judged the pitch of two tones as same or different. In the pitch pattern detection (PPD) task, the subjects judged the pattern of a tone complex. Using tone sets from level 0 to level 8, pitch thresholds were determined using the Parameter Estimation by Sequential Testing (PEST) staircase procedure. The tasks were performed without prior training.

RESULTS

Every test was performed twice for each ear, and the better results were adopted as the threshold values. The PDirD thresholds varied considerably among the subjects and showed significantly larger deviations relative to those of the PPD thresholds. The number of below 0 thresholds, which are considered inadequate results, was significantly larger in the PDiffD task. In the PPD task, all thresholds except one were above level 6. The average total time taken to complete the PPD task was 7.7min, which was significantly lesser than that taken to complete the other two tasks.

CONCLUSION

The results of our study suggest that the PPD task is a reliable and easily available tool for the assessment of pitch discrimination.

Transcranial Direct Current Stimulation for the Treatment of Chronic Tinnitus: A Randomized Controlled Study

BACKGROUND

Tinnitus is an often disabling condition for which there is no effective therapy. Current research suggests that tinnitus may develop due to maladaptive plastic changes and altered activity in the auditory and prefrontal cortex. Transcranial direct current stimulation (tDCS) modulates brain activity and has been shown to transiently suppress tinnitus in trials.

OBJECTIVE

To investigate the efficacy and safety of tDCS in the treatment of chronic subjective tinnitus.

METHODS

In a randomized, parallel, double-blind, sham-controlled study, the efficacy and safety of cathodal tDCS to the auditory cortex with anode over the prefrontal cortex was investigated in five sessions over five consecutive days. Tinnitus was assessed after the last session on day 5, and at follow-up visits 1 and 3 months post stimulation using the Tinnitus Handicap Inventory (THI, primary outcome measure), Subjective Tinnitus Severity Scale, Hospital Anxiety and Depression scale, Visual Analogue Scale, and Clinical Global Impression scale.

RESULTS

42 patients were investigated, 21 received tDCS and 21 sham stimulation. There were no beneficial effects of tDCS on tinnitus as assessed by primary and secondary outcome measures. Effect size assessed with Cohen's d amounted to 0.08 (95% CI: -0.52 to 0.69) at 1 month and 0.18 (95% CI: -0.43 to 0.78) at 3 months for the THI.

CONCLUSION

tDCS of the auditory and prefrontal cortices is safe, but does not improve tinnitus. Different tDCS protocols might be beneficial.

Right parietal cortex mediates recognition memory for melodies

Functional brain imaging studies have highlighted the significance of right‐lateralized temporal, frontal and parietal brain areas for memory for melodies. The present study investigated the involvement of bilateral posterior parietal cortices (PPCs) for the recognition memory of melodies using transcranial direct current stimulation (tDCS). Participants performed a recognition task before and after tDCS. The task included an encoding phase (12 melodies), a retention period, as well as a recognition phase (24 melodies). Experiment 1 revealed that anodal tDCS over the right PPC led to a deterioration of overall memory performance compared with sham. Experiment 2 confirmed the results of Experiment 1 and further showed that anodal tDCS over the left PPC did not show a modulatory effect on memory task performance, indicating a right lateralization for musical memory. Furthermore, both experiments revealed that the decline in memory for melodies can be traced back to an interference of anodal stimulation on the recollection process (remember judgements) rather than to familiarity judgements. Taken together, this study revealed a causal involvement of the right PPC for memory for melodies and demonstrated a key role for this brain region in the recollection process of the memory task.

Polarity-specific transcranial direct current stimulation disrupts auditory pitch learning

Transcranial direct current stimulation (tDCS) is attracting increasing interest because of its potential for therapeutic use. While its effects have been investigated mainly with motor and visual tasks, less is known in the auditory domain. Past tDCS studies with auditory tasks demonstrated various behavioral outcomes, possibly due to differences in stimulation parameters, task-induced brain activity, or task measurements used in each study. Further research, using well-validated tasks is therefore required for clarification of behavioral effects of tDCS on the auditory system. Here, we took advantage of findings from a prior functional magnetic resonance imaging study, which demonstrated that the right auditory cortex is modulated during fine-grained pitch learning of microtonal melodic patterns. Targeting the right auditory cortex with tDCS using this same task thus allowed us to test the hypothesis that this region is causally involved in pitch learning. Participants in the current study were trained for 3 days while we measured pitch discrimination thresholds using microtonal melodies on each day using a psychophysical staircase procedure. We administered anodal, cathodal, or sham tDCS to three groups of participants over the right auditory cortex on the second day of training during performance of the task. Both the sham and the cathodal groups showed the expected significant learning effect (decreased pitch threshold) over the 3 days of training; in contrast we observed a blocking effect of anodal tDCS on auditory pitch learning, such that this group showed no significant change in thresholds over the 3 days. The results support a causal role for the right auditory cortex in pitch discrimination learning.

Modulation of pre-attentive spectro-temporal feature processing in the human auditory system by HD-tDCS

The present study examined the functional lateralization of the human auditory cortex (AC) for pre-attentive spectro-temporal feature processing. By using high-definition transcranial direct current stimulation (HD-tDCS), we systematically modulated neuronal activity of the bilateral AC. We assessed the influence of anodal and cathodal HD-tDCS delivered over the left or right AC on auditory mismatch negativity (MMN) in response to temporal as well as spectral deviants in 12 healthy subjects. The results showed that MMN to temporal deviants was significantly enhanced by anodal HD-tDCS applied over the left AC only. Our data indicate a left hemispheric dominance for the pre-attentive processing of low-level temporal information.

Modulation of Perception or Emotion? A Scoping Review of Tinnitus Neuromodulation Using Transcranial Direct Current Stimulation

Background. Tinnitus is the phantom perception of sound and can have negative effect on the quality of life. Transcranial direct current stimulation (tDCS) is a noninvasive neuromodulation technique, which can increase or decrease the cortical excitability in the brain region to which it is applied. tDCS has been used for tinnitus research since 2006. Objective. To investigate whether tDCS affects tinnitus perception, related emotion, or both, and the potential implications for tinnitus management. Methods. A scoping review was undertaken using the methods proposed by Arksey and O’Malley. After initial consideration of title relevance and reading abstracts, 15 studies were included in this review. The data from these studies were charted to investigate the impact of tDCS on tinnitus perception and emotions. Results. tDCS results in transient suppression of tinnitus loudness and annoyance; however, it does not lead to long-term impact on tinnitus related emotion. Local stimulation of different sites of stimulation (left temporoparietal area, dorsolateral prefrontal cortex, and auditory cortex) might modulate tinnitus perception (loudness) and emotions differently; however, further research is needed to explore this hypothesis. This review has identified aspects of methodologies that require attention in upcoming tinnitus and tDCS trials to offer better insights. Conclusions. tDCS is an effective research tool for transient tinnitus neuromodulation. However, efforts should be invested in designing clinical trials using local and multiple sites of stimulation, optimized parameters, and objective outcome measures before it can be translated in to a clinical tool for tinnitus management.

Combining transcranial direct current stimulation and tailor-made notched music training to decrease tinnitus-related distress--a pilot study

The central auditory system has a crucial role in tinnitus generation and maintenance. Curative treatments for tinnitus do not yet exist. However, recent attempts in the therapeutic application of both acoustic stimulation/training procedures and electric/magnetic brain stimulation techniques have yielded promising results. Here, for the first time we combined tailor-made notched music training (TMNMT) with transcranial direct current stimulation (tDCS) in an effort to modulate TMNMT efficacy in the treatment of 32 patients with tonal tinnitus and without severe hearing loss. TMNMT is characterized by regular listening to so-called notched music, which is generated by digitally removing the frequency band of one octave width centered at the individual tinnitus frequency. TMNMT was applied for 10 subsequent days (2.5 hours of daily treatment). During the initial 5 days of treatment and the initial 30 minutes of TMNMT sessions, tDCS (current strength: 2 mA; anodal (N = 10) vs. cathodal (N = 11) vs. sham (N = 11) groups) was applied simultaneously. The active electrode was placed on the head surface over left auditory cortex; the reference electrode was put over right supra-orbital cortex. To evaluate treatment outcome, tinnitus-related distress and perceived tinnitus loudness were assessed using standardized tinnitus questionnaires and a visual analogue scale. The results showed a significant treatment effect reflected in the Tinnitus Handicap Questionnaire that was largest after 5 days of treatment. This effect remained significant at the end of follow-up 31 days after treatment cessation. Crucially, tDCS did not significantly modulate treatment efficacy - it did not make a difference whether anodal, cathodal, or sham tDCS was applied. Possible explanations for the findings and functional modifications of the experimental design for future studies (e.g. the selection of control conditions) are discussed.

The Harvard Beat Assessment Test (H-BAT): a battery for assessing beat perception and production and their dissociation

Humans have the abilities to perceive, produce, and synchronize with a musical beat, yet there are widespread individual differences. To investigate these abilities and to determine if a dissociation between beat perception and production exists, we developed the Harvard Beat Assessment Test (H-BAT), a new battery that assesses beat perception and production abilities. H-BAT consists of four subtests: (1) music tapping test (MTT), (2) beat saliency test (BST), (3) beat interval test (BIT), and (4) beat finding and interval test (BFIT). MTT measures the degree of tapping synchronization with the beat of music, whereas BST, BIT, and BFIT measure perception and production thresholds via psychophysical adaptive stair-case methods. We administered the H-BAT on thirty individuals and investigated the performance distribution across these individuals in each subtest. There was a wide distribution in individual abilities to tap in synchrony with the beat of music during the MTT. The degree of synchronization consistency was negatively correlated with thresholds in the BST, BIT, and BFIT: a lower degree of synchronization was associated with higher perception and production thresholds. H-BAT can be a useful tool in determining an individual's ability to perceive and produce a beat within a single session.

Temporal accuracy and variability in the left and right posterior parietal cortex

Several brain-imaging and lesion studies have suggested a role for the posterior parietal cortex (PPC) in computing interval-timing tasks. PPC also seems to have a key role in modulating visuospatial mechanisms, which are known to affect temporal performance. By applying transcranial direct current stimulation (tDCS) over the left and right PPC, we aimed to modulate timing ability performance in healthy humans performing a cognitively controlled timing task. In two separate experiments we compared time-processing abilities of two groups of healthy adults submitted to anodal, cathodal or sham tDCS over right or left PPC, by employing a supra-second time reproduction task. Cathodal stimulation over the right PPC affected temporal accuracy by leading participants to overestimate time intervals. Moreover, when applied to the left PPC, it reduced variability in reproducing temporal intervals. No effect was reported for anodal stimulation. These results expand current knowledge on the role of the parietal cortex on temporal processing. We provide evidence that the parietal cortex of both hemispheres is involved in temporal processing by acting on distinct components of timing performance such as accuracy and variability.

Hearing feelings: a quantitative meta-analysis on the neuroimaging literature of emotional prosody perception

With the advent of neuroimaging considerable progress has been made in uncovering the neural network involved in the perception of emotional prosody. However, the exact neuroanatomical underpinnings of the emotional prosody perception process remain unclear. Furthermore, it is unclear what the intrahemispheric basis might be of the relative right-hemispheric specialization for emotional prosody perception that has been found previously in the lesion literature. In an attempt to shed light on these issues, quantitative meta-analyses of the neuroimaging literature were performed to investigate which brain areas are robustly associated with stimulus-driven and task-dependent perception of emotional prosody. Also, lateralization analyses were performed to investigate whether statistically reliable hemispheric specialization across studies can be found in these networks. A bilateral temporofrontal network was found to be implicated in emotional prosody perception, generally supporting previously proposed models of emotional prosody perception. Right-lateralized convergence across studies was found in (early) auditory processing areas, suggesting that the right hemispheric specialization for emotional prosody perception reported previously in the lesion literature might be driven by hemispheric specialization for non-prosody-specific fundamental acoustic dimensions of the speech signal.

Absolute Pitch and Synesthesia: Two Sides of the Same Coin? Shared and Distinct Neural Substrates of Music Listening

People with Absolute Pitch can categorize musical pitches without a reference, whereas people with tone-color synesthesia can see colors when hearing music. Both of these special populations perceive music in an above-normal manner. In this study we asked whether AP possessors and tone-color synesthetes might recruit specialized neural mechanisms during music listening. Furthermore, we tested the degree to which neural substrates recruited for music listening may be shared between these special populations. AP possessors, tone-color synesthetes, and matched controls rated the perceived arousal levels of musical excerpts in a sparse-sampled fMRI study. Both APs and synesthetes showed enhanced superior temporal gyrus (STG, secondary auditory cortex) activation relative to controls during music listening, with left-lateralized enhancement in the APs and right-lateralized enhancement in the synesthetes. When listening to highly arousing excerpts, AP possessors showed additional activation in the left STG whereas synesthetes showed enhanced activity in the bilateral lingual gyrus and inferior temporal gyrus (late visual areas). Results support both shared and distinct neural enhancements in AP and synesthesia: common enhancements in early cortical mechanisms of perceptual analysis, followed by relative specialization in later association and categorization processes that support the unique behaviors of these special populations during music listening.

Polarity-dependent transcranial direct current stimulation effects on central auditory processing

Given the polarity dependent effects of transcranial direct current stimulation (tDCS) in facilitating or inhibiting neuronal processing, and tDCS effects on pitch perception, we tested the effects of tDCS on temporal aspects of auditory processing. We aimed to change baseline activity of the auditory cortex using tDCS as to modulate temporal aspects of auditory processing in healthy subjects without hearing impairment. Eleven subjects received 2mA bilateral anodal, cathodal and sham tDCS over auditory cortex in a randomized and counterbalanced order. Subjects were evaluated by the Random Gap Detection Test (RGDT), a test measuring temporal processing abilities in the auditory domain, before and during the stimulation. Statistical analysis revealed a significant interaction effect of time vs. tDCS condition for 4000 Hz and for clicks. Post-hoc tests showed significant differences according to stimulation polarity on RGDT performance: anodal improved 22.5% and cathodal decreased 54.5% subjects' performance, as compared to baseline. For clicks, anodal also increased performance in 29.4% when compared to baseline. tDCS presented polarity-dependent effects on the activity of the auditory cortex, which results in a positive or negative impact in a temporal resolution task performance. These results encourage further studies exploring tDCS in central auditory processing disorders.