"Telling me not to worry…" Hyperscanning and Neural Dynamics of Emotion Processing During Guided Imagery and Music

Study protocol of a randomized control trial on the effectiveness of improvisational music therapy for autistic children

BACKGROUND

Music therapy is the clinical use of musical interventions to improve mental and physical health across multiple domains, including social communication. Autistic children, who have difficulties in social communication and often increased anxiety, tend to show a strong preference for music, because it can be structured and systematic, and therefore more predictable than social interaction. This makes music therapy a promising medium for therapeutic support and intervention. Previous clinical trials of music therapy compared to traditional therapy for autistic children have shown encouraging but nevertheless mixed results.

KEY AIMS

The primary aim is to conduct a randomised controlled trial (RCT) of improvisational music therapy for autistic children and test its effectiveness in at improving social communication and wellbeing, and to reduce anxiety.

RESEARCH PLAN

The RCT will be conducted with 200 autistic children in the UK aged 7 to 11 years old. Participants will be randomly assigned to either improvisational music therapy or support as usual. The trial will be an assessor-blind, pragmatic two-arm cluster RCT comparing the impact of 12-weeks of improvisational music therapy in addition to support as usual, vs. support as usual for autistic children.

METHODS

Researchers who are blind to which arm the children are in will conduct assessments and obtain data via caregiver reports. The primary outcome will be the absolute change in the total score of the Brief Observation of Social Communication Change (BOSCC) assessed at baseline, T1 (13 weeks) and T2 (39 weeks) follow-ups. The BOSCC consists of specific items that were developed to identify changes in social-communication behaviours. Secondary outcome measures include: (1) Parent reported anxiety scale for youth with ASD (Note that we do not use the term 'ASD' or Autism Spectrum Disorder, because many autistic people feel it is stigmatising. Instead, we use the term 'autism') (PRAS-ASD) (2) Young Child Outcome Rating Scale, for wellbeing (YCORS), (3) Strengths and Difficulties Questionnaire (SDQ); and (4) Vineland Adaptive Behaviour Scale (VABS). (5) The Children's Communication Checklist-2 (CCC-2) will be completed to evaluate pragmatic speech with fluent speakers only; (6) The Music Engagement Scale (MES); and (7) Assessment of the Quality of Relationship (AQR) will be used to evaluate the child-therapist relationships using video-analysis of music therapy sessions. Additional data will be collected by administering the Wechsler Abbreviated Scale of Intelligence (WASI-II), Music at Home Questionnaire (M@H), and children's versions of the Empathy Quotient (EQ) and Systemizing Quotient (SQ). Audio and video data from the therapy sessions will be collected and analysed (using both human and computer-based feature-coding, e.g., machine learning and AI-driven methods) to identify how music and non-musical interactions foster change throughout the therapy.

DISCUSSION

This study aims to observe if the interactions, engagement, and therapeutic modalities fostered during music therapy sessions can translate to non-musical contexts and improve autistic children's social communication skills, identifying possible mediating factors contributing to the effectiveness of music therapy, potentially informing policy making and governance.

TRIAL REGISTRATION

This randomised control trial is registered with the NIH U.S. National Library of Medicine:  https://clinicaltrials.gov/search?term=NCT06016621 , clinicalTrials.gov Identifier: NCT0601662, Registration Date 19th August 2023.

Advances and trends in the application of functional near-infrared spectroscopy for pediatric assessments: a bibliometric analysis

Objective

The objective is to elucidate the collaboration and current research status in the pediatric field of fNIRS using bibliometric analysis, and to discuss future directions.

Method

Bibliometric analysis was conducted on publications related to pediatric fNIRS research published before June 2024 in the Web of Science Core Collection using VOSviewer software and R language.

Results

A total of 761 documents were retrieved, published by 2,686 authors from 893 institutions across 44 countries in 239 journals. The number of publications has significantly increased since 2012. The United States is the country with the highest number of publications, University College London is the institution with the most publications, Lloyd-Fox Sarah is the author with the most publications and significant influence, and "Neurophotonics" is the journal with the most publications. The current hotspots mainly involve using fNIRS to study executive functions and autism spectrum disorders in children.

Conclusion

The study provides useful reference information for researchers by analyzing publication numbers, collaborative networks, publishing journals, and research hotspots. In the future, there should be an emphasis on enhancing interdisciplinary and international collaboration to collectively dedicate efforts toward the advancement of fNIRS technology and the standardization of research.

Brain to brain musical interaction: A systematic review of neural synchrony in musical activities

The use of hyperscanning technology has revealed the neural mechanisms underlying multi-person interaction in musical activities. However, there is currently a lack of integration among various research findings. This systematic review aims to provide a comprehensive understanding of the social dynamics and brain synchronization in music activities through the analysis of 32 studies. The findings illustrate a strong correlation between inter-brain synchronization (IBS) and various musical activities, with the frontal, central, parietal, and temporal lobes as the primary regions involved. The application of hyperscanning not only advances theoretical research but also holds practical significance in enhancing the effectiveness of music-based interventions in therapy and education. The review also utilizes Predictive Coding Models (PCM) to provide a new perspective for interpreting neural synchronization in music activities. To address the limitations of current research, future studies could integrate multimodal data, adopt novel technologies, use non-invasive techniques, and explore additional research directions.

Hyperscanning to explore social interaction among autistic minds

Hyperscanning - the monitoring of brain activity of two or more people simultaneously - has emerged to be a popular tool for assessing neural features of social interaction. This perspective article focuses on hyperscanning studies that use functional near-infrared spectroscopy (fNIRS), a technique that is very conducive to studies requiring naturalistic paradigms. In particular, we are interested in neural features that are related to social interaction deficits among individuals with autism spectrum disorders (ASD). This population has received relatively little attention in research using neuroimaging hyperscanning techniques, compared to neurotypical individuals. The study is outlined as follows. First, we summarize the findings about brain-behavior connections related to autism from previously published fNIRS hyperscanning studies. Then, we propose a preliminary theoretical framework of inter-brain coherence (IBC) with testable hypotheses concerning this population. Finally, we provide two examples of areas of inquiry in which studies could be particularly relevant for social-emotional/behavioral development for autistic children, focusing on intergenerational relationships in family units and learning in classroom settings in mainstream schools.

Relationship evolution shapes inter-brain synchrony in affective sharing: The role of self-expansion

The development of social relationships influences a person's self-concept, which in turn affects their perceptions and neural correlates in social interactions. This study employed an EEG-based hyperscanning technique and a longitudinal design to investigate how the evolution of interpersonal relationships impacts inter-brain synchrony during nonverbal social-emotional interactions. The framework for this study is based on the self-expansion model. We found that dyads exhibited enhanced affective sharing abilities and increased brain-to-brain synchrony, particularly in the gamma rhythm across the frontal, parietal, and left temporoparietal regions, after seven months together compared to when they first met. Additionally, the results indicate that inter-brain coupling evolves as relationships develop, with synchrony in nonverbal social-emotional interactions increasing as self-expansion progresses. Crucially, in the deep learning model, interpersonal closeness can be successfully classified by inter-brain synchrony during emotional-social interactions. The longitudinal EEG-hyperscanning design of our study allows for capturing dynamic changes over time, offering new insights into the neurobiological foundations of social interaction and the potential of neural synchrony as a biomarker for relationship dynamics.

Symphonic resonance: optimizing hypnotic suggestions with music to harmonize depression and rumination

Depression is a complex, multi-dimensional disorder that is recognized as a leading cause of human suffering and disability. A wide variety of treatments, both physical and psychological, have been developed to lessen the burden on depressed individuals and those they may affect. Hypnosis has been shown to be an effective vehicle for delivering psychological treatments for alleviating depression in a number of studies, but it is always a challenge to increase the effectiveness of suggestions given in hypnosis. The addition of music to enhance hypnotic approaches has been studied and received substantial support for its potential effectiveness. This article explores the merits of incorporating music into the delivery of hypnosis sessions and offers specific recommendations for the use of rhythmic methods as a means of deepening hypnosis and increasing the impact of one's suggestions for reducing depressive ruminations. Five case examples are provided to illustrate the successful use of this integrative approach to treatment.

Effect of music therapy intervention on anxiety and pain during percutaneous renal biopsy: a randomized controlled trial

Background

Percutaneous renal biopsy (PRB) may subject patients to emotional distress and pain before and during the biopsy. The aim of this study was to evaluate the effects of complementary/non-pharmacological interventions such as music therapy (MT) on anxiety, pain and satisfaction in renal patients undergoing PRB.

Methods

A prospective, single-centre, single-blind, randomized controlled two-arm trial was conducted. Patients ≥18 years of age, hospitalized at the Nephrology, Dialysis and Transplantation Unit (Bari, Italy) and scheduled for PRB were screened. Participants were assigned to standard treatment (CG) or to the music therapy (MT) intervention group. Participants in the MT group received standard care and an MT intervention by a certified music therapist qualified in guided imagery and music. The CG patients received the standard of care. MT and CG patients were subjected to identical measurements (pre/post) of the parameters in the State Trait Anxiety Inventory Y1 (STAI-Y1), visual analogue scale for pain (VAS-P) and satisfaction (VAS-S) and heart rate variability.

Results

A statistically significant difference in the anxiety scores after PRB between MT and CG patients (STAI-Y1 35.4 ± 6.2 versus 42.9 ± 9.0) was observed. MT also had strong and significant effects on VAS-P compared with CG (5.0 ± 1.4 versus 6.3 ± 1.3, respectively; P < .001) and VAS-S (7.8 ± 1.0 versus 6.0 ± 0.9, respectively; P < .001). Decreased activity of the sympathetic nervous system and increased activity of the parasympathetic nervous system was observed after PRB in the MT group.

Conclusion

Our study supports the use of MT to mitigate the psychological anxiety, pain and sympathetic activation associated with PRB.

Hyperscanning Studies on Interbrain Synchrony and Child Development: A Narrative Review

Social interactions between parents and children are closely linked with children's development, and interbrain synchrony has been shown to be a neural marker of social interaction. However, to truly capture the essence of social interactions through interbrain synchrony, it is necessary to simultaneously discuss the parental and child brains and adequately record neurological signals during parent-child interactions in interactive tasks. In the current review, we have reviewed three main contents. First, we discuss the correlation between parent-child interbrain synchrony and the development of cognitive (e.g., emotion regulation, attention, and learning) and behavioral abilities (e.g., cooperation, problem-solving) in children. Second, we examine the different neural mechanisms of interbrain synchrony in mother-child and father-child interactions, aiming to highlight the separate roles of mother and father in child development. Last, we have integrated four methods to enhance interbrain synchrony, including communication patterns, nonverbal behavior, music, and multichannel stimulation. A significant correlation exists between parent-child interbrain synchrony and the development of children's cognitive and behavioral abilities. This summary may be useful for expanding researchers' and practitioners' understanding of the ways in which parenting and the parent-child relationship shape children' cognitive and behavioral abilities.

Intra- and inter-brain coupling and activity dynamics during improvisational music therapy with a person with dementia: an explorative EEG-hyperscanning single case study

Objective

Real-life research into the underlying neural dynamics of improvisational music therapy, used with various clinical populations, is largely lacking. This single case study explored within-session differences in musical features and in within- and between-brain coupling between a Person with Dementia (PwD) and a music therapist during a music therapy session.

Methods

Dual-EEG from a music therapist and a PwD (male, 31 years) was recorded. Note density, pulse clarity and synchronicity were extracted from audio-visual data. Three music therapists identified moments of interest and no interest (MOI/MONI) in two drum improvisations. The Integrative Coupling Index, reflecting time-lagged neural synchronization, and musical features were compared between the MOI and MONI.

Results

Between-brain coupling of 2 Hz activity was increased during the MOI, showing anteriority of the therapist's neural activity. Within-brain coupling for the PwD was stronger from frontal and central areas during the MOI, but within-brain coupling for the therapist was stronger during MONI. Differences in musical features indicated that both acted musically more similar to one another during the MOI.

Conclusion

Within-session differences in neural synchronization and musical features highlight the dynamic nature of music therapy.

Significance

The findings contribute to a better understanding of social and affective processes in the brain and (interactive) musical behaviors during specific moments in a real-life music therapy session. This may provide insights into the role of such moments for relational-therapeutic processes.

Effect of Preoperative Music Therapy Versus Intravenous Midazolam on Anxiety, Sedation and Stress in Stomatology Surgery: A Randomized Controlled Study

BACKGROUND

Patients undergoing surgery and general anesthesia often experience anxiety, fear and stress, with negative bodily responses. These may be managed by the pre-procedural application of anxiolytic, analgesic, and anesthetic drugs that have, however, potential risks or side effects. Music therapy (MT) can be used as a complementary no-drug intervention alongside standard surgical care before, during and after medical procedures. The aim of this study was to evaluate the effects of preoperative MT intervention compared to premedication with midazolam on levels of anxiety, sedation and stress during general anesthesia for elective stomatology surgery.

METHODS

A two-arm randomized and controlled single-center, parallel-group, pre-post event study was conducted. In total, 70 patients affected by stage I or II (both clinically and instrumentally N0) micro-invasive oral cancer and undergoing elective surgery under general anesthesia were assigned to the control group (CG) or to the music therapy group (MTG). MTG patients received preoperative music therapy intervention (MT) from a certified music therapist before surgery, while the CG patients did not receive MT but instead received premedication with intravenous midazolam, 0.02 mg/kg. Anesthesia was the same in both groups. The systolic blood pressure (SBP), diastolic blood pressure (DBP) and heart rate (HR) were recorded at the entrance to the operating room, just before the induction of anesthesia and every 5 min until the end of surgery. An anxiety visual analogues scale (A-VAS) was used to evaluate the level of anxiety. The bispectral index (BIS) monitor was used to measure the depth of sedation just before and 10 min after both music intervention and midazolam administration. Stress response was assessed 5 min before and 20 min after surgery via the control of plasma prolactin (PRL), growth hormone (GH), and cortisol levels. The patient global impression of satisfaction (PGIS) was tested 1 h after surgery. Participants in the MTG were asked to answer 3 questions concerning their experience with MT.

RESULTS

No statistical differences among the PRL, GH and cortisol levels between the two groups were registered before and after the treatment, as well as for PAS, PAD and HR. Significant differences in the A-VAS scores between the MTG and CG (p < 0.01) was observed. Compared to the CG, MTG patients had a statistically significantly lower BIS score (p = 0.02) before induction. A PGIS score of 86.7% revealed that patients in the MTG were very satisfied, versus 80% in the CG (p < 0.05).

CONCLUSION

Preoperative music therapy could be an alternative to intravenous midazolam when aiming to promote a preoperative and post-operative state of anxiolysis and sedation in stomatology surgery, even if no differences were found in terms of the surgery-related stress response according to physiological and hormonal determinations.

A two for one special: EEG hyperscanning using a single-person EEG recording setup

EEG hyperscanning refers to recording electroencephalographic (EEG) data from multiple participants simultaneously. Many hyperscanning experimental designs seek to mimic naturalistic behavior, relying on unpredictable participant-generated stimuli. The majority of this research has focused on neural oscillatory activity that is quantified over hundreds of milliseconds or more. This contrasts with traditional event-related potential (ERP) research in which analysis focuses on transient responses, often only tens of milliseconds in duration. Deriving ERPs requires precise time-locking between stimuli and EEG recordings, and thus typically relies on pre-set stimuli that are presented to participants by a system that controls stimulus timing and synchronization with an EEG system. EEG hyperscanning methods typically use separate EEG amplifiers for each participant, increasing cost and complexity - including challenges in synchronizing data between systems. Here, we describe a method that allows for simultaneous acquisition of EEG data from a pair of participants engaged in conversation, using a single EEG system with simultaneous audio data collection that is synchronized with the EEG recording. This allows for the post-hoc insertion of trigger codes so that it is possible to analyze ERPs time-locked to specific events. We further demonstrate methods for deriving ERPs elicited by another person's spontaneous speech, using this setup.•EEG hyperscanning method using a single EEG amplifier•EEG hyperscanning method allowing simultaneous recording of audio data directly into the EEG data file for perfect synchronization•EEG method for naturalistic language and human interaction studies that allows the study of event-related potentials time-locked to spontaneous speech.

Neuroplastic Changes in Addiction Memory-How Music Therapy and Music-Based Intervention May Reduce Craving: A Narrative Review

Recent findings indicate that Music Therapy (MT) and Music-Based Interventions (MBIs) may reduce craving symptoms in people with Substance Use Disorders (SUD). However, MT/MBIs can lead SUD clients to recall memories associated with their drug history and the corresponding strong emotions (addiction memories). Craving is a central component of SUD, possibly linked to relapse and triggered by several factors such as the recall of memories associated with the drug experience. Therefore, to address the topic of what elements can account for an improvement in craving symptoms after MT/MBIs, we conducted a narrative review that (1) describes the brain correlates of emotionally salient autobiographical memories evoked by music, (2) outlines neuroimaging and neurophysiological studies suggesting how the experience of craving may encompass the recall of emotionally filled moments, and (3) points out the role of perineuronal nets (PNNs) in addiction memory neuroplasticity. We highlight how autobiographical memory retrieval, music-evoked autobiographical memories, and craving share similar neural activations with PNNs which represent a causal element in the processing of addiction memory. We finally conclude by considering how the neuroplastic characteristics of addiction memory might represent the ground to update and/or recalibrate, within the therapy, the emotional content related to the recall.

Using music to probe how perception shapes imagination

Recent work using music highlights how past experiences and the immediate perceptual environment can shape imagination. Given that aspects of past experiences can be shared, depending on culture, as can the immediate perceptual environment, imaginings that might appear idiosyncratic or entirely subjective can in fact be broadly shared.

Does music induce interbrain synchronization between a non-speaking youth with cerebral palsy (CP), a parent, and a neurologic music therapist? A brief report

Shared emotional experiences during musical activities among musicians can be coupled with brainwave synchronization. For non-speaking individuals with CP, verbal communication may be limited in expressing mutual empathy. Therefore, this case study explored interbrain synchronization among a non-speaking CP (female, 18 yrs), her parent, and a music therapist by measuring their brainwaves simultaneously during four music and four storytelling sessions. In only the youth-parent dyad, we observed a significantly higher level of interbrain synchronization during music rather than story-telling condition. However, in both the youth-parent and youth-therapist dyad, regardless of condition type, significant interbrain synchronization emerged in frontal and temporal lobes in the low-frequency bands, which are associated with socio-emotional responses. Although interbrain synchronization may have been induced by multiple factors (e.g., external stimuli, shared empathetic experiences, and internal physiological rhythms), the music activity setting deserves further study as a potential facilitator of neurophysiological synchrony between youth with CP and caregivers/healthcare providers.

EEG Hyperscanning and Qualitative Analysis of Moments of Interest in Music Therapy for Stroke Rehabilitation—A Feasibility Study

Interdisciplinary research into the underlying neural processes of music therapy (MT) and subjective experiences of patients and therapists are largely lacking. The aim of the current study was to assess the feasibility of newly developed procedures (including electroencephalography/electrocardiography hyperscanning, synchronous audio–video monitoring, and qualitative interviews) to study the personal experiences and neuronal dynamics of moments of interest during MT with stroke survivors. The feasibility of our mobile setup and procedures as well as their clinical implementation in a rehabilitation centre and an acute hospital ward were tested with four phase C patients. Protocols and interviews were used for the documentation and analysis of the feasibility. Recruiting patients for MT sessions was feasible, although data collection on three consecutive weeks was not always possible due to organisational constraints, especially in the hospital with acute ward routines. Research procedures were successfully implemented, and according to interviews, none of the patients reported any burden, tiredness, or increased stress due to the research procedures, which lasted approx. 3 h (ranging from 135 min to 209 min) for each patient. Implementing the research procedures in a rehabilitation unit with stroke patients was feasible, and only small adaptations were made for further research.

Systemic physiology augmented functional near-infrared spectroscopy hyperscanning: a first evaluation investigating entrainment of spontaneous activity of brain and body physiology between subjects

Significance: Functional near-infrared spectroscopy (fNIRS) enables measuring the brain activity of two subjects while they interact, i.e., the hyperscanning approach. Aim: In our exploratory study, we extended classical fNIRS hyperscanning by adding systemic physiological measures to obtain systemic physiology augmented fNIRS (SPA-fNIRS) hyperscanning while blocking and not blocking the visual communication between the subjects. This approach enables access brain-to-brain, brain-to-body, and body-to-body coupling between the subjects simultaneously. Approach: Twenty-four pairs of subjects participated in the experiment. The paradigm consisted of two subjects that sat in front of each other and had their eyes closed for 10 min, followed by a phase of 10 min where they made eye contact. Brain and body activity was measured continuously by SPA-fNIRS. Results: Our study shows that making eye contact for a prolonged time causes significant changes in brain-to-brain, brain-to-body, and body-to-body coupling, indicating that eye contact is followed by entrainment of the physiology between subjects. Subjects that knew each other generally showed a larger trend to change between the two conditions. Conclusions: The main point of this study is to introduce a new framework to investigate brain-to-brain, body-to-body, and brain-to-body coupling through a simple social experimental paradigm. The study revealed that eye contact leads to significant synchronization of spontaneous activity of the brain and body physiology. Our study is the first that employed the SPA-fNIRS approach and showed its usefulness to investigate complex interpersonal physiological changes.

Patients' and professionals' perspectives on the consideration of patients' convenient therapy periods as part of personalised rehabilitation: a focus group study with patients and therapists from inpatient neurological rehabilitation

BACKGROUND

Research on the optimal period for administering health services, especially rehabilitation interventions, is scarce. The aims of this study were to explore the construct of patients' convenient therapy periods and to identify indicators based on the perspectives of patients and different health professionals from inpatient neurological rehabilitation clinics.

METHODS

This study was part of a larger project on patients' convenient therapy periods following a mixed methods approach. In the current study a grounded theory approach was employed based on the use of focus group interviews. Focus group interviews were conducted in three different inpatient neurological rehabilitation clinics. Patients and therapists from inpatient neurological rehabilitation clinics who were able to speak and to participate in conversations were included.

RESULTS

A total of 41 persons, including 23 patients and 18 therapists, such as music and occupational therapists, participated in a total of six focus group interviews. The analysis of the focus group interviews resulted in the identification of a total of 1261 codes, which could be summarised in fifteen categories. However, these categories could be divided into five indicators and ten impact factors of convenient therapy periods. Identified indicators were verbal and non-verbal communication, mental functions, physiological needs, recreational needs, and therapy initiation.

CONCLUSIONS

The results provide initial evidence that convenient therapy periods are clinically relevant for patients and therapists. Different states of patients' ability to effectively participate in a rehabilitation intervention exist. A systematic consideration of patients' convenient therapy periods could contribute to a personalised and more efficient delivery of intervention in neurological rehabilitation. To our knowledge, this study is one of the first attempts to research convenient therapy periods.

Inter-Brain Synchronization During Sandplay Therapy: Individual Analyses

Interactions between the client (Cl) and therapist (Th) evolve therapeutic relationships in psychotherapy. An interpersonal link or therapeutic space is implicitly developed, wherein certain important elements are expressed and shared. However, neural basis of psychotherapy, especially of non-verbal modalities, have scarcely been explored. Therefore, we examined the neural backgrounds of such therapeutic alliances during sandplay, a powerful art/play therapy technique. Real-time and simultaneous measurement of hemodynamics was conducted in the prefrontal cortex (PFC) of Cl-Th pairs participating in sandplay and subsequent interview sessions through multichannel near-infrared spectroscopy. As sandplay is highly individualized, and no two sessions and products (sandtrays) are the same, we expected variation in interactive patterns in the Cl–Th pairs. Nevertheless, we observed a statistically significant correlation between the spatio-temporal patterns in signals produced by the homologous regions of the brains. During the sandplay condition, significant correlations were obtained in the lateral PFC and frontopolar (FP) regions in the real Cl-Th pairs. Furthermore, a significant correlation was observed in the FP region for the interview condition. The correlations found in our study were explained as a “remote” synchronization (i.e., unconnected peripheral oscillators synchronizing through a hub maintaining free desynchronized dynamics) between two subjects in a pair, possibly representing the neural foundation of empathy, which arises commonly in sandplay therapy (ST).

Interpersonal Conflict Increases Interpersonal Neural Synchronization in Romantic Couples

Previous studies on dual-brain social interaction have shown different patterns of interpersonal neural synchronization (INS) between conflictual and supportive interactions, but the role of emotion in the dual-brain mechanisms of such interactions is not well understood. Furthermore, little is known about how the dual-brain mechanisms are affected by relationship type (e.g., romantic relationship vs. friendship) and interaction mode (e.g., verbal vs. nonverbal). To elaborate on these issues, this study used functional near-infrared spectroscopy to collect hemodynamic signals from romantic couples and cross-sex friends while they were discussing conflictual, neutral, or supportive topics. For the couples but not the friends, INS between the sensorimotor cortex of both participants was greater when discussing the conflictual topic than when discussing the supportive topic. INS was positively correlated with the arousal level but not the valence level of communication contents. INS was also positively correlated with interpersonal physiological synchronization based on galvanic skin response, a physiological measure of arousal. Furthermore, the differences in INS between the conflictual and supportive topics were closely associated with verbal rather than nonverbal behaviors. Together, these findings suggest that it is the arousal level induced by verbal interactions during interpersonal conflicts that increases romantic couples' INS.

Affiliative bonding between teachers and students through interpersonal synchronisation in brain activity

Human beings organise socially. Theories have posited that interpersonal neural synchronisation might underlie the creation of affiliative bonds. Previous studies tested this hypothesis mainly during a social interaction, making it difficult to determine whether the identified synchronisation is associated with affiliative bonding or with social interaction. This study addressed this issue by focusing on the teacher–student relationship in the resting state both before and after a teaching period. Brain activity was simultaneously measured in both individuals using functional near-infrared spectroscopy. The results showed a significant increase in brain synchronisation at the right sensorimotor cortex between the teacher and student in the resting state after, but not before, the teaching period. Moreover, the synchronisation increased only after a turn-taking mode of teaching but not after a lecturing or video mode of teaching. A chain mediation analysis showed that brain synchronisation during teaching partially mediated the relationship between the brain synchronisation increase in the resting state and strength of the affiliative bond. Finally, both role assignment and social interaction were found to be required for affiliative bonding. Together, these results support the hypothesis that interpersonal synchronisation in brain activity underlies affiliative bonding and that social interaction mechanically mediates the bonding process.

Neurophysiological Synchrony Between Children With Severe Physical Disabilities and Their Parents During Music Therapy

Although physiological synchronization has been associated with the level of empathy in emotionally meaningful relationships, little is known about the interbrain synchrony between non-speaking children with severe disabilities and their familial caregivers. In a repeated measures observational study, we ascertained the degree of interbrain synchrony during music therapy in 10 child-parent dyads, where the children were non-speaking and living with severe motor impairments. Interbrain synchrony was quantified via measurements of spectral coherence and Granger causality between child and parent electroencephalographic (EEG) signals collected during ten 15-min music therapy sessions per dyad, where parents were present as non-participating, covert observers. Using cluster-based permutation tests, we found significant child-parent interbrain synchrony, manifesting most prominently across dyads in frontal brain regions within β and low γ frequencies. Specifically, significant dyadic coherence was observed contra-laterally, between child frontal right and parental frontal left regions at β and lower γ bands in empathy-related brain areas. Furthermore, significant Granger influences were detected bidirectionally (from child to parent and vice versa) in the same frequency bands. In all dyads, significant increases in session-specific coherence and Granger influences were observed over the time course of a music therapy session. The observed interbrain synchrony suggests a cognitive-emotional coupling during music therapy between child and parent that is responsive to change. These findings encourage further study of the socio-empathic capacity and interpersonal relationships formed between caregivers and non-speaking children with severe physical impairments.

Joint recording of EEG and audio signals in hyperscanning and pseudo-hyperscanning experiments

Hyperscanning is an emerging technique that allows for the study of brain similarities between interacting individuals. This methodology has powerful implications for understanding the neural basis of joint actions, such as conversation; however, it also demands precise time-locking between the different brain recordings and sensory stimulation. Such precise timing, nevertheless, is often difficult to achieve. Recording auditory stimuli jointly with the ongoing high temporal resolution neurophysiological signal presents an effective way to control timing asynchronies offline between the digital trigger sent by the stimulation program and the actual onset of the auditory stimulus delivered to participants via speakers/headphones. This configuration is particularly challenging in hyperscanning setups due to the general increased complexity of the methodology. In other designs using the related technique of pseudo-hyperscanning, combined brain-auditory recordings are also a highly desirable feature, since reliable offline synchronization can be performed by using the shared audio signal. Here, we describe two hardware configurations wherein the real-time delivered auditory stimulus is recorded jointly with ongoing electroencephalographic (EEG) recordings. Specifically, we describe and provide customized implementations for joint EEG-audio recording in hyperscanning and pseudo-hyperscanning paradigms using hardware and software from Brain Products GmbH.•Joint EEG-audio recording configuration for hyperscanning and pseudo-hyperscanning paradigms.•Near zero-latency playback of auditory signal captured by a microphone.•Precise alignment between EEG and auditory stimulation.

Trends of differentiation and integration in UK music therapy and the spectrum of music-centredness

A long-standing trend to differentiate and even oppose psychodynamic and ecological approaches to practice can be identified in the UK music therapy literature. This is complicated by the way in which ecologically oriented thinking is associated with practice identified to be music-centred. While the trend to differentiate and separate approaches is most apparent in the literature, it is also evident that in practice, therapists have long integrated different perspectives and ways of working, this integral trend having its roots in the work of the UK music therapy pioneers. This article explores how the ecologically oriented thinking associated with the Community Music Therapy movement, and introduced soon after the turn of the 21st century, served in part to broaden the scope of UK practice in a progressive, integrally oriented way. However, the article also discusses the rejection of psychotherapeutically oriented thinking made by some ecologically oriented authors to make space for the new way of thinking. It is suggested that this rejection has been less helpful for the development of the profession as a whole, as the different ways of working in music therapy can be understood to address different types and levels of need. This means that psychodynamic, developmental, ecological, neurological and other perspectives are all potentially important. Case vignettes are used to illustrate this and an integral approach to working, with music-centredness discussed in a way that embraces the full spectrum of UK practice.

Neuronal Effects of Listening to Entrainment Music Versus Preferred Music in Patients With Chronic Cancer Pain as Measured via EEG and LORETA Imaging

Previous studies examining EEG and LORETA in patients with chronic pain discovered an overactivation of high theta (6–9 Hz) and low beta (12–16 Hz) power in central regions. MEG studies with healthy subjects correlating evoked nociception ratings and source localization described delta and gamma changes according to two music interventions. Using similar music conditions with chronic pain patients, we examined EEG in response to two different music interventions for pain. To study this process in-depth we conducted a mixed-methods case study approach, based on three clinical cases. Effectiveness of personalized music therapy improvisations (entrainment music – EM) versus preferred music on chronic pain was examined with 16 participants. Three patients were randomly selected for follow-up EEG sessions three months post-intervention, where they listened to recordings of the music from the interventions provided during the research. To test the difference of EM versus preferred music, recordings were presented in a block design: silence, their own composed EM (depicting both “pain” and “healing”), preferred (commercially available) music, and a non-participant’s EM as a control. Participants rated their pain before and after the EEG on a 1–10 scale. We conducted a detailed single case analysis to compare all conditions, as well as a group comparison of entrainment-healing condition versus preferred music condition. Power spectrum and according LORETA distributions focused on expected changes in delta, theta, beta, and gamma frequencies, particularly in sensory-motor and central regions. Intentional moment-by-moment attention on the sounds/music rather than on pain and decreased awareness of pain was experienced from one participant. Corresponding EEG analysis showed accompanying power changes in sensory-motor regions and LORETA projection pointed to insula-related changes during entrainment-pain music. LORETA also indicated involvement of visual-spatial, motor, and language/music improvisation processing in response to his personalized EM which may reflect active recollection of creating the EM. Group-wide analysis showed common brain responses to personalized entrainment-healing music in theta and low beta range in right pre- and post-central gyrus. We observed somatosensory changes consistent with processing pain during entrainment-healing music that were not seen during preferred music. These results may depict top–down neural processes associated with active coping for pain.

The Interplay Between Chamber Musicians During Two Public Performances of the Same Piece: A Novel Methodology Using the Concept of "Flow"

The purpose of the study is to explore a new research methodology that will improve our understanding of “flow” through indicators of physiological and qualitative state. We examine indicators of “flow” experienced by musicians of a youth string quartet, two women (25, 29) and two men (23, 24). Electrocardiogram (ECG) equipment was used to record heart rate variability (HRV) data throughout the four movements in one and the same quartet performed during two concerts. Individual physiological indicators of flow were supplemented by assessments of group “state flow” (means from standardized questionnaires) and a group interview in which the musicians provided qualitative data. A matrix was constructed for the characterization of different kinds of demands in the written music in each one of the four movements for each one of the musicians. HRV derived from ECG data showed non-significant trends for group state flow across the eight musical episodes. Individual-level analysis showed that compared to the other players the first violin player had the highest mean heart rate and the lowest increase in high frequency (HF) power in HRV during this particular movement, particularly during the second concert. The qualitative data illustrated how an interplay of synchronized social interactions between this player and their colleagues during the musical performance was associated with a feeling of group state flow and served to support the first violinist. The case illustrates that the proposed mixed methodology drawing on physiological and qualitative data, has the potential to provide meaningful information about experiences of a flow state, both at individual and group levels. Applications in future research are possible.

Hypothesis: The highly folded brain surface might be structured and located so as to facilitate inter-brain synchronization

We integrate recent findings from neuro-anatomy, electroencephalography, quantum biology and social/neurodevelopment to propose that the brain surface might be specialised for communication with other brains.

Ground breaking, but still small-scale, research has demonstrated that human brains can act in synchrony and detect the brain activity of other human brains. Group aggregation, in all species, maximises community support and safety but does not depend on verbal or visual interaction. The morphology of the brain’s outermost layers, across a wide range of species, exhibits a highly folded fractal structure that is likely to maximise exchange at the surface: in humans, a reduced brain surface area is associated with disorders of social communication. The brain sits in a vulnerable exposed location where it is prone to damage, rather than being housed in a central location such as within the ribcage.

These observations have led us to the hypothesis that the brain surface might be specialised for interacting with other brains at its surface, allowing synchronous non-verbal interaction. To our knowledge, this has not previously been proposed or investigated.

Music therapy in pediatric asthma improves pulmonary function while reducing hospitalizations

Objective: The aim of this study was to evaluate music therapy (MT), in conjunction with standard care, as a complementary option for asthma management in pediatric patients.Methods: 173 children were randomly assigned to one of three groups: 1) Music: a single individualized MT session along with a recorder and journal with instructions for home use; 2) Music Plus: weekly group MT sessions along with a recorder and journal for home use; or 3) Control: standard of care. Primary endpoints included pulmonary function tests (FEV1, FVC, FEF25-75, PEF), hospitalizations, ER visits, missed school days, and quality of life (Juniper).Results: Significant intergroup differences relative to Controls were observed for FEV1/FVC (Music and Music Plus, p < 0.05) and FEF25-75 (Music Plus; p < 0.01). Music Plus participants experienced fewer hospitalizations compared to Controls (p < 0.001), corresponding to 1.16 fewer hospitalizations per patient-year. Caregivers' perception of their children's QOL significantly increased in the Music (p = 0.011) and Music Plus (p < 0.001) groups compared to Controls.Conclusion: These results reflect MT's potential to favorably impact pediatric asthma management as a child-friendly, low-risk intervention. Further research is needed to substantiate the possible benefits of incorporating MT into standard treatment regimens.

Dynamic Orchestration of Brains and Instruments During Free Guitar Improvisation

Playing music in ensemble requires enhanced sensorimotor coordination and the non-verbal communication of musicians that need to coordinate their actions precisely with those of others. As shown in our previous studies on guitar duets, and also on a guitar quartet, intra- and inter-brain synchronization plays an essential role during such interaction. At the same time, sensorimotor coordination as an essential part of this interaction requires being in sync with the auditory signals coming from the played instruments. In this study, using acoustic recordings of guitar playing and electroencephalographic (EEG) recordings of brain activity from guitarists playing in duet, we aimed to explore whether the musicians' brain activity synchronized with instrument sounds produced during guitar playing. To do so, we established an analytical method based on phase synchronization between time-frequency transformed guitar signals and raw EEG signals. Given phase synchronization, or coupling between guitar and brain signals, we constructed so-called extended hyper-brain networks comprising all possible interactions between two guitars and two brains. Applying a graph-theoretical approach to these networks assessed across time, we present dynamic changes of coupling strengths or dynamic orchestration of brains and instruments during free guitar improvisation for the first time. We also show that these dynamic network topology changes are oscillatory in nature and are characterized by specific spectral peaks, indicating the temporal structure in the synchronization patterns between guitars and brains. Moreover, extended hyper-brain networks exhibit specific modular organization varying in time, and binding each time, different parts of the network into the modules, which were mostly heterogeneous (i.e., comprising signals from different instruments and brains or parts of them). This suggests that the method capturing synchronization between instruments and brains when playing music provides crucial information about the underlying mechanisms. We conclude that this method may be an indispensable tool in the investigation of social interaction, music therapy, and rehabilitation dynamics.