Cortical processing modulation in DOC by preferred music-coupled 40 Hz binaural stimulation: an exploratory EEG-fNIRS...

Area of Science:

• Neuroscience
• Neurology
• Rehabilitation Medicine

Background:

• Disorders of Consciousness (DOC) present significant challenges in diagnosis and treatment.
• Assessing neural complexity and connectivity is crucial for understanding brain function in DOC patients.
• Standard rehabilitation may not fully restore neural function in these patients.

Purpose of the Study:

• To investigate the efficacy of 40 Hz binaural beat therapy (BBT) combined with preferred music in enhancing neural complexity and connectivity in patients with DOC.
• To compare the effects of BBT with music against standard rehabilitation.
• To explore the correlation between neural changes and clinical outcomes.

Main Methods:

• A randomized controlled trial involving 40 patients with DOC (MCS, VS/UWS).
• Intervention group received daily 40 Hz BBT with preferred music; control group received standard rehabilitation.
• Outcomes measured included Coma Recovery Scale-Revised (CRS-R), EEG-based approximate entropy (ApEn), cross-ApEn (C-ApEn), and fNIRS-based functional connectivity (FC).

Main Results:

• Both groups showed improvements in CRS-R scores.
• The 40 Hz BBT group exhibited significant enhancements in prefrontal ApEn, central-prefrontal C-ApEn, and average FC (HbO) with moderate to large effect sizes.
• These neural enhancements were not observed in VS/UWS patients within the BBT group, and the control group showed smaller, non-significant effect sizes.

Conclusions:

• 40 Hz BBT combined with preferred music may enhance neural complexity and functional connectivity in DOC patients.
• The therapeutic effects of 40 Hz BBT with music were not evident in VS/UWS patients.
• Prefrontal ApEn showed the strongest correlation with clinical outcomes, suggesting its potential as a biomarker.