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40‐Hz auditory stimulation for intracranial interictal activity: A pilot study
Author(s) -
Quon Robert J.,
Leslie Grace A.,
Camp Edward J.,
Meisenhelter Stephen,
Steimel Sarah A.,
Song Yinchen,
Ettinger Alan B.,
Bujarski Krzysztof A.,
Casey Michael A.,
Jobst Barbara C.
Publication year - 2021
Publication title -
acta neurologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.967
H-Index - 95
eISSN - 1600-0404
pISSN - 0001-6314
DOI - 10.1111/ane.13437
Subject(s) - audiology , ictal , stimulation , medicine , vagus nerve stimulation , epilepsy , electroencephalography , auditory cortex , psychology , population , neuroscience , vagus nerve , environmental health
Objectives To study the effects of auditory stimuli on interictal epileptiform discharge (IED) rates evident with intracranial monitoring. Materials and methods Eight subjects undergoing intracranial EEG monitoring for refractory epilepsy participated in this study. Auditory stimuli consisted of a 40‐Hz tone, a 440‐Hz tone modulated by a 40‐Hz sinusoid, Mozart's Sonata for Two Pianos in D Major (K448), and K448 modulated by a 40‐Hz sinusoid (modK448). Subjects were stratified into high‐ and low‐IED rate groups defined by baseline IED rates. Subject‐level analyses identified individual responses to auditory stimuli, discerned specific brain regions with significant reductions in IED rates, and examined the influence auditory stimuli had on whole‐brain sigma power (12–16 Hz). Results All subjects in the high baseline IED group had a significant 35.25% average reduction in IEDs during the 40‐Hz tone; subject‐level reductions localized to mesial and lateral temporal regions. Exposure to Mozart K448 showed significant yet less homogeneous responses. A post hoc analysis demonstrated two of the four subjects with positive IED responses had increased whole‐brain power at the sigma frequency band during 40‐Hz stimulation. Conclusions Our study is the first to evaluate the relationship between 40‐Hz auditory stimulation and IED rates in refractory epilepsy. We reveal that 40‐Hz auditory stimuli may be a noninvasive adjunctive intervention to reduce IED burden. Our pilot study supports the future examination of 40‐Hz auditory stimuli in a larger population of subjects with high baseline IED rates.