Enhancing Consciousness Detection in Severe Acquired Brain Injury: The Impact of Preferred Music and Binaural Beats

Research Objectives: Previous studies on patients with disorders of consciousness (DoC) have shown that music can enhance arousal and attention compared to white noise or disliked music, suggesting a potential impact of music therapy on consciousness recovery. Another potential sensory stimulation is binaural beats, where two tones with slightly different frequencies are presented separately to each ear. Binaural beats may influence cognition, particularly attention, as shown in a recent meta-analysis. Our project aimed to compare the short-term effects of preferred music versus binaural beats (with Beta waves, 20-30hz) on DoC patients' responsiveness. We hypothesized that patient-preferred music would increase behavioral responsiveness compared to baseline, while binaural beats would produce different effects (either lower or higher responsiveness).

Design: Prospective study using a within subject design.

Setting: Eight rehabilitation centers located in USA, Germany, Italy, Belgium and Argentina.

Participants: Seventy-seven patients (24 VS, age: 51+/-20, 41 males, 27 Anoxia, TSI: 0.4-8y) were recruited for this study.

Interventions: A within subject design was used with one session and 2 conditions (beats and music) presented in pseudo-randomized order between subjects. Stimuli were presented in one single contact using earbuds at the patients’ bedside.

Main Outcome Measures: Frequencies of behavioral responses were recorded at baseline and after each condition using selected items of the Coma Recovery Scale-Revised.

Results: Non parametric statistical tests had to be done since data were not normally distributed. Comparing the three conditions using Friedman tests revealed several trends but significant effects were obtained for variables related to arousal only. Comparing conditions using Conover post-hocs, higher arousal and more frequent response to command were observed only in response to music vs. baseline as well as more frequent visual tracking, particularly, in non-anoxic etiology, in response to music vs. baseline. Very interestingly, when using preferred music (in less extent beats), we found a misdiagnosis of 21% (5/24) in VS and 29% (4/14) in MCS- (due to response to command) when compared to baseline without stimulus presentation.

Conclusions: According to our results, preferred music (and not binaural beats) seems to promote arousal but also improves the detection of important signs of consciousness (such as response to command and visual pursuit/fixation).

Author(s) Disclosures: Nihil