Modulation of electric brain responses evoked by pitch deviants through transcranial direct current stimulation

Perceptual and Cognitive Effects of Focal Transcranial Direct Current Stimulation of Auditory Cortex in Tinnitus

OBJECTIVES

Transcranial direct current stimulation (tDCS) has been studied as a potential treatment for many brain conditions. Although tDCS is well tolerated, continued study of perceptual and cognitive side effects is warranted, given the complexity of functional brain organization. This study tests the feasibility of brief tablet-based tasks to assess auditory and cognitive side effects in a recently reported pilot study of auditory-cortex tDCS in chronic tinnitus and attempts to confirm that this untested multisession tDCS protocol does not worsen hearing.

MATERIALS AND METHODS

Participants with chronic tinnitus completed two hearing tasks (pure-tone thresholds, Words In Noise [WIN]) and two cognitive tasks (Flanker, Dimension Change Card Sort) from the NIH Toolbox (2024 Toolbox Assessments, Inc, Lincolnwood, IL). Participants were randomized to active or sham 4×1 silver/silver-chloride tDCS of left auditory cortex (n = 10/group). 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 WIN stimuli modestly improved after five active tDCS sessions (t34 = -2.07, p = 0.05). On cognitive tasks, reaction times (RTs) were quicker after sham tDCS, reflecting expected practice effects (eg, t88 = 3.22, p = 0.002 after five sessions on the Flanker task). However, RTs 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 do not seem to adversely affect hearing or cognition but may modestly improve hearing in noise 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.

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.

Auditory cortex and beyond: Deficits in congenital amusia

Congenital amusia is a neuro-developmental disorder of music perception and production, with the observed deficits contrasting with the sophisticated music processing reported for the general population. Musical deficits within amusia have been hypothesized to arise from altered pitch processing, with impairments in pitch discrimination and, notably, short-term memory. We here review research investigating its behavioral and neural correlates, in particular the impairments at encoding, retention, and recollection of pitch information, as well as how these impairments extend to the processing of pitch cues in speech and emotion. The impairments have been related to altered brain responses in a distributed fronto-temporal network, which can be observed also at rest. Neuroimaging studies revealed changes in connectivity patterns within this network and beyond, shedding light on the brain dynamics underlying auditory cognition. Interestingly, some studies revealed spared implicit pitch processing in congenital amusia, showing the power of implicit cognition in the music domain. Building on these findings, together with audiovisual integration and other beneficial mechanisms, we outline perspectives for training and rehabilitation and the future directions of this research domain.

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.

Effects of Transcranial Electrical Stimulation on Human Auditory Processing and Behavior-A Review

Transcranial electrical stimulation (tES) can adjust the membrane potential by applying a weak current on the scalp to change the related nerve activity. In recent years, tES has proven its value in studying the neural processes involved in human behavior. The study of central auditory processes focuses on the analysis of behavioral phenomena, including sound localization, auditory pattern recognition, and auditory discrimination. To our knowledge, studies on the application of tES in the field of hearing and the electrophysiological effects are limited. Therefore, we reviewed the neuromodulatory effect of tES on auditory processing, behavior, and cognitive function and have summarized the physiological effects of tES on the auditory cortex.

Random Feedback Makes Listeners Tone-Deaf

The mental representation of pitch structure (tonal knowledge) is a core component of musical experience and is learned implicitly through exposure to music. One theory of congenital amusia (tone deafness) posits that conscious access to tonal knowledge is disrupted, leading to a severe deficit of music cognition. We tested this idea by providing random performance feedback to neurotypical listeners while they listened to melodies for tonal incongruities and had their electrical brain activity monitored. The introduction of random feedback was associated with a reduction of accuracy and confidence, and a suppression of the late positive brain response usually elicited by conscious detection of a tonal violation. These effects mirror the behavioural and neurophysiological profile of amusia. In contrast, random feedback was associated with an increase in the amplitude of the early right anterior negativity, possibly due to heightened attention to the experimental task. This successful simulation of amusia in a normal brain highlights the key role of feedback in learning, and thereby provides a new avenue for the rehabilitation of learning disorders.