Auditory Stimulation Modulates Resting-State Functional Connectivity in Unresponsive Wakefulness Syndrome Patients

Abstract

Passive listening to music is associated with several psychological and physical benefits in both, healthy and diseased populations. In this fMRI study, we examined whether preferred music has effects on the functional connectivity within resting-state networks related to consciousness. Thirteen patients in unresponsive wakefulness syndrome (UWS) and 18 healthy controls (HC) were enrolled. Both groups were exposed to different auditory stimulation (scanner noise, preferred music, and aversive auditory stimulation). Functional connectivity was analyzed using a seed-based approach. In HC, no differences were found between the three conditions, indicating that their networks are already working at high level. UWS patients showed impaired functional connectivity within all resting-state networks. In addition, functional connectivity of the auditory network was modulated by preferred music and aversive auditory stimulation. Hence, both conditions have the potential to modulate brain activity of UWS patients.

Music Stimulation for People with Disorders of Consciousness: A Scoping Review

“…Third, the studies reported quantitative or mixed quantitative and qualitative data. Studies were excluded if they did not meet one or more of the aforementioned criteria (see e.g., [22,28,30,[42][43][44][45][46]).…”

“…Boltzmann et al [28] exposed 13 UWS patients to two stimulation conditions, one consisting of a preferred music compilation and the other consisting of an aversive auditory stimulation. The two stimulation conditions and scanner noise, each lasting 8 min, were presented in a random order across patients.…”

“…Physiological indices typically included measures such as heart rate or heart rate variability, respiration frequency, blood pressure, and electrodermal (skin) conductance (e.g., [22,26,47,50,54]. Brain activity was assessed via means such as magnetic resonance imaging (e.g., [28,29,57]), electroencephalographic recording (e.g., [34,42,56,59,70]), and positron emission tomography [31]. Behavioral responses included facial expressions and blinks [41,53,54,59], eye, lip, finger and/or head movements [43,50,64,67], or forms of agitation movements [49].…”

“…The second reason is the view that the emotional content of salient music can activate limbic and paralimbic structures, as well as the reward circuit, thus improving the general functioning and well-being of the people exposed to it [26,27]. Another possible motive that seems to justify the preference for music (or auditory stimulation in general over visual stimulation) is that people with disorders of consciousness tend to have an undamaged hearing system, as opposed to a frequently impaired visual system [17,19,28].…”

A Behavioral Approach to Treatment and Assessment of People with Disorders of Consciousness: The Response-contingent Stimulation Strategy

“…Verbal stories/messages mainly involve the narration/recalling of meaningful events the patient had previously experienced and/or the description of the current situation with a positive perspective for recovery and future [28,35,36]. The use of such an intervention strategy is supported by the view that (a) the emotional content of the stories/messages can activate limbic and paralimbic structures of the brain (see above) [37][38][39], (b) the calling of the patient's name can promote forms of behavioral or nonbehavioral (physiological) responses of alertness and attention [31,40], and (c) the overall narration can constitute a useful form of auditory stimulation, that is, beneficial input for a sensory channel, which is generally well preserved in this population [26,41].…”