Search Results (15)

Background: This paper presents a systematic review and meta-analysis to identify the effects of Rhythmic Auditory Stimulation (RAS) delivered via wearable devices on the gait and balance in patients with Parkinson’s disease. Method: The PICO criteria were established according to the PRISMA 2020 guidelines, and literature searches were performed across five databases covering studies published between 2015 and 2025: PubMed, Embase, Cochrane, Scopus, and Web of Science. After applying the inclusion criteria, eleven randomized controlled trials (RCTs) were selected. The quality of the studies was evaluated using the PEDro Scale and ROB-2. Statistical analyses were performed using Review Manager 5.4 based on the number of samples, means, and standard deviations to calculate the effect sizes. Result: The analysis results showed that wearable RAS significantly improved the gait speed (SMD = 0.49, p < 0.05) and balance ability (SMD = 0.40, p < 0.05), while no significant differences in the gait pattern, FOG-Q, or UPDRS-III were observed. The heterogeneity among studies was low, and the funnel plots were distributed symmetrically, indicating minimal publication bias. The average PEDro score was 7.33, suggesting moderate-to-high methodological quality. Conclusion: wearable RAS was identified as an evidence-based intervention effective in improving the gait speed and balance in patients with Parkinson’s disease. Full article

Background: Despite recent breakthroughs in pharmacological treatment for Alzheimer’s disease, high costs and the complex procedure to monitor safety have limited access for many patients. Less invasive and more accessible non-pharmacological therapies that support neuroplasticity and slow cognitive decline are needed. Processing Inner Strength Toward Actualization (PISTA) stimulation applies structured tactile input to promote cortical–subcortical activation. This study evaluated the long-term effects of PISTA on cognition and pain in older adults with mild cognitive impairment or early dementia. Methods: This single-arm, prospective trial enrolled 100 outpatients aged 47–70 years at outset (50 women, 50 men) with no control group. Participants received clinician-supervised PISTA stimulation three times weekly for 48 months. Each 30 min session delivered rhythmic tactile input calibrated to individual sensory thresholds. Cognitive performance was assessed monthly using the Mini-Mental State Examination (MMSE). Perceived pain was measured monthly with the Numeric Pain Rating Scale. Outcomes were analyzed using ANCOVA, adjusting for age, sex, and baseline cognitive status. Results: Cognitive scores improved significantly across all age strata, with a mean annual MMSE increase of 0.75 points (95% CI: 0.26–1.21; p < 0.0025). Pain intensity decreased in parallel (mean reduction: 0.56 points; 95% CI: 0.34–0.78; p < 0.001). Improvements in cognition and pain were moderately correlated (r = 0.38). The greatest combined benefits occurred in participants aged 55–62 years. No serious adverse events were observed during the 48-month trial. Conclusions: PISTA stimulation produced sustained improvement in cognition and reduced perceived pain, supporting its promising role as a safe, non-invasive adjunct for neurodegenerative cognitive decline. These findings suggest peripheral sensory activation as a promising driver of functional neuroplasticity and warrant verification in randomized, controlled trials. Full article

Background: Rhythmic sensory stimulation, including structured musical interventions, has gained renewed interest as a non-pharmacological strategy that may modulate cortical excitability and network stability in focal epilepsy. Although several small studies have reported changes in seizure frequency or epileptiform activity during rhythmic or music exposure, the underlying mechanisms and translational relevance remain insufficiently synthesized. Objective: This narrative review summarizes clinical evidence on music-based and rhythmic sensory interventions in focal epilepsy, outlines plausible neurophysiological mechanisms related to neural entrainment and large-scale network regulation, and discusses emerging opportunities for digital delivery of rhythmic protocols in everyday self-management. Methods: A structured search of recent clinical, neurophysiological, and rehabilitation literature was performed with emphasis on rhythmic auditory, tactile, and multimodal stimulation in epilepsy or related conditions. Additional theoretical and translational sources addressing oscillatory dynamics, entrainment, timing networks, and patient-centered digital tools were reviewed to establish a mechanistic framework. Results: Existing studies—although limited by small cohorts and heterogeneous methodology—suggest that certain rhythmic structures, including specific musical compositions, may transiently modulate cortical synchronization, reduce epileptiform discharges, or alleviate seizure-related symptoms in selected patients. Evidence from neurologic music therapy and rhythmic stimulation in other neurological disorders further supports the concept that externally delivered rhythms can influence timing networks, attentional control, and interhemispheric coordination. Advances in mobile health platforms enable structured rhythmic exercises to be delivered and monitored in real-world settings. Conclusions: Music-based and rhythmic sensory interventions represent a promising but underexplored adjunctive approach for focal epilepsy. Their effectiveness likely depends on individual network characteristics and on the structure of the applied rhythm. Digital integration may enhance personalization and adherence. Rigorous clinical trials and mechanistic studies are required to define optimal parameters, identify responders, and clarify the role of rhythmic stimulation within modern epilepsy care. Full article

Epilepsy is increasingly conceptualized as a disorder of large-scale network instability, involving impairments in interhemispheric connectivity, prefrontal inhibitory control, and slow-frequency temporal processing. Rhythmic sensory stimulation—auditory, vibrotactile, or multisensory—can entrain neuronal oscillations and modulate attentional and sensorimotor networks, yet its mechanistic relevance to epileptic network physiology remains insufficiently explored. This conceptual and mechanistic article integrates empirical findings from entrainment research, prefrontal timing theories, multisensory integration, and network-based models of seizure dynamics and uses them to formulate a hypothesis-driven framework for multisensory exogenous rhythmic stimulation (ERS) in focal epilepsy. Rather than presenting a tested intervention, we propose a set of speculative mechanistic pathways through which low-frequency rhythmic cues might serve as an external temporal reference, engage fronto-parietal control systems, facilitate multisensory-driven sensorimotor coupling, and potentially modulate interhemispheric frontal coherence. These putative mechanisms are illustrated by exploratory neurophysiological observations, including a small pilot study reporting frontal coherence changes during mobile ERS exposure, but they have not yet been validated in controlled experimental settings. The framework does not imply therapeutic benefit; instead, it identifies theoretical pathways through which rhythmic sensory cues may transiently interact with epileptic networks. The proposed model is intended as a conceptual foundation for future neurophysiological validation, computational simulations, and early feasibility research in the emerging field of digital neuromodulation, rather than as evidence of clinical efficacy. This Hypothesis article formulates explicitly testable predictions regarding how multisensory ERS may transiently modulate candidate physiological markers of prefrontal network stability in focal epilepsy. Full article

Background/Objectives: Patterned Sensory Enhancement (PSE), a Neurologic Music Therapy technique, utilizes rhythm and other musical elements to facilitate functional movement in diverse clinical populations. This scoping review is the first to systematically synthesize the current evidence surrounding PSE’s use and its effects on motor function across various populations in order to evaluate its therapeutic potential, identify gaps in the existing literature, and guide future research efforts. Methods: A literature search was conducted across five major databases (MEDLINE, Embase, PsycINFO, CINAHL, and Scopus) in accordance with the PRISMA-ScR guidelines. Results: From 1018 screened articles, 15 met the inclusion criteria. PSE has been demonstrated as effective across clinical populations, including Cerebral Palsy, stroke, Parkinson’s Disease, and psychiatric conditions. However, the results for studies on geriatric populations remain inconsistent. Despite the variability in the outcome measures and movement types assessed, PSE is consistently supported as an effective approach for enhancing motor function. However, to date, only a small number of studies across populations have been conducted. Conclusions: This scoping review suggests that PSE holds significant potential for improving motor function across a range of clinical populations. Further research is needed to explore the long-term effects, use standardized terminology, and identify the optimal implementation strategies tailored to the unique needs of different populations to maximize its therapeutic benefit. Full article

Given the cervical spinal cord’s role in locomotor and rhythmic upper limb tasks, its neuromodulation has emerged as an important area of study for understanding human spinal rhythmogenesis. We previously demonstrated that, under unloading conditions, arm muscle vibrostimulation can elicit non-voluntary upper limb oscillations. In this study, we investigated the effects of transcranial magnetic stimulation (TMS) of the motor cortex during both voluntary and non-voluntary (vibration-induced) rhythmic arm movements. We analyzed motor-evoked potentials, mean arm muscle activity, and kinematic parameters of arm movements, including cycle duration and shoulder and elbow joint angular oscillations. Motor-evoked potentials in proximal arm muscles were significantly modulated during both movement types. Notably, low-frequency TMS markedly enhanced non-voluntary arm oscillations, whereas its effect on voluntary movements was statistically non-significant. This differential response is likely due to the absence of characteristic supraspinal influences in sensory-induced spinal activation during non-voluntary movements. These findings align with previous evidence showing that supraspinal pathways facilitate rhythmogenesis in the lower limbs, and they now extend this concept to the upper limbs. Overall, our results suggest that therapies aimed at modulating cervical central pattern generators may benefit from the active engagement of supraspinal motor circuits. Full article

Alzheimer’s disease (AD), the most prevalent form of dementia, is marked by progressive cognitive decline, affecting memory, language, orientation, and behavior. Pathological hallmarks include extracellular amyloid plaques and intracellular tau tangles, which disrupt synaptic function and connectivity. Neural oscillations, the rhythmic synchronization of neuronal activity across frequency bands, are integral to cognitive processes but become dysregulated in AD, contributing to network dysfunction and memory impairments. Targeting these oscillations has emerged as a promising therapeutic strategy. Preclinical studies have demonstrated that specific frequency modulations can restore oscillatory balance, improve synaptic plasticity, and reduce amyloid and tau pathology. In animal models, interventions, such as gamma entrainment using sensory stimulation and transcranial alternating current stimulation (tACS), have shown efficacy in enhancing memory function and modulating neuroinflammatory responses. Clinical trials have reported promising cognitive improvements with repetitive transcranial magnetic stimulation (rTMS) and deep brain stimulation (DBS), particularly when targeting key hubs in memory-related networks, such as the default mode network (DMN) and frontal–parietal network. Moreover, gamma-tACS has been linked to increased cholinergic activity and enhanced network connectivity, which are correlated with improved cognitive outcomes in AD patients. Despite these advancements, challenges remain in optimizing stimulation parameters, individualizing treatment protocols, and understanding long-term effects. Emerging approaches, including transcranial pulse stimulation (TPS) and closed-loop adaptive neuromodulation, hold promise for refining therapeutic strategies. Integrating neuromodulation with pharmacological and lifestyle interventions may maximize cognitive benefits. Continued interdisciplinary efforts are essential to refine these approaches and translate them into clinical practice, advancing the potential for neural oscillation-based therapies in AD. Full article

Alpha-band (7–13 Hz) activity has been linked to visuo-attentional performance in healthy participants and to impaired functionality of the visual system in a variety of clinical populations including patients with acquired posterior brain lesion and neurodevelopmental and psychiatric disorders. Crucially, several studies suggested that short uni- and multi-sensory rhythmic stimulation (i.e., visual, auditory and audio-visual) administered in the alpha-band effectively induces transient changes in alpha oscillatory activity and improvements in visuo-attentional performance by synchronizing the intrinsic brain oscillations to the external stimulation (neural entrainment). The present review aims to address the current state of the art on the alpha-band sensory entrainment, outlining its potential functional effects and current limitations. Indeed, the results of the alpha-band entrainment studies are currently mixed, possibly due to the different stimulation modalities, task features and behavioral and physiological measures employed in the various paradigms. Furthermore, it is still unknown whether prolonged alpha-band sensory entrainment might lead to long-lasting effects at a neural and behavioral level. Overall, despite the limitations emerging from the current literature, alpha-band sensory entrainment may represent a promising and valuable tool, inducing functionally relevant changes in oscillatory activity, with potential rehabilitative applications in individuals characterized by impaired alpha activity. Full article

This study aims to create an all-around insight into the evolutions, status, and global trends of rhythmic auditory stimulation (RAS) research via enhanced bibliometric methods for the 2001–2020 time period. Articles concerning RAS were extracted from the Web of Science database. CiteSpace, Bibliometrix, VOSviewer, and Graphpad Prism were employed to analyze publication patterns and research trends. A total of 586 publications related to RAS between 2001 and 2020 were retrieved from the Web of Science database. The researcher Goswami U. made the greatest contribution to this field. The University of Toronto was the institution that published the most articles. Motor dysfunction, sensory perception, and cognition are the three major domains of RAS research. Neural tracking, working memory, and neural basis may be the latest research frontiers. This study reveals the publication patterns and topic trends of RAS based on the records published between 2001 and 2020. The insights obtained provided useful references for the future research and applications of RAS. Full article

(1) Introduction: Neurologic music therapy (NMT) is a non-pharmacological approach of interaction through the therapeutic use of music in motor, sensory and cognitive dysfunctions caused by damage or diseases of the nervous system. (2) Objective: This study aimed to critically appraise the available literature on the application of particular NMT techniques in the rehabilitation of geriatric disorders. (3) Methods: PubMed, ScienceDirect and EBSCOhost databases were searched. We considered randomized controlled trials (RCTs) from the last 12 years using at least one of the NMT techniques from the sensorimotor, speech/language and cognitive domains in the therapy of patients over 60 years old and with psychogeriatric disorders. (4) Results: Of the 255 articles, 8 met the inclusion criteria. All papers in the final phase concerned the use of rhythmic auditory stimulation (RAS) (sensorimotor technique) in the rehabilitation of both Parkinson’s disease (PD) patients (six studies) and stroke patients (SPs) (two studies). (5) Conclusion: All reports suggest that the RAS technique has a significant effect on the improvement of gait parameters and the balance of PD patients and SPs, as well as the risk of falls in PD patients. Full article

The state and excitability of pattern generators are attracting the increasing interest of neurophysiologists and clinicians for understanding the mechanisms of the rhythmogenesis and neuromodulation of the human spinal cord. It has been previously shown that tonic sensory stimulation can elicit non-voluntary stepping-like movements in non-injured subjects when their limbs were placed in a gravity-neutral unloading apparatus. However, large individual differences in responsiveness to such stimuli were observed, so that the effects of sensory neuromodulation manifest only in some of the subjects. Given that spinal reflexes are an integral part of the neuronal circuitry, here we investigated the extent to which spinal pattern generation excitability in response to the vibrostimulation of muscle proprioceptors can be related to the H-reflex magnitude, in both the lower and upper limbs. For the H-reflex measurements, three conditions were used: stationary limbs, voluntary limb movement and passive limb movement. The results showed that the H-reflex was considerably higher in the group of participants who demonstrated non-voluntary rhythmic responses than it was in the participants who did not demonstrate them. Our findings are consistent with the idea that spinal reflex measurements play important roles in assessing the rhythmogenesis of the spinal cord. Full article

Patients with stroke suffer from impaired locomotion, exhibiting unstable walking with increased gait variability. Effects of rhythmic sensory stimulation on unstable gait of patients with chronic stroke are unclear. This study aims to determine the effects of rhythmic sensory stimulation on the gait of patients with chronic stroke. Twenty older adults with stroke and twenty age- and gender-matched healthy controls walked 60 m under four conditions: normal walking with no stimulation, walking with rhythmic auditory stimulation (RAS) through an earphone in the ear, walking with rhythmic somatosensory stimulation (RSS) through a haptic device on the wrist of each participant, and walking with rhythmic combined stimulation (RCS: RAS + RSS). Gait performance in the stroke group significantly improved during walking with RAS, RSS, and RCS compared to that during normal walking (p < 0.008). Gait variability significantly decreased under the RAS, RSS, and RCS conditions compared to that during normal walking (p < 0.008). Rhythmic sensory stimulation is effective in improving the gait of patients with chronic stroke, regardless of the type of rhythmic stimuli, compared to healthy controls. The effect was greater in patients with reduced mobility, assessed by the Rivermead Mobility Index (RMI). Full article

The creation and improvement of non-invasive closed-loop brain stimulation technologies represent an exciting and rapidly expanding field of neuroscience. To identify the appropriate way to close the feedback loop in adaptive neurostimulation procedures, it was previously proposed to use on-line automatic sensory stimulation with the parameters modulated by the patient’s own rhythmical processes, such as respiratory rate, heart rate, and electroencephalogram (EEG) rhythms. The current paper aims to analyze several recent studies demonstrating further development in this line of research. The advantages of using automatic closed-loop feedback from human endogenous rhythms in non-invasive adaptive neurostimulation procedures have been demonstrated for relaxation assistance, for the correction of stress-induced functional disturbances, for anxiety management, and for the cognitive rehabilitation of an individual. Several distinctive features of the approach are noted to delineate its further development. Full article

Using functional magnetic resonance imaging, here we monitored the brain activity in 12 early blind subjects and 12 blindfolded control subjects, matched for age, gender and musical experience, during a beat detection task. Subjects were required to discriminate regular (“beat”) from irregular (“no beat”) rhythmic sequences composed of sounds or vibrotactile stimulations. In both sensory modalities, the brain activity differences between the two groups involved heteromodal brain regions including parietal and frontal cortical areas and occipital brain areas, that were recruited in the early blind group only. Accordingly, early blindness induced brain plasticity changes in the cerebral pathways involved in rhythm perception, with a participation of the visually deprived occipital brain areas whatever the sensory modality for input. We conclude that the visually deprived cortex switches its input modality from vision to audition and vibrotactile sense to perform this temporal processing task, supporting the concept of a metamodal, multisensory organization of this cortex. Full article

The common evolutionary history humans share with mammals provides us with a solid basis for understanding normal oropharyngeal anatomy and functions. Physiologically, feeding is a cycle of neurophysiologic activity, where sensory input travels to the CNS which sends motor signals out to the periphery. Research with animal models is valuable because it is possible to disrupt this cycle, and develop predictive models on the causal basis of deviation from normal. Based on work with animal models, normal mammalian infant feeding behavior consists of the tongue functioning as a pump. First, the tongue assists in acquisition of milk from the nipple into the oral cavity, and then it pumps milk from the oral cavity into the valleculae prior to the pharyngeal swallow. Starting with this basic model, feeding in infant pigs was manipulated to determine the impact of variation in sensory input on behavioral output. One set of experiments suggested that chemo- or liquid sensation, in the form of milk is necessary to elicit continuing rhythmic activity. However, the rates of rhythmic suckling are intrinsic to an animal, and variation in rate cannot be entrained. Another set showed that initiation of the swallow does not purely depend on the volume of milk delivered, but also on the sensory stimulation at the mouth. These results support the idea that feeding behavior involves complex sensory integration. Full article