AUTHOR=Xiao Qiuyi , Zheng Xiaochun , Wen Yun , Yuan Zhanxing , Chen Zerong , Lan Yue , Li Shuiyan , Huang Xiyan , Zhong Haili , Xu Chengwei , Zhan Chang’an , Pan Jiahui , Xie Qiuyou 

TITLE=Individualized music induces theta-gamma phase-amplitude coupling in patients with disorders of consciousness

JOURNAL=Frontiers in Neuroscience

VOLUME=18

YEAR=2024

URL=https://www.frontiersin.org/journals/neuroscience/articles/10.3389/fnins.2024.1395627

DOI=10.3389/fnins.2024.1395627

ISSN=1662-453X

ABSTRACT=<sec id="sec1"><title>Objective</title><p>This study aimed to determine whether patients with disorders of consciousness (DoC) could experience neural entrainment to individualized music, which explored the cross-modal influences of music on patients with DoC through phase-amplitude coupling (PAC). Furthermore, the study assessed the efficacy of individualized music or preferred music (PM) versus relaxing music (RM) in impacting patient outcomes, and examined the role of cross-modal influences in determining these outcomes.</p></sec><sec id="sec2"><title>Methods</title><p>Thirty-two patients with DoC [17 with vegetative state/unresponsive wakefulness syndrome (<italic>VS</italic>/UWS) and 15 with minimally conscious state (MCS)], alongside 16 healthy controls (HCs), were recruited for this study. Neural activities in the frontal–parietal network were recorded using scalp electroencephalography (EEG) during baseline (BL), RM and PM. Cerebral-acoustic coherence (CACoh) was explored to investigate participants’ abilitiy to track music, meanwhile, the phase-amplitude coupling (PAC) was utilized to evaluate the cross-modal influences of music. Three months post-intervention, the outcomes of patients with DoC were followed up using the Coma Recovery Scale-Revised (CRS-R).</p></sec><sec id="sec3"><title>Results</title><p>HCs and patients with MCS showed higher CACoh compared to <italic>VS</italic>/UWS patients within musical pulse frequency (<italic>p</italic> = 0.016, <italic>p</italic> = 0.045; <italic>p</italic> &lt; 0.001, <italic>p</italic> = 0.048, for RM and PM, respectively, following Bonferroni correction). Only theta-gamma PAC demonstrated a significant interaction effect between groups and music conditions (<italic>F</italic><sub>(2,44)</sub> = 2.685, <italic>p</italic> = 0.036). For HCs, the theta-gamma PAC in the frontal–parietal network was stronger in the PM condition compared to the RM (<italic>p</italic> = 0.016) and BL condition (<italic>p</italic> &lt; 0.001). For patients with MCS, the theta-gamma PAC was stronger in the PM than in the BL (<italic>p</italic> = 0.040), while no difference was observed among the three music conditions in patients with <italic>VS</italic>/UWS. Additionally, we found that MCS patients who showed improved outcomes after 3 months exhibited evident neural responses to preferred music (<italic>p</italic> = 0.019). Furthermore, the ratio of theta-gamma coupling changes in PM relative to BL could predict clinical outcomes in MCS patients (<italic>r</italic> = 0.992, <italic>p</italic> &lt; 0.001).</p></sec><sec id="sec4"><title>Conclusion</title><p>Individualized music may serve as a potential therapeutic method for patients with DoC through cross-modal influences, which rely on enhanced theta-gamma PAC within the consciousness-related network.</p></sec>