Immediate effects of binaural beats stimulation on prefrontal cortical activity in stroke patients: A pilot electroencephalogram study

Medicine (Baltimore). 2025 Nov 7;104(45):e45784. doi: 10.1097/MD.0000000000045784.

Abstract

Binaural beat stimulation (BBS) has been applied to explore cognitive and sleep disorders. This pilot study aimed to examine the immediate effects of a 4-Hz frequency BBS combined with music on prefrontal cortex activity in patients with stroke. We recruited 12 patients with chronic stroke from the rehabilitation department of a medical university-affiliated hospital. Each subject received "Musical Moonlight Sonata," "4-Hz frequency BBS," and "Musical Moonlight Sonata combined with 4-Hz BBS" interventions in a random order within a 3-hour experimental period. Each intervention lasted for 20 minutes, with 30-minute rest intervals between interventions. An 8-channel wearable dry electrode electroencephalography system was used to record the prefrontal cortex activity before and after each intervention. Within-group analysis revealed an increase in alpha power following: "Musical Moonlight Sonata" intervention (R = 0.57, P = .049). Significant differences in prefrontal cortical activity were found between the 3 interventions (partial η² = 0.24, P = .04). Compared to the "4-Hz BBS" intervention, the "Musical Moonlight Sonata" intervention significantly increased alpha power in the affected prefrontal cortex. Preliminary findings indicate that a 20-min intervention with Moonlight Sonata music alone had an immediate effect on prefrontal cortex activity in patients with chronic stroke. The 4-Hz BBS or the combined music and 4-Hz BBS intervention did not seem to be as effective in changing prefrontal cortex activity after stroke.

Keywords: binaural beat stimulation; music therapy; prefrontal cortex activity; stroke.

MeSH terms

  • Acoustic Stimulation* / methods
  • Aged
  • Electroencephalography / methods
  • Female
  • Humans
  • Male
  • Middle Aged
  • Music Therapy* / methods
  • Pilot Projects
  • Prefrontal Cortex* / physiopathology
  • Stroke Rehabilitation* / methods
  • Stroke* / physiopathology