{"doi":"10.1111/ane.13437","title":"40‐Hz auditory stimulation for intracranial interictal activity: A pilot study","abstract":"OBJECTIVES: To study the effects of auditory stimuli on interictal epileptiform discharge (IED) rates evident with intracranial monitoring. MATERIALS AND METHODS: Eight subjects undergoing intracranial EEG monitoring for refractory epilepsy participated in this study. Auditory stimuli consisted of a 40-Hz tone, a 440-Hz tone modulated by a 40-Hz sinusoid, Mozart's Sonata for Two Pianos in D Major (K448), and K448 modulated by a 40-Hz sinusoid (modK448). Subjects were stratified into high- and low-IED rate groups defined by baseline IED rates. Subject-level analyses identified individual responses to auditory stimuli, discerned specific brain regions with significant reductions in IED rates, and examined the influence auditory stimuli had on whole-brain sigma power (12-16 Hz). RESULTS: All subjects in the high baseline IED group had a significant 35.25% average reduction in IEDs during the 40-Hz tone; subject-level reductions localized to mesial and lateral temporal regions. Exposure to Mozart K448 showed significant yet less homogeneous responses. A post hoc analysis demonstrated two of the four subjects with positive IED responses had increased whole-brain power at the sigma frequency band during 40-Hz stimulation. CONCLUSIONS: Our study is the first to evaluate the relationship between 40-Hz auditory stimulation and IED rates in refractory epilepsy. We reveal that 40-Hz auditory stimuli may be a noninvasive adjunctive intervention to reduce IED burden. Our pilot study supports the future examination of 40-Hz auditory stimuli in a larger population of subjects with high baseline IED rates.","journal":"Acta Neurologica Scandinavica","year":2021,"id":183310,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":13,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9531,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2021-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":670581,"name":"Grace Leslie","orcid":"0000-0003-3497-6426","position":1,"is_corresponding":false},{"id":368325,"name":"Edward J. Camp","orcid":"0000-0002-7733-9999","position":2,"is_corresponding":false},{"id":368322,"name":"Stephen Meisenhelter","orcid":"0000-0001-7603-2090","position":3,"is_corresponding":false},{"id":368324,"name":"Sarah A. Steimel","orcid":"0000-0003-4121-4964","position":4,"is_corresponding":false},{"id":368323,"name":"Yinchen Song","orcid":"0000-0001-5820-0353","position":5,"is_corresponding":false},{"id":670583,"name":"Alan B. Ettinger","orcid":"0000-0003-0025-9699","position":6,"is_corresponding":false},{"id":670582,"name":"Krzysztof A. Bujarski","orcid":"0000-0002-1329-5085","position":7,"is_corresponding":false},{"id":670580,"name":"Michael A. Casey","orcid":"0000-0001-6937-0104","position":8,"is_corresponding":false},{"id":227176,"name":"Barbara C. Jobst","orcid":"0000-0001-9243-2238","position":9,"is_corresponding":false},{"id":315569,"name":"Robert J. Quon","orcid":"0000-0002-9926-1539","position":0,"is_corresponding":true}],"reference_count":47,"raw_metadata":null,"created_at":"2026-07-18T23:48:17.816498Z","pmid":"33893999","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}