[Behavioral treatment of functional anejaculation and factors influencing the therapeutic effect].

OBJECTIVE: To study the effect of a modified behavioral treatment (MBT) on functional anejaculation and analyze the factors influencing the therapeutic efficacy. METHODS: We enrolled in this study 59 men aged 24－45 years visiting the Andrology Clinic of Shanghai First Maternity and Infant Hospital from August 2019 to May 2021 and complaining of aejaculation in sexual intercourse but normally ejaculating during masturbation. Thirty-nine of the patients underwent conventional behavioral treatment (the CBT group) and the other 20 received MBT, namely, changing the masturbation method combined with audiovisual stimulation during sexual intercourse (the MBT group). We compared the therapeutic effects between the two groups of patients, and analyzed the correlation of the outcomes of MBT with age, abstinence duration, use of audiovisual stimulation, change of the sexual position, mean bilateral testis volume and sex hormone levels. RESULTS: After treatment, 22 (37.29%) of the patients achieved successful ejaculation at least once in sexual intercourse, 11 (55.00%) in the MBT group, and the other 11 (28.21) in the CBT group, with a significantly higher effectiveness rate in the former than in the latter (P<0.05). The effectiveness rate was significantly correlated to the method of standing-position masturbation plus sexual intercourse and reduction in the frequency of masturbation among various strategies of behavioral treatment (P<0.05). CONCLUSION: MBT has a certain effect on functional anejaculation, and targeting the previous events of the patient is the key to the therapeutic efficacy. Further exploration of more effective strategies of behavioral treatment will become the trend of development in the management of functional anejaculation.

Visual and Auditory Information During Decision Making in Sport.

In 2 experiments, the authors investigated the effects of bimodal integration in a sport-specific task. Beach volleyball players were required to make a tactical decision, responding either verbally or via a motor response, after being presented with visual, auditory, or both kinds of stimuli in a beach volleyball scenario. In Experiment 1, players made the correct decision in a game situation more often when visual and auditory information were congruent than in trials in which they experienced only one of the modalities or incongruent information. Decision-making accuracy was greater when motor, rather than verbal, responses were given. Experiment 2 replicated this congruence effect using different stimulus material and showed a decreasing effect of visual stimulation on decision making as a function of shorter visual stimulus durations. In conclusion, this study shows that bimodal integration of congruent visual and auditory information results in more accurate decision making in sport than unimodal information.

Audiovisual Stimulation Modulates Physical Performance and Biochemical and Hormonal Status of Athletes.

We studied the effect of audiovisual stimulation training course on physical development, functional state of the cardiovascular system, blood biochemical parameters, and hormonal status of athletes. The training course led to improvement of physical performance and adaptive capacities of the circulatory system, increase in plasma levels of total protein, albumin, and glucose and total antioxidant activity, and decrease in triglyceride, lipase, total bilirubin, calcium, and phosphorus. The concentration of hormones (cortisol, thyrotropin, triiodothyronine, and thyroxine) also decreased under these conditions. In the control group, an increase in the concentration of creatinine and uric acid and a tendency toward elevation of lowdensity lipoproteins and total antioxidant activity were observed in the absence of changes in cardiac function and physical performance; calcium and phosphorus concentrations reduced. The improvement in functional state in athletes was mainly associated with intensification of anabolic processes and suppression of catabolic reactions after audiovisual stimulation (in comparison with the control). Stimulation was followed by an increase in the number of correlations between biochemical and hormonal changes and physical performance of athletes, which attested to better integration of processes at the intersystem level.

Effects of sensory overstimulation in postpartum rats.

Research in rodents has shown that exposure to excessive early life audiovisual stimulation leads to altered anxiety-like behaviors and cognitive deficits. Since this period of stimulation typically begins prior to weaning, newborn rodents receive sensory overstimulation (SOS) as a litter within their home cage while the dam is present. However, the effects of SOS during the postpartum period remain unexplored. To this end, we adapted an SOS paradigm for use in rats and exposed rat dams and their litters from postpartum days (PD) 10-23. Maternal observations were conducted to determine whether SOS produced changes in positive and/or negative maternal behaviors. Next, we assessed changes in anxiety-like behavior and cognition by testing dams in the elevated zero maze, open field, and novel object recognition tests. To assess potential effects on HPA-axis function, levels of the stress hormone corticosterone (CORT) were measured approximately 1-week after the cessation of SOS exposure. Our results indicate increased nursing and licking in SOS dams compared to controls, although SOS dams also exhibited significant increases in pup dragging. Moreover, SOS dams exhibited reduced self-care behaviors and nest-building compared to control dams. No differences were found for anxiety-like behaviors, object recognition memory, or CORT levels. This study is the first to assess the impact of postpartum SOS exposure in rat dams. Our findings suggest an SOS-induced enhancement in positive caregiving, but limited impact in all other measures.

Precise timing of audiovisual stimulation conquers chemobrain.

In a recent study, Kim et al. utilized gamma entrainment using sensory stimuli (GENUS) to rescue cognitive impairment and glial dysregulation associated with cisplatin and methotrexate chemotherapy, specifically when applied both throughout and after chemotherapy administration. GENUS provides a time-dependent, non-invasive method for treating chemobrain, with broader implications for resolving neurodegenerative neuroinflammation.

What are wereallydecoding? Unveiling biases in EEG-based decoding of the spatial focus of auditory attention.

Objective.Spatial auditory attention decoding (Sp-AAD) refers to the task of identifying the direction of the speaker to which a person is attending in a multi-talker setting, based on the listener's neural recordings, e.g. electroencephalography (EEG). The goal of this study is to thoroughly investigate potential biases when training such Sp-AAD decoders on EEG data, particularly eye-gaze biases and latent trial-dependent confounds, which may result in Sp-AAD models that decode eye-gaze or trial-specific fingerprints rather than spatial auditory attention.Approach.We designed a two-speaker audiovisual Sp-AAD protocol in which the spatial auditory and visual attention were enforced to be either congruent or incongruent, and we recorded EEG data from sixteen participants undergoing several trials recorded at distinct timepoints. We trained a simple linear model for Sp-AAD based on common spatial patterns filters in combination with either linear discriminant analysis (LDA) or k-means clustering, and evaluated them both across- and within-trial.Main results.We found that even a simple linear Sp-AAD model is susceptible to overfitting to confounding signal patterns such as eye-gaze and trial fingerprints (e.g. due to feature shifts across trials), resulting in artificially high decoding accuracies. Furthermore, we found that changes in the EEG signal statistics across trials deteriorate the trial generalization of the classifier, even when the latter is retrained on the test trial with an unsupervised algorithm.Significance.Collectively, our findings confirm that there exist subtle biases and confounds that can strongly interfere with the decoding of spatial auditory attention from EEG. It is expected that more complicated non-linear models based on deep neural networks, which are often used for Sp-AAD, are even more vulnerable to such biases. Future work should perform experiments and model evaluations that avoid and/or control for such biases in Sp-AAD tasks.

Brain function effects of autonomous sensory meridian response (ASMR) video viewing.

Background: Autonomous sensory meridian response (ASMR) is the sensation of tingling from audiovisual stimuli that leads to positive emotions. ASMR is used among young people to relax, induce sleep, reduce stress, and alleviate anxiety. However, even without experiencing tingling, ASMR is used by many young people to seek relaxation. Auditory stimulation in ASMR is thought to play the most important role among its triggers, and previous studies have used a mixture of auditory and visual stimulation and auditory stimulation. This is the first study to approach the differences between the effects of direct audiovisual and auditory stimulation from the perspective of brain function using functional magnetic resonance imaging (fMRI) and to clarify the effects of ASMR, which attracts many young people. Methods: The subjects were 30 healthy subjects over 19 years old or older who had not experienced tingling. Brain function was imaged by fMRI while watching ASMR videos or listening to the sound files only. We administered a questionnaire based on a Likert scale to determine if the participants felt a "relaxed mood" and "tingling mood" during the task. Results: Significant activation was found in the visual cortex for audiovisual stimulation and in the visual and auditory cortex for auditory stimulation. In addition, activation of characteristic sites was observed. The specific sites of activation for audiovisual stimulation were the middle frontal gyrus and the left nucleus accumbens, while the specific sites of activation for auditory stimulation were the bilateral insular cortices. The questionnaire showed no significant differences in either "relaxed mood" or "tingling mood" in response to auditory and visual stimulation or auditory stimulation alone. Conclusion: The results of this study showed that there was a clear difference between auditory and audiovisual stimulation in terms of the areas of activation in the brain, but the questionnaire did not reveal any difference in the subjects' mood. Audiovisual stimulation showed activation of the middle frontal gyrus and the nucleus accumbens, whereas auditory stimulation showed activation of the insular cortex. This difference in brain activation sites suggests a difference in mental health effects between auditory and audiovisual stimulation. However, future research on comparisons between those who experience tingling and those who do not, as well as investigations of physiological indices, and examination of the relationship with activated areas in the brain may show that ASMR is useful for mental health.

Associations between Health Education and Mental Health, Burnout, and Work Engagement by Application of Audiovisual Stimulation.

Due to the COVID-19 pandemic, health education programs and workplace health promotion (WHP) could only be offered under difficult conditions, if at all. In Germany for example, mandatory lockdowns, working from home, and physical distancing have led to a sharp decline in expenditure on prevention and health promotion from 2019 to 2020. At the same time, the pandemic has negatively affected many people's mental health. Therefore, our goal was to examine audiovisual stimulation as a possible measure in the context of WHP, because its usage is contact-free, time flexible, and offers, additionally, voice-guided health education programs. In an online survey following a cross-sectional single case study design with 393 study participants, we examined the associations between audiovisual stimulation and mental health, work engagement, and burnout. Using multiple regression analyses, we could identify positive associations between audiovisual stimulation and mental health, burnout, and work engagement. However, longitudinal data are needed to further investigate causal mechanisms between mental health and the use of audiovisual stimulation. Nevertheless, especially with regard to the pandemic, audiovisual stimulation may represent a promising measure for improving mental health at the workplace.

Open-Loop Audiovisual Stimulation Induces Delta EEG Activity in Older Adults With Osteoarthritis Pain and Insomnia.

OBJECTIVE: People with chronic insomnia tend to have cortical hyperarousal marked by excessive beta-/gamma-frequency brain activity during both wake and sleep. Currently, treatment options for managing hyperarousal are limited. Open-loop audiovisual stimulation (AVS) may be such a treatment. The purpose of this study was to provide a mechanistic foundation for future AVS research in sleep promotion by examining quantitative electroencephalogram (QEEG) responses to an AVS sleep-induction program. METHOD: Sixteen older adults with both chronic insomnia and osteoarthritis pain were randomly assigned to either active- or placebo-control AVS. Electroencephalogram (EEG) was collected during baseline (5 min, eyes closed/resting) and throughout 30 min of AVS. RESULTS: Findings showed significantly elevated mean baseline gamma (35-45 Hz) power in both groups compared to an age- and gender-matched, noninsomnia normative database, supporting cortical hyperarousal. After 30 min of exposure to AVS, the active group showed significantly increased delta power compared to the placebo-control group, providing the first controlled evidence that active AVS induction increases delta QEEG activity in insomnia patients and that these changes are immediate. In the active group, brain locations that showed the most delta induction (Cz, Fp, O1, and O2) were associated with the sensory-thalamic pathway, consistent with the sensory stimulation provided by the active AVS program. CONCLUSIONS: Findings demonstrate that delta induction, which can promote sleep, is achievable using a 30-min open-loop AVS program. The potential for AVS treatment of insomnia in the general population remains to be demonstrated in well-designed clinical trials.

Development and Implementation of a New Telerehabilitation System for Audiovisual Stimulation Training in Hemianopia.

Telerehabilitation, defined as the method by which communication technologies are used to provide remote rehabilitation, although still underused, could be as efficient and effective as the conventional clinical rehabilitation practices. In the literature, there are descriptions of the use of telerehabilitation in adult patients with various diseases, whereas it is seldom used in clinical practice with child and adolescent patients. We have developed a new audiovisual telerehabilitation (AVT) system, based on the multisensory capabilities of the human brain, to provide a new tool for adults and children with visual field defects in order to improve ocular movements toward the blind hemifield. The apparatus consists of a semicircular structure in which visual and acoustic stimuli are positioned. A camera is integrated into the mechanical structure in the center of the panel to control eye and head movements. Patients can use this training system with a customized software on a tablet. From hospital, the therapist has complete control over the training process, and the results of the training sessions are automatically available within a few minutes on the hospital website. In this paper, we report the AVT system protocol and the preliminary results on its use by three adult patients. All three showed improvements in visual detection abilities with long-term effects. In the future, we will test this apparatus with children and their families. Since interventions for impairments in the visual field have a substantial cost for individuals and for the welfare system, we expect that our research could have a profound socio-economic impact avoiding prolonged and intensive hospital stays.

Reducing the rate of misdiagnosis in patients with chronic disorders of consciousness: Is there a place for audiovisual stimulation?

BACKGROUND: The patients with chronic Disorders of Consciousness (DoC) mostly present with extremely challenging differential diagnosis. The advanced analysis of electroencephalographic (EEG) signals induced by brain stimulation paradigms may provide an appropriate approach to differentiate patients with DoC, besides the clinical assessment. OBJECTIVE: This study was performed with an objective of identifying residual brain network perturbations following an innovative, non-invasive audiovisual stimulation protocol, which could be related to behavioral responsiveness in patients with DoC. METHODS: The study comprised of ten healthy controls (HC), seven patients with Minimally Conscious State (MCS), and nine patients with Unresponsive Wakefulness Syndrome (UWS). Both synchronous as well as asynchronous transorbital and transauricolar alternating current were employed as stimuli and their effects were measured in terms of functional and effective connectivity. RESULTS: A more noticeable deterioration of long range connectivity patterns were found in patients with UWS than in those with MCS, with an exception of two patients with UWS, who showed connectivity values similar to those of MCS patients. CONCLUSION: The audiovisual stimulation paradigm used in the present study may be employed as a supportive bedside tool for improving the differential diagnosis in patients with DoC.