The European Academy of Neurology Brain Health Strategy: One brain, one life, one approach.

BACKGROUND AND PURPOSE: Brain health is essential for health, well-being, productivity and creativity across the entire life. Its definition goes beyond the absence of disease embracing all cognitive, emotional, behavioural and social functions which are necessary to cope with life situations. METHODS: The European Academy of Neurology (EAN) Brain Health Strategy responds to the high and increasing burden of neurological disorders. It aims to develop a non-disease-, non-age-centred holistic and positive approach ('one brain, one life, one approach') to prevent neurological disorders (e.g., Alzheimer's disease and other dementias, stroke, epilepsy, headache/migraine, Parkinson's disease, multiple sclerosis, sleep disorders, brain cancer) but also to preserve brain health and promote recovery after brain damage. RESULTS: The pillars of the EAN Brain Health Strategy are (1) to contribute to a global and international brain health approach (together with national and subspecialty societies, other medical societies, the World Health Organization, the World Federation of Neurology, patients' organizations, industry and other stakeholders); (2) to support the 47 European national neurological societies, healthcare and policymakers in the implementation of integrated and people-centred campaigns; (3) to foster research (e.g., on prevention of neurological disorders, determinants and assessments of brain health); (4) to promote education of students, neurologists, general practitioners, other medical specialists and health professionals, patients, caregivers and the general public; (5) to raise public awareness of neurological disorders and brain health. CONCLUSIONS: By adopting this 'one brain, one life, one approach' strategy in cooperation with partner societies, international organizations and policymakers, a significant number of neurological disorders may be prevented whilst the overall well-being of individuals is enhanced by maintaining brain health through the life course.

Delta- and theta-band cortical tracking and phase-amplitude coupling to sung speech by infants.

The amplitude envelope of speech carries crucial low-frequency acoustic information that assists linguistic decoding at multiple time scales. Neurophysiological signals are known to track the amplitude envelope of adult-directed speech (ADS), particularly in the theta-band. Acoustic analysis of infant-directed speech (IDS) has revealed significantly greater modulation energy than ADS in an amplitude-modulation (AM) band centred on ∼2 Hz. Accordingly, cortical tracking of IDS by delta-band neural signals may be key to language acquisition. Speech also contains acoustic information within its higher-frequency bands (beta, gamma). Adult EEG and MEG studies reveal an oscillatory hierarchy, whereby low-frequency (delta, theta) neural phase dynamics temporally organize the amplitude of high-frequency signals (phase amplitude coupling, PAC). Whilst consensus is growing around the role of PAC in the matured adult brain, its role in the development of speech processing is unexplored. Here, we examined the presence and maturation of low-frequency (<12 Hz) cortical speech tracking in infants by recording EEG longitudinally from 60 participants when aged 4-, 7- and 11- months as they listened to nursery rhymes. After establishing stimulus-related neural signals in delta and theta, cortical tracking at each age was assessed in the delta, theta and alpha [control] bands using a multivariate temporal response function (mTRF) method. Delta-beta, delta-gamma, theta-beta and theta-gamma phase-amplitude coupling (PAC) was also assessed. Significant delta and theta but not alpha tracking was found. Significant PAC was present at all ages, with both delta and theta -driven coupling observed.

The Music of Silence: Part II: Music Listening Induces Imagery Responses.

During music listening, humans routinely acquire the regularities of the acoustic sequences and use them to anticipate and interpret the ongoing melody. Specifically, in line with this predictive framework, it is thought that brain responses during such listening reflect a comparison between the bottom-up sensory responses and top-down prediction signals generated by an internal model that embodies the music exposure and expectations of the listener. To attain a clear view of these predictive responses, previous work has eliminated the sensory inputs by inserting artificial silences (or sound omissions) that leave behind only the corresponding predictions of the thwarted expectations. Here, we demonstrate a new alternate approach in which we decode the predictive electroencephalography (EEG) responses to the silent intervals that are naturally interspersed within the music. We did this as participants (experiment 1, 20 participants, 10 female; experiment 2, 21 participants, 6 female) listened or imagined Bach piano melodies. Prediction signals were quantified and assessed via a computational model of the melodic structure of the music and were shown to exhibit the same response characteristics when measured during listening or imagining. These include an inverted polarity for both silence and imagined responses relative to listening, as well as response magnitude modulations that precisely reflect the expectations of notes and silences in both listening and imagery conditions. These findings therefore provide a unifying view that links results from many previous paradigms, including omission reactions and the expectation modulation of sensory responses, all in the context of naturalistic music listening.SIGNIFICANCE STATEMENT Music perception depends on our ability to learn and detect melodic structures. It has been suggested that our brain does so by actively predicting upcoming music notes, a process inducing instantaneous neural responses as the music confronts these expectations. Here, we studied this prediction process using EEGs recorded while participants listen to and imagine Bach melodies. Specifically, we examined neural signals during the ubiquitous musical pauses (or silent intervals) in a music stream and analyzed them in contrast to the imagery responses. We find that imagined predictive responses are routinely co-opted during ongoing music listening. These conclusions are revealed by a new paradigm using listening and imagery of naturalistic melodies.

The Music of Silence: Part I: Responses to Musical Imagery Encode Melodic Expectations and Acoustics.

Musical imagery is the voluntary internal hearing of music in the mind without the need for physical action or external stimulation. Numerous studies have already revealed brain areas activated during imagery. However, it remains unclear to what extent imagined music responses preserve the detailed temporal dynamics of the acoustic stimulus envelope and, crucially, whether melodic expectations play any role in modulating responses to imagined music, as they prominently do during listening. These modulations are important as they reflect aspects of the human musical experience, such as its acquisition, engagement, and enjoyment. This study explored the nature of these modulations in imagined music based on EEG recordings from 21 professional musicians (6 females and 15 males). Regression analyses were conducted to demonstrate that imagined neural signals can be predicted accurately, similarly to the listening task, and were sufficiently robust to allow for accurate identification of the imagined musical piece from the EEG. In doing so, our results indicate that imagery and listening tasks elicited an overlapping but distinctive topography of neural responses to sound acoustics, which is in line with previous fMRI literature. Melodic expectation, however, evoked very similar frontal spatial activation in both conditions, suggesting that they are supported by the same underlying mechanisms. Finally, neural responses induced by imagery exhibited a specific transformation from the listening condition, which primarily included a relative delay and a polarity inversion of the response. This transformation demonstrates the top-down predictive nature of the expectation mechanisms arising during both listening and imagery.SIGNIFICANCE STATEMENT It is well known that the human brain is activated during musical imagery: the act of voluntarily hearing music in our mind without external stimulation. It is unclear, however, what the temporal dynamics of this activation are, as well as what musical features are precisely encoded in the neural signals. This study uses an experimental paradigm with high temporal precision to record and analyze the cortical activity during musical imagery. This study reveals that neural signals encode music acoustics and melodic expectations during both listening and imagery. Crucially, it is also found that a simple mapping based on a time-shift and a polarity inversion could robustly describe the relationship between listening and imagery signals.

Cortical encoding of melodic expectations in human temporal cortex.

Humans engagement in music rests on underlying elements such as the listeners' cultural background and interest in music. These factors modulate how listeners anticipate musical events, a process inducing instantaneous neural responses as the music confronts these expectations. Measuring such neural correlates would represent a direct window into high-level brain processing. Here we recorded cortical signals as participants listened to Bach melodies. We assessed the relative contributions of acoustic versus melodic components of the music to the neural signal. Melodic features included information on pitch progressions and their tempo, which were extracted from a predictive model of musical structure based on Markov chains. We related the music to brain activity with temporal response functions demonstrating, for the first time, distinct cortical encoding of pitch and note-onset expectations during naturalistic music listening. This encoding was most pronounced at response latencies up to 350 ms, and in both planum temporale and Heschl's gyrus.

Infant-directed speech facilitates seven-month-old infants' cortical tracking of speech.

This study assessed cortical tracking of temporal information in incoming natural speech in seven-month-old infants. Cortical tracking refers to the process by which neural activity follows the dynamic patterns of the speech input. In adults, it has been shown to involve attentional mechanisms and to facilitate effective speech encoding. However, in infants, cortical tracking or its effects on speech processing have not been investigated. This study measured cortical tracking of speech in infants and, given the involvement of attentional mechanisms in this process, cortical tracking of both infant-directed speech (IDS), which is highly attractive to infants, and the less captivating adult-directed speech (ADS), were compared. IDS is the speech register parents use when addressing young infants. In comparison to ADS, it is characterised by several acoustic qualities that capture infants' attention to linguistic input and assist language learning. Seven-month-old infants' cortical responses were recorded via electroencephalography as they listened to IDS or ADS recordings. Results showed stronger low-frequency cortical tracking of the speech envelope in IDS than in ADS. This suggests that IDS has a privileged status in facilitating successful cortical tracking of incoming speech which may, in turn, augment infants' early speech processing and even later language development.

Decoding the auditory brain with canonical component analysis.

The relation between a stimulus and the evoked brain response can shed light on perceptual processes within the brain. Signals derived from this relation can also be harnessed to control external devices for Brain Computer Interface (BCI) applications. While the classic event-related potential (ERP) is appropriate for isolated stimuli, more sophisticated "decoding" strategies are needed to address continuous stimuli such as speech, music or environmental sounds. Here we describe an approach based on Canonical Correlation Analysis (CCA) that finds the optimal transform to apply to both the stimulus and the response to reveal correlations between the two. Compared to prior methods based on forward or backward models for stimulus-response mapping, CCA finds significantly higher correlation scores, thus providing increased sensitivity to relatively small effects, and supports classifier schemes that yield higher classification scores. CCA strips the brain response of variance unrelated to the stimulus, and the stimulus representation of variance that does not affect the response, and thus improves observations of the relation between stimulus and response.

Indexing cortical entrainment to natural speech at the phonemic level: Methodological considerations for applied research.

Speech is central to human life. As such, any delay or impairment in receptive speech processing can have a profoundly negative impact on the social and professional life of a person. Thus, being able to assess the integrity of speech processing in different populations is an important goal. Current standardized assessment is mostly based on psychometric measures that do not capture the full extent of a person's speech processing abilities and that are difficult to administer in some subjects groups. A potential alternative to these tests would be to derive "direct", objective measures of speech processing from cortical activity. One such approach was recently introduced and showed that it is possible to use electroencephalography (EEG) to index cortical processing at the level of phonemes from responses to continuous natural speech. However, a large amount of data was required for such analyses. This limits the usefulness of this approach for assessing speech processing in particular cohorts for whom data collection is difficult. Here, we used EEG data from 10 subjects to assess whether measures reflecting phoneme-level processing could be reliably obtained using only 10 min of recording time from each subject. This was done successfully using a generic modeling approach wherein the data from a training group composed of 9 subjects were combined to derive robust predictions of the EEG signal for new subjects. This allowed the derivation of indices of cortical activity at the level of phonemes and the disambiguation of responses to specific phonetic features (e.g., stop, plosive, and nasal consonants) with limited data. This objective approach has the potential to complement psychometric measures of speech processing in a wide variety of subjects.

Eye Can Hear Clearly Now: Inverse Effectiveness in Natural Audiovisual Speech Processing Relies on Long-Term Crossmodal Temporal Integration.

UNLABELLED: Speech comprehension is improved by viewing a speaker's face, especially in adverse hearing conditions, a principle known as inverse effectiveness. However, the neural mechanisms that help to optimize how we integrate auditory and visual speech in such suboptimal conversational environments are not yet fully understood. Using human EEG recordings, we examined how visual speech enhances the cortical representation of auditory speech at a signal-to-noise ratio that maximized the perceptual benefit conferred by multisensory processing relative to unisensory processing. We found that the influence of visual input on the neural tracking of the audio speech signal was significantly greater in noisy than in quiet listening conditions, consistent with the principle of inverse effectiveness. Although envelope tracking during audio-only speech was greatly reduced by background noise at an early processing stage, it was markedly restored by the addition of visual speech input. In background noise, multisensory integration occurred at much lower frequencies and was shown to predict the multisensory gain in behavioral performance at a time lag of ∼250 ms. Critically, we demonstrated that inverse effectiveness, in the context of natural audiovisual (AV) speech processing, relies on crossmodal integration over long temporal windows. Our findings suggest that disparate integration mechanisms contribute to the efficient processing of AV speech in background noise. SIGNIFICANCE STATEMENT: The behavioral benefit of seeing a speaker's face during conversation is especially pronounced in challenging listening environments. However, the neural mechanisms underlying this phenomenon, known as inverse effectiveness, have not yet been established. Here, we examine this in the human brain using natural speech-in-noise stimuli that were designed specifically to maximize the behavioral benefit of audiovisual (AV) speech. We find that this benefit arises from our ability to integrate multimodal information over longer periods of time. Our data also suggest that the addition of visual speech restores early tracking of the acoustic speech signal during excessive background noise. These findings support and extend current mechanistic perspectives on AV speech perception.