Binaural Pulse Modulation (BPM) as Adjunctive Treatment for Anxiety: A Pilot Study (Preprint)

BACKGROUND Several decades of feedback research with EEG signals have shown that participants can be trained to influence the amplitude or topography of specific components of scalp electric activity. However, it has been very difficult to influence specific mental states or treat psychiatric disorders with EEG-based neurofeedback, probably because of its low spatial specificity and difficulties associated with the poor signal-to-noise ratio provided by single trial-based EEG. For this reason, tuned sound may be a viable alternative. OBJECTIVE Our objective in this pilot study was to examine the possibility of using a Binaural Pulse-Mode-Modulation-type (BPM) device to restore an effective psycho-emotional state by activating the endogenous methods of self-regulation to activate the processes of recovery from anxiety and mood disorders. We desired to evaluate if emotional distress would be altered (reduced) or regulated by means of BPM-type systems. METHODS Sixty adult participants were studied with self-reported measures of distress (Generalized Anxiety Disorder 7, Covid-Stress Scale, PTSD Checklist for DSM-5, Beck Depression Inventory-II) were completed before, after, four weeks, and 12 weeks post-treatment. This BPM produced two frequencies combined to create a binaural pulse through differential auditory tone presentations, and the user response adjusted to the appropriate target tone for effective treatment. Each individual calibrated the binaural pulse to increase the level of emotion experienced while imagining an experience with a similar emotional valence or while engaged in a cognitive function while also listening to the sound. “Treatment” was based on the individual's control of the binaural pulses to achieve the desired state. The training focused on specific aspects of their psychological difficulties while listening to an auditory tone, turning a knob until the sound increased the desired emotional state. Another knob was turned to intensify the emotional state associated with distress reduction. RESULTS On self-report measures, the BPM treatment group was significantly better than the sham treatment and control groups. These findings indicate that over the four-week intervention period, BPM was similarly effective to standard treatment approaches for anxiety, PTSD, and stress. CONCLUSIONS BPM appears to result in a temporary change in self-reported levels of distress during treatment. Limitations of the study are reviewed and directions for further research are offered. CLINICALTRIAL Not a clinical trial