Audio-Visual Entrainment

Audio-visual entrainment (AVE), a subset of brainwave entrainment, uses flashes of lights and pulses of tones to guide the brain into various states of brainwave activity. AVE devices are often termed light and sound machines or mind machines.Altering brainwave activity is believed to aid in the treatment of psychological and physiological disorders.

Introduction
All of our senses (except smell) access the brain's cerebral cortex via the thalamus, and because the thalamus is highly innervated with the cortex, sensory stimulation can easily influence cortical activity. In order to affect brain (neuronal) activity, sensory stimulation must be within the frequency range of roughly 0.5 to 25 hertz (Hz). Touch, photic and auditory stimulation are capable of affecting brain wave activity. A large area of skin must be stimulated to affect brainwaves, which leaves both auditory and photic stimulation as the most effective and easiest means of affecting brain activity. Therefore, mind machines are typically in the form of light and sound devices.

Auditory or visual stimulation (AVS) can take a variety of forms, generating different subjective and clinical effects. The simplest form of stimulation is to present a series of random light flashes and/or sound pulses to a subject such as from watching TV or cars drive by, and investigate the resulting subjective experiences or electroencephalography (EEG) effects. AVE, however, involves organized, repetitive stimulation at a particular frequency for a specific period of time, and the frequency of stimulation is reflected within the EEG. This is a called "open loop" stimulation, or free-running entrainment, and is not contingent on monitoring brainwaves in any way. "Close loop" AVE would involve visual and auditory stimulation in response to one's EEG.

History
Clinical reports of flicker stimulation appear as far back as the beginning of the 20th century. Pierre Janot, at the Salpetriere Hospital in France, reported that by having his patients gaze into the flickering light produced from a spinning, spoked wheel in front of a kerosene lantern, they showed a reduction in their anxiety and hysteria. With the development of the EEG, Adrian and Matthews published their results showing that the alpha rhythm could be "drive" above and below the natural frequency with photic stimulation. This discovery prompted several small physiological outcome studies on the "flicker following response," the brain's electrical response to repetitive stimulation      As EEG equipment improved, so did a renewed interest in the brain's evoked response to photic and auditory entrainment and soon, a variety of studies were completed.

In 1956, W. Gray Walter published the first results on thousands of test subjects comparing flicker stimulation with the subjective emotional feelings it produced. Test subjects reported all types of visual illusions and in particular, the "whirling spiral" which was significant with alpha production. In the late 1950s, as a result of Kroger's observations as to why US military radar operators often drifted into trance, Kroger teamed up with Sidney Schneider of the Schneider Instrument Company. They produced the world's first electronic clinical photic stimulator - the "Brainwave Synchronizer." It had powerful hypnotic qualities and soon studies on hypnotic induction were published  A variety of companies developing AVE (light and sound) devices have been established since this time.

Physiology of Audio-Visual Entrainment
AVE is believed to achieve its effects through several mechanisms simultaneously. These include:

1) altered EEG activity

2) dissociation/hypnotic induction

3) limbic stabilization

4) improved neurotransmitter production

5) altered cerebral blood flow

AVE consists of constant, repetitive stimuli of the proper frequency and sufficient strength to "excite" the thalamus and neocortex. These stimuli do not transfer energy directly into the cortex. The direct transmission of energy from AVE only goes so far as to excite retinal cells in the eyes and pressure sensitive cilia within the cochlea in the ears. The nerve pathways from the eyes and ears carry the elicited electrial potentials into the thalamus. From there, the entrained electrical activity within the thalamus is "amplified" and distributed throughout other limbic areas and the cerebral cortexes via the cortical thalamic loop. AVE involved the continuous electrical response of the brain in relation to the stimulus frequency plus the mathematical representation (harmonics) of the stimulus wave shape.

Effects of Audio-Visual Entrainment
AVE effects on the EEG are found primarily over the sensory-motor strip, frontally, and in the parietal lobe (somatosensory) regions and slightly less within the prefrontal cortex.

It is within these areas where motor activation, attention, executive function, and somatosensory (body) awareness is primarily mediated. Auditory entrainment (AE) is the same concept as visual entrainment, with the exception that auditory signals are passed from the cochlea of the ears into the thalamus via the [medial geniculate nucleus]], whereas visual entrainment passes from the retina into the thalamus via the lateral geniculate nucleus. Eyes-closed AVE at 18.5 Hz has been shown to increase EEG brainwave activity by 49% at the vertex. At the vertex (with the eyes closed) AE has been shown to increase EEG brainwave activity by 21%. Successful entrainment leads to a meditative, peaceful kind of dissociation, where the individual experiences a loss of somatic and cognitive awareness.

Evidence of Sensory Effects of AVE
Both Huxley and Walter were among the first to articulate the subjective correlates of photic stimulation. They described subjective experiences of incessantly changing patterns, whose color was a function of the rate of flashing. Between ten and fifteen flashes per second, Walter reported orange and red; above fifteen, green and blue; above eighteen, white and grey. Huxley also described enriched and intensified experiences when subjects were under the effects of mescaline or lysergic acid. In his view, the rhythms of the lamp interacted with the rhythms of the brain's electrical activity to produce a complex interference pattern, which is translated by the brain's perceptual circuts into a conscious pattern of color and movement. Glicksohn also reported on altered states of consciousness from photic driving and its relationship of self-perceived creativity.

Other studies have shown that stimulation can produce both transient and lasting changes in the EEG. Collura articulated the relationship between the low-frequency and high-frequency components of the steady-state visual evoked potential as reflecting anatomically and physiologically distinct response mechanisms.

Additional clinical studies explored the use of photic entrainment to induce hypnotic trance, to augment anasthesia during surgery, and to reduce pain, control gagging and accelerate healing in dentistry. More recently, the induction of dissociation was explored, which aided the understanding of dissociative pathology and development of better techniques for relaxing people suffering from trauma and posttraumatic stress disorder.

Dissociation begins after approximately four to eight minutes from properly applied AVE. A restabilization effect occurs where muscles relax, electro-dermal activity decreases, peripheral blood flow stabilizes, breathing becomes diaphragmatic and relaxed, and heart rates becomes uniform and smooth. Visual entrainment alone, in the alpha frequency range (7-10 Hz), has been shown to easily induce hypnosis, and it has been shown that nearly 80% of subjects entered into either a light or deep hypnotic trance within six minutes during alpha AVE. . AVE provides an excellent medium for achieving an altered state of consciousness.

Treatment Implications of AVE
A review of 20 studies on brainwave entrainment found that it is effective in improving cognition and behavioral problems, and alleviating stress and pain.

The results of a study on children with attention-deficit disorder found that AVE was more effective than neurofeedback for treating ADD symptoms.

A migraine headache study involving seven migraine sufferers found that AVE sessions reduced migraine duration from a pretreatment average of 6 hours to a posttreatment average of 35 minutes. Measuring 50 of the participants' mirgaines, 49 migraines decreased in severity and 36 were stopped when using AVE.

Another clinical study showed declines in depression, anxiety and suicidal ideation following a treatment program using AVE. A study by Berg and Siever used audio-visual entrainment devices on women suffering with seasonal affective disorder. Both depression and anxiety symptoms were reduced in participants, as compared to a placebo phase. Participants also reported improvements in their social lives, with increased happiness and sociability, decreased appetite, increased energy and weight loss. A study by Cantor and Stevens found significant decreases in depression scores in participants after 4 weeks of using AVE.

A study by Thomas and Siever showed that many people with chronic temporo-mandibular dysfunction (TMD) brace up when asked to relax. AVE at 10 Hz produced deep masseter muscle relaxation and finger warming within six minutes. Audio entrainment has shown promise as a singular therapeutic modality for treating jaw tension and TMD pain. AVE has been used to reduce jaw pain, patient anxiety and heart rate during dental procedures.