Depression Clinical Trial
Official title:
Effects of Non-audible Infra- and Ultrasound on Brain Structure and -Function, Cognitive Functions, and Well-being
Findings in neuroscientific research show that the environment one lives in has measurable effects on brain morphology and functioning. Human exposure to airborne infra- and ultrasound has been constantly increasing during the last decades. For instance, the European Renewable Energy Directive, established in 2009, lead to an increased use of wind turbines, generating infrasound. The EU Directive states that until 2020 a 20% of the EUs' total energy needs is to be generated with renewables, therefore the current infrasound load in the European environment will increase further. Similarly, ultrasound is ubiquitous in the modern public environment, emitted from public address systems, animal repellents, industrial machines, even toothbrushes. The present study aims to investigate potential long-term effects of exposure to infra- and ultrasound on subjective well-being, cognitive and brain functioning, as well as on brain structure. The study will apply a randomized-(placebo) controlled single-blind approach to investigate this subject.
Regarding effects of infra- and ultrasound on the brain, a pioneer study demonstrated that
exposure to non-audible infrasound was associated with changes of neural activity across
several brain regions, including areas involved in auditory and emotional processing, as well
as autonomic control. These findings indicate that subliminal infrasound may have pathogenic
effects. Research also indicates that low intensity focused ultrasound (LIFU) modulates the
BOLD signal. However, the impact of ultrasound on auditory and other brain regions remains
broadly unclear until today. Regarding adverse effects of low frequency noise on (mental)
health and cognitive functions, preliminary evidence (summarized by two reviews) suggests
mainly negative effects on sleep, stress levels (both subjective and objective; i.e. cortisol
levels), headaches, fatigue, concentration, and memory. These reviews do however not
explicitly address audible low frequency noise vs. non-audible infrasound.
Research on the effects of infra- and ultrasound on cognitive functioning and well-being is
in the fledgling stage. The few studies published so far vary strongly in their applied
methods and results. Repeatedly, the media has covered stories about individuals suffering
from 'ultrasound-sickness', a condition where the affected person suffers from headache,
nausea and pain. In line with these subjective accounts, a review paper suggested that
ultrasound exposure can be associated with hyperthermia, nausea, headaches, tinnitus and low
blood pressure, as well as with neural excitability, irritation, memory problems and
difficulties with concentration and learning, suggesting adverse effects of ultrasound
exposure regarding (mental) health and cognition.
Nonetheless, there are also indicators of positive effects of these types of sound; a study
suggested that brief bursts of infrasound may have a positive effect on cognitive function.
Also, pioneer works in the field are currently testing ultrasound therapy for Alzheimer's
patients. It appears, that the effects (positive vs. negative) may be highly variable;
depending upon the frequency, sound pressure levels and duration of exposure; as well as the
quality of sound (mixed audible and non-audible vs. purely non-audible). Future studies need
to clearly define these variables in order to be able to make clear statements about effects.
The present study will hopefully shed further light on the long-term effects of (non-audible)
infra- and ultrasound regarding human brain connectivity, structure and function, related
cognitive functions and overall well-being. This may also lead to a more sophisticated and
fact-based debate about 'noise pollution' of modern human living-environments.
Healthy participants, who gave their written consent, will be exposed to infra- or ultrasound
for 28 consecutive days during their night sleep. The sound sources produce sound that is at
least 10 dB below the hearing threshold. The sources were designed to mimic exposure to
infra- and ultrasound in everyday life. The construction and calibration of the sources was
realized by experts of the Physical Technical Federal Institute of Germany (Physikalisch
Technische Bundesanstalt; PTB), located in Braunschweig. Sound sources will be installed and
gauged at the participants' bedrooms, following a standardized procedure and emit sound for 8
hours during the participants' typical sleeping time. N = 60 participants will be randomized
to one out of four conditions:
1. Infrasound verum (n = 20; frequency = 6Hz, sound pressure = 85dB)
2. Infrasound placebo (n = 10)
3. Ultrasound verum (n = 20; frequency = 22.4 kHz, sound pressure = variable +/- 10 dB)
4. Ultrasound placebo (n = 10); (single blind procedure).
First, participants, age 18-40, will be screened for eligibility. In addition, a hearing
assessment will be conducted to assure normal auditory ability of all participants. Before
and after the sound exposure period, participants will be tested using psychological and
(neuro-)cognitive test batteries and questionnaires in order to assess psychiatric and
somatic symptoms, well-being and cognitive functioning (particularly tasks that also
represent everyday cognitive challenges and assess executive functions); (T1, T2).
Furthermore, sensitivity to sound (including to infra- and ultrasound) and current exposure
to different sound sources (T1 and T2) will be assessed with questionnaires. In addition,
Magnet Resonance Imaging (MRI) will be conducted in order to illuminate morphological and
functional brain changes (T1 and T2). In the scanner, participants will execute a spatial
n-back task. The task assesses participants' working memory and is also suited to assess
stressful reactions due to permanent cognitive load - thus constituting a 'proxy' for a
stressful working task in real life. During the n-back task, a dot is presented sequentially
at different positions in a grid. Participants are instructed to indicate whether the
currently presented dot coincides with the dot presented 3 trials before for each of the
presented dots. During the 4-week exposure period through infra-/ ultrasound, participants
will also fill out weekly questionnaires, assessing well-being, general health levels,
psychiatric and somatic symptoms, quality of sleep, headache and overall quality of life.
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