EEG-Guided Binaural Beat Audio to Reduce Performance-Related Stress and Improve Cognition

Effects of EEG-guided Binaural Beat Audio Intervention on Brain Reactivity Associated With Performance-related Stress and Cognition Among Professional Musicians: A Randomized, Double-blinded, Sham-controlled Functional Neuroimaging Trial

Performance-related stress can impair sustained attention, inhibitory control, and memory. This randomized, double-blinded, sham-controlled parallel-arm trial evaluates whether a 30-minute EEG-guided binaural beat audio intervention reduces subjective stress/performance anxiety and improves cognition, and whether it changes task-related brain reactivity measured by fMRI. The intervention uses real-time single-electrode EEG recorded over the left prefrontal cortex to dynamically adjust binaural beat frequencies to guide the brain toward a target state; the sham condition uses non-binaural music delivered through identical headphones.

Adult music majors preparing for an upcoming concert will complete pre- and post-intervention fMRI sessions during cognitive/music tasks (Stop Signal Reaction Task, Music Reading Task, Music Memory Retrieval Task) and complete visual analog scales (VAS) assessing performance anxiety, stress, and related subjective states. The primary outcomes include fMRI task-related activity in stress-regulation regions (dlPFC, amygdala, hippocampus), behavioral inhibition indices from the stop-signal task, music memory retrieval accuracy, and VAS-reported stress/performance anxiety.

Study Overview

• Status: Not yet recruiting
• Conditions: Stress; Performance; Cognitive Performance; Cognitive Abilities
• Intervention / Treatment: Other: EEG-guided binaural beat audio; Other: Non-binaural audio intervention

Detailed Description

This study will test the efficacy and neurophysiologic mechanism of a novel EEG-guided binaural beat audio intervention for mitigating performance-related stress and enhancing cognition in musicians. The study is conducted at Texas Tech University (recruitment/screening/analysis) with neuroimaging and cognitive task data collection at the Texas Tech Neuroimaging Institute (TTNI).

Participants complete a single in-person visit (~3 hours) including consent and eligibility screening, task training, pre-intervention VAS and fMRI scanning, randomization to intervention or sham, a 30-minute audio session, post-intervention fMRI scanning, and post-intervention VAS.

The experimental audio intervention uses a proprietary algorithm with real-time EEG feedback from a single electrode over the left prefrontal cortex to dynamically adjust binaural beat frequencies during a 30-minute session delivered through headphones. The sham comparator uses non-binaural audio (music without interaural frequency differences) delivered identically. Participants and researchers conducting assessments are blinded to allocation.

• Study Type: Interventional
• Enrollment (Estimated): 32
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Chathurika S Dhanasekara, MD, PhD; Phone Number: 806 743 2378; Email: Samudani.Dhanasekara@ttuhsc.edu
• Study Contact Backup: Name: Chanaka N Kahathuduwa, MD, PhD; Phone Number: 306 412 9974; Email: chanaka.kahathuduwa@ttuhsc.edu

Study Locations

• United States
  • Texas
    • Lubbock, Texas, United States, 79430
      • Texas Tech University
      • Contact: Chathurika S Dhanasekara, MD, PhD; Phone Number: 806 743 2378; Email: Samudani.Dhanasekara@ttuhsc.edu
      • Contact: Chanaka N Kahathuduwa, MD, PhD; Phone Number: 806 412 9974; Email: Chanaka.Kahathuduwa@ttuhsc.edu
      • Principal Investigator: Chathurika S Dhanasekara, MD, PhD

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: Yes

Description

Inclusion Criteria:

• Adults (18+ years) enrolled as undergraduate music majors at Texas Tech University
• Currently preparing for an upcoming concert performance within the next 3 months
• Able to read standard musical notation

Exclusion Criteria:

• Subjects with contraindications to undergo MRI after being screened by the TTNI safety screening sheet - specifically, Subjects with implanted devices that are not compatible with MRI including, but not limited to cardiac pacemakers, cardiac defibrillators, aneurysm clips, carotid artery vascular clamps, implanted nerve stimulators (neuron-stimulators also called TENS or wires), bone growth or bone fusion stimulators, cochlear implants, vagus nerve stimulators, filters for blood clots (Umbrella, Greenfield, bird's nest), embolization coils (e.g. Gianturco) in the brain, ocular implants, vascular stents, medication pumps, medication patches delivering medications, implanted limbs, ventricular shunts, metal joints, rods, plates, pins, screws, nails, or clips, penile implants, or contraceptives devices including IUDs, cervical pessaries and diaphragms Subjects who have undergone cataract surgery Subjects who have shrapnel or metal in the head, eyes or skin Subjects with a history of working with metal fragments ( or have had metal removed from eyes Subjects with gunshot wounds or BB gun injury Subjects with permanent metal body piercings or jewelry that cannot be removed Subjects who use hearing aids or have braces / permanent retainers that cannot be removed temporarily for the MRI scans Subjects with large tattoos in the head and neck area Subjects with claustrophobia Subjects who are currently pregnant or suspected to be pregnant
• Physical, medical, neurological or psychiatric impairments (including substance abuse)
• Current use of medications that could affect cognitive performance (including beta-blockers, stimulants, anxiolytics, antidepressants, or antipsychotics)
• History of head injury resulting in loss of consciousness/history of brain surgery
• History of diagnosed hearing impairment or use of hearing aids
• Current or past diagnosis of epilepsy or seizure disorders
• Unwillingness or inability to refrain from alcohol consumption 48 hours prior to the study visit
• Unwillingness or inability to refrain from caffeine consumption 12 hours prior to the study visit
• Current/past history of substance abuse
• Pregnancy or possibility of pregnancy
• Unwillingness or inability to follow written, on-screen, and verbal instructions given by the study team

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Other
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: EEG-guided binaural beat audio; 30-minute session delivered via headphones; proprietary algorithm uses real-time single-electrode EEG from the left prefrontal cortex to dynamically adjust binaural beat frequencies.	Other: EEG-guided binaural beat audio; 30-minute session delivered via headphones; proprietary algorithm uses real-time single-electrode EEG from the left prefrontal cortex to dynamically adjust binaural beat frequencies.
Sham Comparator: non-binaural audio; 30-minute session of music without frequency differences between ears (non-binaural), delivered via identical headphones; blinding maintained.	Other: Non-binaural audio intervention; 30-minute session of music without frequency differences between ears (non-binaural), delivered via identical headphones; blinding maintained.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Differences in fMRI blood oxygen level dependent (BOLD) responses of the brain in response to Stop Signals of a Stop Signal Reaction Time (SSRT) recorded following administration of each intervention and sham control.	fMRI task-related activity in dlPFC, amygdala, and hippocampus during SSRT.	Baseline (immediately prior to 30-minute intervention/control audio session) and immediately post-intervention/control audio session (within 30 minutes after completion of session).
Differences in fMRI blood oxygen level-dependent (BOLD) responses in the brain to images of the staff during the Music Reading Task (MRT), recorded following administration of each intervention and sham control.	fMRI task-related activity in dlPFC, amygdala, hippocampus, and reactivity of mirror-neuron-related regions will be examined and compared between the groups.	Baseline (immediately prior to 30-minute intervention/control audio session) and immediately post-intervention/control audio session (within 30 minutes after completion of session).
Differences in fMRI blood-oxygen-level-dependent (BOLD) responses in the brain to images of the staff during the Music Memory Retrieval Task (MMRT), recorded after administration of each intervention and the sham control.	fMRI task-related activity in dlPFC, amygdala, hippocampus, and reactivity of mirror-neuron-related regions will be examined and compared between the groups.	Baseline (immediately prior to 30-minute intervention/control audio session) and immediately post-intervention/control audio session (within 30 minutes after completion of session).

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Stop Signal Reaction Time	Estimated time (milliseconds) required to inhibit a prepotent response following a stop signal, computed using the horse-race model and drift-diffusion theory. Lower values indicate better inhibitory control.	Baseline (immediately prior to 30-minute intervention/control audio session) and immediately post-intervention/control audio session (within 30 minutes after completion of session).
Reaction Time on Music Memory Retrieval Task.	Mean response latency (seconds) during the Music Memory Retrieval Task recognition phase. Lower values indicate faster information retrieval and decision speed without implying a speed-accuracy trade-off. The unit of measurement is in seconds.	Baseline (immediately prior to 30-minute intervention/control audio session) and immediately post-intervention/control audio session (within 30 minutes after completion of session).
Hit Rate of Music Memory Retrieval Task.	Subjects will be presented with images of staff. Proportion of targets correctly identified as "seen." Range 0-1; higher values indicate better recognition sensitivity. The unit of measurement is in proportion (0-1).	Baseline (immediately prior to 30-minute intervention/control audio session) and immediately post-intervention/control audio session (within 30 minutes after completion of session).
False Alarm Rate of Music Memory Retrieval Task.	Subjects will be presented with images of staff. Proportion of non-targets incorrectly endorsed as "seen." Range 0-1; lower values indicate better discrimination (fewer false positives). The unit of measurement is in proportion (0-1).	Baseline (immediately prior to 30-minute intervention/control audio session) and immediately post-intervention/control audio session (within 30 minutes after completion of session).
Self-reported stress level, rated on a visual analogue scale.	100 mm VAS, anchored at 0 ("Not Stressed") and 100 ("Stressed"). Higher scores = greater stress.	Baseline (immediately prior to 30-minute intervention/control audio session) and immediately post-intervention/control audio session (within 40 minutes after completion of session).
Self-reported level of confidence in performance on a visual analogue scale.	100 mm VAS, anchored at 0 ("Not confident at all") and 100 ("Extremely confident"). Higher scores = greater perceived confidence in performance.	Baseline (immediately prior to 30-minute intervention/control audio session) and immediately post-intervention/control audio session (within 40 minutes after completion of session).
Self-reported performance anxiety level, rated on a visual analogue scale.	100 mm VAS, anchored at 0 ("Not anxious at all") and 100 ("Extremely anxious"). Higher scores = greater perceived confidence in performance.	Baseline (immediately prior to 30-minute intervention/control audio session) and immediately post-intervention/control audio session (within 40 minutes after completion of session).
Self-reported performance on cognitive tasks, rated on a visual analogue scale.	100 mm VAS, anchored at 0 ("Worst Performance") and 100 ("Best Performance"). Higher scores = greater perceived confidence in performance.	Baseline (immediately prior to 30-minute intervention/control audio session) and immediately post-intervention/control audio session (within 40 minutes after completion of session).
Self-reported rating of overall well-being, rated on a visual analogue scale.	100 mm VAS, anchored at 0 ("Very poor well-being") and 100 ("Excellent well-being"). Higher scores = better well-being.	Baseline (immediately prior to 30-minute intervention/control audio session) and immediately post-intervention/control audio session (within 40 minutes after completion of session).

Collaborators and Investigators

• Sponsor: Texas Tech University Health Sciences Center
• Collaborators: Texas Tech University

Study record dates

Study Major Dates

• Study Start (Estimated): April 7, 2026
• Primary Completion (Estimated): May 31, 2026
• Study Completion (Estimated): August 30, 2026

Study Registration Dates

• First Submitted: February 5, 2026
• First Submitted That Met QC Criteria: February 5, 2026
• First Posted (Actual): February 12, 2026

Study Record Updates

• Last Update Posted (Actual): April 13, 2026
• Last Update Submitted That Met QC Criteria: April 6, 2026
• Last Verified: February 1, 2026

More Information

Terms related to this study

• Keywords: neurofeedback; stress; cognitive performance
• Other Study ID Numbers: IRB2025-681

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: UNDECIDED
• IPD Plan Description: De-identified individual participant data may be shared with qualified researchers upon a reasonable request and after obtaining institutional approval, as the study is based on a proprietary algorithm owned by Texas Tech University.

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No