Impact of Rhythmic Auditory Stimulation on Neurocognition: Proposed Mechanism of Action of Rhythmic Auditory Stimulation on Neurocognitive Abilities

Rhythmic Auditory Stimulation (RAS) is a rhythm-based therapeutic technique used for gait and motor rehabilitation. It is a technique that has shown a positive impact in several neurological conditions such as Parkinson’s disease, multiple sclerosis, cerebral palsy, etc. It is important to note that in addition to improving movement and balance, RAS is also found to have a positive effect on neurocognition, such as attention, memory, speech, and language functions. Indeed, neural networks do not work in silos. There are always interactions and distal effects. In this manuscript, we aim to delineate further the mechanism by which RAS, typically used for improvement in gait, is found to have a secondary effect on cognition. Automaticity is the capacity to execute motor movements without the allocation of attention, achieved through training and consolidation; in individuals with gait deficit, automaticity is compromised or lost, therefore, movement performed is facilitated by executive or attentional control. Application of RAS, utilizing rhythmic cues that serve as an extrinsic reference for the initiation and ongoing timing of movements through the process of entrainment, stimulates the attentional areas of the brain via auditory stimulus to produce motor movement. Due to stimulation of the attentional areas, primarily the prefrontal cortex and anterior cingulate cortex, the cognitive abilities associated with these areas of the brain are influenced. However, a comprehensive investigation in this area is essential to discern and solidify the proposed mechanism. And we believe that the proposed mechanism will provide a basis for subsequent research along this avenue. RAS is a viable and cost-effective rehabilitation technique that warrants the need for extensive research to determine its long-term effect on neurocognition.