No abstract

A variety of evidence supports the dominance of the right hemisphere in perceptual and visuo-spatial processing. Although growing evidence shows a strong link between alpha oscillations and the functionality of the visual system, asymmetries in alpha oscillatory patterns still need to be investigated. Converging findings indicate that the typical alpha desynchronization occurring in the transition from the eyes-closed to the eyes-open resting state might represent an index of reactivity of the visual system. Thus, investigating hemispheric asymmetries in EEG reactivity at the opening of the eyes in brain-lesioned patients may shed light on the contribution of specific cortical sites and each hemisphere in regulating the oscillatory patterns reflecting the functionality of the visual system. To this aim, EEG signal was recorded during eyes-closed and eyes-open resting state in hemianopic patients with posterior left or right lesions, patients without hemianopia with anterior lesions and healthy controls. Hemianopics with both left and right posterior lesions showed a reduced alpha reactivity at the opening of the eyes, suggesting that posterior cortices have a pivotal role in the functionality of alpha oscillations. However, right-lesioned hemianopics showed a greater dysfunction, demonstrated by a reactivity reduction more distributed over the scalp, compared to left-lesioned hemianopics. Moreover, they also revealed impaired reactivity in the theta range. This favors the hypothesis of a specialized role of the right hemisphere in orchestrating oscillatory patterns, both coordinating widespread alpha oscillatory activity and organizing focal processing in the theta range, to support visual processing at the opening of the eyes.

Emerging evidence suggests a role of the posterior cortices in regulating alpha oscillatory activity and organizing low-level processing in non-alpha frequency bands. Therefore, posterior brain lesions, which damage the neural circuits of the visual system, might affect functional connectivity patterns of brain rhythms. To test this hypothesis, eyes-closed resting state EEG signal was acquired from patients with hemianopia with left and right posterior lesions, patients without hemianopia with more anterior lesions and healthy controls. Left-lesioned hemianopics showed reduced intrahemispheric connectivity in the range of upper alpha only in the lesioned hemisphere, whereas right-lesioned hemianopics exhibited reduced intrahemispheric alpha connectivity in both hemispheres. In terms of network topology, these impairments were characterized by reduced local functional segregation, with no associated change in global functional integration. This suggests a crucial role of posterior cortices in promoting functional connectivity in the range of alpha. Right-lesioned hemianopics revealed also additional impairments in the theta range, with increased connectivity in this frequency band, characterized by both increased local segregated activity and decreased global integration. This indicates that lesions to right posterior cortices lead to stronger impairments in alpha connectivity and induce additional alterations in local and global low-level processing, suggesting a specialization of the right hemisphere in generating alpha oscillations and in coordinating complex interplays with lower frequency bands. Importantly, hemianopic patient’s visual performance in the blind field was linked to alpha functional connectivity, corroborating the notion that alpha oscillatory patterns represent a biomarker of the integrity and the functioning of the underlying visual system.

Alpha-band (7–13 Hz) activity has been linked to visuo-attentional performance in healthy participants and to impaired functionality of the visual system in a variety of clinical populations including patients with acquired posterior brain lesion and neurodevelopmental and psychiatric disorders. Crucially, several studies suggested that short uni- and multi-sensory rhythmic stimulation (i.e., visual, auditory and audio-visual) administered in the alpha-band effectively induces transient changes in alpha oscillatory activity and improvements in visuo-attentional performance by synchronizing the intrinsic brain oscillations to the external stimulation (neural entrainment). The present review aims to address the current state of the art on the alpha-band sensory entrainment, outlining its potential functional effects and current limitations. Indeed, the results of the alpha-band entrainment studies are currently mixed, possibly due to the different stimulation modalities, task features and behavioral and physiological measures employed in the various paradigms. Furthermore, it is still unknown whether prolonged alpha-band sensory entrainment might lead to long-lasting effects at a neural and behavioral level. Overall, despite the limitations emerging from the current literature, alpha-band sensory entrainment may represent a promising and valuable tool, inducing functionally relevant changes in oscillatory activity, with potential rehabilitative applications in individuals characterized by impaired alpha activity.