Dithering suppresses half-harmonic neural synchronisation to photic stimulation in humans

While entraining neural rhythms using brain stimulation has been suggested as a therapeutic mechanism to normalise brain activity in conditions such as depression, chronic pain, or Alzheimers disease, periodic stimulation can also inadvertently entrain brain rhythms at sub- and superharmonics of the stimulation frequency, which could lead to deleterious effects. Slightly jittering stimulation pulses (called "dithering") was previously proposed on the basis of mathematical modelling to selectively entrain a target neural rhythm while avoiding harmonic entrainment. In this study, we investigated the potential of dithering in humans. Using photic stimulation (light flicker) and EEG recordings in healthy participants, we showed that dithering suppresses half-harmonic synchronisation relative to perfectly periodic flicker, and more so than synchronisation at the stimulation frequency. This was also the case for a periodic condition with reduced stimulation amplitude, as predicted by theory. Furthermore, we demonstrated using synthetic data and modelling that the half-harmonic responses observed in participants cannot be explained by the super-position of evoked responses (even when modulated at the half-harmonic frequency), and are better matched by a minimal oscillator model. Our findings are consistent with half-harmonic EEG synchronisation in response to photic stimulation predom-inantly reflecting half-harmonic entrainment rather than the summation of evoked responses, and with dithering being an effective strategy to suppress subharmonic entrainment.