Music Streaming Services as Adjunct Therapies for Depression, Anxiety, and Bipolar Symptoms: Convergence of Digital Technologies, Mobile Apps, Emotions, and Global Mental Health

Schriewer, Karl; Bułaj, Grzegorz

doi:10.3389/fpubh.2016.00217

Cited by 20 publications

(21 citation statements)

References 49 publications

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“…For patients with refractory epilepsy, mobile medical app delivering self-care and antiseizure music can be validated for use with neuromodulation devices like vagus nerve and deep brain stimulation, VNS and DBS, respectively, although additional safety and efficacy studies and regulatory authorization would be required before marketing such combination therapies. Recently, we described music streaming as an adjunct digital therapy for depression, anxiety and bipolar spectrum disorders (Schriewer and Bulaj, 2016 ). Music and multimedia streaming of the antiseizure digital content can complement the use of a mobile medical app for seizure control.…”

Section: Discussionmentioning

confidence: 99%

“…The drug-SaMD combination product offers means to: (1) integrate pharmacological and behavioral therapies with self-care, (2) create new personalized treatments for epilepsy, and (3) improve medication adherence and patient engagement. Our work has implications beyond epilepsy, since combining prescription medications and music-based interventions is also applicable to the treatment of depression (Schriewer and Bulaj, 2016 ), pain (Chai et al, 2017 ) and potentially other neurological disorders (Sihvonen et al, 2017 ).…”

Section: Introductionmentioning

confidence: 99%

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Mobile Software as a Medical Device (SaMD) for the Treatment of Epilepsy: Development of Digital Therapeutics Comprising Behavioral and Music-Based Interventions for Neurological Disorders

Afra

Bruggers

Sweney

et al. 2018

Front. Hum. Neurosci.

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Digital health technologies for people with epilepsy (PWE) include internet-based resources and mobile apps for seizure management. Since non-pharmacological interventions, such as listening to specific Mozart's compositions, cognitive therapy, psychosocial and educational interventions were shown to reduce epileptic seizures, these modalities can be integrated into mobile software and delivered by mobile medical apps as digital therapeutics. Herein, we describe: (1) a survey study among PWE about preferences to use mobile software for seizure control, (2) a rationale for developing digital therapies for epilepsy, (3) creation of proof-of-concept mobile software intended for use as an adjunct digital therapeutic to reduce seizures, and (4) broader applications of digital therapeutics for the treatment of epilepsy and other chronic disorders. A questionnaire was used to survey PWE with respect to preferred features in a mobile app for seizure control. Results from the survey suggested that over 90% of responders would be interested in using a mobile app to manage their seizures, while 75% were interested in listening to specific music that can reduce seizures. To define digital therapeutic for the treatment of epilepsy, we designed and created a proof-of-concept mobile software providing digital content intended to reduce seizures. The rationale for all components of such digital therapeutic is described. The resulting web-based app delivered a combination of epilepsy self-care, behavioral interventions, medication reminders and the antiseizure music, such as the Mozart's sonata K.448. To improve long-term patient engagement, integration of mobile medical app with music and multimedia streaming via smartphones, tablets and computers is also discussed. This work aims toward development and regulatory clearance of software as medical device (SaMD) for seizure control, yielding the adjunct digital therapeutic for epilepsy, and subsequently a drug-device combination product together with specific antiseizure medications. Mobile medical apps, music, therapeutic video games and their combinations with prescription medications present new opportunities to integrate pharmacological and non-pharmacological interventions for PWE, as well as those living with other chronic disorders, including depression and pain.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Mobile Software as a Medical Device (SaMD) for the Treatment of Epilepsy: Development of Digital Therapeutics Comprising Behavioral and Music-Based Interventions for Neurological Disorders

Afra

Bruggers

Sweney

et al. 2018

Front. Hum. Neurosci.

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“…This drug-device combination strategy has apparent benefits to treat pain or epilepsy because digital therapeutics can simultaneously target depression as a comorbidity. Since antidepressants and psychotherapies have comparably low remission rates (30-40%) in patients with depression (140), delivering depression-related digital content (e.g., physical exercise and music) may help to ameliorate depressive symptoms (20,23,126,(141)(142)(143). From preclinical development perspectives, it is worth mentioning that EE was shown to reduce seizures in temporal lobe epilepsy model in rats (144) and depressive symptoms after seizures (49).…”

Section: Translational Implications Of Studying Enriched Environmentmentioning

confidence: 99%

“…Since digital technologies can deliver music-based interventions (20), these opportunities are relevant for treatments of pain, epilepsy, stroke, dementia, and other chronic medical conditions (21)(22)(23)(24)(25)(26)(27). Music showed clinical benefits of reducing acute and chronic pain (25)(26)(27).…”

Section: Introductionmentioning

confidence: 99%

Music-Enhanced Analgesia and Antiseizure Activities in Animal Models of Pain and Epilepsy: Toward Preclinical Studies Supporting Development of Digital Therapeutics and Their Combinations With Pharmaceutical Drugs

Metcalf

Huntsman

Garcia³

et al. 2019

Front. Neurol.

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Digital therapeutics (software as a medical device) and mobile health (mHealth) technologies offer a means to deliver behavioral, psychosocial, disease self-management and music-based interventions to improve therapy outcomes for chronic diseases, including pain and epilepsy. To explore new translational opportunities in developing digital therapeutics for neurological disorders, and their integration with pharmacotherapies, we examined analgesic and antiseizure effects of specific musical compositions in mouse models of pain and epilepsy. The music playlist was created based on the modular progression of Mozart compositions for which reduction of seizures and epileptiform discharges were previously reported in people with epilepsy. Our results indicated that music-treated mice exhibited significant analgesia and reduction of paw edema in the carrageenan model of inflammatory pain. Among analgesic drugs tested (ibuprofen, cannabidiol (CBD), levetiracetam, and the galanin analog NAX 5055), music intervention significantly decreased paw withdrawal latency difference in ibuprofen-treated mice and reduced paw edema in combination with CBD or NAX 5055. To the best of our knowledge, this is the first animal study on music-enhanced antinociceptive activity of analgesic drugs. In the plantar incision model of surgical pain, music-pretreated mice had significant reduction of mechanical allodynia. In the corneal kindling model of epilepsy, the cumulative seizure burden following kindling acquisition was lower in animals exposed to music. The music-treated group also exhibited significantly improved survival, warranting further research on music interventions for preventing Sudden Unexpected Death in Epilepsy (SUDEP). We propose a working Metcalf et al. Music-Enhanced Analgesic and Antiseizure Activities model of how musical elements such as rhythm, sequences, phrases and punctuation found in K.448 and K.545 may exert responses via parasympathetic nervous system and the hypothalamic-pituitary-adrenal (HPA) axis. Based on our findings, we discuss: (1) how enriched environment (EE) can serve as a preclinical surrogate for testing combinations of non-pharmacological modalities and drugs for the treatment of pain and other chronic diseases, and (2) a new paradigm for preclinical and clinical development of therapies leading to drug-device combination products for neurological disorders, depression and cancer. In summary, our present results encourage translational research on integrating non-pharmacological and pharmacological interventions for pain and epilepsy using digital therapeutics.

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“…The use of wearables can further optimize digital interventions through neurobiofeedback mechanisms (Ramirez et al, 2015 ), with new biofeedback technologies, such as the FDA-cleared smartwatch Embrace (Empatica), being developed. The flexibility of digital content in mobile health technologies is further emphasized by adding music as an “active component” of therapy (Schriewer and Bulaj, 2016 ; Afra et al, 2018 ) or integrating exercise and educational empowerment into a video game designed for children with cancer (Bruggers et al, 2018 ). Integrating judiciously tailored motivational quotes into digital content as an “active ingredient” in mobile and web-based apps may offer additional means to improve patient engagement, self-esteem, and ultimately self-efficacy.…”

Section: Digital Health and Mobile Medical Applicationsmentioning

confidence: 99%

Improving Self-Esteem With Motivational Quotes: Opportunities for Digital Health Technologies for People With Chronic Disorders

Bedrov

Bułaj

2018

Front. Psychol.

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Music Streaming Services as Adjunct Therapies for Depression, Anxiety, and Bipolar Symptoms: Convergence of Digital Technologies, Mobile Apps, Emotions, and Global Mental Health

Cited by 20 publications

References 49 publications

Mobile Software as a Medical Device (SaMD) for the Treatment of Epilepsy: Development of Digital Therapeutics Comprising Behavioral and Music-Based Interventions for Neurological Disorders

Mobile Software as a Medical Device (SaMD) for the Treatment of Epilepsy: Development of Digital Therapeutics Comprising Behavioral and Music-Based Interventions for Neurological Disorders

Music-Enhanced Analgesia and Antiseizure Activities in Animal Models of Pain and Epilepsy: Toward Preclinical Studies Supporting Development of Digital Therapeutics and Their Combinations With Pharmaceutical Drugs

Improving Self-Esteem With Motivational Quotes: Opportunities for Digital Health Technologies for People With Chronic Disorders

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