Neuronal Effects of Listening to Entrainment Music Versus Preferred Music in Patients With Chronic Cancer Pain as Measured via EEG and LORETA Imaging

Abstract

Previous studies examining EEG and LORETA in patients with chronic pain discovered an overactivation of high theta (6–9 Hz) and low beta (12–16 Hz) power in central regions. MEG studies with healthy subjects correlating evoked nociception ratings and source localization described delta and gamma changes according to two music interventions. Using similar music conditions with chronic pain patients, we examined EEG in response to two different music interventions for pain. To study this process in-depth we conducted a mixed-methods case study approach, based on three clinical cases. Effectiveness of personalized music therapy improvisations (entrainment music – EM) versus preferred music on chronic pain was examined with 16 participants. Three patients were randomly selected for follow-up EEG sessions three months post-intervention, where they listened to recordings of the music from the interventions provided during the research. To test the difference of EM versus preferred music, recordings were presented in a block design: silence, their own composed EM (depicting both “pain” and “healing”), preferred (commercially available) music, and a non-participant’s EM as a control. Participants rated their pain before and after the EEG on a 1–10 scale. We conducted a detailed single case analysis to compare all conditions, as well as a group comparison of entrainment-healing condition versus preferred music condition. Power spectrum and according LORETA distributions focused on expected changes in delta, theta, beta, and gamma frequencies, particularly in sensory-motor and central regions. Intentional moment-by-moment attention on the sounds/music rather than on pain and decreased awareness of pain was experienced from one participant. Corresponding EEG analysis showed accompanying power changes in sensory-motor regions and LORETA projection pointed to insula-related changes during entrainment-pain music. LORETA also indicated involvement of visual-spatial, motor, and language/music improvisation processing in response to his personalized EM which may reflect active recollection of creating the EM. Group-wide analysis showed common brain responses to personalized entrainment-healing music in theta and low beta range in right pre- and post-central gyrus. We observed somatosensory changes consistent with processing pain during entrainment-healing music that were not seen during preferred music. These results may depict top–down neural processes associated with active coping for pain.

Music listening and stress recovery in healthy individuals: A systematic review with meta-analysis of experimental studies

“…Tentatively, the effects of music listening may be more prominent for the stress recovery of individuals in medical or therapeutic contexts, compared to that of individuals under acute stress in an experimental context. Whereas the time course of stress responses and stress recovery in experimental settings can be considered relatively brief [24,26,40,83], the time course of stress responses and stress recovery within medical and therapeutic settings may be significantly more protracted [12,13]. Thus, within medical and therapeutic settings, music may be exerting its influence on neuroendocrine, physiological, and psychological processes that have been subjected to longer periods of strain [27,99].…”

“…To our knowledge, our review is the first to comprehensively investigate the effect of music listening on stress recovery within healthy individuals. Given the explicit focus of our review, our meta-analytic data set excluded the more prominent effects of music listening in both medical and therapeutic settings [12,13], allowing us to obtain results that are tentatively more representative of daily stress recovery processes. Despite this, the present review is not without its limitations:…”

“…To expand on the above considerations: stressors in medical or therapeutic settings (e.g., treatment anxiety, pregnancy, and labor) and their subsequent stress recovery processes can be difficult to generalize to more daily settings [10][11][12][13]. Next, with regards to music-based interventions, music listening simply involves listening to a particular song, while music therapy is characterized by the presence of a therapeutic process and use of personal music experiences, and thus must be performed by a trained music therapist [14].…”

Improvement of pain experience and changes in heart rate variability through music-imaginative pain treatment

“…Empirical research of MIPT has focused either on the activation of neuronal processes by MEG resp. EEG-measures ( 6 , 8 ) or on therapeutic processes by qualitative studies ( 9 , 10 ). Up to now, outcome studies ( 3 , 11 , 12 ) show promising results, but they are not transferable to patients with somatoform pain disorders, and existing systematic reviews do not include studies on this clientele ( 13 – 16 ).…”

Mechanistic research approaches in music therapy for pain: Humanizing and contextualized options for clinician-researchers

“…Only recently have researchers focused on identifying and validating cognitive mechanisms of pain relief using music ( 5 ). The body of research investigating neurological mechanisms on music interventions for pain focus on music listening rather than music therapy interventions; two studies investigating neurological responses to music therapy for pain involve case studies ( 6 ) or address lab-induced pain ( 7 ). Though these support at least two different ways music therapy can support analgesia (music as distraction vs. music as active coping), more evidence is needed.…”