Standardizing music characteristics for the management of pain: A systematic review and meta-analysis of clinical trials

Martín-Saavedra, Juan Sebastián; Vergara-Mendez, Laura Daniela; Pradilla, Iván; Vélez-van-Meerbeke, Alberto; Talero-Gutiérrez, Claudia

doi:10.1016/j.ctim.2018.07.008

Cited by 58 publications

(53 citation statements)

References 66 publications

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“…For example, the American College of Physicians updated clinical guidelines recommending physical exercise and yoga as the first line therapy for lower back pain (75). While there are many animal studies on exerciseinduced analgesia (76,77), analgesic properties of music have been sparsely investigated in animal models (43) in contrast to growing clinical evidence (22,(24)(25)(26)(78)(79)(80)(81)(82). show that hyperalgesia was observed in animals exposed to control conditions and music-exposed mice show a reduced latency difference.…”

Section: Discussionmentioning

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). For epilepsy, there is clinical and preclinical evidence that specific musical compositions exert anticonvulsant effects (4,(28)(29)(30)(31)(32).…”

Section: Introductionmentioning

confidence: 99%

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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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Section: Discussionmentioning

confidence: 99%

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.

View full text Add to dashboard Cite

show abstract

“…Exposure to silence for as little as 2 hours per day can promote neuron development in adult mice, enhancing cell development in the hippocampus, the region related to the formation of memories. 34 Alternatively, exposure to music can effect neurochemistry, 35 cardiovascular parameters, 36 reduce pain medication requirements, 37 and lead to an overall improvement in patient-reported outcomes. 38 Acoustic stimulation during sleep has been linked to enhanced slow wave activity, with subsequent improvement in sleep-dependent memory storage in older adults.…”

Section: Sound and Healthmentioning

confidence: 99%

Innovative ICU Solutions to Prevent and Reduce Delirium and Post–Intensive Care Unit Syndrome

Luetz

Grunow

Mörgeli

et al. 2019

Semin Respir Crit Care Med

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Delirium, the most common form of acute brain dysfunction affecting up to 80% of intensive care unit (ICU) patients, has been shown to predict long-term cognitive impairment, one of the domains in “Post-ICU Syndrome” (PICS). The ICU environment affects several potentially modifiable risk factors for delirium, such as disorientation and disruption, of the sleep–wake cycle. Innovative solutions aim to transform standard concepts of ICU room design to limit potential stressors, and utilizing the patient care space as a treatment tool, exerting positive, therapeutic effects. The main areas affected by most architectural and interior design modifications are sound environment, light control, floor planning, and room arrangement. Implementation of corresponding solutions is challenging considering the significant medical and technical demands of ICUs. This article discusses innovative concepts and promising approaches in ICU design that may be used to prevent stress and to support the healing process of patients, potentially limiting the impact of delirium and PICS.

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“…Next, we argue that structural elements of music and choice over musical selection are two pivotal treatment characteristics in music-listening interventions that lack a systematic investigation in previous studies ( 10 , 59 ). In a recent meta-analysis by Martin-Saavedra et al ( 60 ), the common neglect of reporting musical characteristics (e.g., tempo, instrumentation, presence of lyrics) in previous randomized controlled trials investigating music for pain management was criticized, since no clear conclusions can be drawn based on the current literature. In this regard, in their analyses of three experimental pain studies using participants' self-selected music, Knox et al ( 61 ) found that timbral and tonal aspects were significantly correlated with measures of experimentally induced pain perception, indicating that structural elements of music might differentially moderate the effects of music on pain reduction.…”

Section: Introductionmentioning

confidence: 99%

Efficacy, Treatment Characteristics, and Biopsychological Mechanisms of Music-Listening Interventions in Reducing Pain (MINTREP): Study Protocol of a Three-Armed Pilot Randomized Controlled Trial

et al. 2020

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Background: Pain can severely compromise a person's overall health and well-being. Music-listening interventions have been shown to alleviate perceived pain and to modulate the body's stress-sensitive systems. Despite the growing evidence of pain- and stress-reducing effects of music-listening interventions from experimental and clinical research, current findings on music-induced analgesia are inconclusive regarding the role of specific treatment characteristics and the biopsychological mechanisms underlying these effects. Objective: The overall aim of this pilot randomized controlled trial is to test and compare the differential effects of frequency-modulated and unmodulated music (both researcher-selected) on experimentally induced perception of acute pain and to test the efficacy of the interventions in reducing biological and subjective stress levels. Moreover, these two interventions will be compared to a third condition, in which participants listen to self-selected unmodulated music. Methods and Analysis: A total of 90 healthy participants will be randomly allocated to one of the three music-listening intervention groups. Each intervention encompasses 10 sessions of music listening in our laboratory. Frequency-modulation will involve stepwise filtering of frequencies in the audible range of 50–4,000 Hz. Acute pain will be induced via the cold pressor test. Primary (i.e., pain tolerance, perceived pain intensity) and secondary (i.e., heart rate variability, electrodermal activity, hair cortisol, subjective stress) outcomes will be measured at baseline, post, and follow-up. In addition, intermittent measurements as well as a follow-up assessment and a range of tertiary measures (e.g., music-induced emotions) are included. Discussion: This is the first study to systematically test and compare the effects of music frequencies along with the control over music selection, both of which qualify as central treatment characteristics of music-listening interventions. Results will be highly informative for the design of subsequent large-scale clinical trials and provide valuable conclusions for the implementation of music-listening interventions for the reduction of perceived pain. Clinical Trial Registration: Clinical Trials Database of the U.S. National Library of Medicine: Identifier NCT02991014.

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Standardizing music characteristics for the management of pain: A systematic review and meta-analysis of clinical trials

Cited by 58 publications

References 66 publications

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

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

Innovative ICU Solutions to Prevent and Reduce Delirium and Post–Intensive Care Unit Syndrome

Efficacy, Treatment Characteristics, and Biopsychological Mechanisms of Music-Listening Interventions in Reducing Pain (MINTREP): Study Protocol of a Three-Armed Pilot Randomized Controlled Trial

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