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Schoeller F, Horowitz AH, Jain A, Maes P, Reggente N, Christov-Moore L, Pezzulo G, Barca L, Allen M, Salomon R, Miller M, Di Lernia D, Riva G, Tsakiris M, Chalah MA, Klein A, Zhang B, Garcia T, Pollack U, Trousselard M, Verdonk C, Dumas G, Adrien V, Friston K. Interoceptive technologies for psychiatric interventions: From diagnosis to clinical applications. Neurosci Biobehav Rev 2024; 156:105478. [PMID: 38007168 DOI: 10.1016/j.neubiorev.2023.105478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2023] [Revised: 11/16/2023] [Accepted: 11/19/2023] [Indexed: 11/27/2023]
Abstract
Interoception-the perception of internal bodily signals-has emerged as an area of interest due to its implications in emotion and the prevalence of dysfunctional interoceptive processes across psychopathological conditions. Despite the importance of interoception in cognitive neuroscience and psychiatry, its experimental manipulation remains technically challenging. This is due to the invasive nature of existing methods, the limitation of self-report and unimodal measures of interoception, and the absence of standardized approaches across disparate fields. This article integrates diverse research efforts from psychology, physiology, psychiatry, and engineering to address this oversight. Following a general introduction to the neurophysiology of interoception as hierarchical predictive processing, we review the existing paradigms for manipulating interoception (e.g., interoceptive modulation), their underlying mechanisms (e.g., interoceptive conditioning), and clinical applications (e.g., interoceptive exposure). We suggest a classification for interoceptive technologies and discuss their potential for diagnosing and treating mental health disorders. Despite promising results, considerable work is still needed to develop standardized, validated measures of interoceptive function across domains and before these technologies can translate safely and effectively to clinical settings.
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Affiliation(s)
- Felix Schoeller
- Fluid Interfaces Group, Media Lab, Massachusetts Institute of Technology, USA; Institute for Advanced Consciousness Studies, Santa Monica, CA, USA; Department Cognitive Sciences, University of Haifa, Israel.
| | - Adam Haar Horowitz
- Fluid Interfaces Group, Media Lab, Massachusetts Institute of Technology, USA; Center for Sleep and Cognition, Beth Israel Deaconess Medical Center, Harvard Medical School, USA
| | - Abhinandan Jain
- Fluid Interfaces Group, Media Lab, Massachusetts Institute of Technology, USA
| | - Pattie Maes
- Fluid Interfaces Group, Media Lab, Massachusetts Institute of Technology, USA
| | - Nicco Reggente
- Institute for Advanced Consciousness Studies, Santa Monica, CA, USA
| | | | - Giovanni Pezzulo
- Institute of Cognitive Sciences and Technologies, National Research Council, Rome, Italy
| | - Laura Barca
- Institute of Cognitive Sciences and Technologies, National Research Council, Rome, Italy
| | - Micah Allen
- Center of Functionally Integrative Neuroscience, Aarhus University, Denmark; Cambridge Psychiatry, University of Cambridge, UK
| | - Roy Salomon
- Department Cognitive Sciences, University of Haifa, Israel
| | - Mark Miller
- Center for Human Nature, Artificial Intelligence and Neuroscience, Hokkaido University, Japan
| | - Daniele Di Lernia
- Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy; Applied Technology for Neuro- Psychology Laboratory, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - Giuseppe Riva
- Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy; Applied Technology for Neuro- Psychology Laboratory, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - Manos Tsakiris
- The Warburg Institute, School of Advanced Study, University of London, UK; Department of Psychology, Royal Holloway, University of London, UK; Department of Behavioural and Cognitive Sciences, University of Luxembourg, Luxembourg
| | - Moussa A Chalah
- EA 4391, Excitabilité Nerveuse et Thérapeutique, Université Paris-Est Créteil, Créteil, France; Service de Physiologie - Explorations Fonctionnelles, Hôpital Henri Mondor, Créteil, France
| | - Arno Klein
- Child Mind Institute, New York City, USA
| | - Ben Zhang
- Institute for Advanced Consciousness Studies, Santa Monica, CA, USA
| | - Teresa Garcia
- Institute for Advanced Consciousness Studies, Santa Monica, CA, USA
| | - Ursula Pollack
- Institute for Advanced Consciousness Studies, Santa Monica, CA, USA
| | - Marion Trousselard
- Institut de Recherche Biomédicale des Armées, Place Général Valérie André, 91220 Brétigny-sur-Orge, France
| | - Charles Verdonk
- Institut de Recherche Biomédicale des Armées, Place Général Valérie André, 91220 Brétigny-sur-Orge, France
| | | | - Vladimir Adrien
- Infrastructure for Clinical Research in Neurosciences (iCRIN) Psychiatry, Paris Brain Institute, Paris, France; Department of Psychiatry, Hôpital Saint-Antoine, AP-HP, Sorbonne Université, 75012 Paris, France
| | - Karl Friston
- Queen Sq, Institute of Neurology, UCL, London WC1N 3AR, UK
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Loewy J. Underlying Music Mechanisms Influencing the Neurology of Pain: An Integrative Model. Brain Sci 2022; 12:1317. [PMID: 36291251 PMCID: PMC9599384 DOI: 10.3390/brainsci12101317] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 09/26/2022] [Accepted: 09/26/2022] [Indexed: 08/10/2023] Open
Abstract
Pain is often debilitating, and is associated with many pathologies, as either a cause or consequence. Pharmacological interventions, such as opioids, to manage pain may lead to potential problems, such as addiction. When pain is controlled and managed, it can prevent negative associated outcomes affiliated with disease. Music is a low-cost option that shows promise in the management of painful circumstances. Music therapy has provided potent options for pain relief across a variety of ages and populations. As a nonpharmacological alternative or complement lacking side effects, music interventions are growing in clinical application and research protocols. This article considers the neurological implications of varying kinds of pain to provide working considerations that preempt the use of music and music-therapy applications in treating pain.
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Affiliation(s)
- Joanne Loewy
- The Louis Armstrong Center for Music and Medicine, Mount Sinai Health System, Icahn School of Medicine, New York, NY 10003, USA
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Ettenberger M, Maya R, Salgado-Vasco A, Monsalve-Duarte S, Betancourt-Zapata W, Suarez-Cañon N, Prieto-Garces S, Marín-Sánchez J, Gómez-Ortega V, Valderrama M. The Effect of Music Therapy on Perceived Pain, Mental Health, Vital Signs, and Medication Usage of Burn Patients Hospitalized in the Intensive Care Unit: A Randomized Controlled Feasibility Study Protocol. Front Psychiatry 2021; 12:714209. [PMID: 34733185 PMCID: PMC8558489 DOI: 10.3389/fpsyt.2021.714209] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Accepted: 09/13/2021] [Indexed: 11/17/2022] Open
Abstract
Background: Burn patients experience major physiological and psychological stressors during treatment and rehabilitation, including elevated levels of pain, anxiety, stress, or depression. Music interventions inclusive of music therapy (MT) have been shown to improve such symptoms, but rigorous clinical trials investigating specific music therapy methods in adult burn patients are scarce. Methods: This is a single center Randomized Controlled Trial (RCT) protocol with two parallel arms. Participants are 81 adult burn patients admitted to the Intensive Care Unit (ICU) of the University Hospital Fundación Santa Fe de Bogotá in Colombia. The intervention consists of a Music Assisted Relaxation (MAR) protocol, a music therapy technique composed of entrained live music combined with a guided relaxation and/or the use of imagery. The effects of the MAR will be compared to a control group (treatment as usual) over a period of maximum 2 weeks or six interventions. The primary outcome measure is perceived background pain, as measured with a Visual Analog Scale (VAS) before and after each intervention. Secondary outcomes are anxiety and depression levels; vital signs; and the use of pain medication. Additionally, some patients in the intervention group will be invited to participate in electroencephalography, electromyography, and electrocardiography recordings during the MAR. Discussion: This study protocol follows the SPIRIT guidelines for defining items of clinical trials and is the first study in Colombia to evaluate the effects of music therapy for adult burn patients. With this RCT it is hoped to gather new knowledge about the potential of music therapy to help critical care patients cope and recover from their injuries during the hospitalization in the ICU. Trial registration: www.clinicaltrials.gov, Identifier: NCT04571255. Protocol version: V1.0, May 24th 2021.
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Affiliation(s)
- Mark Ettenberger
- Department of Music Therapy, University Hospital Fundación Santa Fe de Bogotá, Bogotá, Colombia
| | - Rafael Maya
- Department of Music Therapy, University Hospital Fundación Santa Fe de Bogotá, Bogotá, Colombia
| | - Andrés Salgado-Vasco
- Department of Music Therapy, University Hospital Fundación Santa Fe de Bogotá, Bogotá, Colombia
| | | | | | - Nicolas Suarez-Cañon
- Department of Critical Care, University Hospital Fundación Santa Fe de Bogotá, Bogotá, Colombia
| | - Sergio Prieto-Garces
- Department of Critical Care, University Hospital Fundación Santa Fe de Bogotá, Bogotá, Colombia
| | | | | | - Mario Valderrama
- Department of Biomedical Engineering, University Los Andes, Bogotá, Colombia
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Developing Music-based Emotion Regulation (MBER): A theoretical model for age-related depression prevention. ARTS IN PSYCHOTHERAPY 2021. [DOI: 10.1016/j.aip.2021.101769] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Samadani A, Kim S, Moon J, Kang K, Chau T. Neurophysiological Synchrony Between Children With Severe Physical Disabilities and Their Parents During Music Therapy. Front Neurosci 2021; 15:531915. [PMID: 33994913 PMCID: PMC8119766 DOI: 10.3389/fnins.2021.531915] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2020] [Accepted: 03/16/2021] [Indexed: 12/30/2022] Open
Abstract
Although physiological synchronization has been associated with the level of empathy in emotionally meaningful relationships, little is known about the interbrain synchrony between non-speaking children with severe disabilities and their familial caregivers. In a repeated measures observational study, we ascertained the degree of interbrain synchrony during music therapy in 10 child-parent dyads, where the children were non-speaking and living with severe motor impairments. Interbrain synchrony was quantified via measurements of spectral coherence and Granger causality between child and parent electroencephalographic (EEG) signals collected during ten 15-min music therapy sessions per dyad, where parents were present as non-participating, covert observers. Using cluster-based permutation tests, we found significant child-parent interbrain synchrony, manifesting most prominently across dyads in frontal brain regions within β and low γ frequencies. Specifically, significant dyadic coherence was observed contra-laterally, between child frontal right and parental frontal left regions at β and lower γ bands in empathy-related brain areas. Furthermore, significant Granger influences were detected bidirectionally (from child to parent and vice versa) in the same frequency bands. In all dyads, significant increases in session-specific coherence and Granger influences were observed over the time course of a music therapy session. The observed interbrain synchrony suggests a cognitive-emotional coupling during music therapy between child and parent that is responsive to change. These findings encourage further study of the socio-empathic capacity and interpersonal relationships formed between caregivers and non-speaking children with severe physical impairments.
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Affiliation(s)
| | - Song Kim
- School of Optometry & Vision Science, University of Waterloo, Waterloo, ON, Canada
| | - Jae Moon
- Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada.,Institute of Biomedical Engineering (BME), University of Toronto, Toronto, ON, Canada
| | - Kyurim Kang
- Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada.,Music and Health Science Research Collaboratory (MaHRC), Faculty of Music, University of Toronto, Toronto, ON, Canada
| | - Tom Chau
- Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada.,Institute of Biomedical Engineering (BME), University of Toronto, Toronto, ON, Canada
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Béquet AJ, Hidalgo-Muñoz AR, Jallais C. Towards Mindless Stress Regulation in Advanced Driver Assistance Systems: A Systematic Review. Front Psychol 2021; 11:609124. [PMID: 33424721 PMCID: PMC7786307 DOI: 10.3389/fpsyg.2020.609124] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Accepted: 11/12/2020] [Indexed: 12/22/2022] Open
Abstract
Background: Stress can frequently occur in the driving context. Its cognitive effects can be deleterious and lead to uncomfortable or risky situations. While stress detection in this context is well developed, regulation using dedicated advanced driver-assistance systems (ADAS) is still emergent. Objectives: This systematic review focuses on stress regulation strategies that can be qualified as "subtle" or "mindless": the technology employed to perform regulation does not interfere with an ongoing task. The review goal is 2-fold: establishing the state of the art on such technological implementation in the driving context and identifying complementary technologies relying on subtle regulation that could be applied in driving. Methods: A systematic review was conducted using search operators previously identified through a concept analysis. The patents and scientific studies selected provide an overview of actual and potential mindless technology implementations. These are then analyzed from a scientific perspective. A classification of results was performed according to the different stages of emotion regulation proposed by the Gross model. Results: A total of 47 publications were retrieved, including 21 patents and 26 studies. Six of the studies investigated mindless stress regulation in the driving context. Patents implemented strategies mostly linked to attentional deployment, while studies tended to investigate response modulation strategies. Conclusions: This review allowed us to identify several ADAS relying on mindless computing technologies to reduce stress and better understand the underlying mechanisms allowing stress reduction. Further studies are necessary to better grasp the effect of mindless technologies on driving safety. However, we have established the feasibility of their implementation as ADAS and proposed directions for future research in this field.
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Affiliation(s)
- Adolphe J Béquet
- TS2-LESCOT, Univ Gustave Eiffel, IFSTTAR, Univ Lyon, Lyon, France
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7
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Dvir T, Lotan N, Viderman R, Elefant C. The body communicates: Movement synchrony during music therapy with children diagnosed with ASD. ARTS IN PSYCHOTHERAPY 2020. [DOI: 10.1016/j.aip.2020.101658] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Gaebel C, Rittner S, Stoffel M, Jarczok MN, Aguilar-Raab C, Ditzen B, Warth M. Study protocol of the MUSED study: A randomized controlled trial to evaluate the psychobiological effects of group music therapy in women with depression. NORDIC JOURNAL OF MUSIC THERAPY 2020. [DOI: 10.1080/08098131.2020.1760921] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Christine Gaebel
- Institute of Medical Psychology, Center for Psychosocial Medicine, University Hospital Heidelberg, Heidelberg, Germany
- Ruprecht-Karls University Heidelberg, Heidelberg, Germany
| | - Sabine Rittner
- Institute of Medical Psychology, Center for Psychosocial Medicine, University Hospital Heidelberg, Heidelberg, Germany
| | - Martin Stoffel
- Institute of Medical Psychology, Center for Psychosocial Medicine, University Hospital Heidelberg, Heidelberg, Germany
- Ruprecht-Karls University Heidelberg, Heidelberg, Germany
| | - Marc N. Jarczok
- Clinic for Psychosomatic Medicine and Psychotherapy, University Hospital Ulm, Ulm, Germany
| | - Corina Aguilar-Raab
- Institute of Medical Psychology, Center for Psychosocial Medicine, University Hospital Heidelberg, Heidelberg, Germany
- Ruprecht-Karls University Heidelberg, Heidelberg, Germany
| | - Beate Ditzen
- Institute of Medical Psychology, Center for Psychosocial Medicine, University Hospital Heidelberg, Heidelberg, Germany
- Ruprecht-Karls University Heidelberg, Heidelberg, Germany
| | - Marco Warth
- Institute of Medical Psychology, Center for Psychosocial Medicine, University Hospital Heidelberg, Heidelberg, Germany
- Ruprecht-Karls University Heidelberg, Heidelberg, Germany
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9
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Loewy J, Jaschke AC. Mechanisms of Timing, Timbre, Repertoire, and Entrainment in Neuroplasticity: Mutual Interplay in Neonatal Development. Front Integr Neurosci 2020; 14:8. [PMID: 32210771 PMCID: PMC7069513 DOI: 10.3389/fnint.2020.00008] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2019] [Accepted: 02/04/2020] [Indexed: 11/17/2022] Open
Abstract
Neonatal brain development relies on a combination of critical factors inclusive of genetic predisposition, attachment, and the conditions of the pre and postneonatal environment. The status of the infant’s developing brain in its most vulnerable state and the impact that physiological elements of music, silences and sounds may make in the earliest stages of brain development can enhance vitality. However, little attention has been focused on the integral aspects of the music itself. This article will support research that has hypothesized conditions of music therapeutic applications in an effort to further validate models of neurobehavioral care that have optimized conditions for growth, inclusive of recommendations leading toward the enhancement of self-regulatory behaviors.
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Affiliation(s)
- Joanne Loewy
- The Louis Armstrong Center for Music and Medicine, Mount Sinai Beth Israel, Icahn School of Medicine, New York, NY, United States
| | - Artur C Jaschke
- Department of Music Therapy, Beatrix Children's Hospital-University Medical Centre, ArtEZ University of the Arts, Groningen, Netherlands.,Department of Neonatology and Clinical Neuropsychology, Amsterdam, Netherlands
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Rebecca W, Michael JS. A music therapy feasibility study with adults on a hospital neuroscience unit: Investigating service user technique choices and immediate effects on mood and pain. ARTS IN PSYCHOTHERAPY 2020. [DOI: 10.1016/j.aip.2019.101585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Warth M, Koehler F, Weber M, Bardenheuer HJ, Ditzen B, Kessler J. "Song of Life (SOL)" study protocol: a multicenter, randomized trial on the emotional, spiritual, and psychobiological effects of music therapy in palliative care. BMC Palliat Care 2019; 18:14. [PMID: 30700278 PMCID: PMC6354383 DOI: 10.1186/s12904-019-0397-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2018] [Accepted: 01/21/2019] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Although patients in palliative care commonly report high emotional and spiritual needs, effective psychosocial treatments based on high quality studies are rare. First research provides evidence for benefits of psychosocial interventions in advanced cancer care. To specifically address end-of-life care requirements, life review techniques and creative-arts based therapies offer a promising potential. Therefore, the present study protocol presents a randomized controlled trial on the effectiveness of a newly developed music therapy technique that is based on a biographically meaningful song ("Song of Life"; SOL). METHODS In a design with two parallel arms, 104 patients at two palliative care units will be randomly assigned to three sessions of either SOL (experimental group) or relaxation exercises (control group). Improvements in the psychological domain of quality of life will be the primary endpoint, while secondary outcomes encompass spiritual well-being, ego-integrity, overall quality of life, and distress. Additionally, caregivers will be asked to provide feedback about the treatment. Assessment of biopsychological stress markers and qualitative analysis of perceived strengths and weaknesses will complement data collection. DISCUSSION Based on the results of a previous pilot study, we dedicated considerable efforts to optimizing the intervention and selecting appropriate outcomes for the present trial. We are confident to have designed a methodologically rigorous study that will contribute to the evidence-base and help to develop the potential of psychosocial interventions in palliative care. TRIAL REGISTRATION German Clinical Trials Register (DRKS) - DRKS00015308 (date of registration: September 07th 2018).
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Affiliation(s)
- Marco Warth
- Institute of Medical Psychology, Center for Psychosocial Medicine, University Hospital Heidelberg, Bergheimer Str. 20, 69115, Heidelberg, Germany.
| | - Friederike Koehler
- Institute of Medical Psychology, Center for Psychosocial Medicine, University Hospital Heidelberg, Bergheimer Str. 20, 69115, Heidelberg, Germany
| | - Martin Weber
- Interdisciplinary Palliative Care Unit, III. Department of Medicine, University Medical Center of the Johannes Gutenberg University of Mainz, Mainz, Germany
| | - Hubert J Bardenheuer
- Center of Pain Therapy and Palliative Care Medicine, Department of Anesthesiology, University Hospital Heidelberg, Im Neuenheimer Feld 131, 69120, Heidelberg, Germany
| | - Beate Ditzen
- Institute of Medical Psychology, Center for Psychosocial Medicine, University Hospital Heidelberg, Bergheimer Str. 20, 69115, Heidelberg, Germany
| | - Jens Kessler
- Center of Pain Therapy and Palliative Care Medicine, Department of Anesthesiology, University Hospital Heidelberg, Im Neuenheimer Feld 131, 69120, Heidelberg, Germany
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Strange J. Text Watch. BRITISH JOURNAL OF MUSIC THERAPY 2018. [DOI: 10.1177/1359457518805992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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13
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Edwards J. Connecting, attunement and rhythms of relating in creative arts therapies. ARTS IN PSYCHOTHERAPY 2018. [DOI: 10.1016/j.aip.2018.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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