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Curzel F, Tillmann B, Ferreri L. Lights on music cognition: A systematic and critical review of fNIRS applications and future perspectives. Brain Cogn 2024; 180:106200. [PMID: 38908228 DOI: 10.1016/j.bandc.2024.106200] [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: 04/06/2024] [Revised: 06/10/2024] [Accepted: 06/16/2024] [Indexed: 06/24/2024]
Abstract
Research investigating the neural processes related to music perception and production constitutes a well-established field within the cognitive neurosciences. While most neuroimaging tools have limitations in studying the complexity of musical experiences, functional Near-Infrared Spectroscopy (fNIRS) represents a promising, relatively new tool for studying music processes in both laboratory and ecological settings, which is also suitable for both typical and pathological populations across development. Here we systematically review fNIRS studies on music cognition, highlighting prospects and potentialities. We also include an overview of fNIRS basic theory, together with a brief comparison to characteristics of other neuroimaging tools. Fifty-nine studies meeting inclusion criteria (i.e., using fNIRS with music as the primary stimulus) are presented across five thematic sections. Critical discussion of methodology leads us to propose guidelines of good practices aiming for robust signal analyses and reproducibility. A continuously updated world map is proposed, including basic information from studies meeting the inclusion criteria. It provides an organized, accessible, and updatable reference database, which could serve as a catalyst for future collaborations within the community. In conclusion, fNIRS shows potential for investigating cognitive processes in music, particularly in ecological contexts and with special populations, aligning with current research priorities in music cognition.
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Affiliation(s)
- Federico Curzel
- Laboratoire d'Étude des Mécanismes Cognitifs (EMC), Université Lumière Lyon 2, Bron, Auvergne-Rhône-Alpes, 69500, France; Lyon Neuroscience Research Center (CRNL), INSERM, U1028, CNRS, UMR 5292, Université Claude Bernard Lyon1, Université de Lyon, Bron, Auvergne-Rhône-Alpes, 69500, France.
| | - Barbara Tillmann
- Lyon Neuroscience Research Center (CRNL), INSERM, U1028, CNRS, UMR 5292, Université Claude Bernard Lyon1, Université de Lyon, Bron, Auvergne-Rhône-Alpes, 69500, France; LEAD CNRS UMR5022, Université de Bourgogne-Franche Comté, Dijon, Bourgogne-Franche Comté 21000, France.
| | - Laura Ferreri
- Laboratoire d'Étude des Mécanismes Cognitifs (EMC), Université Lumière Lyon 2, Bron, Auvergne-Rhône-Alpes, 69500, France; Department of Brain and Behavioural Sciences, Università di Pavia, Pavia, Lombardia 27100, Italy.
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Xiang Q, Chen JJ, Feng NN, Li XH. Research progress of music intervention in nursing of premature infants in neonatal intensive care unit. Technol Health Care 2024:THC241263. [PMID: 39302405 DOI: 10.3233/thc-241263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/22/2024]
Abstract
BACKGROUND With the continuous advancement of medical technology, the survival rate of preterm infants is gradually improving, However, due to the underdeveloped function of various organs and systems, preterm infants are often exposed to light, noise, medical as well as nursing operations and other stimuli during their hospitalization in neonatal intensive care unit (NICU); it is highly susceptible to a number of problems, such as pain, unstable vital signs, growth retardation, and sleep disruption. OBJECTIVE This article reviews the research progress of music intervention in nursing of premature infants in NICU with both traditional and conventional care. METHODS This article reviews the research background, methodology/design, and measurement/application effects of music interventions, including Chinese and Western traditional music, in the care of preterm infants in NICU. All scholarly literature retrieved from MEDLINE\PubMed, Science Citation Index Expanded, Google scholar, CNKI scholar, Scopus and PubsHub. RESULTS As a simple and effective non-pharmacological intervention, music intervention can effectively alleviate neonatal surgical pain, increase heart rate and oxygen saturation, promote sleep, growth and development, and improve neurological development. CONCLUSIONS This review provide theoretical references for clinical practice.
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Affiliation(s)
- Qiong Xiang
- Department of Nursing, Institute of Medicine, Jishou University, Hunan, China
- Institute of Medicine, Medical Research Center, Jishou University, Hunan, China
- Department of Nursing, Institute of Medicine, Jishou University, Hunan, China
| | - Jia-Jia Chen
- Department of Nursing, Institute of Medicine, Jishou University, Hunan, China
- Department of Nursing, Institute of Medicine, Jishou University, Hunan, China
| | - Ni-Na Feng
- Department of Nursing, Institute of Medicine, Jishou University, Hunan, China
| | - Xian-Hui Li
- Department of Nursing, Institute of Medicine, Jishou University, Hunan, China
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Monaci MG, Caruzzo CM, Raso R, Spagnuolo C, Benedetti MC, Grandjean D, Filippa M. Maternal singing reduced pain indexes in 2-month-old infants and increased proximity during vaccinations. Acta Paediatr 2024; 113:1664-1671. [PMID: 38264948 DOI: 10.1111/apa.17121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Revised: 01/08/2024] [Accepted: 01/12/2024] [Indexed: 01/25/2024]
Abstract
AIM Immunisation is a global health priority, but methods of non-pharmacological pain relief are not widely used in routine clinical practice. In this study, we set out to investigate the effects of maternal singing during the routine vaccination of infants. METHODS We recruited 67 mother-infant pairs at Health Centres in the Aosta Region of Italy. Infants aged 2-4 months were randomly allocated to a singing intervention group or to a control group whose injections were administered following standard practice. Pre- and post-immunisation pain was blindly assessed using the Modified Behavioural Pain Scale, and mother-infant proximity indexes were assigned based on muted video-tracks. RESULTS When assessed for pain, the infants in the maternal singing group were assigned significantly lower movement indexes (p = 0.032) and marginally significantly lower cry indexes (p = 0.076). A higher frequency of mother-to-infant gaze (p < 0.005) was observed in the singing group dyads. Finally, the intervention group mothers' self-perceived ease in singing was correlated with their previous singing experience and with lower anxiety following the vaccination procedure (p < 0.05). CONCLUSION Maternal singing during immunisation procedures benefits both mothers and babies. The practice of singing is a biologically rooted and adaptive form of intuitive parental communication that should be encouraged, especially in at-risk populations.
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Affiliation(s)
| | | | - Romina Raso
- Department of Social Sciences, University of Valle D'Aosta, Aosta, Italy
| | | | | | - Didier Grandjean
- Swiss Center of Affective Sciences, Faculty of Psychology and Educational Sciences, University of Geneva, Geneva, Switzerland
| | - Manuela Filippa
- Swiss Center of Affective Sciences, Faculty of Psychology and Educational Sciences, University of Geneva, Geneva, Switzerland
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Dewan MV, Jungilligens J, Kobus S, Diezel M, Dathe AK, Schweiger B, Hüning B, Felderhoff-Müser U, Bruns N. The effect of live music therapy on white matter microstructure in very preterm infants - A randomized controlled trial. Eur J Paediatr Neurol 2024; 51:132-139. [PMID: 38941879 DOI: 10.1016/j.ejpn.2024.06.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2023] [Revised: 05/31/2024] [Accepted: 06/20/2024] [Indexed: 06/30/2024]
Abstract
OBJECTIVE Music therapy (MT) is proposed to enrich the acoustic environment of very preterm infants (VPT) on the neonatal intensive care unit during a vulnerable period of brain development. The objective of this study was to investigate the effect of MT on the white matter (WM) microstructure. It is hypothesized that MT affects WM integrity in VPT. METHODS Randomized controlled trial enrolling infants born <32 weeks' gestation. Infants were randomized to MT or standard care. Live MT was provided twice weekly from the second postnatal week onwards by a trained music therapist. At term equivalent age, participants underwent a cranial magnetic resonance imaging scan including sequences for diffusion tensor imaging analysis. Differences in WM microstructure were assessed using tract based spatial statistics with fractional anisotropy. RESULTS Of 80 infants enrolled, 42 were eligible for diffusion tensor imaging analysis (MT: n = 22, standard care: n = 20). While primary tract based spatial statistics analysis revealed no significant differences between groups, post hoc analysis with uncorrected p-values and a significance threshold of p < 0.01 revealed significant fractional anisotropy differences in several WM tracts including the bilateral superior longitudinal fasciculus, the left forceps minor and left fasciculus uncinatus, the corpus callosum, the left external capsule, and the right corticospinal tract. CONCLUSION Post hoc analysis results suggest an effect of MT on WM integrity in VPT. Larger studies including long-term outcome are necessary to confirm these effects of MT on WM microstructure and to assess its impact on clinical neurodevelopment. CLINICAL TRIAL REGISTRATION Clinical trial number DRKS00025753.
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Affiliation(s)
- Monia Vanessa Dewan
- Department of Paediatrics I, University Hospital Essen, University of Duisburg-Essen, Essen, Germany; Center for Translational Neuro- and Behavioural Sciences, C-TNBS, Faculty of Medicine, University Duisburg-Essen, Essen, Germany.
| | - Johannes Jungilligens
- Department of Neurology, University Hospital Knappschaftskrankenhaus Bochum, Ruhr University Bochum, Bochum, Germany
| | - Susann Kobus
- Department of Paediatrics I, University Hospital Essen, University of Duisburg-Essen, Essen, Germany; Center for Translational Neuro- and Behavioural Sciences, C-TNBS, Faculty of Medicine, University Duisburg-Essen, Essen, Germany
| | - Marlis Diezel
- Department of Paediatrics I, University Hospital Essen, University of Duisburg-Essen, Essen, Germany; Center for Translational Neuro- and Behavioural Sciences, C-TNBS, Faculty of Medicine, University Duisburg-Essen, Essen, Germany
| | - Anne-Kathrin Dathe
- Department of Paediatrics I, University Hospital Essen, University of Duisburg-Essen, Essen, Germany; Center for Translational Neuro- and Behavioural Sciences, C-TNBS, Faculty of Medicine, University Duisburg-Essen, Essen, Germany; Department of Health and Nursing, Occupational Therapy, Ernst-Abbe-University of Applied Sciences Jena, Germany
| | - Bernd Schweiger
- Institute of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, University Duisburg-Essen, Essen, Germany
| | - Britta Hüning
- Department of Paediatrics I, University Hospital Essen, University of Duisburg-Essen, Essen, Germany; Center for Translational Neuro- and Behavioural Sciences, C-TNBS, Faculty of Medicine, University Duisburg-Essen, Essen, Germany
| | - Ursula Felderhoff-Müser
- Department of Paediatrics I, University Hospital Essen, University of Duisburg-Essen, Essen, Germany; Center for Translational Neuro- and Behavioural Sciences, C-TNBS, Faculty of Medicine, University Duisburg-Essen, Essen, Germany
| | - Nora Bruns
- Department of Paediatrics I, University Hospital Essen, University of Duisburg-Essen, Essen, Germany; Center for Translational Neuro- and Behavioural Sciences, C-TNBS, Faculty of Medicine, University Duisburg-Essen, Essen, Germany
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Tang X, Sha S, Bei F, Shen N, Zhu Z, Ren Z, Gao W, Wang Q, Tian S, Jin Q, Shayiti S, Zhang Y. Uni- and multimodal sensory-supported interventions for very preterm and extremely preterm infants in the neonatal intensive care unit: An overview of systematic reviews and interventional studies. Nurs Crit Care 2024. [PMID: 38945698 DOI: 10.1111/nicc.13112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 05/23/2024] [Accepted: 05/28/2024] [Indexed: 07/02/2024]
Abstract
BACKGROUND Very and extremely preterm infants (VEPIs) experience sensory deprivation in the neonatal intensive care unit (NICU). While various sensory-supported interventions might improve immediate physiological response, their impact on long-term development remains unclear. Additionally, these interventions may pose challenges in the NICU environment due to complex treatments and monitoring requirements. AIMS This review aimed to understand the current evidence on sensory-supported interventions in the NICU, identify the components of these interventions and determine their effects on the VEPIs. STUDY DESIGN A systematic search across nine electronic databases (PubMed, EBSCO, EMBASE, Web of Science, Scopus, Cochrane, Cochrane trial, IEEE Xplore DL and ACM DL) was conducted in December 2020 and updated in September 2022. The search gathers information on sensory-supported interventions for VEPIs in the NICU. RESULTS The search yielded 23 systematic reviews and 22 interventional studies, categorized into auditory (19), tactile/kinesthetic (5), positional/movement support (7), visual (1) and multisensory (13) interventions. While unimodal and multimodal interventions showed short-term benefits, their long-term effects on VEPIs are indeterminate. Translating these findings into clinical practice remains a challenge due to identified gaps. CONCLUSION Our reviews indicate that sensory-supported interventions have a transient impact, with intervention studies reporting positive effects. Future research should develop and test comprehensive, continuous multisensory interventions tailored for the early NICU stage. RELEVANCE TO CLINICAL PRACTICE Multimodal sensory interventions show promise for VEPIs, but long-term effects need further study. Standardizing protocols for NICU integration and parental involvement is crucial. Ongoing research and collaboration are essential for optimizing interventions and personalized care.
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Affiliation(s)
- Xiaoli Tang
- Department of Neonatology, Shanghai Children's Medical Center Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Jiao Tong University School of Nursing, Shanghai, China
- Department of Nursing, Shanghai Children's Medical Center Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Engineering Research Center of Intelligence Pediatrics, Shanghai Children's Medical Center Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Sha Sha
- Department of Neonatology, Shanghai Children's Medical Center Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Fei Bei
- Department of Neonatology, Shanghai Children's Medical Center Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Nanping Shen
- Department of Nursing, Shanghai Children's Medical Center Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zhiyu Zhu
- Department of Neonatology, Shanghai Children's Medical Center Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zijin Ren
- Shanghai Jiao Tong University School of Nursing, Shanghai, China
| | - Wenying Gao
- Shanghai Jiao Tong University School of Nursing, Shanghai, China
| | - Qihui Wang
- Shanghai Jiao Tong University School of Nursing, Shanghai, China
| | - Siying Tian
- Shanghai Jiao Tong University School of Nursing, Shanghai, China
| | - Qian Jin
- Department of Neonatology, Shanghai Children's Medical Center Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Subinuer Shayiti
- Shanghai Jiao Tong University School of Nursing, Shanghai, China
- Shanghai Engineering Research Center of Intelligence Pediatrics, Shanghai Children's Medical Center Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Ying Zhang
- Shanghai Jiao Tong University School of Nursing, Shanghai, China
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Amodei N, Nixon E, Zhang S, Hu Y, Vance A, Maye M. Associations between sociodemographic characteristics and neonatal length of the stay. J Perinatol 2024; 44:851-856. [PMID: 38773215 DOI: 10.1038/s41372-024-01976-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2023] [Revised: 03/29/2024] [Accepted: 04/16/2024] [Indexed: 05/23/2024]
Abstract
BACKGROUND Infants with past NICU admission have a significantly higher risk of developing neurodevelopmental disorders. Studies have demonstrated an iatrogenic effect of the NICU environment on neurodevelopmental outcomes, even while accounting for physical factors. It is, therefore, critical that an infant's LOS is driven by physical needs versus sociodemographic barriers. METHODS We leveraged electronic health records and a backward selection regression model to explore physical and sociodemographic predictors of infant LOS. RESULTS Our results demonstrated that physical predictors (birthweight and ventilator use) accounted for the majority of variance in our model but that a sociodemographic predictor, mean visits per day, was also significant. CONCLUSIONS Infants who were visited more frequently experienced a shorter LOS, possibly due to increased parental involvement resulting in more individualized care and directly impacting infant stability and morbidity. By supporting visitation, we can reduce the costs of lengthy NICU hospitalizations while improving infant and parent health and well-being.
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Affiliation(s)
- Natalie Amodei
- Wayne State University School of Medicine, Detroit, MI, USA
| | - Ellen Nixon
- American Hospital Association, Chicago, IL, USA
| | | | - Yong Hu
- Henry Ford Health, Detroit, MI, USA
| | - Ashlee Vance
- Henry Ford Health and Michigan State University Health Sciences (HFH+MSU Health Sciences), Center for Health Policy and Health Services Research, One Ford Place, Detroit, MI, USA
| | - Melissa Maye
- Henry Ford Health and Michigan State University Health Sciences (HFH+MSU Health Sciences), Center for Health Policy and Health Services Research, One Ford Place, Detroit, MI, USA.
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Zheng Y, Zhang L, Ma S, Wu B, Chen P, Xu Y, Tan W, Li H, Wu Q, Zheng J. Care intervention on psychological outcomes among patients admitted to intensive care unit: an umbrella review of systematic reviews and meta-analyses. Syst Rev 2023; 12:237. [PMID: 38098025 PMCID: PMC10720116 DOI: 10.1186/s13643-023-02372-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Accepted: 10/23/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND Numerous studies have explored care interventions to improve the psychological outcome of intensive care unit (ICU) patients, but inconclusive evidence makes it difficult for decision-makers, managers, and clinicians to get familiar with all available literature and find appropriate interventions. This umbrella review aimed to analyze the relationship between care intervention and psychological outcomes of ICU patients based on existing systematic reviews. METHODS An umbrella review of evidence across systematic reviews and meta-analyses published between 1987 and 2023 was undertaken. We systematically searched reviews that examined the association between care intervention and the improvement of adverse psychological outcomes in ICU patients using PubMed, EMBASE, Web of Science, Cochrane Library, and manual reference screening. The measurement tool (AMSTAR 2) was applied to evaluate the methodological quality of included studies. The excess significance bias, between-study heterogeneity expressed by I2, small-study effect, and evidence class were estimated. RESULTS A total of 5110 articles were initially identified from the search databases and nine of them were included in the analysis. By applying standardized criteria, only weak evidence was observed in 13 associations, even though most included reviews were of moderate to high methodological quality. These associations pertained to eight interventions (music therapy, early rehabilitation, post-ICU follow-up, ICU diary, information intervention, preoperative education, communication and psychological support, surrogate decision-making) and five psychological outcomes (post-intensive care syndrome, transfer anxiety, post-traumatic stress disorder, anxiety, and depression). Weak or null association was shown among the rest of the associations (e.g., weak association between music therapy and maternal anxiety or stress level). CONCLUSIONS The evidence of these eight supporting interventions to improve the adverse psychological outcomes of ICU patients and caregivers was weak. Data from more and better-designed studies with larger sample sizes are needed to establish robust evidence.
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Affiliation(s)
- Yafang Zheng
- The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, People's Republic of China
- Guangdong Provincial Hospital of Traditional Chinese Medicine, No. 111 Dade Road, Guangzhou, 510120, People's Republic of China
| | - Lijuan Zhang
- The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, People's Republic of China
- Guangdong Provincial Hospital of Traditional Chinese Medicine, No. 111 Dade Road, Guangzhou, 510120, People's Republic of China
| | - Shihong Ma
- The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, People's Republic of China
- Guangdong Provincial Hospital of Traditional Chinese Medicine, No. 111 Dade Road, Guangzhou, 510120, People's Republic of China
| | - Bian Wu
- The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, People's Republic of China
- Guangdong Provincial Hospital of Traditional Chinese Medicine, No. 111 Dade Road, Guangzhou, 510120, People's Republic of China
| | - Peipei Chen
- The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, People's Republic of China
- Guangdong Provincial Hospital of Traditional Chinese Medicine, No. 111 Dade Road, Guangzhou, 510120, People's Republic of China
| | - Yan Xu
- The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, People's Republic of China
- Guangdong Provincial Hospital of Traditional Chinese Medicine, No. 111 Dade Road, Guangzhou, 510120, People's Republic of China
| | - Wenting Tan
- The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, People's Republic of China
- Guangdong Provincial Hospital of Traditional Chinese Medicine, No. 111 Dade Road, Guangzhou, 510120, People's Republic of China
| | - Hanzhan Li
- The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, People's Republic of China
- Guangdong Provincial Hospital of Traditional Chinese Medicine, No. 111 Dade Road, Guangzhou, 510120, People's Republic of China
| | - Qiaomei Wu
- The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, People's Republic of China.
- Guangdong Provincial Hospital of Traditional Chinese Medicine, No. 111 Dade Road, Guangzhou, 510120, People's Republic of China.
| | - Jingxia Zheng
- The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, People's Republic of China.
- Guangdong Provincial Hospital of Traditional Chinese Medicine, No. 111 Dade Road, Guangzhou, 510120, People's Republic of China.
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Mata Ferro M, Falcó Pegueroles A, Fernández Lorenzo R, Saz Roy MÁ, Rodríguez Forner O, Estrada Jurado CM, Bonet Julià N, Geli Benito C, Hernández Hernández R, Bosch Alcaraz A. The effect of a live music therapy intervention on critically ill paediatric patients in the intensive care unit: A quasi-experimental pretest-posttest study. Aust Crit Care 2023; 36:967-973. [PMID: 36868934 DOI: 10.1016/j.aucc.2023.01.006] [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: 07/19/2022] [Revised: 12/29/2022] [Accepted: 01/07/2023] [Indexed: 03/05/2023] Open
Abstract
BACKGROUND Music therapy as a nonpharmacological means of managing patient pain, anxiety, and discomfort is a recognised technique, although it is not widely used in the paediatric intensive care unit (PICU). AIM The aim of this study was to assess the clinical effect of a live music therapy intervention on vital signs and levels of discomfort and pain for paediatric patients in the PICU. METHODS This was a quasi-experimental pretest-posttest study. The music therapy intervention was carried out by two music therapists who were specifically trained, each possessing a master's degree in the field of hospital music therapy. Ten minutes before the start of the music therapy session, the investigators recorded the vital signs of the patients and assessed their levels of discomfort and pain. The procedure was repeated at the start of the intervention; at 2, 5, and 10 min during the intervention; and at 10 min following the conclusion of the intervention. RESULTS Two hundred fifty-nine patients were included; 55.2% were male, with a median age of 1 year (0-21). A total of 96 (37.1%) patients suffered a chronic illness. The main reason for PICU admission was respiratory illness, at 50.2% (n = 130). Significantly lower values were observed for heart rate (p = 0.002), breathing rate (p < 0.001), and degree of discomfort (p < 0.001) during the music therapy session. CONCLUSIONS Live music therapy results in reduced heart rates, breathing rates, and paediatric patient discomfort levels. Although music therapy is not widely used in the PICU, our results suggest that using interventions such as that used in this study could help reduce patient discomfort.
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Affiliation(s)
- María Mata Ferro
- Pediatric Intensive Care Unit, Sant Joan de Déu Hospital, Barcelona, Spain
| | - Anna Falcó Pegueroles
- Department of Fundamental Care and Medical-Surgical Nursing, School of Nursing, Faculty of Medicine and Health Sciences, University of Barcelona (UB), Barcelona, Spain
| | | | - M Ángeles Saz Roy
- Department of Public Health, Mental Health and Maternal and Child Health Nursing, School of Nursing, Faculty of Medicine and Health Sciences, University of Barcelona (UB), Barcelona, Spain
| | | | | | | | | | | | - Alejandro Bosch Alcaraz
- Pediatric Intensive Care Unit, Sant Joan de Déu Hospital, Barcelona, Spain; Department of Public Health, Mental Health and Maternal and Child Health Nursing, School of Nursing, Faculty of Medicine and Health Sciences, University of Barcelona (UB), Barcelona, Spain.
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Haslbeck FB, Mueller K, Karen T, Loewy J, Meerpohl JJ, Bassler D. Musical and vocal interventions to improve neurodevelopmental outcomes for preterm infants. Cochrane Database Syst Rev 2023; 9:CD013472. [PMID: 37675934 PMCID: PMC10483930 DOI: 10.1002/14651858.cd013472.pub2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/08/2023]
Abstract
BACKGROUND Preterm birth interferes with brain maturation, and subsequent clinical events and interventions may have additional deleterious effects. Music as therapy is offered increasingly in neonatal intensive care units aiming to improve health outcomes and quality of life for both preterm infants and the well-being of their parents. Systematic reviews of mixed methodological quality have demonstrated ambiguous results for the efficacy of various types of auditory stimulation of preterm infants. A more comprehensive and rigorous systematic review is needed to address controversies arising from apparently conflicting studies and reviews. OBJECTIVES We assessed the overall efficacy of music and vocal interventions for physiological and neurodevelopmental outcomes in preterm infants (< 37 weeks' gestation) compared to standard care. In addition, we aimed to determine specific effects of various interventions for physiological, anthropometric, social-emotional, neurodevelopmental short- and long-term outcomes in the infants, parental well-being, and bonding. SEARCH METHODS We searched Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, CINAHL, PsycINFO, Web of Science, RILM Abstracts, and ERIC in November 2021; and Proquest Dissertations in February 2019. We searched the reference lists of related systematic reviews, and of studies selected for inclusion and clinical trial registries. SELECTION CRITERIA We included parallel, and cluster-randomised controlled trials with preterm infants < 37 weeks` gestation during hospitalisation, and parents when they were involved in the intervention. Interventions were any music or vocal stimulation provided live or via a recording by a music therapist, a parent, or a healthcare professional compared to standard care. The intervention duration was greater than five minutes and needed to occur more than three times. DATA COLLECTION AND ANALYSIS Three review authors independently extracted data. We analysed the treatment effects of the individual trials using RevMan Web using a fixed-effects model to combine the data. Where possible, we presented results in meta-analyses using mean differences with 95% CI. We performed heterogeneity tests. When the I2 statistic was higher than 50%, we assessed the source of the heterogeneity by sensitivity and subgroup analyses. We used GRADE to assess the certainty of the evidence. MAIN RESULTS We included 25 trials recruiting 1532 infants and 691 parents (21 parallel-group RCTs, four cross-over RCTs). The infants gestational age at birth varied from 23 to 36 weeks, taking place in NICUs (level 1 to 3) around the world. Within the trials, the intervention varied widely in type, delivery, frequency, and duration. Music and voice were mainly characterised by calm, soft, musical parameters in lullaby style, often integrating the sung mother's voice live or recorded, defined as music therapy or music medicine. The general risk of bias in the included studies varied from low to high risk of bias. Music and vocal interventions compared to standard care Music/vocal interventions do not increase oxygen saturation in the infants during the intervention (mean difference (MD) 0.13, 95% CI -0.33 to 0.59; P = 0.59; 958 infants, 10 studies; high-certainty evidence). Music and voice probably do not increase oxygen saturation post-intervention either (MD 0.63, 95% CI -0.01 to 1.26; P = 0.05; 800 infants, 7 studies; moderate-certainty evidence). The intervention may not increase infant development (Bayley Scales of Infant and Toddler Development (BSID)) with the cognitive composition score (MD 0.35, 95% CI -4.85 to 5.55; P = 0.90; 69 infants, 2 studies; low-certainty evidence); the motor composition score (MD -0.17, 95% CI -5.45 to 5.11; P = 0.95; 69 infants, 2 studies; low-certainty evidence); and the language composition score (MD 0.38, 95% CI -5.45 to 6.21; P = 0.90; 69 infants, 2 studies; low-certainty evidence). Music therapy may not reduce parental state-trait anxiety (MD -1.12, 95% CI -3.20 to 0.96; P = 0.29; 97 parents, 4 studies; low-certainty evidence). The intervention probably does not reduce respiratory rate during the intervention (MD 0.42, 95% CI -1.05 to 1.90; P = 0.57; 750 infants; 7 studies; moderate-certainty evidence) and post-intervention (MD 0.51, 95% CI -1.57 to 2.58; P = 0.63; 636 infants, 5 studies; moderate-certainty evidence). However, music/vocal interventions probably reduce heart rates in preterm infants during the intervention (MD -1.38, 95% CI -2.63 to -0.12; P = 0.03; 1014 infants; 11 studies; moderate-certainty evidence). This beneficial effect was even stronger after the intervention. Music/vocal interventions reduce heart rate post-intervention (MD -3.80, 95% CI -5.05 to -2.55; P < 0.00001; 903 infants, 9 studies; high-certainty evidence) with wide CIs ranging from medium to large beneficial effects. Music therapy may not reduce postnatal depression (MD 0.50, 95% CI -1.80 to 2.81; P = 0.67; 67 participants; 2 studies; low-certainty evidence). The evidence is very uncertain about the effect of music therapy on parental state anxiety (MD -0.15, 95% CI -2.72 to 2.41; P = 0.91; 87 parents, 3 studies; very low-certainty evidence). We are uncertain about any further effects regarding all other secondary short- and long-term outcomes on the infants, parental well-being, and bonding/attachment. Two studies evaluated adverse effects as an explicit outcome of interest and reported no adverse effects from music and voice. AUTHORS' CONCLUSIONS Music/vocal interventions do not increase oxygen saturation during and probably not after the intervention compared to standard care. The evidence suggests that music and voice do not increase infant development (BSID) or reduce parental state-trait anxiety. The intervention probably does not reduce respiratory rate in preterm infants. However, music/vocal interventions probably reduce heart rates in preterm infants during the intervention, and this beneficial effect is even stronger after the intervention, demonstrating that music/vocal interventions reduce heart rates in preterm infants post-intervention. We found no reports of adverse effects from music and voice. Due to low-certainty evidence for all other outcomes, we could not draw any further conclusions regarding overall efficacy nor the possible impact of different intervention types, frequencies, or durations. Further research with more power, fewer risks of bias, and more sensitive and clinically relevant outcomes are needed.
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Affiliation(s)
| | - Katharina Mueller
- Zentrum für Kinder und Jugendmedizin, University Freiburg, Freiburg, Germany
| | - Tanja Karen
- Department of Neonatology, University Hospital Zurich, Zurich, Switzerland
| | - Joanne Loewy
- Mount Sinai Health System, The Louis Armstrong Center for Music & Medicine, New York City, USA
| | - Joerg J Meerpohl
- Institute for Evidence in Medicine, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Dirk Bassler
- Department of Neonatology, University Hospital Zurich, Zurich, Switzerland
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10
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van Dokkum NH, Fagan LJ, Cullen M, Loewy JV. Assessing HeartSong as a Neonatal Music Therapy Intervention: A Qualitative Study on Personal and Professional Caregivers' Perspectives. Adv Neonatal Care 2023; 23:264-271. [PMID: 37075326 DOI: 10.1097/anc.0000000000001068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/21/2023]
Abstract
BACKGROUND The music therapy HeartSong intervention pairs newborn infant heartbeats with parents' Song of Kin. Formal evidence on professional and personal caregiver perspectives of this intervention is lacking. PURPOSE This survey study evaluates the HeartSong music therapy intervention from parent and staff perspectives. METHODS A qualitative study assessing inclusion of HeartSong for family neonatal intensive care unit (NICU) care surveyed 10 professional caregivers comprising medical and psychosocial NICU teams anonymously reflecting their impressions of the intervention. Digital survey of parents/guardians contacted through semistructured phone interviews relayed impressions of recordings: subsequent setup, Song of Kin selection, and use of HeartSong, including thoughts/feelings about it as an intervention. RESULTS Professional and personal caregivers valued the HeartSong intervention for bereavement support, family support, including parental, extended family/infant support, and to enhance bonding. Emergent themes: memory-making, connectedness/closeness, support of parent role, processing mental health needs of stressful NICU days, and subsequent plans for lifelong HeartSong use. Therapeutic experience was named as a crucial intervention aspect and participants recommended the HeartSong as a viable, accessible NICU intervention. IMPLICATIONS FOR PRACTICE AND RESEARCH HeartSong's use showed efficacy as a clinical NICU music therapy intervention for families of critically ill and extremely preterm infants, when provided by trained, specialized, board-certified music therapists. Future research focusing on HeartSong in other NICU populations might benefit infants with cardiac disease, parental stress, and anxiety attending to parent-infant bonding. Costs and time benefits related to investment are needed before implementation is considered.
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Affiliation(s)
- Nienke H van Dokkum
- The Louis Armstrong Center for Music & Medicine, Mount Sinai Hospitals, New York City, New York (Dr van Dokkum and Mss Fagan and Loewy); Department of Pediatrics, Division of Neonatology, Beatrix Children's Hospital, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands (Dr van Dokkum); and Department of Neonatology, Mount Sinai West Hospital, New York City, New York (Ms Cullen)
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11
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Loscalzo Y, Antichi L, Cipriani G, Magi L, Giannini M. Premature Triadic Music Therapy (PT-MT) for babies and their parents: a pilot study. J Reprod Infant Psychol 2023; 41:193-212. [PMID: 34520309 DOI: 10.1080/02646838.2021.1979199] [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] [Indexed: 10/20/2022]
Abstract
OBJECTIVE We aim to test the feasibility and effectiveness of Premature Triadic Music Therapy (PT-MT) in the premature baby unit. METHODS The design was a clinical pre-test-post-test trial with a convenience sample. Inclusion criteria were a gestational age higher than 28 weeks for preterm infants and the absence of shock or extreme distress for parents. Six preterm children (with a gestational age of 33 to 36 weeks) and their parents participated in the study. For the children, we measured heart rate, blood perfusion, and blood saturation at three different times (pre-PT-MT, during PT-MT, after PT-MT) as quantitative indicators of distress. Their parents completed the Edinburgh Postnatal Depression Scale (EPDS) before and after the PT-MT intervention. RESULTS We found a statistically significant lower heart rate and a marginally statistically significant higher blood perfusion during PT-MT, as compared to the baseline. However, these changes were not present at the end of PT-MT. The parents' EPDS scores were not statistically significantly lower at the post-test, although, the Medians of the scores did decrease. CONCLUSIONS PT-MT is a promising intervention for the reduction of distress in both parents and children. Further studies should include a higher number of sessions and participants.
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Affiliation(s)
- Yura Loscalzo
- Department of Health Sciences, School of Psychology, University of Florence, Florence, Italy
| | - Lorenzo Antichi
- Department of Health Sciences, School of Psychology, University of Florence, Florence, Italy
| | - Gianni Cipriani
- Aim - Associazione Italiana Professionisti Della Musicoterapia [Italian Association of Music Therapy Professionals], Reggio Emilia, Italy
| | - Letizia Magi
- San Donato Hospital in Arezzo, Neonatology Unit, Arezzo, Italy
| | - Marco Giannini
- Department of Health Sciences, School of Psychology, University of Florence, Florence, Italy
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12
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Dincer E, Özer H, Topçuoğlu S, Karatekin G. Ultrasonography Causes Agitation and Pain Leading to Hemodynamic Disturbance in Neonates: A Prospective Observational Study. CHILDREN (BASEL, SWITZERLAND) 2023; 10:children10020347. [PMID: 36832476 PMCID: PMC9955673 DOI: 10.3390/children10020347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 01/24/2023] [Accepted: 02/08/2023] [Indexed: 02/12/2023]
Abstract
BACKGROUND Ultrasonography is widely used in neonatological practice and studies investigating the hemodynamic effects of various treatment protocols or clinical situations. On the other hand, pain causes changes in the cardiovascular system; so, in the case of ultrasonography leading to pain in neonates, it may cause hemodynamic alterations. In this prospective study, we evaluate whether ultrasonographic application causes pain and changes in the hemodynamic system. METHODS Newborns undergoing ultrasonographic examination were enrolled in the study. Vital signs, cerebral and mesenteric tissue oxygenation (StO2) levels, and middle cerebral artery (MCA) Doppler measurements were recorded, and NPASS scores were calculated before and after ultrasonography. RESULTS We enrolled 39 patients in the study. After ultrasonography, Neonatal Pain, Agitation, and Sedation Scale (NPASS) scores were significantly higher (p < 0.01), and all vital signs (heart rate, respiratory rate, SpO2, diastolic and systolic blood pressure; p = 0.03; p < 0.01, p < 0.01, p < 0.01, p = 0.02, p = 0.03, respectively) were altered. Cerebral (p = 0.008) and mesenteric (p = 0.039) StO2 levels were significantly lower in the whole study group, MCA end-diastolic velocity decreased (p = 0.02), and the resistive index (p = 0.03) increased in patients whose NPASS score was >7 after ultrasonography. CONCLUSIONS This study is the first to show that ultrasonography may cause pain in newborn patients, and alters vital signs and hemodynamic parameters. Therefore, precautions should be taken to protect newborn babies from pain during ultrasound applications, as they are already exposed to many noxious stimuli. Furthermore, pain scores should be considered in studies using ultrasonography and evaluating hemodynamic parameters to increase the reliability of the studies.
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Affiliation(s)
- Emre Dincer
- Department of Neonatology, University of Health Sciences, Zeynep Kamil Maternity and Children’s Research and Training Hospital, Op. Dr. Burhanettin Öncel Cad No. 10, Üsküdar, Istanbul 34668, Turkey
- Correspondence: ; Tel.: +90-505-915-50-00
| | - Hamza Özer
- Department of Radiology, Bolu Abant İzzet Baysal University Medical Faculty, Bolu 14030, Turkey
| | - Sevilay Topçuoğlu
- Department of Neonatology, University of Health Sciences, Zeynep Kamil Maternity and Children’s Research and Training Hospital, Op. Dr. Burhanettin Öncel Cad No. 10, Üsküdar, Istanbul 34668, Turkey
| | - Güner Karatekin
- Department of Neonatology, University of Health Sciences, Zeynep Kamil Maternity and Children’s Research and Training Hospital, Op. Dr. Burhanettin Öncel Cad No. 10, Üsküdar, Istanbul 34668, Turkey
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13
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Pino O, Di Pietro S, Poli D. Effect of Musical Stimulation on Placental Programming and Neurodevelopment Outcome of Preterm Infants: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2718. [PMID: 36768104 PMCID: PMC9915377 DOI: 10.3390/ijerph20032718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 01/26/2023] [Accepted: 02/01/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND The fetal environment is modulated by the placenta, which integrates and transduces information from the maternal environment to the fetal developmental program and adapts rapidly to changes through epigenetic mechanisms that respond to internal (hereditary) and external (environmental and social) signals. Consequently, the fetus corrects the trajectory of own development. During the last trimester of gestation, plasticity shapes the fetal brain, and prematurity can alter the typical developmental trajectories. In this period, prevention through activity-inducing (e.g., music stimulation) interventions are currently tested. The purpose of this review is to describe the potentialities of music exposure on fetus, and on preterm newborns in the Neonatal Intensive Care Unit evaluating its influence on neurobehavioral development. METHODS Databases were searched from 2010 to 2022 for studies investigating mechanisms of placental epigenetic regulation and effects of music exposure on the fetus and pre-term neonates. RESULTS In this case, 28 selected papers were distributed into three research lines: studies on placental epigenetic regulation (13 papers), experimental studies of music stimulation on fetus or newborns (6 papers), and clinical studies on premature babies (9 papers). Placental epigenetic changes of the genes involved in the cortisol and serotonin response resulted associated with different neurobehavioral phenotypes in newborns. Prenatal music stimulation had positive effects on fetus, newborn, and pregnant mother while post-natal exposure affected the neurodevelopment of the preterm infants and parental interaction. CONCLUSIONS The results testify the relevance of environmental stimuli for brain development during the pre- and perinatal periods and the beneficial effects of musical stimulation that can handle the fetal programming and the main neurobehavioral disorders.
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Affiliation(s)
- Olimpia Pino
- Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy
| | - Sofia Di Pietro
- Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy
| | - Diana Poli
- INAIL Research, Department of Occupational and Environmental Medicine, Epidemiology and Hygiene Via Fontana Candida 1, 00078 Monte Porzio Catone, Italy
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14
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Smith AR, Hagan J, Walden M, Brickley A, Biard M, Rhee C, McIver P, Shoemark H, Brand MC. The Effect of Contingent Singing on Infants with Bronchopulmonary Dysplasia in the Neonatal Intensive Care Unit. J Music Ther 2023; 60:98-119. [PMID: 36592139 DOI: 10.1093/jmt/thac019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
A significant component of care for infants with bronchopulmonary dysplasia (BPD) is providing an optimal environment for supporting neurodevelopment and growth. Interventions that support the behavioral and physiologic stability of this population may play an important role in improving overall outcomes. Contingent singing is a music intervention that allows the caregiver to tailor certain musical elements, such as rhythm and tempo, to match behavioral and physiologic cues and support the infant in achieving optimal stabilization. A randomized crossover design was used to study the effect of contingent singing on the behavioral state and physiologic measures compared to standard care practices in the neonatal intensive care unit (NICU). Data were collected on a sample of 37 infants diagnosed with BPD. There were no significant differences in the physiologic measures or behavioral states of infants in the contingent singing sessions compared to control sessions. Parents and staff reported favorable views of music therapy in the NICU, and there were no adverse responses from infants during contingent singing. Further research is needed to determine the effectiveness of this intervention on the physiologic stability of infants with BPD.
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Affiliation(s)
| | - Joseph Hagan
- Texas Children's Hospital & Baylor College of Medicine
| | - Marlene Walden
- Arkansas Children's Hospital & University of Arkansas for Medical Sciences
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15
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Neonatal Musicality: Do Newborns Detect Emotions in Music? PSYCHOLOGICAL STUDIES 2022. [DOI: 10.1007/s12646-022-00688-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
AbstractThis study aimed to explore healthy, term neonates’ behavioural and physiological responses to music using frame-by-frame analysis of their movements (Experiment 1; N = 32, 0–3 days old) and heart rate measurements (Experiment 2; N = 66, 0–6 days old). A ‘happy’ and ‘sad’ music was first validated by independent raters for their emotional content from a large pool of children’s songs and lullabies, and the effect of the emotions in these two music pieces and a control, no-music condition was compared. The results of the frame-by-frame behavioural analysis showed that babies had emotion-specific responses across the three conditions. Happy music decreased their arousal levels, shifting from drowsiness to sleep, and resulted in longer latencies in other forms of self-regulatory behaviour, such as sucking. The decrease in arousal was accompanied by heart rate deceleration. In the sad music condition, relative ‘stillness’ was observed, and longer leg stretching latencies were measured. In both music conditions, longer latencies of fine motor finger and toe movements were found. Our findings suggest that the emotional response to music possibly emerges very early ontogenetically as part of a generic, possibly inborn, human musicality.
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16
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Sensory-based interventions in the NICU: systematic review of effects on preterm brain development. Pediatr Res 2022; 92:47-60. [PMID: 34508227 DOI: 10.1038/s41390-021-01718-w] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Revised: 07/12/2021] [Accepted: 08/17/2021] [Indexed: 11/08/2022]
Abstract
BACKGROUND Infants born preterm are known to be at risk for abnormal brain development and adverse neurobehavioral outcomes. To improve early neurodevelopment, several non-pharmacological interventions have been developed and implemented in the neonatal intensive care unit (NICU). Sensory-based interventions seem to improve short-term neurodevelopmental outcomes in the inherently stressful NICU environment. However, how this type of intervention affects brain development in the preterm population remains unclear. METHODS A systematic review of the literature was conducted for published studies in the past 20 years reporting the effects of early, non-pharmacological, sensory-based interventions on the neonatal brain after preterm birth. RESULTS Twelve randomized controlled trials (RCT) reporting short-term effects of auditory, tactile, and multisensory interventions were included after the screening of 1202 articles. Large heterogeneity was identified among studies in relation to both types of intervention and outcomes. Three areas of focus for sensory interventions were identified: auditory-based, tactile-based, and multisensory interventions. CONCLUSIONS Diversity in interventions and outcome measures challenges the possibility to perform an integrative synthesis of results and to translate these for evidence-based clinical practice. This review identifies gaps in the literature and methodological challenges for the implementation of RCTs of sensory interventions in the NICU. IMPACT This paper represents the first systematic review to investigate the effect of non-pharmacological, sensory-based interventions in the NICU on neonatal brain development. Although reviewed RCTs present evidence on the impact of such interventions on the neonatal brain following preterm birth, it is not yet possible to formulate clear guidelines for clinical practice. This review integrates existing literature on the effect of sensory-based interventions on the brain after preterm birth and identifies methodological challenges for the conduction of high-quality RCTs.
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Hakvoort L, Tönjes D. Music-mechanisms at the core of music therapy: Towards a format for a description of music therapy micro-interventions. NORDIC JOURNAL OF MUSIC THERAPY 2022. [DOI: 10.1080/08098131.2022.2070925] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Laurien Hakvoort
- Department of Music therapy, ArtEZ University of the Arts, Enschede, The Netherlands
- Muzis, Private Practice for Music Therapy, Netherlands
| | - Djemida Tönjes
- Department of Music therapy, ArtEZ University of the Arts, Enschede, The Netherlands
- Zorggroep Noorderboog, Meppel, Netherlands
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18
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Sadeghi Niaraki S, Pouraboli B, Safaiee Fakhr A, Mirlashari J, Ranjbar H. The Effect of Endotracheal Suctioning Using the Four-handed Care on Physiological Criteria and Behavioral Responses of the Preterm Infants: Randomized Crossover Clinical Trial. J Caring Sci 2022; 11:21-27. [PMID: 35603088 PMCID: PMC9012900 DOI: 10.34172/jcs.2022.09] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Accepted: 08/22/2021] [Indexed: 11/09/2022] Open
Abstract
Background: Endotracheal suctioning, despite its necessity, is one of the procedures that can cause pain and stress for infants admitted to neonatal intensive care units. Pain and stress manifest with physiological and behavioral responses in infants. Purpose: This study is a cross-sectional clinical trial that aimed to investigate the effect of endotracheal suctioning using four-handed care on the physiological criteria and behavioral responses of preterm infants. Methods:In this study, 40 infants were randomly divided into two groups of 20, one group was first suctioned by the routine method (two hands) and then with the four-handed method. The other group was first suctioned by the four-handed method and then with the routine one. The ALPS NEO was used to evaluate behavioral criteria. One camera recorded facial expressions and body movements, and physiological data were recorded from the monitor simultaneously. Results:Four-handed suctioning method can prevent an increase in heart rate during and two minutes after suctioning but it did not affect behavioral responses and oxygen saturation of the preterm infants admitted to NICUs. Since one of the symptoms of pain and stress in infants is the change of vital signs, especially the heart rate, stable heart rate during painful procedures can be an indication of the effectiveness of the four-hand method in invasive procedures such as suctioning. Implications for Practice: We recommend four-handed method for suctioning of endotracheal tube. Implications for Research: Evaluate the effect of four-handed care by mother on physiological criteria and behavioral responses of the preterm infants.
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Affiliation(s)
- Somayeh Sadeghi Niaraki
- Department of Pediatric and Neonatal Nursing, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Batool Pouraboli
- Department of Pediatric and Neonatal Nursing, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Aida Safaiee Fakhr
- Department of Public Health and Paraclinics, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Jila Mirlashari
- Department of Pediatric and Neonatal Nursing, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
- Department of OBGYN, Women’s Health Research Institute, University of British Columbia, Vancouver, BC, Canada
| | - Hadi Ranjbar
- Research Center for Mental Health, Iran University of Medical Sciences, Tehran, Iran
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Ferber SG, Als H, McAnulty G, Klinger G, Weller A. Multi-level hypothalamic neuromodulation of self-regulation and cognition in preterm infants: Towards a control systems model. COMPREHENSIVE PSYCHONEUROENDOCRINOLOGY 2022; 9:100109. [PMID: 35755927 PMCID: PMC9216652 DOI: 10.1016/j.cpnec.2021.100109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2021] [Accepted: 12/28/2021] [Indexed: 11/21/2022] Open
Abstract
Preterm infants, age-corrected for prematurity, score on average, 10 points lower on IQ tests than full-term infants tested at comparable ages. This review focuses on the potential contribution of the hypothalamus to cognitive neuro-regulatory development in preterm infants through its bidirectional neural connections with the prefrontal cortex and its neuroendocrine activity. It aims to clarify the central role of the hypothalamus in preterm high stress situations and in influencing cognitive development via its connectivity to the cerebral cortex. The review further evaluates epigenomic sensitivity to environmental inputs. Recent results suggest that an optimal range of DNA methylations (via a continuous process of decreasing levels of receptor methylations that are too high, and increasing levels that are too low) appears necessary in order to reach an adaptive level of receptor availability. Several studies have demonstrated amelioration of preterm infants' stress while in the Newborn Intensive Care Unit (NICUs) and following discharge. The authors postulate that feedback mechanisms and correction signals are the basis for a hypothalamic homeostatic modulating function, a "hypothalamic resistance response", which may account for the stress reduction brought about by in- and post-NICU early interventions and their results of promoting self-regulation and cognition.
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Key Words
- Cognitive
- Controlled process variable, (CPV)
- Corticotropin-releasing hormone, (CRH)
- Epigenetics
- Hypothalamic pituitary adrenal axis, (HPA axis)
- Hypothalamic pituitary gonadal axis, (HPG axis)
- Hypothalamic pituitary thyroid axis, (HPT axis)
- Hypothalamus
- Lateral hypothalamus, (LH)
- Magnetic resonance imaging, (MRI)
- Neuro-regulatory development
- Newborn intensive care unit, (NICU)
- Oxytocin, (OT)
- Prefrontal cortex
- Prefrontal cortex, (PFC)
- Premature infants
- Set point, (SP)
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Affiliation(s)
- Sari Goldstein Ferber
- Department of Psychology and the Leslie and Susan Gonda (Goldschmied) Multidisciplinary Brain Research Center, Bar Ilan University, Ramat Gan, Israel
| | - Heidelise Als
- Department of Psychiatry, Boston Children's Hospital and Harvard Medical School, Boston, MA, USA
| | - Gloria McAnulty
- Department of Psychiatry, Boston Children's Hospital and Harvard Medical School, Boston, MA, USA
| | - Gil Klinger
- Department of Neonatology, Schneider Children's Medical Center, Sackler Medical School, Tel Aviv University, Petach Tikvah, Israel
| | - Aron Weller
- Department of Psychology and the Leslie and Susan Gonda (Goldschmied) Multidisciplinary Brain Research Center, Bar Ilan University, Ramat Gan, Israel
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Goldstein Ferber S, Weller A, Ben-Shachar M, Klinger G, Geva R. Development of the Ontogenetic Self-Regulation Clock. Int J Mol Sci 2022; 23:993. [PMID: 35055184 PMCID: PMC8778416 DOI: 10.3390/ijms23020993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 01/07/2022] [Accepted: 01/15/2022] [Indexed: 01/27/2023] Open
Abstract
To date, there is no overarching proposition for the ontogenetic-neurobiological basis of self-regulation. This paper suggests that the balanced self-regulatory reaction of the fetus, newborn and infant is based on a complex mechanism starting from early brainstem development and continuing to progressive control of the cortex over the brainstem. It is suggested that this balance occurs through the synchronous reactivity between the sympathetic and parasympathetic systems, both which originate from the brainstem. The paper presents an evidence-based approach in which molecular excitation-inhibition balance, interchanges between excitatory and inhibitory roles of neurotransmitters as well as cardiovascular and white matter development across gestational ages, are shown to create sympathetic-parasympathetic synchrony, including the postnatal development of electroencephalogram waves and vagal tone. These occur in developmental milestones detectable in the same time windows (sensitive periods of development) within a convergent systematic progress. This ontogenetic stepwise process is termed "the self-regulation clock" and suggest that this clock is located in the largest connection between the brainstem and the cortex, the corticospinal tract. This novel evidence-based new theory paves the way towards more accurate hypotheses and complex studies of self-regulation and its biological basis, as well as pointing to time windows for interventions in preterm infants. The paper also describes the developing indirect signaling between the suprachiasmatic nucleus and the corticospinal tract. Finally, the paper proposes novel hypotheses for molecular, structural and functional investigation of the "clock" circuitry, including its associations with other biological clocks. This complex circuitry is suggested to be responsible for the developing self-regulatory functions and their neurobehavioral correlates.
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Affiliation(s)
- Sari Goldstein Ferber
- Department of Psychology, Bar Ilan University, Ramat Gan 5290002, Israel; (A.W.); (R.G.)
- The Leslie and Susan Gonda (Goldschmied) Multidisciplinary Brain Research Center, Bar Ilan University, Ramat Gan 5290002, Israel;
| | - Aron Weller
- Department of Psychology, Bar Ilan University, Ramat Gan 5290002, Israel; (A.W.); (R.G.)
- The Leslie and Susan Gonda (Goldschmied) Multidisciplinary Brain Research Center, Bar Ilan University, Ramat Gan 5290002, Israel;
| | - Michal Ben-Shachar
- The Leslie and Susan Gonda (Goldschmied) Multidisciplinary Brain Research Center, Bar Ilan University, Ramat Gan 5290002, Israel;
| | - Gil Klinger
- Department of Neonatology, Schneider Children’s Medical Center, Sackler Medical School, Tel Aviv University, Petach Tikvah 4920235, Israel;
| | - Ronny Geva
- Department of Psychology, Bar Ilan University, Ramat Gan 5290002, Israel; (A.W.); (R.G.)
- The Leslie and Susan Gonda (Goldschmied) Multidisciplinary Brain Research Center, Bar Ilan University, Ramat Gan 5290002, Israel;
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Brandon DH, Hatch D, Barnes A, Vance AJ, Harney J, Voigtman B, Younge N. Impact of diaper change frequency on preterm infants' vital sign stability and skin health: A RCT. Early Hum Dev 2022; 164:105510. [PMID: 34896732 PMCID: PMC8886570 DOI: 10.1016/j.earlhumdev.2021.105510] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 11/05/2021] [Accepted: 11/17/2021] [Indexed: 01/19/2023]
Abstract
BACKGROUND Bundling nurse caregiving interventions are promoted to minimize infant stress. PURPOSE To evaluate impact of bundled nursing care and diaper change frequency on vital sign stability and skin health of preterm infants born ≤32 weeks gestation. METHOD Stable preterm infants on a 3-hour feeding schedule were randomly assigned to 3- vs. 6-hour diaper changes. Diapers were changed prior to 6 h if stool was present. Direct observation of bundled care events (BCE) identify caregiving activities during each BCE. Skin pH, transepidermal water loss (TEWL), and neonatal skin condition scores (NSCS) were obtained. Vital sign data (HR, RR, O2 saturation) was downloaded from bedside monitors. RESULTS Forty-six infants contributed to 605 BCEs. BCEs lasted on average 28 min and included nine different activities (e.g., vital signs, feeding). Significant increases in heart rate during BCEs occurred in approximately half of the observations. Among observations with a diaper change increases in heart rate during diapering occurred in over 74% of observations Infants who were awake at the beginning of BCEs had 48% lower odds of having a change in heart rate than infants who were sleeping (p = .02). There were no group differences (3- vs. 6-hour diaper change) in skin health outcomes (TEWL, pH, NSCS). CONCLUSION Reducing diaper change frequency without stool present should be considered to minimize caregiving stress in preterm infants. Additional research should evaluate the intrusiveness and clusters of activities that significantly impact physiologic stability to better individualize the timing of routine yet intrusive activities. Clinicaltrials.gov registry # NCT03370757.
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Affiliation(s)
- Debra H. Brandon
- Duke University School of Nursing, DUMC 3322, 307 Trent Drive, Durham, NC 27710,Duke University School of Medicine, Department of Pediatrics, DUMC 2739, Duke University Hospital, Durham, NC 27710
| | - Daniel Hatch
- Duke University School of Nursing, DUMC 3322, 307 Trent Drive, Durham, NC 27710, United States of America.
| | - Angel Barnes
- Duke University School of Nursing, DUMC 3322, 307 Trent Drive, Durham, NC 27710, United States of America.
| | - Ashlee J. Vance
- Duke University School of Nursing, DUMC 3322, 307 Trent Drive, Durham, NC 27710
| | - Jane Harney
- Duke University School of Nursing, DUMC 3322, 307 Trent Drive, Durham, NC 27710, United States of America.
| | - Barbara Voigtman
- Kimberly Clark Corporation South Office, 2001 Marathon Avenue, Neenah, WI 54956, United States of America.
| | - Noelle Younge
- Duke University School of Medicine, Department of Pediatrics, Duke University Hospital, DUMC 2739, Durham, NC 27710, United States of America.
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22
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Mohan A, Gokulakrishnan G, El‐Saie A, Brickley A, Hagan J, Pammi M. Music therapy for preterm neonates in the neonatal intensive care unit: An overview of systematic reviews. Acta Paediatr 2021; 110:3180-3200. [PMID: 34346112 DOI: 10.1111/apa.16055] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 07/26/2021] [Accepted: 08/02/2021] [Indexed: 01/08/2023]
Abstract
AIM To summarise the quantity and quality of evidence for using music therapy for preterm infants in the neonatal intensive care unit (NICU). METHODS We performed an overview of evidence for the effectiveness and safety of MT for preterm infants in the NICU. We performed a random-effects meta-analysis of data from studies that fit the definition of MT. RESULTS We identified 12 eligible systematic reviews and the methodological quality by AMSTAR-2 ranged from moderate to critically low. We identified 14 eligible randomised trials and 7 observational studies where the intervention fits the definition of MT. Meta-analysis of the RCTs showed that MT significantly decreases heart rate, mean difference (MD) (95% CI), -3.21 [-5.22, -1.19], respiratory rate, MD -2.93 [-5.65, -0.22], and maternal anxiety, MD -17.50 [-20.10, -14.90], and increases feeding volume, MD 29.59 [12.79, 46.38]. Long-term neurodevelopmental or safety outcomes were not reported. GRADE assessment of outcomes ranged from low to very low, downgraded for high risk of bias in the included studies, inconsistency and imprecision. CONCLUSION Low to very low certainty evidence suggests that MT in preterm infants improves short-term physiological parameters, feeding and maternal anxiety but safety and long-term outcomes were not reported.
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Affiliation(s)
| | - Ganga Gokulakrishnan
- Section of Neonatology Department of Pediatrics Baylor College of Medicine and Texas Children’s Hospital Houston TX USA
| | - Ahmed El‐Saie
- Section of Neonatology Department of Pediatrics Baylor College of Medicine and Texas Children’s Hospital Houston TX USA
| | - Alix Brickley
- Children’s Hospital Colorado in the Ponzio Creative Arts Therapy Program Denver CO USA
| | - Joseph Hagan
- Section of Neonatology Department of Pediatrics Baylor College of Medicine and Texas Children’s Hospital Houston TX USA
| | - Mohan Pammi
- Section of Neonatology Department of Pediatrics Baylor College of Medicine and Texas Children’s Hospital Houston TX USA
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23
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Papatzikis E, Elhalik M, Inocencio SAM, Agapaki M, Selvan RN, Muhammed FS, Haroon NA, Dash SK, Sofologi M, Bezoni A. Key Challenges and Future Directions When Running Auditory Brainstem Response (ABR) Research Protocols with Newborns: A Music and Language EEG Feasibility Study. Brain Sci 2021; 11:brainsci11121562. [PMID: 34942864 PMCID: PMC8699561 DOI: 10.3390/brainsci11121562] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Revised: 11/18/2021] [Accepted: 11/19/2021] [Indexed: 11/25/2022] Open
Abstract
Although many musical intervention studies exist in the wider framework of neuroscience and psychology, the preliminary importance of feasibility studies is rarely discussed. Adding to this fact the limited research existing on the therapeutic and restorative potential of music exposure during early developmental periods, pushed us to concentrate on investigating newborns’ perception of music and its impact on the brain. Here, we explore the feasibility of a randomized controlled trial (RCT) approach when measuring and comparing the neurophysiological perception of music versus language on the brainstem of newborns using auditory brainstem response (ABR). Twenty-five healthy full-term infants were recruited, eight of which were measured within their first 10 days postpartum. The evaluation of the study’s feasibility appealed to five main objectives that essentially answer the question: Can our protocol work? Each objective proposes questions based on Orsmond and Cohn’s guiding framework, designed to assess, and assist feasibility in understanding barriers toward a study’s success. Our results justify that newborns are well capable of undergoing the study and given meticulous considerations and improvements on the intervention resources. The procedure’s communication and technical obstacles are resoluble. Moreover, assimilation of external factors to adapt, such as the culture variation and the ABR protocol implementation are necessary. The study was well received in the selected region (Middle East), and the recording procedure showed potential outcomes for a comprehensive RCT.
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Affiliation(s)
- Efthymios Papatzikis
- Department of Early Childhood Education and Care, Oslo Metropolitan University, 0167 Oslo, Norway
- Correspondence:
| | - Mahmoud Elhalik
- Neonatal Intensive Care Unit, Latifa Women and Children’s Hospital, Dubai 9115, United Arab Emirates; (M.E.); (F.S.M.); (N.A.H.); (S.K.D.)
| | | | | | - Rosari Naveena Selvan
- Institute for Physics 3—Biophysics and Bernstein Center for Computational Neuroscience, University of Göttingen, 37073 Göttingen, Germany;
- Department of Psychology, University of Münster, 48149 Münster, Germany
| | - Faseela Shejeed Muhammed
- Neonatal Intensive Care Unit, Latifa Women and Children’s Hospital, Dubai 9115, United Arab Emirates; (M.E.); (F.S.M.); (N.A.H.); (S.K.D.)
| | - Nazreen Abdulla Haroon
- Neonatal Intensive Care Unit, Latifa Women and Children’s Hospital, Dubai 9115, United Arab Emirates; (M.E.); (F.S.M.); (N.A.H.); (S.K.D.)
| | - Swarup Kumar Dash
- Neonatal Intensive Care Unit, Latifa Women and Children’s Hospital, Dubai 9115, United Arab Emirates; (M.E.); (F.S.M.); (N.A.H.); (S.K.D.)
| | - Maria Sofologi
- Psychology Laboratory, Department of Early Childhood Education, School of Education, University of Ioannina, 45110 Ioannina, Greece;
- Institute of Humanities and Social Sciences, University Research Centre of Ioannina, 45110 Ioannina, Greece
| | - Antonia Bezoni
- Department of Midwifery, Røyken Health Station, 3440 Røyken, Norway;
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24
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Mikulis N, Inder TE, Erdei C. Utilising recorded music to reduce stress and enhance infant neurodevelopment in neonatal intensive care units. Acta Paediatr 2021; 110:2921-2936. [PMID: 34107110 DOI: 10.1111/apa.15977] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 06/02/2021] [Accepted: 06/08/2021] [Indexed: 12/01/2022]
Abstract
AIM This paper summarises published evidence on the use of recorded music in high-risk infants to reduce stress and improve neurodevelopment, forming recommendations for proposed clinical applications in neonatal intensive care units. METHODS We searched two comprehensive library catalogues and two databases for articles evaluating the impact of recorded music interventions on hospitalised preterm infants. Original and review papers published in English in the 10 years prior to this search were selected if the study included a component of recorded music interventions. RESULTS Most original studies (80.95%) and all literature reviews (100%) reported positive effects of recorded music interventions for preterm infants, primarily in the short term. No negative effects were reported. Evidence is emerging regarding the neurobiological mechanisms of recorded music on longer-term effects on preterm infant neurodevelopment. Clinical applications were suggested drawing upon available evidence. Due to generally small sample sizes and variability in study design, unanswered questions remain. CONCLUSION Carefully designed recorded music interventions appear to be safe, feasible and effective in reducing stress and improving neurodevelopment of hospitalised infants. Additional rigorous, well-powered trials with relevant outcomes are needed to further refine specific elements for recorded music interventions to better inform practice.
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Affiliation(s)
- Nicole Mikulis
- Brigham and Women's Hospital, Pediatric Newborn Medicine Boston Massachusetts USA
| | - Terrie E. Inder
- Brigham and Women's Hospital, Pediatric Newborn Medicine Boston Massachusetts USA
- Harvard Medical School Boston Massachusetts USA
| | - Carmina Erdei
- Brigham and Women's Hospital, Pediatric Newborn Medicine Boston Massachusetts USA
- Harvard Medical School Boston Massachusetts USA
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25
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Ren H, Zou L, Wang L, Lu C, Yuan Y, Dai C, Chen W. Evaluation of the Short-Term Music Therapy on Brain Functions of Preterm Infants Using Functional Near-Infrared Spectroscopy. Front Neurol 2021; 12:649340. [PMID: 34650500 PMCID: PMC8505667 DOI: 10.3389/fneur.2021.649340] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Accepted: 08/19/2021] [Indexed: 11/23/2022] Open
Abstract
Music contains substantial contents that humans can perceive and thus has the capability to evoke positive emotions. Even though neonatal intensive care units (NICUs) can provide preterm infants a developmental environment, they still cannot fully simulate the environment in the womb. The reduced maternal care would increase stress levels in premature infants. Fortunately, music intervention has been proved that it can improve the NICU environment, such as stabilize the heart rate and the respiratory rate, reduce the incidence of apnea, and improve feeding. However, the effects of music therapy on the brain development of preterm infants need to be further investigated. In this paper, we evaluated the influence of short-term music therapy on the brain functions of preterm infants measured by functional near-infrared spectroscopy (fNIRS). We began by investigating how premature babies perceive structural information of music by calculating the correlations between music features and fNIRS signals. Then, the influences of short-term music therapy on brain functions were evaluated by comparing the resting-state functional connectivity before and after the short-term music therapy. The results show that distinct brain regions are responsible for processing corresponding musical features, indicating that preterm infants have the capability to process the complex musical content. However, the results of network analysis show that short-term music intervention is insufficient to cause the changes in cerebral functional connectivity. Therefore, long-term music therapy may be required to achieve the deserved effects on brain functional connectivity.
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Affiliation(s)
- Haoran Ren
- School of Information Science and Technology, The Center for Intelligent Medical Electronics, Fudan University, Shanghai, China
| | - Liangyan Zou
- Department of Neonatology, Children's Hospital of Fudan University, Shanghai, China
| | - Laishuan Wang
- Department of Neonatology, Children's Hospital of Fudan University, Shanghai, China
| | - Chunmei Lu
- Department of Neonatology, Children's Hospital of Fudan University, Shanghai, China
| | - Yafei Yuan
- School of Information Science and Technology, The Center for Intelligent Medical Electronics, Fudan University, Shanghai, China
| | - Chenyun Dai
- School of Information Science and Technology, The Center for Intelligent Medical Electronics, Fudan University, Shanghai, China
| | - Wei Chen
- School of Information Science and Technology, The Center for Intelligent Medical Electronics, Fudan University, Shanghai, China.,Shanghai Key Laboratory of Medical Imaging Computing and Computer Assisted Intervention, Shanghai, China
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26
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Individualized Family-Centered Developmental Care: A Model for High-Quality Care. J Perinat Neonatal Nurs 2021; 35:294-297. [PMID: 34726644 DOI: 10.1097/jpn.0000000000000609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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27
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Bieleninik Ł, Ettenberger M, Epstein S, Elefant C, Arnon S. Potential Psychological and Biological Mechanisms Underlying the Effectiveness of Neonatal Music Therapy during Kangaroo Mother Care for Preterm Infants and Their Parents. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:8557. [PMID: 34444304 PMCID: PMC8394319 DOI: 10.3390/ijerph18168557] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 08/06/2021] [Accepted: 08/11/2021] [Indexed: 12/11/2022]
Abstract
Neonatal music therapy (MT) has become more accessible worldwide. Previous research suggests multiple benefits of MT for preterm infants and their caregivers; however, far too little attention has been paid to understanding the mechanisms of change in previous Neonatal Intensive Care Unit (NICU)-MT research so far. This perspective article describes potential mechanisms of MT interventions exposed during kangaroo mother care on the preterm infant's response (behavioral and physiological outcomes) and the mother-infant relationship. The paper focuses on the hypothalamic-pituitary-adrenal axis' role in stabilization of behavioral state, the autonomic nervous system's role in stabilization of physiologic state, as well as co-regulation as a potential mechanism for the developing of the parent-infant relationship. Mechanisms play a pivotal role in understanding variables related to the therapy course and well as in generating new knowledge regarding treatment susceptibility and optimizing resources. Understanding of the mechanisms of how interventions may lead to specific outcomes plays an important role in addressing the issue of improvement of currently available approaches of MT used in the NICU.
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Affiliation(s)
- Łucja Bieleninik
- Department of Clinical and Health Psychology, Faculty of Social Sciences, Institute of Psychology, University of Gdansk, 80-309 Gdansk, Poland
- GAMUT—The Grieg Academy Music Therapy Research Centre, NORCE Norwegian Research Centre AS, 5029 Bergen, Norway
| | - Mark Ettenberger
- Music Therapy Service, University Hospital Fundación Santa Fe de Bogotá, Bogotá 110111, Colombia;
- SONO—Centro de Musicoterapia, Bogotá 110221, Colombia
| | - Shulamit Epstein
- School for Creative Arts Therapies, University of Haifa, Haifa 3498838, Israel; (S.E.); (C.E.)
| | - Cochavit Elefant
- School for Creative Arts Therapies, University of Haifa, Haifa 3498838, Israel; (S.E.); (C.E.)
| | - Shmuel Arnon
- Department of Neonatology, Meir Medical Center, Kfar Saba 44281, Israel;
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 69978, Israel
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28
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Palazzi A, Meschini R, Piccinini CA. NICU music therapy effects on maternal mental health and preterm infant's emotional arousal. Infant Ment Health J 2021; 42:672-689. [PMID: 34378804 DOI: 10.1002/imhj.21938] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2020] [Accepted: 07/01/2021] [Indexed: 12/21/2022]
Abstract
In recent decades, music therapy in the Neonatal Intensive Care Unit (NICU) has been shown to regulate preterm infant's physiological responses and improve maternal mental health. This study investigated the effects of the music therapy intervention for the mother-preterm infant dyad (MUSIP) for maternal anxiety, postnatal depression, and stress, and preterm infants' weight gain, length of hospitalization, heart rate (HR), and oxygen saturation (So2 ). A pre-experimental design was used with 33 mother-preterm infant dyads in a Brazilian NICU: 16 dyads in the Music Therapy Group (MTG) and 17 dyads in the Control Group (CG). The MTG took part in the MUSIP, aimed at supporting maternal singing with the preterm baby. Infants' HR and So2 were recorded at each minute from 10 min before to 10 min after sessions 1, 3, and 6. Before infants' discharge, maternal anxiety and depression scores were lower in the MTG compared to the CG. Anxiety, depression, and stress levels decreased significantly after the intervention in the MTG. With regard to infants, HR and So2 ranges were higher during music therapy, compared to before and after sessions. MUSIP improved maternal mental health and affected preterm infants' emotional arousal, with positive trends in decreasing HR, stabilizing So2 , and reducing length of hospitalization.
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Affiliation(s)
- Ambra Palazzi
- Universidade Federal do Rio Grande do Sul (UFRGS), Psychology Institute, Porto Alegre, Brazil
| | - Rita Meschini
- S. Stefano Rehabilitation Institute, Porto Potenza Picena (MC), Italy
| | - Cesar Augusto Piccinini
- Universidade Federal do Rio Grande do Sul (UFRGS), Psychology Institute, Porto Alegre, Brazil
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29
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Kobus S, Diezel M, Dewan MV, Huening B, Dathe AK, Felderhoff-Mueser U, Bruns N. Music Therapy Is Effective during Sleep in Preterm Infants. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18168245. [PMID: 34443994 PMCID: PMC8391215 DOI: 10.3390/ijerph18168245] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/27/2021] [Revised: 07/29/2021] [Accepted: 07/30/2021] [Indexed: 11/16/2022]
Abstract
Recent research found evidence supporting music therapy for preterm infants to stabilize vital signs and possibly promote neurodevelopment. Even though preterm infants spend a considerable amount of time sleeping, the effectiveness of music therapy during sleep has not been studied. The aim of this study was to investigate the effect of music therapy on preterm infants' vital signs with respect to the state of wakefulness. The first 20 consecutive infants born with <32 weeks' gestational age (GA) from the intervention group of an ongoing randomized controlled trial received live music therapy twice a week until hospital discharge. The heart rate, respiratory rate, oxygen saturation, and state of wakefulness were recorded before and after therapy. We observed significantly lower heart and respiratory rates and higher oxygen saturation after live music therapy sessions in general (mean differences -4.9 beats per min; -7.0 breaths per min and +1.5%, respectively). When music therapy was applied during sleep, respiratory rates significantly lowered by 8.8 breaths per min and oxygen saturation increased by 1.6%, whereas in the awake state the vital parameters did not significantly change (heart rate -5.2 beats per min; respiratory rate +0.6 breaths per min and oxygen saturation +1.0%). Music therapy stabilized the respiratory rates and oxygen saturations in sleeping preterm infants.
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30
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Bos M, Dokkum NH, Ravensbergen A, Kraft KE, Bos AF, Jaschke AC. Pilot study finds that performing live music therapy in intensive care units may be beneficial for infants' neurodevelopment. Acta Paediatr 2021; 110:2350-2351. [PMID: 33811376 PMCID: PMC8360105 DOI: 10.1111/apa.15867] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Revised: 03/29/2021] [Accepted: 03/31/2021] [Indexed: 11/29/2022]
Affiliation(s)
- Mai Bos
- Division of Neonatology Department of Pediatrics Beatrix Children’s Hospital University Medical Center Groningen University of Groningen Groningen The Netherlands
| | - Nienke H. Dokkum
- Division of Neonatology Department of Pediatrics Beatrix Children’s Hospital University Medical Center Groningen University of Groningen Groningen The Netherlands
| | - Anne‐Greet Ravensbergen
- Division of Neonatology Department of Pediatrics Beatrix Children’s Hospital University Medical Center Groningen University of Groningen Groningen The Netherlands
- Department of Music Therapy ArtEZ University of the Arts Enschede The Netherlands
| | - Karianne E. Kraft
- Division of Neonatology Department of Pediatrics Beatrix Children’s Hospital University Medical Center Groningen University of Groningen Groningen The Netherlands
| | - Arend F. Bos
- Division of Neonatology Department of Pediatrics Beatrix Children’s Hospital University Medical Center Groningen University of Groningen Groningen The Netherlands
| | - Artur C. Jaschke
- Division of Neonatology Department of Pediatrics Beatrix Children’s Hospital University Medical Center Groningen University of Groningen Groningen The Netherlands
- Department of Music Therapy ArtEZ University of the Arts Enschede The Netherlands
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Hasegawa Y, Hoshiyama M. Effect of environmental music on autonomic function in infants in intensive and growing care units. J Neonatal Perinatal Med 2021; 13:395-401. [PMID: 31771074 DOI: 10.3233/npm-180174] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
BACKGROUND The aim of this study is (1) to observe the effect of the background music (BGM) in the incubator on heart rate variability (HRV) during the first few weeks of life in preterm infants in the neonatal intensive (NICU) and growing care units (GCU) and (2) to investigate the effect of environmental music on autonomic function in the infants. METHODS Thirty infants, including premature (26 3/7 - 38 4/7 weeks) and low-birth weight (LBW) (946-2,440 g) infants, admitted to the NICU or GCU were involved. The heart rate, low- (LF, 0.05-0.15 Hz) and high- (HF, 0.15-0.4 Hz) frequency HRV components, and LF/HF ratio were measured. The BGM, lullabies for a baby, was delivered through a speaker in the incubator, and the HRV components were compared among before, during, and after intervention with BGM. RESULTS The mean HR did not change among the experimental conditions. The LF and HF values decreased during the BGM condition, but not LF/HF, compared with the condition before BGM. CONCLUSIONS The present results showed that an auditory environment affected the autonomic function of infants with a range of BGM in the NICU/GCU. The present study also suggested that BGM, a non-invasive and non-pharmacological intervention, could be an evaluation tool for autonomic function in infants in NICU/GCU.
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Affiliation(s)
- Y Hasegawa
- Department of Rehabilitation Sciences, Graduate School of Health Sciences, Nagoya University, Nagoya, Japan
| | - M Hoshiyama
- Brain and Mind Research Center, Nagoya University, Higashi-ku, Nagoya, Japan
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32
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Liu Y, Li ZF, Zhong YH, Zhao ZH, Deng WX, Chen LL, Liu BB, Du TJ, Zhang Y. Early combined rehabilitation intervention to improve the short-term prognosis of premature infants. BMC Pediatr 2021; 21:269. [PMID: 34107905 PMCID: PMC8188692 DOI: 10.1186/s12887-021-02727-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Accepted: 05/20/2021] [Indexed: 11/26/2022] Open
Abstract
Background To explore the clinical effect of early combined rehabilitation intervention on premature infants in the neonatal intensive care unit (NICU). Methods Premature infants with gestational ages less than 32 weeks or birth weights less than 1500 g were included in the present study.The participants were divided into the intervention group and control group. All infants received the current routine treatment based on the clinical guidelines, and the intervention group was additionally treated by visual and auditory stimulation, oral motor function, respiratory function and neurodevelopmental training. The following clinical outcomes were compared: durations of oxygen supplementation and indwelling gastric tube use; incidences of retinopathy of prematurity (ROP) and neonatal necrotizing enterocolitis (NEC); Sliverman scores; incidences of bronchopulmonary dysplasia (BPD) and intraventricular haemorrhage; days of hospitalization; and neurodevelopmental outcomes. Datas were analysed using the following statistical tests: the chi-square test, the independent samples or paired t test, repeated measures ANOVA, and the Wilcoxon rank sum test. Results Compared with those in the control group, premature infants in the intervention group had shorter durations of oxygen supplementation and indwelling gastric tube use, fewer hospitalization days and lower incidences of ROP, BPD, and NEC.The intervention group had lower Sliverman scores and higher Ballard neuromuscular scores than the control group. Conclusion Early combined rehabilitation intervention can improve the short-term clinical outcomes of premature infants.
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Affiliation(s)
- Yang Liu
- Department of Neonatology, Sichuan Provincial Maternity and Child Health Care Hospital, No. 290 West Second Street, Shayan Road, Chengdu, 610031, Sichuan, China.,Sichuan Provincial Maternity and Child Health Care Hospital, Chengdu, 610031, Sichuan Province, China
| | - Zheng-Feng Li
- Department of Neonatology, Sichuan Provincial Maternity and Child Health Care Hospital, No. 290 West Second Street, Shayan Road, Chengdu, 610031, Sichuan, China.,Sichuan Provincial Maternity and Child Health Care Hospital, Chengdu, 610031, Sichuan Province, China
| | - Yun-Huan Zhong
- Department of Neonatology, Sichuan Provincial Maternity and Child Health Care Hospital, No. 290 West Second Street, Shayan Road, Chengdu, 610031, Sichuan, China.,Sichuan Provincial Maternity and Child Health Care Hospital, Chengdu, 610031, Sichuan Province, China
| | - Zhi-Hui Zhao
- Department of Neonatology, Sichuan Provincial Maternity and Child Health Care Hospital, No. 290 West Second Street, Shayan Road, Chengdu, 610031, Sichuan, China.,Sichuan Provincial Maternity and Child Health Care Hospital, Chengdu, 610031, Sichuan Province, China
| | - Wen-Xin Deng
- Department of Neonatology, Sichuan Provincial Maternity and Child Health Care Hospital, No. 290 West Second Street, Shayan Road, Chengdu, 610031, Sichuan, China.,Sichuan Provincial Maternity and Child Health Care Hospital, Chengdu, 610031, Sichuan Province, China
| | - Ling-Ling Chen
- Department of Neonatology, Sichuan Provincial Maternity and Child Health Care Hospital, No. 290 West Second Street, Shayan Road, Chengdu, 610031, Sichuan, China.,Sichuan Provincial Maternity and Child Health Care Hospital, Chengdu, 610031, Sichuan Province, China
| | - Bei-Bei Liu
- Department of Neonatology, Sichuan Provincial Maternity and Child Health Care Hospital, No. 290 West Second Street, Shayan Road, Chengdu, 610031, Sichuan, China.,Sichuan Provincial Maternity and Child Health Care Hospital, Chengdu, 610031, Sichuan Province, China
| | - Tao-Jun Du
- Department of Neonatology, Sichuan Provincial Maternity and Child Health Care Hospital, No. 290 West Second Street, Shayan Road, Chengdu, 610031, Sichuan, China.,Sichuan Provincial Maternity and Child Health Care Hospital, Chengdu, 610031, Sichuan Province, China
| | - Yong Zhang
- Department of Neonatology, Sichuan Provincial Maternity and Child Health Care Hospital, No. 290 West Second Street, Shayan Road, Chengdu, 610031, Sichuan, China. .,Sichuan Provincial Maternity and Child Health Care Hospital, Chengdu, 610031, Sichuan Province, China.
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Bernadou-Debrulle F, Sudres JL, Lenoir-Piat S, Lamotte P, Bouchard JP. [Prematurity and music therapy: harmonic encounters?]. REVUE DE L'INFIRMIÈRE 2020; 70:37-39. [PMID: 33608096 DOI: 10.1016/j.revinf.2020.12.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Premature birth can cause complications of varying nature and intensity in the child's development. The developmental care given to babies born prematurely is of major importance to their physical and psychological development. After clinical assessment, music therapy can be integrated into this care. It is a source of observed benefits.
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Affiliation(s)
| | - Jean-Luc Sudres
- Université Toulouse-Jean-Jaurès, 5, allée Antonio-Machado, 31058 Toulouse cedex 9, France
| | - Sylvie Lenoir-Piat
- Nouvelle clinique de L'Union, boulevard de Ratalens, Saint-Jean, BP 36, 31243 L'Union, France
| | - Pascale Lamotte
- Nouvelle clinique de L'Union, boulevard de Ratalens, Saint-Jean, BP 36, 31243 L'Union, France
| | - Jean-Pierre Bouchard
- Institut psycho-judiciaire et de psychopathologie (IPJP), Institute of Forensic Psychology and Psychopathology, centre hospitalier de Cadillac, 10, avenue Joseph-Caussil, 33410 Cadillac, France; Unité pour malades difficiles (UMD), pôle de psychiatrie médico-légale (PPML), centre hospitalier de Cadillac, 10, avenue Joseph-Caussil, 33410 Cadillac, France.
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Foroushani SM, Herman CA, Wiseman CA, Anthony CM, Drury SS, Howell MP. Evaluating physiologic outcomes of music interventions in the neonatal intensive care unit: a systematic review. J Perinatol 2020; 40:1770-1779. [PMID: 32737404 DOI: 10.1038/s41372-020-0756-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2019] [Revised: 06/02/2020] [Accepted: 07/22/2020] [Indexed: 11/09/2022]
Abstract
Music is widely used in the neonatal intensive care unit. The objectives of this systematic review are: (1) clarify the current literature in regards to the impact of music on neonatal physiologic parameters, (2) highlight the variability in definitions utilized for music interventions, and (3) provide a foundation for future music therapy research focused on influencing neonatal physiology. A systematic literature review was conducted in accordance with PRISMA guidelines, with search terms including "music," "music therapy," "neonates," "newborn," and "NICU." Four hundred and fifty-eight studies were reduced to 16 clinical trials divided based on methodological description of music intervention. Our review highlights variability in the existing literature specifically on neonatal physiological impact of music. Future studies should focus on consistent and well-defined data collection, utilization of standardized definitions for music interventions, and consideration of more sensitive markers of physiology, such as heart rate variability, to enhance study rigor and reproducibility.
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Affiliation(s)
| | - Cade A Herman
- School of Science and Engineering, Tulane University, New Orleans, LA, USA
| | - Carlie A Wiseman
- School of Science and Engineering, Tulane University, New Orleans, LA, USA
| | | | - Stacy S Drury
- Department of Psychiatry, Tulane University School of Medicine, New Orleans, LA, USA.,Department of Pediatrics, Tulane University School of Medicine, New Orleans, LA, USA
| | - Meghan P Howell
- Department of Pediatrics, Tulane University School of Medicine, New Orleans, LA, USA.
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Music therapy for neonatal stress and pain-music to our ears. J Perinatol 2020; 40:1734-1735. [PMID: 32999447 DOI: 10.1038/s41372-020-00838-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 07/31/2020] [Accepted: 09/18/2020] [Indexed: 12/26/2022]
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36
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Yue W, Han X, Luo J, Zeng Z, Yang M. Effect of music therapy on preterm infants in neonatal intensive care unit: Systematic review and meta-analysis of randomized controlled trials. J Adv Nurs 2020; 77:635-652. [PMID: 33200833 DOI: 10.1111/jan.14630] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2020] [Revised: 09/14/2020] [Accepted: 10/26/2020] [Indexed: 01/29/2023]
Abstract
AIM To systematically examine the effectiveness of music therapy on preterm infants in neonatal intensive care unit. BACKGROUND In recent years, the application of music therapy for preterm infants in neonatal intensive care unit has attracted more and more attention because of its clinical effects. However, there still exist disputes among different studies. DESIGN A systematic review and meta-analysis. DATA SOURCES Eleven databases were searched over the period from 1910 -4 November 2019. REVIEW METHODS Papers were selected for analysis in accordance with the PRISMA guidelines. The meta-analysis was carried out by using Review Manager 5.3 software. RESULTS A total of 13 trials involving 1,093 participants were included. Meta-analysis showed music therapy had a significant influence on preterm infant's heart rate, respiratory rate, oral feeding volume, stress level, and maternal anxiety with moderate-to-high heterogeneity among studies. Also, music therapy had no influences on oxygen saturation and behavioural state. CONCLUSIONS Music therapy can not only effectively improve preterm infant's heart rate, stable respiratory rate, and attenuate stress level but also exert positive impact on oral feeding volume. In addition, music therapy also plays a role in reducing maternal anxiety. However, due to the heterogeneity across studies in some outcomes, further studies with larger sample size and more stringent design should be conducted before recommendation. IMPACT Music therapy can significantly improve preterm infant's heart rate, respiratory rate, and stress level, as well as increase oral feeding volume. These results may exert a positive impact on well-being and quality of life in preterm infants in the neonatal intensive care unit. Hospitals can apply music therapy which has been considered a non-pharmacological and no-invasive treatment to preterm infants in the neonatal intensive care unit.
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Affiliation(s)
- Wei Yue
- School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Xinrui Han
- School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Jianghe Luo
- School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Zhumei Zeng
- School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Ming Yang
- School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou, China.,Guangzhou University City, Guangzhou, China
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Gebuza G, Kaźmierczak M, Leńska K. The effects of kangaroo mother care and music listening on physiological parameters, oxygen saturation, crying, awake state and sleep in infants in NICU. J Matern Fetal Neonatal Med 2020; 35:3659-3669. [PMID: 33081550 DOI: 10.1080/14767058.2020.1836619] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVE Kangaroo mother care and musical stimulation are recommended nursing interventions in the NICU. However, there is little research on the combination of kangaroo care with musical stimulation and their relationship with the health condition of infants. The aim of the study was to compare the parameters of the physiological state and behavior of infants during kangaroo mother care as well as kangaroo mother care and musical stimulation. STUDY DESIGN The study included 100 infants, with corrected gestational ages of 35 weeks, with an average body weight of 2704 g. During kangaroo care the child was supported by their parent, then musical stimulation was added to kangaroo care. Measurements were made in an incubator after the 1st and the 15th minute of each intervention. RESULTS Neonatal parameters differed in the incubator and during each intervention. During kangaroo care and kangaroo care and musical stimulation, heart rate (p < .0001), respiration rate (p < .0001), crying (p < .0001) and awake state (p < .0001) decreased, oxygen saturation levels (p < .0001) and the number of children who fell asleep (p < .0001) increased. During kangaroo care and musical stimulation significantly fewer children were awake (p = .0003) and more fell asleep (p < .0001) than after kangaroo care alone (p < .0001). CONCLUSIONS This study suggests that kangaroo care and kangaroo care and musical stimulation can be used to stabilize the physiological functions of infants. Kangaroo care and musical stimulation can be one of the most effective nursing interventions in the neonatal intensive care unit for the care of infants.
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Affiliation(s)
- Grażyna Gebuza
- Faculty of Health Sciences, Nicolaus Copernicus University in Torun, Torun, Poland
| | - Marzena Kaźmierczak
- Faculty of Health Sciences, Nicolaus Copernicus University in Torun, Torun, Poland
| | - Katarzyna Leńska
- Neonatal Intensive Care Unit, University Hospital No 2, Bydgoszcz, Poland
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Bieleninik Ł, Konieczna-Nowak L, Knapik-Szweda S, Kwaśniok J. Evaluating feasibility of the LongSTEP (Longitudinal study of music therapy’s effectiveness for premature infants and their caregivers) protocol with a Polish cohort. NORDIC JOURNAL OF MUSIC THERAPY 2020. [DOI: 10.1080/08098131.2020.1781233] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Łucja Bieleninik
- Department of Clinical Psychology and Neuropsychology; Institute of Psychology, University of Gdańsk, Gdańsk, Poland
- GAMUT – The Grieg Academy Music Therapy Research Centre, NORCE Norwegian Research Centre AS, Bergen, Norway
| | | | - Sara Knapik-Szweda
- The Karol Szymanowski Academy of Music in Katowice, Poland
- Department of Children’s Creativity and Expression in Pedagogy, Faculty of Pedagogy and Psychology, University of Silesia, Katowice, Poland
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Howard C, Powell AS, Pavlidis E, Pavel A, Finn D, Allen A, Olavarria‐Ramirez L, Clarke G, Livingstone V, Boylan GB, Dempsey EM. No effect of a musical intervention on stress response to venepuncture in a neonatal population. Acta Paediatr 2020; 109:511-517. [PMID: 31532835 DOI: 10.1111/apa.15018] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2019] [Revised: 08/04/2019] [Accepted: 09/16/2019] [Indexed: 11/29/2022]
Abstract
AIM To investigate the effect of a musical intervention on neonatal stress response to venepuncture as measured by salivary cortisol levels and pain profile scores. METHODS In a randomised control crossover trial, participants were randomised to both a control arm (sucrose) and intervention arm (sucrose and music) for routine venepuncture procedures. Salivary swabs were collected at baseline, 20 minutes post-venepuncture and 4 hours post-venepuncture. Pain levels were assessed using the Premature Infant Pain Profile (PIPP). A total of 16 preterm neonates participated in both arms to complete the study. RESULTS Cortisol values were elevated at all timepoints in the intervention arm (baseline, 20 minutes, and 4 hours post-procedure) but not significantly so (P = .056, P = .3, and P = .575, respectively). Median change in cortisol values from baseline was +128.48 pg/mL (-47.66 to 517.02) at 20 minutes and +393.52 pg/mL (47.88-1221.34) at 4 hours post-procedure in the control arm compared to -69.564 pg/mL (-860.96 to 397.289) and +100.48 pg/mL (-560.46 to 842.99) at 20 minutes and 4 hours post-procedure in the intervention arm. There was no statistically significant difference observed between groups (P = .311 at 20 minutes, and P = .203 at 4 hours post-procedure). PIPP scores were not significantly different between study arms. CONCLUSION Our findings did not support the additional benefit of music intervention on neonatal stress response to venepuncture in preterm infants.
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Affiliation(s)
- Caoimhe Howard
- Department of Paediatrics and Child Health Neonatal Intensive Care Unit Cork University Maternity Hospital Cork Ireland
| | - Anna S. Powell
- Department of Paediatrics and Child Health Neonatal Intensive Care Unit Cork University Maternity Hospital Cork Ireland
| | - Elena Pavlidis
- INFANT Irish Centre for Fetal and Neonatal Translational Research University College Cork Cork Ireland
| | - Andreea Pavel
- Department of Paediatrics and Child Health Neonatal Intensive Care Unit Cork University Maternity Hospital Cork Ireland
- INFANT Irish Centre for Fetal and Neonatal Translational Research University College Cork Cork Ireland
| | - Daragh Finn
- INFANT Irish Centre for Fetal and Neonatal Translational Research University College Cork Cork Ireland
| | - Andrew Allen
- APC Microbiome Ireland Biosciences Institute University College Cork Cork Ireland
| | | | - Gerard Clarke
- INFANT Irish Centre for Fetal and Neonatal Translational Research University College Cork Cork Ireland
- APC Microbiome Ireland Biosciences Institute University College Cork Cork Ireland
- Department of Psychiatry and Neurobehavioural Science University College Cork Cork Ireland
| | - Vicki Livingstone
- INFANT Irish Centre for Fetal and Neonatal Translational Research University College Cork Cork Ireland
| | - Geraldine B. Boylan
- Department of Paediatrics and Child Health Neonatal Intensive Care Unit Cork University Maternity Hospital Cork Ireland
- INFANT Irish Centre for Fetal and Neonatal Translational Research University College Cork Cork Ireland
| | - Eugene M. Dempsey
- Department of Paediatrics and Child Health Neonatal Intensive Care Unit Cork University Maternity Hospital Cork Ireland
- INFANT Irish Centre for Fetal and Neonatal Translational Research University College Cork Cork Ireland
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40
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Music therapy for preterm infants and their parents during NICU stay and beyond: current recommendations for clinical practice in Poland. HEALTH PSYCHOLOGY REPORT 2020. [DOI: 10.5114/hpr.2020.97346] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Filippa M, Lordier L, De Almeida JS, Monaci MG, Adam-Darque A, Grandjean D, Kuhn P, Hüppi PS. Early vocal contact and music in the NICU: new insights into preventive interventions. Pediatr Res 2020; 87:249-264. [PMID: 31266053 DOI: 10.1038/s41390-019-0490-9] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Accepted: 06/14/2019] [Indexed: 12/11/2022]
Abstract
It is now clearly established that the environment and the sensory stimuli, particularly during the perinatal period, have an impact on infant's development. During the last trimester of gestation, activity-dependent plasticity shapes the fetal brain, and prematurity has been shown to alter the typical developmental trajectories. In this delicate period, preventive interventions aiming at modulating these developmental trajectories through activity-inducing interventions are currently underway to be tested. The purpose of this review paper is to describe the potentialities of early vocal contact and music on the preterm infant's brain development, and their potential beneficial effect on early development. Scientific evidence supports a behavioral orientation of the newborn to organized sounds, such as those of voice and music, and recent neuroimaging studies further confirm full cerebral processing of music as multisensory stimuli. However, the impact of long-term effects of music exposure and early vocal contact on preterm infants' long-term neurodevelopment needs be further investigated. To conclude, it is necessary to establish the neuroscientific bases of the early perception and the long-term effects of music and early vocal contact on the premature newborns' development. Scientific projects are currently on the way to fill this gap in knowledge.
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Affiliation(s)
- Manuela Filippa
- Department of Women, Infants and Adolescents, Division of Development and Growth, University Children Hospital, University of Geneva, Geneva, Switzerland. .,University of Valle d'Aosta, Aosta, Italy. .,Neuroscience of Emotion and Affective Dynamics, Swiss Center for Affective Sciences, and Department of Psychology, Faculty of Psychology and Educational Sciences, University of Geneva, Geneva, Switzerland.
| | - Lara Lordier
- Department of Women, Infants and Adolescents, Division of Development and Growth, University Children Hospital, University of Geneva, Geneva, Switzerland
| | - Joana Sa De Almeida
- Department of Women, Infants and Adolescents, Division of Development and Growth, University Children Hospital, University of Geneva, Geneva, Switzerland
| | | | - Alexandra Adam-Darque
- Laboratory of Cognitive Neurorehabilitation, Department of Clinical Neuroscience, Division of Neurorehabilitation, University Hospital of Geneva and University of Geneva, Geneva, Switzerland
| | - Didier Grandjean
- Neuroscience of Emotion and Affective Dynamics, Swiss Center for Affective Sciences, and Department of Psychology, Faculty of Psychology and Educational Sciences, University of Geneva, Geneva, Switzerland
| | - Pierre Kuhn
- Service de Médecine et réanimation du nouveau-né, Hôpital de Hautepierre, CHU Strasbourg, Strasbourg, France
| | - Petra S Hüppi
- Department of Women, Infants and Adolescents, Division of Development and Growth, University Children Hospital, University of Geneva, Geneva, Switzerland
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van Dokkum NH, Jaschke AC, Ravensbergen AG, Reijneveld SA, Hakvoort L, de Kroon MLA, Bos AF. Feasibility of Live-Performed Music Therapy for Extremely and Very Preterm Infants in a Tertiary NICU. Front Pediatr 2020; 8:581372. [PMID: 33178653 PMCID: PMC7596259 DOI: 10.3389/fped.2020.581372] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Accepted: 09/08/2020] [Indexed: 01/06/2023] Open
Abstract
Objective: We aimed to investigate the feasibility of live-performed music therapy for extremely and very preterm infants admitted to the neonatal intensive care unit (NICU), and their parents, starting the 1st-2nd week after birth. They may benefit from live-performed music therapy as comforting non-pharmacological intervention. Study Design: We included infants born before 30 weeks' gestation in a single center NICU study. Live-performed music therapy was provided three times per week, tailored to the infant's medical condition. Parents were actively involved. Feasibility was determined as a combination of participation, drop-out, overstimulation (based on COMFORT-Neo scores), and evaluations of the intervention by parents and nurses (using a questionnaire on perceived effects on the parent, their infant and the NICU sound environment). Results: We included 18 infants (90% participation rate), with a gestational age of median 27 weeks (IQR 26-28 weeks), 61% males. One infant (5.6%) dropped-out. Differences of COMFORT-Neo scores during and after sessions compared with before sessions were non-significant; overstimulation by music therapy did not occur. Parents reported high satisfaction (highest score possible of 7) with the interventions and reported improvements in both infant and their own respiratory rates. Nurses also reported high satisfaction with the intervention and perceived a quieter NICU sound environment during and after sessions. Conclusion: Live-performed music therapy for extremely and very preterm infants is feasible and well-tolerated, and is experienced as an added value to developmental care. Future studies should assess both short-term and long-term effects, to determine whether this intervention should be part of routine care at the NICU and whether it is most beneficial to start shortly after birth.
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Affiliation(s)
- Nienke H van Dokkum
- Division of Neonatology, Department of Pediatrics, Beatrix Children's Hospital, University Medical Center Groningen, University of Groningen, Groningen, Netherlands.,Department of Health Sciences, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Artur C Jaschke
- Division of Neonatology, Department of Pediatrics, Beatrix Children's Hospital, University Medical Center Groningen, University of Groningen, Groningen, Netherlands.,Department of Music Therapy, ArtEZ University of the Arts, Enschede, Netherlands
| | - Anne-Greet Ravensbergen
- Division of Neonatology, Department of Pediatrics, Beatrix Children's Hospital, University Medical Center Groningen, University of Groningen, Groningen, Netherlands.,Department of Music Therapy, ArtEZ University of the Arts, Enschede, Netherlands
| | - Sijmen A Reijneveld
- Department of Health Sciences, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Laurien Hakvoort
- Department of Music Therapy, ArtEZ University of the Arts, Enschede, Netherlands
| | - Marlou L A de Kroon
- Department of Health Sciences, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Arend F Bos
- Division of Neonatology, Department of Pediatrics, Beatrix Children's Hospital, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
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Devi D, Rustina Y, Efendi D. The Effectiveness of Auditory Stimuli from Murottal Quran to Improve Comfort and Weight in Low Birth Weight Infants: Randomized Controlled Trial. JURNAL NERS 2019. [DOI: 10.20473/jn.v14i1.14823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Introduction: Low birth weight (LBW) infants who have been hospitalized are exposed to various conditions that provoke discomfort, which could trigger a stress response and growth disorders. This study aimed to identify the effects of auditory stimuli from Murottal Quran when it comes to the comfort and weight of LBW infants.Methods: This study used a clinical randomized controlled trial design involving 52 low birth weight infants. The infants were randomly assigned to either the intervention group (n=26) or the control (n=26). The intervention of Murottal Quran was given using a speaker 4 times a day for 20 minutes every 3 hours. This intervention was conducted for three days.Results: The results of this study show that there is a significant difference in the comfort of low birth weight infants after Murottal Qur’an on the first, second, and third days between the intervention and control groups (p=0.014; <0.001; <0.001). There was no significant difference in the weight between the intervention and control groups in the first, second, and third days (p=0.481; 0.481; 0.464).Conclusion: The auditory stimuli of Murottal Quran can help to improve the comfort level of low birth weight infants during hospitalization. It can therefore be used as a supportive therapy to facilitate low birth weight infant and premature infant development.
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Haslbeck FB, Karen T, Loewy J, Meerpohl JJ, Bassler D. Musical and vocal interventions to improve neurodevelopmental outcomes for preterm infants. Hippokratia 2019. [DOI: 10.1002/14651858.cd013472] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
| | - Tanja Karen
- University Hospital Zürich; Department of Neonatology; Frauenklinikstrasse 10 Zürich Switzerland
| | - Joanne Loewy
- The Louis Armstrong Center for Music and Medicine; Beth Israel Medical Center New York City USA
| | - Joerg J Meerpohl
- Medical Center - University of Freiburg, Faculty of Medicine; Institute for Evidence in Medicine (for Cochrane Germany Foundation); Breisacher Str. 153 Freiburg Germany D-79110
| | - Dirk Bassler
- University Hospital Zürich; Department of Neonatology; Frauenklinikstrasse 10 Zürich Switzerland
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The effects of musical auditory stimulation on heart rate autonomic responses to driving: A prospective randomized case-control pilot study. Complement Ther Med 2019; 46:158-164. [PMID: 31519273 DOI: 10.1016/j.ctim.2019.08.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2019] [Revised: 08/06/2019] [Accepted: 08/06/2019] [Indexed: 11/23/2022] Open
Abstract
Stress induced by driving has been revealed to increase the chances of cardiovascular complications and is involved or related to traffic accidents. In order to develop strategies to avoid health problems during driving we aimed to evaluate the acute effects of auditory stimulation with music on heart rate variability (HRV) during driving in congested urban traffic. This is a prospective cross-sectional randomized controlled pilot study conducted with five healthy women. Subjects were evaluated on two different random days, whose order of execution was established through a randomization process. In the music protocol the volunteers were exposed to music for the entire 20 min of traffic while in the control protocol the subjects performed the same procedures but were not exposed to any music. We noted that all Higuchi fractal dimension parameters except Kmax 10, Kmax 130 and Kmax 140 were reduced between pre-driving in the control protocol vs. driving in the control protocol. The same changes were noted between pre-driving in the music protocol vs. driving in the control protocol. In conclusion, musical auditory stimulation improved nonlinear HRV changes induced by driving.
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Abstract
Preterm babies are cared for in neonatal intensive care units (NICU), which are busy places with a lot of mechanical noise increasingly recognized to disrupt normal brain development. NICUs therefore invest in developmental care procedures, with music for example, but neurobiological evidence for these interventions is missing. We present results from a clinical trial to study the effects of a music intervention on preterm infants’ brain development. Based on resting-state fMRI, we provide evidence that music enhanced connectivity in a brain circuitry involving the salience network with regions implicated in sensory and higher-order cognitive functions, previously found to be altered in preterm infants. To our knowledge, this study is unique in observing an impact of music on brain development in preterm newborns. Neonatal intensive care units are willing to apply environmental enrichment via music for preterm newborns. However, no evidence of an effect of music on preterm brain development has been reported to date. Using resting-state fMRI, we characterized a circuitry of interest consisting of three network modules interconnected by the salience network that displays reduced network coupling in preterm compared with full-term newborns. Interestingly, preterm infants exposed to music in the neonatal intensive care units have significantly increased coupling between brain networks previously shown to be decreased in premature infants: the salience network with the superior frontal, auditory, and sensorimotor networks, and the salience network with the thalamus and precuneus networks. Therefore, music exposure leads to functional brain architectures that are more similar to those of full-term newborns, providing evidence for a beneficial effect of music on the preterm brain.
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Affiliation(s)
- Katherine Sanchez
- Speech and Language Group Murdoch Children's Research Institute Parkville Vic. Australia
| | - Angela T. Morgan
- Speech and Language Group Murdoch Children's Research Institute Parkville Vic. Australia
- Department of Audiology and Speech Pathology The University of Melbourne Parkville Vic. Australia
- Royal Children's Hospital Parkville Vic. Australia
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48
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Chorna O, Filippa M, De Almeida JS, Lordier L, Monaci MG, Hüppi P, Grandjean D, Guzzetta A. Neuroprocessing Mechanisms of Music during Fetal and Neonatal Development: A Role in Neuroplasticity and Neurodevelopment. Neural Plast 2019; 2019:3972918. [PMID: 31015828 PMCID: PMC6446122 DOI: 10.1155/2019/3972918] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2018] [Revised: 01/06/2019] [Accepted: 02/24/2019] [Indexed: 01/17/2023] Open
Abstract
The primary aim of this viewpoint article is to examine recent literature on fetal and neonatal processing of music. In particular, we examine the behavioral, neurophysiological, and neuroimaging literature describing fetal and neonatal music perception and processing to the first days of term equivalent life. Secondly, in light of the recent systematic reviews published on this topic, we discuss the impact of music interventions on the potential neuroplasticity pathways through which the early exposure to music, live or recorded, may impact the fetal, preterm, and full-term infant brain. We conclude with recommendations for music stimuli selection and its role within the framework of early socioemotional development and environmental enrichment.
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Affiliation(s)
- O. Chorna
- Department of Developmental Neuroscience, IRCCS Fondazione Stella Maris, Pisa, Italy
| | - M. Filippa
- Division of Development and Growth, Department of Pediatrics, University Hospital of Geneva, Geneva, Switzerland
- Swiss Center for Affective Sciences, University of Geneva, Geneva, Switzerland
- Social Science Department, University of Valle d'Aosta, Aosta, Italy
| | - J. Sa De Almeida
- Division of Development and Growth, Department of Pediatrics, University Hospital of Geneva, Geneva, Switzerland
| | - L. Lordier
- Division of Development and Growth, Department of Pediatrics, University Hospital of Geneva, Geneva, Switzerland
| | - M. G. Monaci
- Social Science Department, University of Valle d'Aosta, Aosta, Italy
| | - P. Hüppi
- Division of Development and Growth, Department of Pediatrics, University Hospital of Geneva, Geneva, Switzerland
| | - D. Grandjean
- Swiss Center for Affective Sciences and Department of Psychology and Educational Sciences, University of Geneva, Switzerland
| | - A. Guzzetta
- Department of Developmental Neuroscience, IRCCS Fondazione Stella Maris, Pisa, Italy
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
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Lejeune F, Lordier L, Pittet MP, Schoenhals L, Grandjean D, Hüppi PS, Filippa M, Borradori Tolsa C. Effects of an Early Postnatal Music Intervention on Cognitive and Emotional Development in Preterm Children at 12 and 24 Months: Preliminary Findings. Front Psychol 2019; 10:494. [PMID: 30890993 PMCID: PMC6411849 DOI: 10.3389/fpsyg.2019.00494] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Accepted: 02/19/2019] [Indexed: 12/12/2022] Open
Abstract
Preterm birth is associated with a higher prevalence of neurodevelopmental deficits. Indeed, preterm children are at increased risk for cognitive, behavioral, and socio-emotional difficulties. There is currently an increasing interest in introducing music intervention in neonatal intensive care unit (NICU) care. Several studies have shown short-term beneficial effects. A recent study has shown that listening to a familiar music (heard daily during the NICU stay) enhanced preterm infants’ functional connectivity between auditory cortices and subcortical brain regions at term-equivalent age. However, the long-term effects of music listening in the NICUs have never been explored. The aim of this study was to evaluate at 12 and 24 months the effects of music listening in the NICU on cognitive and emotional development in preterm children by comparing them to a preterm control group with no previous music exposure and to a full-term group. Participants were 44 children (17 full-term and 27 preterm). Preterm children were randomized to either music intervention or control condition (without music). The preterm-music group regularly listened to music from 33 weeks postconceptional age until hospital discharge or term-equivalent age. At 12 months, children were evaluated on the Bayley Scales of Infant and Toddler Development, Third Edition, then with 4 episodes of the Laboratory Temperament Assessment Battery (assessing expressions of joy, anger, and fear, and sustained attention). At 24 months, the children were evaluated with the same tests, and with 3 additional episodes of the Effortful Control Battery (assessing inhibition). Results showed that the scores of preterm children, music and control, differed from those of full-term children for fear reactivity at 12 months of age and for anger reactivity at 24 months of age. Interestingly, these significant differences were less important between the preterm-music and the full-term groups than between the preterm-control and the full-term groups. The present study provides preliminary, but promising, scientific findings on the beneficial long-term effects of music listening in the NICU on neurodevelopmental outcomes in preterm children, and more specifically on emotion mechanisms at 12 and 24 months of age. Our findings bring new insights for supporting early music intervention in the NICU.
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Affiliation(s)
- Fleur Lejeune
- Child Clinical Neuropsychology Unit, Faculty of Psychology and Education Sciences, University of Geneva, Geneva, Switzerland
| | - Lara Lordier
- Division of Development and Growth, Department of Pediatrics, Geneva University Hospitals, Geneva, Switzerland
| | - Marie P Pittet
- Division of Development and Growth, Department of Pediatrics, Geneva University Hospitals, Geneva, Switzerland
| | - Lucie Schoenhals
- Division of Development and Growth, Department of Pediatrics, Geneva University Hospitals, Geneva, Switzerland
| | - Didier Grandjean
- Swiss Center for Affective Sciences, University of Geneva, Geneva, Switzerland.,Neuroscience of Emotion and Affective Dynamics Lab, Faculty of Psychology and Educational Sciences, University of Geneva, Geneva, Switzerland
| | - Petra S Hüppi
- Division of Development and Growth, Department of Pediatrics, Geneva University Hospitals, Geneva, Switzerland
| | - Manuela Filippa
- Division of Development and Growth, Department of Pediatrics, Geneva University Hospitals, Geneva, Switzerland.,Swiss Center for Affective Sciences, University of Geneva, Geneva, Switzerland.,Neuroscience of Emotion and Affective Dynamics Lab, Faculty of Psychology and Educational Sciences, University of Geneva, Geneva, Switzerland
| | - Cristina Borradori Tolsa
- Division of Development and Growth, Department of Pediatrics, Geneva University Hospitals, Geneva, Switzerland
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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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