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Baxter AL, Thrasher A, Etnoyer-Slaski JL, Cohen LL. Multimodal mechanical stimulation reduces acute and chronic low back pain: Pilot data from a HEAL phase 1 study. FRONTIERS IN PAIN RESEARCH 2023; 4:1114633. [PMID: 37179530 PMCID: PMC10169671 DOI: 10.3389/fpain.2023.1114633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Accepted: 02/22/2023] [Indexed: 05/15/2023] Open
Abstract
Background Effective non-opioid pain management is of great clinical importance. The objective of this pilot study was to evaluate the effectiveness of multimodal mechanical stimulation therapy on low back pain. Methods 11 female and 9 male patients aged 22-74 years (Mean 41.9 years, SD 11.04) receiving physical rehabilitation for acute (12) or chronic (8) low back pain chose heat (9) or ice (11) to accompany a 20-minute session of mechanical stimulation (M-Stim) therapy (Registered with Clinicaltrials.gov NCT04494841.) The M-Stim was delivered in 12 possible repeating "therapy cycle" patterns by three vibration motors (50 Hz, 100 Hz, 200 Hz) with amplitudes between 0.1-0.3 m/s2. Ten patients used a contained motor chassis attached to a thermoconductive single-curve metal plate. The next 10 patients' device had motors attached directly to a multidimensionally curved plate. Results Mean pain on a 10 cm Visual Analog Scale (VAS) with the first motor/plate configuration went from 4.9 ± 2.3 cm to 2.5 ± 2.1 cm (57% decrease, p = 0.0112), while the second reduced pain from 4.8 ± 2.0 cm to 3.2 ± 1.9 cm (45%, p = 0.0353). Initial pain was greater with acute injury (5.8 ± 2.0 cm vs. 3.98 ± 1.8, p = 0.025) and for patients older than 40 (5.44 vs. 4.52), but pain reduction was proportional for chronic and younger patients. There was no significant difference between plate configurations. Conclusions A Phase I clinical pilot investigation on a multi-motor multi-modal device was promising for drug free pain relief. Results suggested pain relief independent of thermal modality, patient age, or pain chronicity. Future research should investigate pain reduction over time for acute and chronic pain. Clinical Trial Registration https://ClinicalTrials.gov, identifier: NCT04494841.
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Affiliation(s)
- Amy L Baxter
- Pain Care Labs, Atlanta, GA, United States
- Department of Emergency Medicine, Augusta University, Augusta, GA, United States
| | | | | | - Lindsey L Cohen
- Department of Psychology, Georgia State University, Atlanta, GA, United States
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Lad D, Wilkins A, Johnstone E, Vuong QC. Feeling the music: The feel and sound of songs attenuate pain. Br J Pain 2022; 16:518-527. [PMID: 36389008 PMCID: PMC9644099 DOI: 10.1177/20494637221097786] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/18/2024] Open
Abstract
BACKGROUND Extensive research has demonstrated that music and touch can separately attenuate perceived pain intensity. However, little research has investigated how auditory and tactile stimulation can synergistically enhance pain attenuation by music. In the current study, we investigated whether tactile stimulation can enhance music-induced analgesia for noxious force stimulation on the fingertip. METHODS We systematically applied force to 34 listeners' fingertips to induce pain. We then compared the force measurement (in Newton) that gave rise to the same perceived moderate pain intensity when listeners were presented their self-selected liked or disliked song with auditory-only, tactile-only and auditory-tactile stimulation. Higher force indicated less perceived pain. The tactile stimulation were low-frequency modulations extracted from the songs and presented as vibrations on the wrist. RESULTS The results showed a significant interaction between song preference and stimulation condition. Listeners had higher force measurements at the same moderate pain for their liked compared to disliked song only in the auditory-tactile condition. They also had higher force measurements for their liked song with auditory-tactile stimulation compared to the other remaining conditions except for the liked song with auditory-only stimulation. CONCLUSIONS The addition of tactile stimulation enhanced music-induced analgesia which reduced subjective pain intensity. The findings suggest that combined auditory and tactile stimulation may increase the affective content of self-selected preferred music, which may stimulate affective and motivation mechanisms which inhibit pain transmission.
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Affiliation(s)
- Dhillon Lad
- School of Psychology, Newcastle University, Newcastle Upon Tyne, UK
| | - Alex Wilkins
- School of Psychology, Newcastle University, Newcastle Upon Tyne, UK
| | - Emma Johnstone
- School of Psychology, Newcastle University, Newcastle Upon Tyne, UK
| | - Quoc C Vuong
- School of Psychology, Newcastle University, Newcastle Upon Tyne, UK
- Biosciences Institute, Newcastle University, Newcastle Upon Tyne, UK
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Weber A, Busbridge S, Governo R. Evaluation of the Efficacy of Musical Vibroacupuncture in Pain Relief: A Randomized Controlled Pilot Study. Neuromodulation 2020; 24:1475-1482. [PMID: 33029913 DOI: 10.1111/ner.13281] [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] [Received: 03/27/2020] [Revised: 08/05/2020] [Accepted: 08/24/2020] [Indexed: 12/17/2022]
Abstract
OBJECTIVES To investigate if skin vibration employing consonant frequencies emitted by skin transducers attached to a combination of acupuncture points and according to musical harmony (musical chord) produces more significant pain relief compared to just a single frequency. MATERIALS AND METHODS Skin vibrostimulation produced by five electromagnet transducers was applied at five acupoints traditionally used to pain relief and anxiety in 13 pain-free healthy volunteers using the cold pressor test (CPT). The study consisted of three randomized sessions conducted on alternate days, with participants receiving either simultaneous frequencies of 32, 48, and 64 Hz that equate those used in a musical chord, hereby defined as musical vibroacupuncture (MVA), a single frequency of 32 Hz, set as vibroacupuncture (VA) and sham procedure (SP). CPT scores for pain thresholds and pain tolerance were assessed using repeated-measures ANOVAs. Pain intensity was evaluated using a numerical rating scale (NRS), while sensory and affective aspects of pain were rated using the short-form McGill Pain Questionnaire (SF-MPQ) and State-Trait Anxiety Inventory (STAI) Y-Form. RESULTS Pain thresholds did not vary significantly between trials. Pain tolerance scores were markedly higher in MVA compared to baseline (p = 0.0043) or SP (p = 0.006) but not for VA. Pain intensity for MVA also differed significantly from the baseline (p = 0.007) or SP (p = 0.027), but not for VA. No significant differences were found in SF-MPQ and STAI questionnaires. CONCLUSIONS These results suggest that MVA effectively increased pain tolerance and reduced pain intensity when compared with all groups, although not significant to the VA group.
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Affiliation(s)
- Augusto Weber
- School of Computing, Engineering and Mathematics, University of Brighton, Brighton, East Sussex, UK
| | - Simon Busbridge
- School of Computing, Engineering and Mathematics, University of Brighton, Brighton, East Sussex, UK
| | - Ricardo Governo
- Brighton and Sussex Medical School (BSMS), University of Sussex, Brighton, East Sussex, UK
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Rogić Vidaković M, Kostović A, Jerković A, Šoda J, Russo M, Stella M, Knežić A, Vujović I, Mihalj M, Baban J, Ljubenkov D, Peko M, Benzon B, Hagelien MV, Đogaš Z. Using Cutaneous Receptor Vibration to Uncover the Effect of Transcranial Magnetic Stimulation (TMS) on Motor Cortical Excitability. Med Sci Monit 2020; 26:e923166. [PMID: 32459795 PMCID: PMC7275644 DOI: 10.12659/msm.923166] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Background Little is known about how vibrational stimuli applied to hand digits affect motor cortical excitability. The present transcranial magnetic stimulation (TMS) study investigated motor evoked potentials (MEPs) in the upper extremity muscle following high-frequency vibratory digit stimulation. Material/Methods High-frequency vibration was applied to the upper extremity digit II utilizing a miniature electromagnetic solenoid-type stimulator-tactor in 11 healthy study participants. The conditioning stimulation (C) preceded the test magnetic stimulation (T) by inter-stimulus intervals (ISIs) of 5–500 ms in 2 experimental sessions. The TMS was applied over the primary motor cortex for the hand abductor pollicis-brevis (APB) muscle. Results Dunnett’s multiple comparisons test indicated significant suppression of MEP amplitudes at ISIs of 200 ms (P=0.001), 300 ms (P=0.023), and 400 ms (P=0.029) compared to control. Conclusions MEP amplitude suppression was observed in the APB muscle at ISIs of 200–400 ms, applying afferent signaling that originates in skin receptors following the vibratory stimuli. The study provides novel insight on the time course and MEP modulation following cutaneous receptor vibration of the hand digit. The results of the study may have implications in neurology in the neurorehabilitation of patients with increased amplitude of MEPs.
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Affiliation(s)
- Maja Rogić Vidaković
- Department of Neuroscience, Laboratory for Human and Experimental Neurophysiology (LAHEN), University of Split School of Medicine, Split, Croatia
| | - Ana Kostović
- Department of Neuroscience, Laboratory for Human and Experimental Neurophysiology (LAHEN), University of Split School of Medicine, Split, Croatia
| | - Ana Jerković
- Department of Neuroscience, Laboratory for Human and Experimental Neurophysiology (LAHEN), University of Split School of Medicine, Split, Croatia
| | - Joško Šoda
- Signal Processing, Analysis and Advanced Diagnostics Research and Education Laboratory (SPAADREL), University of Split Faculty of Maritime Studies, Split, Croatia
| | - Mladen Russo
- Department of Electronics, Faculty of Electrical Engineering, Mechanical Engineering and Naval Architecture, University of Split, Split, Croatia
| | - Maja Stella
- Department of Electronics, Faculty of Electrical Engineering, Mechanical Engineering and Naval Architecture, University of Split, Split, Croatia
| | - Ante Knežić
- Department of Electronics, Faculty of Electrical Engineering, Mechanical Engineering and Naval Architecture, University of Split, Split, Croatia
| | - Igor Vujović
- Signal Processing, Analysis and Advanced Diagnostics Research and Education Laboratory (SPAADREL), University of Split Faculty of Maritime Studies, Split, Croatia
| | - Mario Mihalj
- Department of Neurology, Laboratory of Electromyoneurography, University Hospital of Split, Split, Croatia
| | - Jure Baban
- Faculty of Electrical Engineering and Computing, University of Zagreb, Zagreb, Croatia
| | - Davor Ljubenkov
- Department of Electrical Engineering and Computer Science (EECS), KTH Royal Institute of Technology, Stockholm, Sweden
| | - Marin Peko
- Department of Electronics, Faculty of Electrical Engineering, Mechanical Engineering and Naval Architecture, University of Split, Split, Croatia
| | - Benjamin Benzon
- Department of Neuroscience, Laboratory for Human and Experimental Neurophysiology (LAHEN), University of Split School of Medicine, Split, Croatia
| | - Maximilian Vincent Hagelien
- Department of Neuroscience, Laboratory for Human and Experimental Neurophysiology (LAHEN), University of Split School of Medicine, Split, Croatia
| | - Zoran Đogaš
- Department of Neuroscience, Laboratory for Human and Experimental Neurophysiology (LAHEN), University of Split School of Medicine, Split, Croatia
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Braun Janzen T, Al Shirawi MI, Rotzinger S, Kennedy SH, Bartel L. A Pilot Study Investigating the Effect of Music-Based Intervention on Depression and Anhedonia. Front Psychol 2019; 10:1038. [PMID: 31133945 PMCID: PMC6517496 DOI: 10.3389/fpsyg.2019.01038] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Accepted: 04/23/2019] [Indexed: 12/17/2022] Open
Abstract
This study investigated the effect of a music-based intervention on depression and associated symptoms. Twenty individuals formally diagnosed with Major Depressive Disorder and in a current Major Depressive Episode (11 females and 8 males; aged between 26 and 65 years) undertook a 5 weeks intervention consisting of music listening combined with rhythmic sensory stimulation. Participants listened to a set of designed instrumental music tracks embedded with low-frequency sounds (30–70 Hz). The stimuli were delivered for 30 min, 5 times per week, using a portable consumer device with built-in stereo speakers and a low-frequency transducer, which allowed the low-frequency sounds embedded in the music to be experienced as a mild vibrotactile sensation around the lower back. Changes from baseline to post-intervention in measures of depression symptoms, sleep quality, quality of life, anhedonia, and music-reward processing were assessed with clinician-based assessments as well as self-reports and a monetary incentive behavioral task. The study results indicated that there were significant changes from baseline in measures of depression and associated symptoms, including sleep quality, quality of life, and anhedonia. However, individual differences in treatment response need to be considered. These findings corroborate previous evidence that music-based intervention, when added to standard care, is a promising adjunctive treatment for Major Depressive Disorder, and open new avenues to investigate the effect of music-based therapy to ameliorate anhedonia-specific dysfunction in major depressive disorder and other neuropsychiatric disorders.
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Affiliation(s)
- Thenille Braun Janzen
- Music and Health Research Collaboratory, Faculty of Music, University of Toronto, Toronto, ON, Canada.,Centre for Mental Health, University Health Network, Toronto, ON, Canada
| | | | - Susan Rotzinger
- Centre for Mental Health, University Health Network, Toronto, ON, Canada.,Arthur Sommer Rotenberg Suicide and Depression Studies Unit, St. Michael's Hospital, Toronto, ON, Canada
| | - Sidney H Kennedy
- Centre for Mental Health, University Health Network, Toronto, ON, Canada.,Arthur Sommer Rotenberg Suicide and Depression Studies Unit, St. Michael's Hospital, Toronto, ON, Canada
| | - Lee Bartel
- Faculty of Music, University of Toronto, Toronto, ON, Canada
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Braun Janzen T, Paneduro D, Picard L, Gordon A, Bartel LR. A parallel randomized controlled trial examining the effects of rhythmic sensory stimulation on fibromyalgia symptoms. PLoS One 2019; 14:e0212021. [PMID: 30822311 PMCID: PMC6396935 DOI: 10.1371/journal.pone.0212021] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2018] [Accepted: 01/21/2019] [Indexed: 12/19/2022] Open
Abstract
This double-blind, two-arm parallel randomized controlled trial investigated the effects of gamma-frequency rhythmic sensory stimulation on fibromyalgia. We were interested in whether rhythmic sensory stimulation would promote significant changes in fibromyalgia and associated symptoms, and whether treatment effects would differ between two distinct treatment parameters. Fifty patients with a formal diagnosis of fibromyalgia were randomly assigned to two test groups. One group received vibrotactile stimulation from a continuous sine wave single-frequency stimulation (40 Hz) for 30 minutes, five days per week, over five weeks, concomitant with usual care. The second group completed the same treatment protocol but received a different stimulation, consisting of random and intermittent complex wave gamma-range vibrotactile stimulation. Fibromyalgia symptoms, pain severity and interference, depression symptoms, quality of life and sleep quality were assessed at baseline and post-intervention. Results indicated that there were statistically significant changes from baseline to post-treatment in measures of fibromyalgia symptom severity, pain interference, depression, and sleep quality. However, treatment outcomes did not differ significantly between groups. These findings provide preliminary evidence that gamma-frequency rhythmic vibroacoustic stimulation may decrease fibromyalgia symptoms and ease associated comorbidities, opening new avenues for further investigation of the effects of rhythmic sensory stimulation on chronic pain conditions.
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Affiliation(s)
- Thenille Braun Janzen
- Music and Health Research Collaboratory, Faculty of Music, University of Toronto, Toronto, Ontario, Canada
| | - Denise Paneduro
- Wasser Pain Management Centre, Sinai Health System, Toronto, Ontario, Canada
| | - Larry Picard
- Wasser Pain Management Centre, Sinai Health System, Toronto, Ontario, Canada
| | - Allan Gordon
- Wasser Pain Management Centre, Sinai Health System, Toronto, Ontario, Canada
| | - Lee R. Bartel
- Faculty of Music, University of Toronto, Toronto, Ontario, Canada
- * E-mail:
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