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Spaccavento S, Carraturo G, Brattico E, Matarrelli B, Rivolta D, Montenegro F, Picciola E, Haumann NT, Jespersen KV, Vuust P, Losavio E. Musical and electrical stimulation as intervention in disorder of consciousness (DOC) patients: A randomised cross-over trial. PLoS One 2024; 19:e0304642. [PMID: 38820520 PMCID: PMC11142721 DOI: 10.1371/journal.pone.0304642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Accepted: 05/14/2024] [Indexed: 06/02/2024] Open
Abstract
BACKGROUND Disorders of consciousness (DOC), i.e., unresponsive wakefulness syndrome (UWS) or vegetative state (VS) and minimally conscious state (MCS), are conditions that can arise from severe brain injury, inducing widespread functional changes. Given the damaging implications resulting from these conditions, there is an increasing need for rehabilitation treatments aimed at enhancing the level of consciousness, the quality of life, and creating new recovery perspectives for the patients. Music may represent an additional rehabilitative tool in contexts where cognition and language are severely compromised, such as among DOC patients. A further type of rehabilitation strategies for DOC patients consists of Non-Invasive Brain Stimulation techniques (NIBS), including transcranial electrical stimulation (tES), affecting neural excitability and promoting brain plasticity. OBJECTIVE We here propose a novel rehabilitation protocol for DOC patients that combines music-based intervention and NIBS in neurological patients. The main objectives are (i) to assess the residual neuroplastic processes in DOC patients exposed to music, (ii) to determine the putative neural modulation and the clinical outcome in DOC patients of non-pharmacological strategies, i.e., tES(control condition), and music stimulation, and (iii) to evaluate the putative positive impact of this intervention on caregiver's burden and psychological distress. METHODS This is a randomised cross-over trial in which a total of 30 participants will be randomly allocated to one of three different combinations of conditions: (i) Music only, (ii) tES only (control condition), (iii) Music + tES. The music intervention will consist of listening to an individually tailored playlist including familiar and self-relevant music together with fixed songs; concerning NIBS, tES will be applied for 20 minutes every day, 5 times a week, for two weeks. After these stimulations two weeks of placebo treatments will follow, with sham stimulation combined with noise for other two weeks. The primary outcomes will be clinical, i.e., based on the differences in the scores obtained on the neuropsychological tests, such as Coma Recovery Scale-Revised, and neurophysiological measures as EEG, collected pre-intervention, post-intervention and post-placebo. DISCUSSION This study proposes a novel rehabilitation protocol for patients with DOC including a combined intervention of music and NIBS. Considering the need for rigorous longitudinal randomised controlled trials for people with severe brain injury disease, the results of this study will be highly informative for highlighting and implementing the putative beneficial role of music and NIBS in rehabilitation treatments. TRIAL REGISTRATION ClinicalTrials.gov identifier: NCT05706831, registered on January 30, 2023.
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Affiliation(s)
- Simona Spaccavento
- Istituti Clinici Scientifici Maugeri IRCCS, Institute of Bari, Bari, Italy
| | - Giulio Carraturo
- Department of Education, Psychology, Communication, University of Bari Aldo Moro, Bari, Italy
| | - Elvira Brattico
- Department of Education, Psychology, Communication, University of Bari Aldo Moro, Bari, Italy
- Center for Music in the Brain, Department of Clinical Medicine, Aarhus University & Royal Academy of Aarhus/Aalborg, Aarhus, Denmark
| | - Benedetta Matarrelli
- Department of Education, Psychology, Communication, University of Bari Aldo Moro, Bari, Italy
| | - Davide Rivolta
- Department of Education, Psychology, Communication, University of Bari Aldo Moro, Bari, Italy
| | - Fabiana Montenegro
- Istituti Clinici Scientifici Maugeri IRCCS, Institute of Bari, Bari, Italy
| | - Emilia Picciola
- Istituti Clinici Scientifici Maugeri IRCCS, Institute of Bari, Bari, Italy
| | - Niels Trusbak Haumann
- Center for Music in the Brain, Department of Clinical Medicine, Aarhus University & Royal Academy of Aarhus/Aalborg, Aarhus, Denmark
| | - Kira Vibe Jespersen
- Center for Music in the Brain, Department of Clinical Medicine, Aarhus University & Royal Academy of Aarhus/Aalborg, Aarhus, Denmark
| | - Peter Vuust
- Center for Music in the Brain, Department of Clinical Medicine, Aarhus University & Royal Academy of Aarhus/Aalborg, Aarhus, Denmark
| | - Ernesto Losavio
- Istituti Clinici Scientifici Maugeri IRCCS, Institute of Bari, Bari, Italy
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Cai W, Han X, Tang X, Cao Z, Yu Z, Sun Z, Wu J, Wu Y, Xie H. Uncovering sympathetic nervous system dysfunction in disorders of consciousness via heart rate variability during head-up tilt test. Physiol Rep 2024; 12:e16000. [PMID: 38584117 PMCID: PMC10999365 DOI: 10.14814/phy2.16000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Revised: 03/20/2024] [Accepted: 03/22/2024] [Indexed: 04/09/2024] Open
Abstract
Few standardized tools are available for evaluation of disorders of consciousness (DOC). The potential of heart rate variability (HRV) during head-up tilt (HUT) test was investigated as a complementary evaluation tool. Twenty-one DOC patients and 21 healthy participants were enrolled in this study comparing clinical characteristics and HRV time- and frequency-domain outcomes and temporal changes during HUT test. During the 1st-5th min of the HUT, DOC group showed a significant increase and decrease in log low frequency (LF) (p = 0.045) and log normalized high frequency (nHF) (p = 0.02), respectively, compared to the supine position and had lower log normalized LF (nLF) (p = 0.004) and log ratio of low-to-high frequency (LF/HF) (p = 0.001) compared to healthy controls. As the HUT continued from the 6th to the 20th min, DOC group exhibited a significant increase in log LF/HF (16th-20th min) (p < 0.05), along with a decrease in log nHF (6th-10th and 16th-20th min) (p < 0.05) and maintained lower log LF, log nLF, and log LF/HF than controls (p < 0.05). 1st-10th min after returning to the supine position, DOC group demonstrated a significant decrease in log nHF (p < 0.01) and increases in log LF/HF (p < 0.01) and had lower log LF (p < 0.01) and log nLF (p < 0.05) compared to controls. In contrast, the control group exhibited a significant decrease in log nHF (p < 0.05) and increase in log LF/HF (p < 0.05) throughout the entire HUT test. Notably, no significant differences were observed when comparing time-domain outcomes reflecting parasympathetic nervous system between the two groups. HRV during HUT test indicated a delayed and attenuated autonomic response, particularly in the sympathetic nervous system, in DOC patients compared with healthy individuals.
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Affiliation(s)
- Weiqiang Cai
- Department of Rehabilitation Medicine, Huashan HospitalFudan UniversityShanghaiChina
| | - Xu Han
- Department of Rehabilitation Medicine, Huashan HospitalFudan UniversityShanghaiChina
| | - Xinwei Tang
- Department of Rehabilitation Medicine, Huashan HospitalFudan UniversityShanghaiChina
| | - Zuojun Cao
- Department of Rehabilitation Medicine, Huashan HospitalFudan UniversityShanghaiChina
| | - Zi Yu
- Department of Rehabilitation Medicine, Huashan HospitalFudan UniversityShanghaiChina
| | - Zuowen Sun
- Department of Rehabilitation Medicine, Huashan HospitalFudan UniversityShanghaiChina
| | - Junfa Wu
- Department of Rehabilitation Medicine, Huashan HospitalFudan UniversityShanghaiChina
| | - Yi Wu
- Department of Rehabilitation Medicine, Huashan HospitalFudan UniversityShanghaiChina
| | - Hongyu Xie
- Department of Rehabilitation Medicine, Huashan HospitalFudan UniversityShanghaiChina
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Li X, Min S. Researching how music affects the autonomic nervous system and influences wound healing processes in trauma patients. Int Wound J 2024; 21:e14790. [PMID: 38414351 PMCID: PMC10899861 DOI: 10.1111/iwj.14790] [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: 01/15/2024] [Revised: 01/31/2024] [Accepted: 02/02/2024] [Indexed: 02/29/2024] Open
Abstract
An area of increasing interest continues to be the interaction between music therapy and its impacts on the autonomic nervous system (ANS) and wound repair in patients who have experienced trauma. This study intended to quantify the effect of music therapy on ANS regulation and wound healing. A cross-sectional observational study from March to December 2023 was undertaken involving 500 trauma patients. A control group received standard care, and an experimental group received daily 30-min music therapy sessions. Heart rate variability (HRV), cortisol levels, wound healing rates and patient-reported outcomes regarding pain, tension and well-being were among the critical parameters assessed. After 1 month, the experimental group exhibited a statistically significant rise in HRV (p < 0.05), suggesting increased parasympathetic activity. The experimental group exhibited a significant decrease in cortisol levels in comparison to the control group, with notable reduction observed after 1 month (p < 0.05). At 9 months, the experimental group exhibited significantly faster wound healing than the control group, with 85% wound recovery as opposed to 75% in control group. There was notable decrease in pain and stress scores at all time intervals in the music therapy group, with the greatest reduction occurring at the 9-month mark (p < 0.05). A significant positive correlation (p < 0.05) was identified between the number of completed music therapy sessions and patient outcomes, with individuals attending more than 20 sessions experiencing 33.6% positive outcomes. In trauma patients, music therapy substantially enhanced ANS regulation and accelerated wound healing. As evidenced by the elevated HRV and decreased cortisol levels, the therapy induced a physiologically tranquil state that is conducive to recovery. The considerable enhancements in the rates of wound healing, in conjunction with the substantial decreases in pain and tension levels, highlighted the therapeutic capacity of music therapy as intervention in trauma care. Additionally, the observed dose-response relationship indicated that customised music therapy regimens are crucial for achieving the best possible results for patients.
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Affiliation(s)
- Xintong Li
- Piano DepartmentSchool of Music, BeiHua UniversityJilin CityJilin ProvinceChina
| | - Siran Min
- Instrumental Music DepartmentSchool of Music, Beihua UniversityJilin CityJilin ProvinceChina
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Parizek D, Visnovcova N, Hamza Sladicekova K, Veternik M, Jakus J, Jakusova J, Visnovcova Z, Ferencova N, Tonhajzerova I. Effect of Selected Music Soundtracks on Cardiac Vagal Control and Complexity Assessed by Heart Rate Variability. Physiol Res 2023; 72:587-596. [PMID: 38015758 PMCID: PMC10751054 DOI: 10.33549/physiolres.935114] [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: 04/17/2023] [Accepted: 06/07/2023] [Indexed: 01/05/2024] Open
Abstract
Listening to music is experimentally associated with positive stress reduction effect on human organisms. However, the opinions of therapists about this complementary non-invasive therapy are still different. PURPOSE The aim of our study was to investigate the effect of selected passive music therapy frequencies without vocals on selected cardio-vagal and complexity indices of short-term heart rate variability (HRV) in healthy youth, in terms of calming the human. MAIN METHODS 30 probands (15 male, averaged age: 19.7+/-1.4 years, BMI: 23.3+/-3.8 kg/m2) were examined during protocol (Silence baseline, Music 1 (20-1000 Hz), Silence 1, Music 2 (250-2000 Hz), Silence 2, Music 3 (1000-16000 Hz), and Silence 3). Evaluated HRV parameters in time, spectral, and geometrical domains represent indices of cardio-vagal and emotional regulation. Additionally, HRV complexity was calculated by approximate entropy and sample entropy (SampEn) and subjective characteristics of each phase by Likert scale. RESULTS the distance between subsequent R-waves in the electrocardiogram (RR intervals [ms]) and SampEn were significantly higher during Music 3 compared to Silence 3 (p=0.015, p=0.021, respectively). Geometrical cardio-vagal index was significantly higher during Music 2 than during Silence 2 (p=0.006). In the subjective perception of the healthy youths evaluated statistically through a Likert scale, the phases of music were perceived significantly more pleasant than the silent phases (p<0.001, p=0.008, p=0.003, respectively). CONCLUSIONS Our findings revealed a rise of cardio-vagal modulation and higher complexity assessed by short-term HRV indices suggesting positive relaxing effect music especially of higher frequency on human organism.
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Affiliation(s)
- D Parizek
- Department of Medical Biophysics, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Martin, Slovak Republic.
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Ling Y, Xu C, Wen X, Li J, Gao J, Luo B. Cortical responses to auditory stimulation predict the prognosis of patients with disorders of consciousness. Clin Neurophysiol 2023; 153:11-20. [PMID: 37385110 DOI: 10.1016/j.clinph.2023.06.002] [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: 07/04/2022] [Revised: 05/15/2023] [Accepted: 06/03/2023] [Indexed: 07/01/2023]
Abstract
OBJECTIVE This study aimed to assess the prognosis of patients with disorders of consciousness (DoC) using auditory stimulation with electroencephalogram (EEG) recordings. METHODS We enrolled 72 patients with DoC in the study, which involved subjecting patients to auditory stimulation while EEG responses were recorded. Coma Recovery Scale-Revised (CRS-R) scores and Glasgow Outcome Scale (GOS) were determined for each patient and followed up for three months. A frequency spectrum analysis was performed on the EEG recordings. Finally, the power spectral density (PSD) index was used to predict the prognosis of patients with DoC based on a support vector machine (SVM) model. RESULTS Power spectral analyses revealed that the cortical response to auditory stimulation showed a decreasing trend with decreasing consciousness levels. Auditory stimulation-induced changes in absolute PSD at the delta and theta bands were positively correlated with the CRS-R and GOS scores. Furthermore, these cortical responses to auditory stimulation had a good ability to discriminate between good and poor prognoses of patients with DoC. CONCLUSIONS Auditory stimulation-induced changes in the PSD were highly predictive of DoC outcomes. SIGNIFICANCE Our findings showed that cortical responses to auditory stimulation may be an important electrophysiological indicator of prognosis in patients with DoC.
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Affiliation(s)
- Yi Ling
- Department of Neurology, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310000, China
| | - Chuan Xu
- Department of Neurology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou 310016, China
| | - Xinrui Wen
- Department of Neurology, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310000, China
| | - Jingqi Li
- Department of Rehabilitation, Hangzhou Mingzhou Brain Rehabilitation Hospital, Hangzhou 311215, China
| | - Jian Gao
- Department of Rehabilitation, Hangzhou Mingzhou Brain Rehabilitation Hospital, Hangzhou 311215, China
| | - Benyan Luo
- Department of Neurology, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310000, China.
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Xiao X, Chen W, Zhang X. The effect and mechanisms of music therapy on the autonomic nervous system and brain networks of patients of minimal conscious states: a randomized controlled trial. Front Neurosci 2023; 17:1182181. [PMID: 37250411 PMCID: PMC10213399 DOI: 10.3389/fnins.2023.1182181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Accepted: 04/13/2023] [Indexed: 05/31/2023] Open
Abstract
Introduction Music therapy has been employed as an alternative treatment modality for the arousal therapy of patients with disorders of consciousness (DOC) in clinical settings. However, due to the absence of continuous quantitative measurements and the lack of a non-musical sound control group in most studies, the identification of the specific impact of music on DOC patients remains challenging. In this study, 20 patients diagnosed with minimally consciousness state (MCS) were selected, and a total of 15 patients completed the experiment. Methods All patients were randomly assigned to three groups: an intervention group (music therapy group, n = 5), a control group (familial auditory stimulation group, n = 5), and a standard care group (no sound stimulation group, n = 5). All three groups received 30 min of therapy five times a week for a total of 4 weeks (20 times per group, 60 times in total). Autonomic nervous system (ANS) measurements, Glasgow Coma Scale (GCS), and functional magnetic resonance-diffusion tensor imaging (fMRI-DTI) were used to measure the peripheral nervous system indicators and brain networks, and to evaluate patients' behavior levels. Results The results reveal that PNN50 (p = 0.0004**), TP (p = 0.0003**), VLF (p = 0.0428**), and LF/HF (p = 0.0001**) in the music group were significantly improved compared with the other two groups. Such findings suggest that the ANS of patients with MCS exhibits higher activity levels during music exposure compared to those exposed to family conversation or no auditory stimulation. In fMRI-DTI detection, due to the relative activity of ANS in the music group, the ascending reticular activation system (ARAS) in the brain network also exhibited significant nerve fiber bundle reconstruction, superior temporal gyrus (STG), transverse temporal gyrus (TTG), inferior temporal gyrus (ITG), limbic system, corpus callosum, subcorticospinal trace, thalamus and brainstem regions. In the music group, the reconstructed network topology was directed rostrally to the diencephalon's dorsal nucleus, with the brainstem's medial region serving as the hub. This network was found to be linked with the caudal corticospinal tract and the ascending lateral branch of the sensory nerve within the medulla. Conclusion Music therapy, as an emerging treatment for DOC, appears to be integral to the awakening of the peripheral nervous system-central nervous system based on the hypothalamic-brainstem-autonomic nervous system (HBA) axis, and is worthy of clinical promotion. The research was supported by the Beijing Science and Technology Project Foundation of China, No. Z181100001718066, and the National Key R&D Program of China No. 2022YFC3600300, No. 2022YFC3600305.
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Affiliation(s)
- Xiang Xiao
- School of Music and Dance, Hunan First Normal University, Changsha, Hunan, China
- School of Rehabilitation Medicine, Capital Medical University, Beijing, China
- Department of Neurorehabilitation, China Rehabilitation Research Center, Beijing, China
| | - Wenyi Chen
- School of Rehabilitation Medicine, Capital Medical University, Beijing, China
- Department of Music Artificial Intelligence and Music Information Technology, Central Conservatory of Music, Beijing, China
- Music Therapy Center, China Rehabilitation Research Center, Beijing, China
| | - Xiaoying Zhang
- School of Rehabilitation Medicine, Capital Medical University, Beijing, China
- Department of Neurorehabilitation, China Rehabilitation Research Center, Beijing, China
- Department of Music Artificial Intelligence and Music Information Technology, Central Conservatory of Music, Beijing, China
- Music Therapy Center, China Rehabilitation Research Center, Beijing, China
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Zheng RZ, Qi ZX, Wang Z, Xu ZY, Wu XH, Mao Y. Clinical Decision on Disorders of Consciousness After Acquired Brain Injury: Stepping Forward. Neurosci Bull 2023; 39:138-162. [PMID: 35804219 PMCID: PMC9849546 DOI: 10.1007/s12264-022-00909-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Accepted: 04/10/2022] [Indexed: 01/22/2023] Open
Abstract
Major advances have been made over the past few decades in identifying and managing disorders of consciousness (DOC) in patients with acquired brain injury (ABI), bringing the transformation from a conceptualized definition to a complex clinical scenario worthy of scientific exploration. Given the continuously-evolving framework of precision medicine that integrates valuable behavioral assessment tools, sophisticated neuroimaging, and electrophysiological techniques, a considerably higher diagnostic accuracy rate of DOC may now be reached. During the treatment of patients with DOC, a variety of intervention methods are available, including amantadine and transcranial direct current stimulation, which have both provided class II evidence, zolpidem, which is also of high quality, and non-invasive stimulation, which appears to be more encouraging than pharmacological therapy. However, heterogeneity is profoundly ingrained in study designs, and only rare schemes have been recommended by authoritative institutions. There is still a lack of an effective clinical protocol for managing patients with DOC following ABI. To advance future clinical studies on DOC, we present a comprehensive review of the progress in clinical identification and management as well as some challenges in the pathophysiology of DOC. We propose a preliminary clinical decision protocol, which could serve as an ideal reference tool for many medical institutions.
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Affiliation(s)
- Rui-Zhe Zheng
- Department of Neurosurgery, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, 200040, China
- National Center for Neurological Disorders, Shanghai, 200040, China
- Shanghai Key Laboratory of Brain Function and Restoration and Neural Regeneration, Shanghai, 200040, China
- Neurosurgical Institute of Fudan University, Shanghai, 200040, China
- Shanghai Clinical Medical Center of Neurosurgery, Shanghai, 200040, China
- State Key Laboratory of Medical Neurobiology, MOE Frontiers Center for Brain Science, School of Basic Medical Sciences and Institutes of Brain Science, Fudan University, Shanghai, 200032, China
| | - Zeng-Xin Qi
- Department of Neurosurgery, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, 200040, China
- National Center for Neurological Disorders, Shanghai, 200040, China
- Shanghai Key Laboratory of Brain Function and Restoration and Neural Regeneration, Shanghai, 200040, China
- Neurosurgical Institute of Fudan University, Shanghai, 200040, China
- Shanghai Clinical Medical Center of Neurosurgery, Shanghai, 200040, China
- State Key Laboratory of Medical Neurobiology, MOE Frontiers Center for Brain Science, School of Basic Medical Sciences and Institutes of Brain Science, Fudan University, Shanghai, 200032, China
| | - Zhe Wang
- Department of Neurosurgery, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, 200040, China
- National Center for Neurological Disorders, Shanghai, 200040, China
- Shanghai Key Laboratory of Brain Function and Restoration and Neural Regeneration, Shanghai, 200040, China
- Neurosurgical Institute of Fudan University, Shanghai, 200040, China
- Shanghai Clinical Medical Center of Neurosurgery, Shanghai, 200040, China
- State Key Laboratory of Medical Neurobiology, MOE Frontiers Center for Brain Science, School of Basic Medical Sciences and Institutes of Brain Science, Fudan University, Shanghai, 200032, China
| | - Ze-Yu Xu
- Department of Neurosurgery, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, 200040, China
- National Center for Neurological Disorders, Shanghai, 200040, China
- Shanghai Key Laboratory of Brain Function and Restoration and Neural Regeneration, Shanghai, 200040, China
- Neurosurgical Institute of Fudan University, Shanghai, 200040, China
- Shanghai Clinical Medical Center of Neurosurgery, Shanghai, 200040, China
- State Key Laboratory of Medical Neurobiology, MOE Frontiers Center for Brain Science, School of Basic Medical Sciences and Institutes of Brain Science, Fudan University, Shanghai, 200032, China
| | - Xue-Hai Wu
- Department of Neurosurgery, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, 200040, China.
- National Center for Neurological Disorders, Shanghai, 200040, China.
- Shanghai Key Laboratory of Brain Function and Restoration and Neural Regeneration, Shanghai, 200040, China.
- Neurosurgical Institute of Fudan University, Shanghai, 200040, China.
- Shanghai Clinical Medical Center of Neurosurgery, Shanghai, 200040, China.
- State Key Laboratory of Medical Neurobiology, MOE Frontiers Center for Brain Science, School of Basic Medical Sciences and Institutes of Brain Science, Fudan University, Shanghai, 200032, China.
| | - Ying Mao
- Department of Neurosurgery, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, 200040, China.
- National Center for Neurological Disorders, Shanghai, 200040, China.
- Shanghai Key Laboratory of Brain Function and Restoration and Neural Regeneration, Shanghai, 200040, China.
- Neurosurgical Institute of Fudan University, Shanghai, 200040, China.
- Shanghai Clinical Medical Center of Neurosurgery, Shanghai, 200040, China.
- State Key Laboratory of Medical Neurobiology, MOE Frontiers Center for Brain Science, School of Basic Medical Sciences and Institutes of Brain Science, Fudan University, Shanghai, 200032, China.
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Lancioni GE, Singh NN, O'Reilly MF, Sigafoos J, Desideri L. Behavioral intervention approaches for people with disorders of consciousness: a scoping review. Disabil Rehabil 2022; 44:7677-7692. [PMID: 34613851 DOI: 10.1080/09638288.2021.1985634] [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: 01/18/2023]
Abstract
PURPOSE This review was intended to provide an overall picture of work conducted during the last decade to assess the impact of behavioral intervention strategies on people with disorders of consciousness (i.e., comatose state, vegetative state/unresponsive wakefulness, or minimally conscious state). The intervention strategies considered were those not based on music or including music as a component of the intervention package. METHODS Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) checklist, a scoping review was carried out to identify and provide a synthesis of eligible studies published in English during the 2010-2021 period. Three databases (i.e., PubMed, PsycINFO, and Web of Science) were employed for the literature search. RESULTS Forty studies met the inclusion criteria. Those studies were grouped into three categories based on whether they assessed the effects of: (i) verbal stories/messages, (ii) multiple stimulation, and (iii) response-contingent stimulation. Then, a narrative synthesis of the studies of each of the three categories was provided to specify the types of patients involved, the intervention and assessment conditions implemented, and the outcome attained. CONCLUSIONS The evidence reported in most of the studies might be considered encouraging and convincing. Even so, it might be very difficult to view the evidence of the various studies cumulatively and make general/conclusive statements due to a number of differences in the intervention conditions applied.Implications for rehabilitationAn informative picture of the studies using behavioral interventions with people with disorders of consciousness is essential to any professional working in the area.Such picture can be highly useful in providing a view of the intervention strategies used for those people, of the variations existing within and across strategies, and of the evidence available.An analysis of the strategies, their implementation and their effects may provide new insights for improving those strategies and eventually increasing their impact.The individuals charged with the implementation process (e.g., family members or nurses) may have a relevant influence on the overall impact of the strategy.
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Affiliation(s)
- Giulio E Lancioni
- Department of Neuroscience and Sense Organs, University of Bari, Bari, Italy
| | - Nirbhay N Singh
- Medical College of Georgia, Augusta University, Augusta, GA, USA
| | - Mark F O'Reilly
- Department of Special Education, University of Texas at Austin, Austin, TX, USA
| | - Jeff Sigafoos
- School of Education, Victoria University of Wellington, Wellington, New Zealand
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Evaluation of the Efficacy of Artificial Neural Network-Based Music Therapy for Depression. COMPUTATIONAL INTELLIGENCE AND NEUROSCIENCE 2022; 2022:9208607. [PMID: 36045957 PMCID: PMC9420578 DOI: 10.1155/2022/9208607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 07/16/2022] [Accepted: 07/23/2022] [Indexed: 11/17/2022]
Abstract
In order to evaluate the therapeutic effect of music therapy on patients with depression, this paper proposes a CNN-based noise detection method with the combination of HHT and FastICA for noise removal, with good data support from the DBN model. DBN-based feature extraction and classification are completed. As the training process of DBN itself requires a large number of training samples, there are also disadvantages such as slow convergence speed and easy to fall into local minima, which lead to a large amount of effort and time, and the learning efficiency is relatively low. A DBN optimization algorithm based on artificial neural network was proposed to evaluate the efficacy of music therapy. First of all, through the comparison of music therapy experimental group and control group, to verify that music therapy is effective for the treatment of depressed patients. Secondly, we propose to optimize the selection of features based on the frequency band energy ratio and the sliding average sample entropy, respectively, and then to classify the EEG of depressed patients under different music perceptions by training the DBN model and continuously adjusting the parameters, combined with the surtax classifier, and the classification accuracy is high. In particular, it can detect the different effects of different music styles, which is of great significance for the selection of appropriate music for the treatment of depressed patients.
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Grimm T, Groß M, Nater UM, Summ O, Kreutz G. Psychophysiological Effects of Biographical Interventions in People With Unresponsive Wakefulness Syndrome and Minimally Conscious State. Front Neurol 2022; 13:788588. [PMID: 35599728 PMCID: PMC9120535 DOI: 10.3389/fneur.2022.788588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2021] [Accepted: 01/05/2022] [Indexed: 11/13/2022] Open
Abstract
Background Various music interventions can evoke favorable behavioral responses or physiological reactions in people with disorders of consciousness (DOC), such as coma, unresponsive wakefulness syndrome (UWS), and minimally conscious state (MCS). However, it appears that no study thus far has investigated the effects of music on the endocrine system of people with DOC. Objective This explorative study aimed to investigate the effects of biographical music and biographical language on the physiological and endocrine systems of people with UWS and MCS. Method A cohort of 20 people with DOC (10 women, 10 men; age range 19–77) received 20 min of biographical music and biographical language. Before and afterward, they were exposed to silence. Physiological and hormonal measurements were conducted before, during, and after the interventions. Results Paired t-tests showed a significant decrease of salivary cortisol in the condition with biographical language interventions. Conclusion Biographical interventions can modulate reactions in the endocrine system in people with DOC. Further studies are needed to establish whether and how individuals living with DOC show psychoneuroendocrine responses to music and other arts-based interventions.
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Affiliation(s)
- Teresa Grimm
- Public Health Department of the City of Oldenburg, Oldenburg, Germany
- Department of Music, Faculty of Linguistics and Cultural Studies, Carl von Ossietzky University, Oldenburg, Germany
- *Correspondence: Teresa Grimm
| | - Martin Groß
- Department of Neurological Intensive Care and Rehabilitation, Evangelisches Krankenhaus Oldenburg, Oldenburg, Germany
- Research Network on Emergency and Intensive Care Medicine Oldenburg, Faculty of Medicine and Health Sciences, Carl von Ossietzky University, Oldenburg, Germany
| | - Urs M. Nater
- Department of Clinical and Health Psychology, Faculty of Psychology, University of Vienna, Vienna, Austria
| | - Oliver Summ
- Department of Neurological Intensive Care and Rehabilitation, Evangelisches Krankenhaus Oldenburg, Oldenburg, Germany
- Faculty of Medicine and Health Sciences, Carl von Ossietzky University, Oldenburg, Germany
| | - Gunter Kreutz
- Department of Music, Faculty of Linguistics and Cultural Studies, Carl von Ossietzky University, Oldenburg, Germany
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11
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Music Stimulation for People with Disorders of Consciousness: A Scoping Review. Brain Sci 2021; 11:brainsci11070858. [PMID: 34203250 PMCID: PMC8301821 DOI: 10.3390/brainsci11070858] [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: 05/05/2021] [Revised: 06/22/2021] [Accepted: 06/24/2021] [Indexed: 11/24/2022] Open
Abstract
Music stimulation is considered to be a valuable form of intervention for people with severe brain injuries and prolonged disorders of consciousness (i.e., unresponsive wakefulness/vegetative state or minimally conscious state). This review was intended to provide an overall picture of work conducted during the last decade to assess the impact of music on behavioral and non-behavioral responses of people with disorders of consciousness. Following the PRISMA-ScR checklist, a scoping review was carried out to identify and provide a synthesis of eligible studies published in English during the 2010–2021 period. Three databases (i.e., PubMed, PsycINFO, and Web of Science) were employed for the literature search. Thirty-four studies met the inclusion criteria. Those studies were grouped into three categories based on whether they assessed the effects of: (i) recorded music, (ii) interactive music, or (iii) response-contingent music. A narrative synthesis of the studies of each of the three categories was eventually provided. While the studies of all three categories reported fairly positive/encouraging results, several methodological questions make it difficult to draw conclusions about those results and their implications for intervention programs in daily contexts.
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12
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Zhang XY, Li JJ, Lu HT, Teng WJ, Liu SH. Positive effects of music therapist's selected auditory stimulation on the autonomic nervous system of patients with disorder of consciousness: a randomized controlled trial. Neural Regen Res 2021; 16:1266-1272. [PMID: 33318404 PMCID: PMC8284264 DOI: 10.4103/1673-5374.301021] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
The current randomized controlled trial was performed at the China Rehabilitation Science Institute, China to test the hypothesis that musical auditory stimulation has positive effects on the autonomic nervous system of patients with disorder of consciousness. Although past studies have recommended that patients with disorder of consciousness listen to patient-preferred music, this practice is not universally accepted by researchers. Twenty patients with severe disorder of consciousness listened to either therapist-selected (n = 10, 6 males and 4 females; 43.33 ± 18.76 years old) or patient-preferred (n = 10, 5 males and 5 females, 48.83 ± 18.79 years old) musical therapy, 30 minutes/day, 5 times/week for 6 weeks. The results showed no obvious differences in heart rate variability-related parameters including heart rate, standard deviation of normal-to-normal R-R intervals, and the root-mean-square of successive heartbeat interval differences of successive heartbeat intervals between the two groups of patients. However, percentage of differences exceeding 50 ms between adjacent normal number of intervals, low-frequency power/high-frequency power, high-frequency power norm, low-frequency power norm, and total power were higher in patients receiving therapist-selected music than in patients receiving their own preferred music. In contrast, this relationship was reversed for the high-frequency power and very-low-frequency band. These results suggest that compared with preferred musical stimulation, therapist-selected musical stimulation resulted in higher interactive activity of the autonomic nervous system. Therefore, therapist-selected musical stimulation should be used to arouse the autonomic nervous system of patients with disorder of consciousness. This study was approved by the Institutional Ethics Committee of China Rehabilitation Research Center, China (approval No. 2018-022-1) on March 12, 2018 and registered with the Chinese Clinical Trial Registry (registration number ChiCTR1800017809) on August 15, 2018.
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Affiliation(s)
- Xiao-Ying Zhang
- School of Rehabilitation Medicine, Capital Medical University; China Rehabilitation Science Institute; Beijing Key Laboratory of Neural Injury and Rehabilitation; Center of Neural Injury and Repair, Beijing Institute for Brain Disorders; Music Therapy Center, Department of Psychology, China Rehabilitation Research Center, Beijing, China
| | - Jian-Jun Li
- School of Rehabilitation Medicine, Capital Medical University; China Rehabilitation Science Institute; Beijing Key Laboratory of Neural Injury and Rehabilitation; Center of Neural Injury and Repair, Beijing Institute for Brain Disorders, Beijing, China
| | - Hai-Tao Lu
- School of Rehabilitation Medicine, Capital Medical University; Department of Neurorehabilitation, China Rehabilitation Research Center, Beijing, China
| | - Wen-Jia Teng
- School of Rehabilitation Medicine, Capital Medical University; Music Therapy Center, Department of Psychology, China Rehabilitation Research Center, Beijing, China
| | - Song-Huai Liu
- School of Rehabilitation Medicine, Capital Medical University; Music Therapy Center, Department of Psychology, China Rehabilitation Research Center, Beijing, China
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13
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Feng L, Romero-Garcia R, Suckling J, Tan J, Larbi A, Cheah I, Wong G, Tsakok M, Lanskey B, Lim D, Li J, Yang J, Goh B, Teck TGC, Ho A, Wang X, Yu JT, Zhang C, Tan C, Chua M, Li J, Totman JJ, Wong C, Loh M, Foo R, Tan CH, Goh LG, Mahendran R, Kennedy BK, Kua EH. Effects of choral singing versus health education on cognitive decline and aging: a randomized controlled trial. Aging (Albany NY) 2020; 12:24798-24816. [PMID: 33346748 PMCID: PMC7803497 DOI: 10.18632/aging.202374] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Accepted: 11/20/2020] [Indexed: 11/25/2022]
Abstract
We conducted a randomized controlled trial to examine choral singing’s effect on cognitive decline in aging. Older Singaporeans who were at high risk of future dementia were recruited: 47 were assigned to choral singing intervention (CSI) and 46 were assigned to health education program (HEP). Participants attended weekly one-hour choral singing or weekly one-hour health education for two years. Change in cognitive function was measured by a composite cognitive test score (CCTS) derived from raw scores of neuropsychological tests; biomarkers included brain magnetic resonance imaging, oxidative damage and immunosenescence. The average age of the participants were 70 years and 73/93 (78.5%) were female. The change of CCTS from baseline to 24 months was 0.05 among participants in the CSI group and -0.1 among participants in the HEP group. The between-group difference (0.15, p=0.042) became smaller (0.12, p=0.09) after adjusting for baseline CCTS. No between-group differences on biomarkers were observed. Our data support the role of choral singing in improving cognitive health in aging. The beneficial effect is at least comparable than that of health education in preventing cognitive decline in a community of elderly people. Biological mechanisms underlying the observed efficacy should be further studied.
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Affiliation(s)
- Lei Feng
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.,Healthy Longevity Translational Research Program, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.,Centre for Healthy Longevity, National University Health System, Singapore, Singapore
| | | | - John Suckling
- Department of Psychiatry, University of Cambridge, UK
| | - Jasmine Tan
- Department of Psychology, Goldsmiths, University of London, UK
| | - Anis Larbi
- Biology of Aging Laboratory, Singapore Immunology Network, Singapore
| | - Irwin Cheah
- Department of Biochemistry, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Glenn Wong
- Biology of Aging Laboratory, Singapore Immunology Network, Singapore
| | | | - Bernard Lanskey
- Yong Siew Toh Conservatory of Music, National University of Singapore, Singapore
| | - Darius Lim
- Darius Lim, Voices of Singapore Choral Society, Singapore
| | - Jialiang Li
- Department of Statistics and Applied Probability, Faculty of Science, National University of Singapore, Singapore
| | - Joanna Yang
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.,Healthy Longevity Translational Research Program, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Benjamin Goh
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.,Healthy Longevity Translational Research Program, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | | | - Allan Ho
- NTUC Health Co-operative Limited, Singapore
| | - Xiu Wang
- Beijing Chui Yang Liu Hospital, Beijing, PR China
| | - Jin-Tai Yu
- Department of Neurology and Institute of Neurology, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China
| | - Can Zhang
- Genetics and Aging Research Unit, McCance Center for Brain Health, MassGeneral Institute for Neurodegenerative Disease, Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA 02129, USA
| | - Crystal Tan
- Biology of Aging Laboratory, Singapore Immunology Network, Singapore
| | - Michelle Chua
- Biology of Aging Laboratory, Singapore Immunology Network, Singapore
| | - Junhua Li
- School of Computer Science and Electronic Engineering, University of Essex, UK
| | - John J Totman
- Clinical Imaging Research Centre, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Caroline Wong
- Clinical Imaging Research Centre, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Marie Loh
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore.,Department of Epidemiology and Biostatistics, Imperial College London, London W2 1PG, UK
| | - Roger Foo
- Cardiovascular Research Institute, National University Health Systems, Singapore.,Genome Institute of Singapore, Singapore
| | - Chay Hoon Tan
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.,Department of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Lee Gan Goh
- Division of Family Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Rathi Mahendran
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.,Healthy Longevity Translational Research Program, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.,Academic Development Department, Duke-NUS Medical School, Singapore
| | - Brian K Kennedy
- Centre for Healthy Longevity, National University Health System, Singapore, Singapore.,Department of Biochemistry, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.,Department of Physiology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.,Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore, Singapore
| | - Ee-Heok Kua
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.,Healthy Longevity Translational Research Program, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
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14
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Can music influence cardiac autonomic system? A systematic review and narrative synthesis to evaluate its impact on heart rate variability. Complement Ther Clin Pract 2020; 39:101162. [DOI: 10.1016/j.ctcp.2020.101162] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Revised: 03/27/2020] [Accepted: 03/27/2020] [Indexed: 12/11/2022]
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15
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Shou Z, Li Z, Wang X, Chen M, Bai Y, Di H. Non-invasive brain intervention techniques used in patients with disorders of consciousness. Int J Neurosci 2020; 131:390-404. [PMID: 32238043 DOI: 10.1080/00207454.2020.1744598] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Aim of the study: With the development of emergency medicine and intensive care technology, the number of people who survive with disorders of consciousness (DOC) has dramatically increased. The diagnosis and treatment of such patients have attracted much attention from the medical community. From the latest evidence-based guidelines, non-invasive brain intervention (NIBI) techniques may be valuable and promising in the diagnosis and conscious rehabilitation of DOC patients.Methods: This work reviews the studies on NIBI techniques for the assessment and intervention of DOC patients.Results: A large number of studies have explored the application of NIBI techniques in DOC patients. The NIBI techniques include transcranial magnetic stimulation, transcranial electric stimulation, music stimulation, near-infrared laser stimulation, focused shock wave therapy, low-intensity focused ultrasound pulsation and transcutaneous auricular vagus nerve stimulation.Conclusions: NIBI techniques present numerous advantages such as being painless, safe and inexpensive; having adjustable parameters and targets; and having broad development prospects in treating DOC patients.
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Affiliation(s)
- Zeyu Shou
- International Vegetative State and Consciousness Science Institute, Hangzhou Normal University, Hangzhou, China.,Key Laboratory of Aging and Cancer Biology of Zhejiang Province, Hangzhou Normal University, Hangzhou, China
| | - Zhilong Li
- International Vegetative State and Consciousness Science Institute, Hangzhou Normal University, Hangzhou, China.,Key Laboratory of Aging and Cancer Biology of Zhejiang Province, Hangzhou Normal University, Hangzhou, China
| | - Xueying Wang
- International Vegetative State and Consciousness Science Institute, Hangzhou Normal University, Hangzhou, China.,Key Laboratory of Aging and Cancer Biology of Zhejiang Province, Hangzhou Normal University, Hangzhou, China
| | - Miaoyang Chen
- International Vegetative State and Consciousness Science Institute, Hangzhou Normal University, Hangzhou, China.,Key Laboratory of Aging and Cancer Biology of Zhejiang Province, Hangzhou Normal University, Hangzhou, China
| | - Yang Bai
- International Vegetative State and Consciousness Science Institute, Hangzhou Normal University, Hangzhou, China.,Key Laboratory of Aging and Cancer Biology of Zhejiang Province, Hangzhou Normal University, Hangzhou, China
| | - Haibo Di
- International Vegetative State and Consciousness Science Institute, Hangzhou Normal University, Hangzhou, China.,Key Laboratory of Aging and Cancer Biology of Zhejiang Province, Hangzhou Normal University, Hangzhou, China
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16
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Riganello F, Larroque SK, Di Perri C, Prada V, Sannita WG, Laureys S. Measures of CNS-Autonomic Interaction and Responsiveness in Disorder of Consciousness. Front Neurosci 2019; 13:530. [PMID: 31293365 PMCID: PMC6598458 DOI: 10.3389/fnins.2019.00530] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2018] [Accepted: 05/08/2019] [Indexed: 12/25/2022] Open
Abstract
Neuroimaging studies have demonstrated functional interactions between autonomic (ANS) and brain (CNS) structures involved in higher brain functions, including attention and conscious processes. These interactions have been described by the Central Autonomic Network (CAN), a concept model based on the brain-heart two-way integrated interaction. Heart rate variability (HRV) measures proved reliable as non-invasive descriptors of the ANS-CNS function setup and are thought to reflect higher brain functions. Autonomic function, ANS-mediated responsiveness and the ANS-CNS interaction qualify as possible independent indicators for clinical functional assessment and prognosis in Disorders of Consciousness (DoC). HRV has proved helpful to investigate residual responsiveness in DoC and predict clinical recovery. Variability due to internal (e.g., homeostatic and circadian processes) and environmental factors remains a key independent variable and systematic research with this regard is warranted. The interest in bidirectional ANS-CNS interactions in a variety of physiopathological conditions is growing, however, these interactions have not been extensively investigated in DoC. In this brief review we illustrate the potentiality of brain-heart investigation by means of HRV analysis in assessing patients with DoC. The authors' opinion is that this easy, inexpensive and non-invasive approach may provide useful information in the clinical assessment of this challenging patient population.
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Affiliation(s)
- Francesco Riganello
- Coma Science Group, GIGA-Consciousness, GIGA Institute, University Hospital of Liège, Liège, Belgium
- S. Anna Institute, Research in Advanced Neurorehabilitation, Crotone, Italy
| | - Stephen Karl Larroque
- Coma Science Group, GIGA-Consciousness, GIGA Institute, University Hospital of Liège, Liège, Belgium
| | - Carol Di Perri
- Coma Science Group, GIGA-Consciousness, GIGA Institute, University Hospital of Liège, Liège, Belgium
- Centre for Clinical Brain Sciences, The University of Edinburgh, Edinburgh, United Kingdom
| | - Valeria Prada
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, and Maternal/Child Sciences, Polyclinic Hospital San Martino IRCCS, University of Genoa, Genoa, Italy
| | - Walter G. Sannita
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, and Maternal/Child Sciences, Polyclinic Hospital San Martino IRCCS, University of Genoa, Genoa, Italy
| | - Steven Laureys
- Coma Science Group, GIGA-Consciousness, GIGA Institute, University Hospital of Liège, Liège, Belgium
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17
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Petot T, Bouscaren N, Maillard O, Huiart L, Boukerrou M, Reynaud D. Comparing the effects of self-selected music versus predetermined music on patient anxiety prior to gynaecological surgery: a study protocol for a randomised controlled trial. Trials 2019; 20:20. [PMID: 30616674 PMCID: PMC6323656 DOI: 10.1186/s13063-018-3093-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2018] [Accepted: 12/02/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Patients undergoing gynaecological surgery are known to experience anxiety. While the use of music selected by patients based on their personal taste has hardly been evaluated, a recent study suggests that musical preferences significantly alter the anxiolytic and relaxing effects of music. Our study aims to determine whether self-selected music decreases patient anxiety prior to gynaecological surgery, as compared with predetermined music from a software programme such as MUSIC CARE®. METHODS The study will consist of a clinical trial comparing the effects of self-selected music versus predetermined music on patient anxiety prior to gynaecological surgery. A minimum of 170 patients will be randomised in a 1:1 ratio. Inclusion criteria will be: women aged 18-55 years, awaiting scheduled gynaecological surgery under general/local anaesthesia or under sedation; having created a personal 20-min playlist; and not having received anxiolytic drugs prior to surgery. The primary outcome will be the difference between the preoperative anxiety score taken 15 to 20 min before the music-listening session and the preoperative anxiety score taken shortly after the session, as measured with the STAI for state anxiety. DISCUSSION This study should help to identify more effective non-medical treatments for preoperative anxiety, as well as to adapt music therapy to the cultural context of patients. TRIAL REGISTRATION ClinicalTrials.gov, ID: NCT03226834 . Registered on 24 July 2017.
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Affiliation(s)
- Tiphaine Petot
- CHU de La Réunion, INSERM, CIC1410, 97410, Saint Pierre, France.
| | | | - Olivier Maillard
- CHU de La Réunion, INSERM, CIC1410, 97410, Saint Pierre, France.,INSERM, IRD, SESSTIM, Sciences Économiques et Sociales de la Santé et Traitement de l'Information Médicale, Aix Marseille University, 13006, Marseille, France
| | - Laetitia Huiart
- CHU de La Réunion, INSERM, CIC1410, 97410, Saint Pierre, France.,INSERM, IRD, SESSTIM, Sciences Économiques et Sociales de la Santé et Traitement de l'Information Médicale, Aix Marseille University, 13006, Marseille, France
| | - Malik Boukerrou
- Service de Gynécologie et d'Obstétrique, CHU de La Réunion, 97410, Saint Pierre, France.,INSERM, EA7388 « Centre d'Etudes Périnatales de l'Océan Indien » (CEPOI), 97410, Saint Pierre, France
| | - Danielle Reynaud
- Service de Gynécologie et d'Obstétrique, CHU de La Réunion, 97410, Saint Pierre, France
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18
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Riganello F, Chatelle C, Schnakers C, Laureys S. Heart Rate Variability as an Indicator of Nociceptive Pain in Disorders of Consciousness? J Pain Symptom Manage 2019; 57:47-56. [PMID: 30267843 DOI: 10.1016/j.jpainsymman.2018.09.016] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2018] [Revised: 09/18/2018] [Accepted: 09/19/2018] [Indexed: 01/18/2023]
Abstract
CONTEXT Heart rate variability is thought to reflect the affective and physiological aspects of pain and is emerging as a possible descriptor of the functional brain organization contributing to homeostasis. OBJECTIVES To investigate whether the short-term Complexity Index (CIs), a measure of heart rate variability complexity is useful to discriminate responses to potentially noxious and nonnoxious stimulation in patients with different levels of consciousness. METHODS Twenty-two patients (11 minimally conscious state [MCS], 11 vegetative state/unresponsive wakefulness syndrome [VS/UWS]) and 14 healthy controls (HC) were enrolled. We recorded the electrocardiographic response and calculated the CIs before (baseline), during, and after nonnoxious and noxious stimulation. Mann-Whitney and Wilcoxon's tests were used to investigate differences in CIs according to the level of consciousness (i.e., HC vs. patients and VS/UWS vs. MCS) and the three conditions (i.e., baseline, nonnoxious, noxious). The correlation between the three conditions and the Coma Recovery Scale-Revised was investigated by Spearman's correlations. RESULTS We observed higher CIs values in HC as compared with patients during the baseline (P < 0.034) and after the noxious stimulation (P < 0.0001). We also found higher values in MCS versus VS/UWS patients after the noxious condition (P < 0.001) and lower values in the noxious versus nonnoxious condition solely for the VS/UWS group (P < 0.007). A correlation was found between CIs in noxious condition and Coma Recovery Scale-Revised scores. CONCLUSION Our results suggest a less complex autonomic response to noxious stimuli in VS/UWS patients. Such method may help to better understand sympathovagal response to potentially painful stimulation in brain-injured patients.
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Affiliation(s)
- Francesco Riganello
- GIGA Consciousness, Coma Science Group, Liège, Belgium; Research in Advanced Neurorehabilitation (RAN), S.Anna Institute, Crotone, Italy.
| | - Camille Chatelle
- GIGA Consciousness, Coma Science Group, Liège, Belgium; Laboratory for NeuroImaging of Coma and Consciousness, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Caroline Schnakers
- Neurosurgery Department, University of California, Los Angeles, California, USA; Research Institute, Casa Colina Hospital and Centers of Healthcare, Pomona, California, USA
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19
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Sibanda A, Carnes D, Visentin D, Cleary M. A systematic review of the use of music interventions to improve outcomes for patients undergoing hip or knee surgery. J Adv Nurs 2018; 75:502-516. [PMID: 30230564 DOI: 10.1111/jan.13860] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Revised: 07/04/2018] [Accepted: 08/30/2018] [Indexed: 12/18/2022]
Abstract
AIM To examine the effectiveness of music as an adjunct treatment for pain, anxiety, and/or postoperative delirium, for patients undergoing hip or knee surgery. BACKGROUND Patients undergoing hip or knee surgery are known to experience pain and anxiety before and after surgery and be prone to postoperative delirium. DESIGN Quantitative systematic review. DATA SOURCES CENTRAL, Embase, Ovid MEDLINE, CINAHL, and PsycINFO databases were systematically searched without time limits (to June 2018). REVIEW METHODS A systematic search yielded 10 randomized controlled trials and quasi-experimental designs. Studies were appraised using the Cochrane Risk of Bias Tool. Data were extracted using the Effective Practice and Organization of Care data extraction tool. RESULTS Mixed results were found for the effect of music on anxiety, pain, and postoperative delirium in patients undergoing hip or knee surgery. Six of 10 included studies provided evidence that music can improve anxiety, pain, or postoperative delirium outcomes for patients undergoing hip or knee surgery. Music effectively reduced anxiety in one of three studies. Three of seven studies reported benefits of music for reducing postoperative pain. Positive effects of music on postoperative delirium were reported in all three studies that evaluated this outcome. Within group improvements were observed in many of the studies. CONCLUSION Music has the potential to improve outcomes of anxiety, pain, and postoperative delirium, for patients undergoing hip or knee surgery. The low number of studies found indicates results should be treated with caution. Further studies are required to provide strong evidence generalizable to a broader population.
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Affiliation(s)
- Annah Sibanda
- School of Health Sciences, College of Health and Medicine, University of Tasmania, Sydney, New South Wales, Australia
| | - Debra Carnes
- Faculty of Education, College of Arts, Law and Education, University of Tasmania, Newnham, Tasmania, Australia
| | - Denis Visentin
- School of Health Sciences, College of Health and Medicine, University of Tasmania, Sydney, New South Wales, Australia
| | - Michelle Cleary
- School of Health Sciences, College of Health and Medicine, University of Tasmania, Sydney, New South Wales, Australia
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20
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VETERNIK M, TONHAJZEROVA I, MISEK J, JAKUSOVA V, HUDECKOVA H, JAKUS J. The Impact of Sound Exposure on Heart Rate Variability in Adolescent Students. Physiol Res 2018; 67:695-702. [DOI: 10.33549/physiolres.933882] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
Previous studies of physiological responses to music and noise showed the effect on the autonomic nervous system. The heart rate variability (HRV) has been used to assess the activation of the sympathetic and the parasympathetic nervous systems. The present study was aimed to examine HRV with exposure to four sine-wave pure tones (20 Hz, 50 Hz, 2 kHz and 15 kHz) in an environment where the sound intensity exceeded level 65 dB (A-weighted). The participants (20 adolescent girls) were lying in supine position during exposure protocol divided into 6 periods, the first time with generated sounds and the second time without sounds. In the protocol without sound exposure, the low frequency band of the HRV spectrum was increased compared to the basal state before examination (period_1: 6.05±0.29 ms2 compared to period_5: 6.56±0.20 ms2, p<0.05). The significant increase of root Mean Square of the Successive Differences (rMSSD, period_1: 4.09±0.16 s compared to period_6: 4.33±0.12 s, p<0.05) and prolongation of R to R peak (RR) interval (period_1: 889±30 ms compared to period_5: 973±30 ms, p<0.001) were observed in the protocol without sound exposure comparing to the protocol with sound exposure where only bradycardia was observed. Contrary to rather polemical data in literature our pilot study suggests that sounds (under given frequencies) have no impact on the heart rate variability and cardiac autonomic regulation.
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Affiliation(s)
| | | | | | | | | | - J. JAKUS
- Department of Medical Biophysics, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Martin, Slovakia
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21
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Riganello F, Larroque SK, Bahri MA, Heine L, Martial C, Carrière M, Charland-Verville V, Aubinet C, Vanhaudenhuyse A, Chatelle C, Laureys S, Di Perri C. A Heartbeat Away From Consciousness: Heart Rate Variability Entropy Can Discriminate Disorders of Consciousness and Is Correlated With Resting-State fMRI Brain Connectivity of the Central Autonomic Network. Front Neurol 2018; 9:769. [PMID: 30258400 PMCID: PMC6145008 DOI: 10.3389/fneur.2018.00769] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2018] [Accepted: 08/24/2018] [Indexed: 12/20/2022] Open
Abstract
Background: Disorders of consciousness are challenging to diagnose, with inconsistent behavioral responses, motor and cognitive disabilities, leading to approximately 40% misdiagnoses. Heart rate variability (HRV) reflects the complexity of the heart-brain two-way dynamic interactions. HRV entropy analysis quantifies the unpredictability and complexity of the heart rate beats intervals. We here investigate the complexity index (CI), a score of HRV complexity by aggregating the non-linear multi-scale entropies over a range of time scales, and its discriminative power in chronic patients with unresponsive wakefulness syndrome (UWS) and minimally conscious state (MCS), and its relation to brain functional connectivity. Methods: We investigated the CI in short (CIs) and long (CIl) time scales in 14 UWS and 16 MCS sedated. CI for MCS and UWS groups were compared using a Mann-Whitney exact test. Spearman's correlation tests were conducted between the Coma Recovery Scale-revised (CRS-R) and both CI. Discriminative power of both CI was assessed with One-R machine learning model. Correlation between CI and brain connectivity (detected with functional magnetic resonance imagery using seed-based and hypothesis-free intrinsic connectivity) was investigated using a linear regression in a subgroup of 10 UWS and 11 MCS patients with sufficient image quality. Results: Higher CIs and CIl values were observed in MCS compared to UWS. Positive correlations were found between CRS-R and both CI. The One-R classifier selected CIl as the best discriminator between UWS and MCS with 90% accuracy, 7% false positive and 13% false negative rates after a 10-fold cross-validation test. Positive correlations were observed between both CI and the recovery of functional connectivity of brain areas belonging to the central autonomic networks (CAN). Conclusion: CI of MCS compared to UWS patients has high discriminative power and low false negative rate at one third of the estimated human assessors' misdiagnosis, providing an easy, inexpensive and non-invasive diagnostic tool. CI reflects functional connectivity changes in the CAN, suggesting that CI can provide an indirect way to screen and monitor connectivity changes in this neural system. Future studies should assess the extent of CI's predictive power in a larger cohort of patients and prognostic power in acute patients.
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Affiliation(s)
- Francesco Riganello
- Coma Science Group, GIGA-Consciousness, University & Hospital of Liege, Liege, Belgium
- Research in Advanced NeuroRehabilitation, Istituto S. Anna, Crotone, Italy
| | - Stephen Karl Larroque
- Coma Science Group, GIGA-Consciousness, University & Hospital of Liege, Liege, Belgium
| | - Mohamed Ali Bahri
- GIGA-Cyclotron Research Center in vivo Imaging, University of Liege, Liege, Belgium
| | - Lizette Heine
- Centre de Recherche en Neurosciences, Inserm U1028 - CNRS UMR5292, University of Lyon 1, Bron, France
| | - Charlotte Martial
- Coma Science Group, GIGA-Consciousness, University & Hospital of Liege, Liege, Belgium
| | - Manon Carrière
- Coma Science Group, GIGA-Consciousness, University & Hospital of Liege, Liege, Belgium
| | | | - Charlène Aubinet
- Coma Science Group, GIGA-Consciousness, University & Hospital of Liege, Liege, Belgium
| | - Audrey Vanhaudenhuyse
- Sensation & Perception Research Group, GIGA-Consciousness, University & Hospital of Liege, Liege, Belgium
| | - Camille Chatelle
- Coma Science Group, GIGA-Consciousness, University & Hospital of Liege, Liege, Belgium
| | - Steven Laureys
- Coma Science Group, GIGA-Consciousness, University & Hospital of Liege, Liege, Belgium
| | - Carol Di Perri
- Coma Science Group, GIGA-Consciousness, University & Hospital of Liege, Liege, Belgium
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom
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Abstract
OBJECTIVES The effects of music interventions including active and receptive music therapy for people living with neurogenic disorders of consciousness (DOC) have been subject to empirical studies in the past. The aim of this systematic review was to find and analyse the current research about the effects of musical interventions on people with DOC. METHODS For this purpose, studies with music interventions and patients with DOC from the year 1900 to 2017 were searched in English, German, and French in different databases. Risk-of-bias-analyses were conducted for each study that fulfilled the inclusion criteria. RESULTS Twenty-two quantitative studies (three randomised controlled trials with more than 10 participants) were found eligible for review. They include a total of 329 participants living with either coma, unresponsive wakefulness syndrome, or minimally conscious state. Music interventions were associated with favourable behavioural and physiological responses in several studies, but methodological quality and outcomes were heterogeneous. CONCLUSIONS More studies with a larger number of participants are needed as well as a consensus on key characteristics of effective short-term and long-term music interventions for DOC.
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Affiliation(s)
- Teresa Grimm
- a Department of Music , Carl von Ossietzky University , Oldenburg , Germany
| | - Gunter Kreutz
- a Department of Music , Carl von Ossietzky University , Oldenburg , Germany
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Differences of Heart Rate Variability Between Happiness and Sadness Emotion States: A Pilot Study. J Med Biol Eng 2017. [DOI: 10.1007/s40846-017-0238-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Musical Auditory Stimulation Influences Heart Rate Autonomic Responses to Endodontic Treatment. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2017; 2017:4847869. [PMID: 28182118 PMCID: PMC5274691 DOI: 10.1155/2017/4847869] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/11/2016] [Revised: 10/20/2016] [Accepted: 11/17/2016] [Indexed: 01/27/2023]
Abstract
We aimed to evaluate the acute effect of musical auditory stimulation on heart rate autonomic regulation during endodontic treatment. The study included 50 subjects from either gender between 18 and 40 years old, diagnosed with irreversible pulpitis or pulp necrosis of the upper front teeth and endodontic treatment indication. HRV was recorded 10 minutes before (T1), during (T2), and immediately (T3 and T4) after endodontic treatment. The volunteers were randomly divided into two equal groups: exposed to music (during T2, T3, and T4) or not. We found no difference regarding salivary cortisol and anxiety score. In the group with musical stimulation heart rate decreased in T3 compared to T1 and mean RR interval increased in T2 and T3 compared to T1. SDNN and TINN indices decreased in T3 compared to T4, the RMSSD and SD1 increased in T4 compared to T1, the SD2 increased compared to T3, and LF (low frequency band) increased in T4 compared to T1 and T3. In the control group, only RMSSD and SD1 increased in T3 compared to T1. Musical auditory stimulation enhanced heart rate autonomic modulation during endodontic treatment.
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Stress Recovery Effects of High- and Low-Frequency Amplified Music on Heart Rate Variability. Behav Neurol 2016; 2016:5965894. [PMID: 27660396 PMCID: PMC5021883 DOI: 10.1155/2016/5965894] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2016] [Revised: 06/18/2016] [Accepted: 06/23/2016] [Indexed: 11/23/2022] Open
Abstract
Sounds can induce autonomic responses in listeners. However, the modulatory effect of specific frequency components of music is not fully understood. Here, we examined the role of the frequency component of music on autonomic responses. Specifically, we presented music that had been amplified in the high- or low-frequency domains. Twelve healthy women listened to white noise, a stress-inducing noise, and then one of three versions of a piece of music: original, low-, or high-frequency amplified. To measure autonomic response, we calculated the high-frequency normalized unit (HFnu), low-frequency normalized unit, and the LF/HF ratio from the heart rate using electrocardiography. We defined the stress recovery ratio as the value obtained after participants listened to music following scratching noise, normalized by the value obtained after participants listened to white noise after the stress noise, in terms of the HFnu, low-frequency normalized unit, LF/HF ratio, and heart rate. Results indicated that high-frequency amplified music had the highest HFnu of the three versions. The stress recovery ratio of HFnu under the high-frequency amplified stimulus was significantly larger than that under the low-frequency stimulus. Our results suggest that the high-frequency component of music plays a greater role in stress relief than low-frequency components.
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