Music-based treatments and pain: Underlying mechanisms

项目摘要 越来越多的研究表明，音乐可以有效地改善各种症状， 包括疼痛。然而，人们对音乐有益效果背后的机制知之甚少。 以治疗为基础。本R21探索性研究的主要目标是评估 对患有中度到重度慢性下腰痛的个体进行完整的R01研究，以 解决有关以音乐为基础的治疗机制的知识差距。要解决主要目标 在这项研究中，我们提出了一项三臂试验，在该试验中，慢性下腰痛患者将随机 被分配到以下三种条件之一：(1)由董事会认证的音乐治疗师(音乐疗法)演奏的现场音乐， (2)录音音乐(音乐医学)，或(3)无声音控制条件(n=20人，每种情况)。 我们还将招募20名没有慢性疼痛的人，并将他们分配到音乐医学条件下。一个 测量脑振荡频谱功率的脑电评估将在 每种实验条件。疼痛强度的测量将在治疗前后进行。 之所以选择下腰痛，是因为它是最常见、最昂贵、最致残的慢性疼痛之一 问题；包括非疼痛样本也将使我们能够确定是否有慢性疼痛的影响 音乐对主要机制变量的影响。我们将计算(1)的效果大小 额叶中线Theta功率的处理及(2)额叶中线Theta变化的中介效应 相对于控制条件，打开音乐条件的会前到会后效果的电源。我们还将 评估两种音乐状态的差异，比较音乐药物对儿童心理健康的影响 机制变量作为是否患有慢性疼痛的函数，并探索在多大程度上 实验条件对疼痛强度和次要结果(抑郁、焦虑、 疼痛干扰和睡眠质量)在实验后24小时内。我们将表演 访谈和定性数据分析，以确定实验的其他意外影响 值得在一项完整的R01研究中更仔细地研究的条件。这项研究的结果将是 用于确定是否有必要进行完整的R01研究，以评估基于音乐的治疗机制，以及 通知设计者如书房。这项研究计划将提供重要的基础知识 关于以音乐为基础的干预机制。转移到临床护理，这一知识可以 帮助患者与治疗配对，这将提高基于音乐的治疗的整体效果 以及其他可能通过对大脑状态的影响而起作用的非药物治疗，通过 脑电波。

Project Summary A growing body of research indicates that music may be used effectively for improving a variety of symptoms, including pain. However, little is known about the mechanisms that underlie the beneficial effects of music- based treatments. The primary objective of this R21 exploratory study is to evaluate the feasibility of performing a full R01 study in a sample of individuals with moderate to severe chronic low back pain to address knowledge gaps regarding the mechanisms of music-based treatments. To address the primary aims of this study, we propose a 3-arm trial in which individuals with chronic low back pain will be randomly assigned to one of three conditions: (1) live music played by a board-certified music therapist (Music Therapy), (2) audio recorded music (Music Medicine), or (3) a no sound control condition (n = 20 subjects per condition). We will also enroll 20 individuals without chronic pain and assign them to the Music Medicine condition. An EEG assessment measuring brain oscillation spectral power will be conducted before and during a session of each experimental condition. Measures of pain intensity will be administered before and after the sessions. Low back pain was selected because it is among the most common, costly, and disabling chronic pain problems; including a non-pain sample will also allow us to determine if having chronic pain or not influences the effects of music on the primary mechanism variables. We will compute effect sizes for (1) the effects of the treatments on frontal midline theta power and (2) the mediation effects of changes in frontal midline theta power on the pre- to post-session effects of the music conditions, relative to the control condition. We will also evaluate the differences between the two music conditions, compare the effects of Music Medicine on the mechanism variables as a function of having or not having chronic pain, and explore the extent to which the experimental conditions have lingering effects on pain intensity and secondary outcomes (depression, anxiety, pain interference, and sleep quality) during the 24 hours after the experimental sessions. We will perform interviews and qualitative data analyses to identify additional unanticipated effects of the experimental conditions that would be worth examining more closely in a full R01 study. The findings from this study will be used to determine if a full R01 study to evaluate the mechanisms of music-based treatments is warranted, and to inform the design of such as study. This program of research will provide important foundational knowledge regarding the mechanisms of music-based interventions. Transferred to clinical care, this knowledge could help in patient-treatment matching which would enhance the overall effectiveness for music-based treatments and other non-pharmacological treatments that may operate via their effects on brain states, as measured by EEG.