Music-based treatments and pain: Underlying mechanisms

项目概要 越来越多的研究表明音乐可以有效地改善多种症状， 包括疼痛。然而，人们对音乐有益作用背后的机制知之甚少—— 为基础的治疗。这项 R21 探索性研究的主要目的是评估 对患有中度至重度慢性腰痛的个体样本进行全面的 R01 研究 解决有关音乐治疗机制的知识差距。解决主要目标 在这项研究中，我们提出了一项三组试验，其中患有慢性腰痛的个体将被随机分组 分配给以下三个条件之一：(1) 由委员会认证的音乐治疗师（音乐治疗）演奏现场音乐， (2) 录音音乐（音乐医学），或 (3) 无声音控制条件（每个条件 n = 20 名受试者）。 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组。安 测量脑振荡频谱功率的脑电图评估将在一次会议之前和期间进行 每个实验条件。将在疗程之前和之后进行疼痛强度测量。 选择腰痛是因为它是最常见、最昂贵且致残的慢性疼痛之一 问题；包括非疼痛样本还可以让我们确定慢性疼痛是否会影响 音乐对主要机制变量的影响。我们将计算 (1) 的影响的影响大小 额叶中线θ功率的治疗和（2）额叶中线θ变化的中介作用 相对于控制条件，对音乐条件的会话前和会话后效果进行控制。我们还将 评估两种音乐条件之间的差异，比较音乐医学对 机制变量作为有或没有慢性疼痛的函数，并探讨慢性疼痛的程度 实验条件对疼痛强度和次要结果（抑郁、焦虑、 实验结束后 24 小时内的疼痛干扰和睡眠质量）。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 用于确定是否需要进行完整的 R01 研究来评估基于音乐的治疗机制，以及 为诸如研究之类的设计提供信息。该研究计划将提供重要的基础知识 关于基于音乐的干预机制。转移到临床护理中，这些知识可以 帮助患者与治疗匹配，这将提高基于音乐的治疗的整体效果 和其他非药物治疗可能通过其对大脑状态的影响来发挥作用，如通过测量 脑电图。

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.