Music-based treatments and pain: Underlying mechanisms

项目摘要 越来越多的研究表明，音乐可以有效地用于改善各种症状， 包括疼痛然而，人们对音乐有益作用的机制知之甚少- 基于治疗。本R21探索性研究的主要目的是评价以下方法的可行性： 在患有中度至重度慢性腰痛的个体样本中进行完整的R 01研究， 解决有关音乐治疗机制的知识差距。为了实现主要目标， 在这项研究中，我们提出了一个3臂试验，其中慢性腰痛患者将被随机 被分配到三个条件之一：（1）由委员会认证的音乐治疗师（音乐治疗）演奏的现场音乐， (2)音频记录的音乐（音乐医学），或（3）无声音控制条件（每种条件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条件。一个 将在治疗前和治疗期间进行EEG评估，测量脑振荡频谱功率。 每个实验条件。疼痛强度的措施将在会议之前和之后进行。 选择下背痛是因为它是最常见、最昂贵和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或不影响 音乐对主要机制变量的影响。我们将计算以下方面的效应量：（1） 治疗对额中线theta功率和（2）额中线theta变化的中介作用 相对于控制条件，对音乐条件的会话前到会话后效果通电。我们还将 评价两种音乐条件下的差异，比较音乐医学对患者的影响， 机制变量作为有或没有慢性疼痛的函数，并探讨在何种程度上， 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）。我们将执行 访谈和定性数据分析，以确定实验的额外意外影响 这些条件值得在完整的R 01研究中更仔细地检查。这项研究的结果将是 用于确定是否有必要进行一项完整的R 01研究，以评估基于音乐的治疗机制，以及 为研究设计提供信息。这项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，这些知识可以 有助于患者-治疗匹配，这将提高基于音乐的治疗的整体有效性 和其他非药物治疗，可以通过其对大脑状态的影响来操作，如通过 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.