Music-based treatments and pain: Underlying mechanisms

基于音乐的治疗和疼痛：潜在机制

• 批准号: 10659013
• 负责人: Mark P Jensen
• 金额: $ 19.54万
• 依托单位: UNIVERSITY OF WASHINGTON
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-07-04 至 2024-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10659013
• 关键词: Acute Pain; Address; Anxiety; Board Certification; Brain; Certification; Chronic disabling pain; Chronic low back pain; Clinical; Clinical Trials; Data; Data Analyses; Effectiveness; Electroencephalography; Enrollment; Goals; Health; Hour; Individual; Intervention; Interview; Investments; Knowledge; Low Back Pain; Measures; Mediating; Mediation; Medicine; Mental Depression; Mind-Body Intervention; Music; Music Therapy; Outcome; Pain; Pain intensity; Pain interference; Pain management; Participant; Patients; Persons; Pilot Projects; Play; Randomized; Research; Research Design; Research Project Grants; Resources; Role; Sampling; Science; Symptoms; Testing; Therapeutic Effect; arm; associated symptom; chronic pain; clinical care; cost; design; effective therapy; improved; independent component analysis; innovation; mind/body; pain reduction; pain relief; pain symptom; programs; response; secondary outcome; side effect; sleep quality; sound; three-arm trial; treatment effect; uptake

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.

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。但是，关于音乐的有益效果的机制知之甚少。 基于治疗。这项R21探索性研究的主要目的是评估 在中度至重度慢性下背痛的个体样本中进行完整的R01研究 解决有关基于音乐治疗的机制的知识差距。解决主要目标 在这项研究中，我们提出了一项3臂试验，其中慢性腰痛的个体将是随机的 分配给三个条件之一：（1）由董事会认证的音乐治疗师（音乐疗法）播放的现场音乐， （2）音频录制的音乐（音乐医学）或（3）没有声音控制条件（n = 20个受试者）。 我们还将注册20个人而没有慢性疼痛，并将他们分配到音乐医学状况。一个 脑电图评估测量脑振荡光谱能力将在一次之前和期间进行 每个实验条件。疼痛强度的度量将在会议前后进行。 之所以选择腰痛，是因为它是最常见，昂贵且残疾的慢性疼痛之一 问题；包括非呼吸样本还将使我们能够确定是否患有慢性疼痛 音乐对主要机制变量的影响。我们将计算（1）的效应大小 额叶中线功率的处理和（2）额叶中线变化的调解效果 相对于控制条件，音乐条件的会议前效应的功率。我们也会 评估两种音乐条件之间的差异，比较音乐医学对 机理变量是患有或没有慢性疼痛的函数，并探索了 实验条件对疼痛强度和继发性结果（抑郁，焦虑，， 疼痛干扰和睡眠质量）在实验课后的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效果 在完整的R01研究中，值得更仔细地检查的条件。这项研究的发现将是 用于确定是否有必要进行完整的R01研究来评估基于音乐的治疗机制，并且 告知诸如研究的设计。该研究计划将提供重要的基础知识 关于基于音乐的干预措施的机制。转移到临床护理中，这些知识可能 帮助患者治疗匹配，这将提高基于音乐的治疗的整体效率 以及其他可能通过对大脑状态作用作用的非药理治疗 脑电。