CONTEXT: Since the mid-1980s, music therapy has been a regular feature of the residential program at the internationally renowned Bristol Cancer Help Centre, United Kingdom. Music therapy complements other therapeutic interventions available to residents at the center. OBJECTIVE: To compare the therapeutic effects of listening to music in a relaxed state with the active involvement of music improvisation (the playing of tuned and untuned percussion instruments) in a music therapy group setting and to investigate the potential influence of music therapy on positive emotions and the immune system of cancer patients. DESIGN: A quantitative pre-posttest, psychological/physiological measures, and qualitative focus group design. SETTING: A cancer help center that offers a fully integrated range of complementary therapies, psychological support, spiritual healing, and nutritional and self-help techniques addressing the physical, mental, emotional, and spiritual needs of cancer patients and their supporters. PARTICIPANTS: Twenty-nine cancer patients, aged 21 to 68 years. INTERVENTION: Group music therapy interventions of listening to recorded/live music in a relaxed state and improvisation. MAIN OUTCOME MEASURES: Increased well-being and relaxation and less tension during the listening experience. Increased well-being and energy and less tension during improvisation. Increased levels of salivary immunoglobulin A and decreased levels of cortisol in both experiences. RESULTS: Psychological data showed increased well-being and relaxation as well as altered energy levels in both interventions. Physiological data showed increased salivary immunoglobulin A in the listening experience and a decrease in cortisol levels in both interventions over a 2-day period. Preliminary evidence of a link between positive emotions and the immune system of cancer patients was found. CONCLUSIONS: These findings, which link listening to music in a relaxed state and improvisation to alterations in psychological and physiological parameters, may provide a better understanding of the effectiveness of music therapy for cancer patients.

Music is known to be able to elicit emotional changes, including anxiolytic effects. The gonadal steroid hormones estradiol and progesterone have also been reported to play important roles in the modulation of anxiety. In the present study, we examined whether the effect of music on anxiety is related to ovarian steroid in female mice. Behavioral paradigms measuring anxiety were tested in gonadally intact (SHAM) and ovariectomized (OVX) female mice chronically treated with either placebo (OVX/Placebo), 17beta-estradiol (OVX/E), or progesterone (OVX/P). In the elevated plus maze, light-dark transition, and marble burying tests, SHAM and OVX/P mice exposed to music showed less anxiety than those exposed to white noise or silence while OVX/placebo mice did not show these effects at all. OVX/E mice showed the anxiolytic effect of music only in the marble burying test. Furthermore, pretreatment with progesterone's metabolite inhibitor completely prevented the anxiolytic effect of music in behavioral tests, while pretreatment with a progesterone receptor blocker did not prevent the anxiolytic effect of music. These results suggest that exposure to music reduces anxiety levels, and ovarian steroids, mainly progesterone, may be involved in the anxiolytic effect of music observed in female mice.

Music listening and music making activities are powerful tools to engage multisensory and motor networks, induce changes within these networks, and foster links between distant, but functionally related brain regions with continued and life-long musical practice. These multimodal effects of music together with music's ability to tap into the emotion and reward system in the brain can be used to facilitate and enhance therapeutic approaches geared toward rehabilitating and restoring neurological dysfunctions and impairments of an acquired or congenital brain disorder. In this article, we review plastic changes in functional networks and structural components of the brain in response to short- and long-term music listening and music making activities. The specific influence of music on the developing brain is emphasized and possible transfer effects on emotional and cognitive processes are discussed. Furthermore, we present data on the potential of using musical tools and activities to support and facilitate neurorehabilitation. We will focus on interventions such as melodic intonation therapy and music-supported motor rehabilitation to showcase the effects of neurologic music therapies and discuss their underlying neural mechanisms.

Music listening and music making activities are powerful tools to engage multisensory and motor networks, induce changes within these networks, and foster links between distant, but functionally related brain regions with continued and life-long musical practice. These multimodal effects of music together with music's ability to tap into the emotion and reward system in the brain can be used to facilitate and enhance therapeutic approaches geared toward rehabilitating and restoring neurological dysfunctions and impairments of an acquired or congenital brain disorder. In this article, we review plastic changes in functional networks and structural components of the brain in response to short- and long-term music listening and music making activities. The specific influence of music on the developing brain is emphasized and possible transfer effects on emotional and cognitive processes are discussed. Furthermore, we present data on the potential of using musical tools and activities to support and facilitate neurorehabilitation. We will focus on interventions such as melodic intonation therapy and music-supported motor rehabilitation to showcase the effects of neurologic music therapies and discuss their underlying neural mechanisms.

The presentation of two pure tones to each ear separately with a slight difference in their frequency results in the perception of a single tone that fluctuates in amplitude at a frequency that equals the difference of interaural frequencies. This perceptual phenomenon is known as binaural auditory beats, and it is thought to entrain electrocortical activity and enhance cognition functions such as attention and memory. The aim of this study was to determine the effect of binaural auditory beats on long-term memory. Participants (n = 32) were kept blind to the goal of the study and performed both the free recall and recognition tasks after being exposed to binaural auditory beats, either in the beta (20 Hz) or theta (5 Hz) frequency bands and white noise as a control condition. Exposure to beta-frequency binaural beatsyielded a greater proportion of correctly recalled words and a higher sensitivity index d' in recognition tasks, while theta-frequency binaural-beat presentation lessened the number of correctly remembered words and the sensitivity index. On the other hand, we could not find differences in the conditional probability for recall given recognition between beta and theta frequencies and white noise, suggesting that the observed changes in recognition were due to the recollection component. These findings indicate that the presentation of binaural auditory beats can affect long-term memory both positively and negatively, depending on the frequency used.

Binaural beats (BBs) are an auditory illusion occurring when two tones of slightly different frequency are presented separately to each ear. BBs have been suggested to alter physiological and cognitive processes through synchronization of the brain hemispheres. To test this, we recorded electroencephalograms (EEG) at rest and while participants listened to BBs or a monaural control condition during which both tones were presented to both ears. We calculated for each condition the interhemispheric coherence, which expressed the synchrony between neural oscillations of both hemispheres. Compared to monaural beats and resting state, BBs enhanced interhemispheric coherence between the auditory cortices. Beat frequencies in the alpha (10 Hz) and theta (4 Hz) frequency range both increased interhemispheric coherence selectively at alpha frequencies. In a second experiment, we evaluated whether this coherence increase has a behavioral aftereffect on binaural listening. No effects were observed in a dichotic digit task performed immediately after BBs presentation. Our results suggest that BBs enhance alpha-band oscillation synchrony between the auditory cortices during auditory stimulation. This effect seems to reflect binaural integration rather than entrainment.

Gamma oscillation plays a role in binding process or sensory integration, a process by which several brain areas beside primary cortex are activated for higher perception of the received stimulus. Beta oscillation is also involved in interpreting received stimulus and occurs following gamma oscillation, and this process is known as gamma-to-beta transition, a process for neglecting unnecessary stimuli in surrounding environment. Gamma oscillation also associates with cognitive functions, memory and emotion. Therefore, modulation of the brain activity can lead to manipulation of cognitive functions. The stimulus used in this study was 40-Hz binaural beat because binaural beat induces frequency following response. This study aimed to investigate the neural oscillation responding to the 40-Hz binaural beat and to evaluate working memory function and emotional states after listening to that stimulus. Two experiments were developed based on the study aims. In the first experiment, electroencephalograms were recorded while participants listened to the stimulus for 30min. The results suggested that frontal, temporal, and central regions were activated within 15min. In the second experiment, word list recall task was conducted before and after listening to the stimulus for 20min. The results showed that, after listening, the recalled words were increase in the working memory portion of the list. Brunel Mood Scale, a questionnaire to evaluate emotional states, revealed changes in emotional states after listening to the stimulus. The emotional results suggested that these changes were consistent with the induced neural oscillations.

A binaural beat is a beat phenomenon that is generated by the dichotic presentation of two almost equivalent pure tones but with slightly different frequencies. The brain responses to binaural beats remain controversial; therefore, the aim of this study was to investigate theta activity responses to a binaural beat by controlling factors affecting localization, including beat frequency, carrier tone frequency, exposure duration, and recording procedure. Exposure to a 6-Hz binaural beat on a 250 Hz carrier tone for 30 min was utilized in this study. Quantitative electroencephalography (QEEG) was utilized as the recording modality. Twenty-eight participants were divided into experimental and control groups. Emotional states were evaluated by Brunel Mood Scale (BRMUS) before and after exposing to the stimulus. The results showed that theta activity was induced in the entire cortex within 10 min of exposure to the stimulus in the experimental group. Compared to the control group, theta activity was also induced at the frontal and parietal-central regions, which included the Fz position, and left hemisphere dominance was presented for other exposure durations. The pattern recorded for 10 min of exposure appeared to be brain functions of a meditative state. Moreover, tension factor of BRUMS was decreased in experimental group compared to control group which resembled the meditation effect. Thus, a 6-Hz binaural beat on a 250 Hz carrier tone was suggested as a stimulus for inducing a meditative state.

A binaural beat is a beat phenomenon that is generated by the dichotic presentation of two almost equivalent pure tones but with slightly different frequencies. The brain responses to binaural beats remain controversial; therefore, the aim of this study was to investigate theta activity responses to a binaural beat by controlling factors affecting localization, including beat frequency, carrier tone frequency, exposure duration, and recording procedure. Exposure to a 6-Hz binaural beat on a 250 Hz carrier tone for 30 min was utilized in this study. Quantitative electroencephalography (QEEG) was utilized as the recording modality. Twenty-eight participants were divided into experimental and control groups. Emotional states were evaluated by Brunel Mood Scale (BRMUS) before and after exposing to the stimulus. The results showed that theta activity was induced in the entire cortex within 10 min of exposure to the stimulus in the experimental group. Compared to the control group, theta activity was also induced at the frontal and parietal-central regions, which included the Fz position, and left hemisphere dominance was presented for other exposure durations. The pattern recorded for 10 min of exposure appeared to be brain functions of a meditative state. Moreover, tension factor of BRUMS was decreased in experimental group compared to control group which resembled the meditation effect. Thus, a 6-Hz binaural beat on a 250 Hz carrier tone was suggested as a stimulus for inducing a meditative state.

BACKGROUND: During labor, women experience a high level of intense, stressful and steady pain that may negatively affect both mothers and neonates. Painkillers have previously been used for childbearing women, but nowadays, owing to some well-known limitations and serious side effects, nonpharmacologic methods such as massage and music therapies are being broadly recommended. The present clinical trial was conducted to compare the effects of massage and music therapies on the severity of labor pain in the Ilam province of western Iran. MATERIALS&METHODS: Overall, 101 primigravidae who were hospitalized for vaginal delivery were recruited and randomly stratified into two groups of either massage (n = 51) or music (n = 50) therapies. Pain was measured using the visual analog scale and the two groups were compared in terms of pain severity before and after the interventions. RESULTS: Mothers in the massage therapy group had a lower level of pain compared with those in the music therapy group (p = 0.009). A significant difference was observed between the two groups in terms of pain severity after intervention (p = 0.01). Agonizing, or most severe, labor pain was significantly relieved after massage therapy (p = 0.001). CONCLUSION: Massage therapy was an effective method for reducing and relieving labor pain compared with music therapy and can be clinically recommended as an alternative, safe and affordable method of pain relief where using either pharmacological or nonpharmacological methods are optional.

BACKGROUND: During labor, women experience a high level of intense, stressful and steady pain that may negatively affect both mothers and neonates. Painkillers have previously been used for childbearing women, but nowadays, owing to some well-known limitations and serious side effects, nonpharmacologic methods such as massage and music therapies are being broadly recommended. The present clinical trial was conducted to compare the effects of massage and music therapies on the severity of labor pain in the Ilam province of western Iran. MATERIALS&METHODS: Overall, 101 primigravidae who were hospitalized for vaginal delivery were recruited and randomly stratified into two groups of either massage (n = 51) or music (n = 50) therapies. Pain was measured using the visual analog scale and the two groups were compared in terms of pain severity before and after the interventions. RESULTS: Mothers in the massage therapy group had a lower level of pain compared with those in the music therapy group (p = 0.009). A significant difference was observed between the two groups in terms of pain severity after intervention (p = 0.01). Agonizing, or most severe, labor pain was significantly relieved after massage therapy (p = 0.001). CONCLUSION: Massage therapy was an effective method for reducing and relieving labor pain compared with music therapy and can be clinically recommended as an alternative, safe and affordable method of pain relief where using either pharmacological or nonpharmacological methods are optional.

Music is known to have the power to induce strong emotions. The present study assessed, based on Electroencephalography (EEG) data, the emotional response of terminally ill cancer patients to a music therapy intervention in a randomized controlled trial. A sample of 40 participants from the palliative care unit in the Hospital del Mar in Barcelona was randomly assigned to two groups of 20. The first group [experimental group (EG)] participated in a session of music therapy (MT), and the second group [control group (CG)] was provided with company. Based on our previous work on EEG-based emotion detection, instantaneous emotional indicators in the form of a coordinate in the arousal-valence plane were extracted from the participants' EEG data. The emotional indicators were analyzed in order to quantify (1) the overall emotional effect of MT on the patients compared to controls, and (2) the relative effect of the different MT techniques applied during each session. During each MT session, five conditions were considered:(initial patient's state before MT starts),(passive listening),(active listening),(relaxation), and(final patient's state). EEG data analysis showed a significant increase in valence (= 0.0004) and arousal (= 0.003) betweenandin the EG. No significant changes were found in the CG. This results can be interpreted as a positive emotional effect of MT in advanced cancer patients. In addition, according to pre- and post-intervention questionnaire responses, participants in the EG also showed a significant decrease in tiredness, anxiety and breathing difficulties, as well as an increase in levels of well-being. No equivalent changes were observed in the CG.

Binaural beats are an auditory illusion perceived when two different pure-tone sine waves are presented one to each ear at a steady intensity and frequency. We evaluated their effectiveness in reducing preoperative anxiety in dentistry. Sixty patients (30 in each group) who were to have impacted third molars removed were studied (experimental group: 20 women and 10 men, mean (range) age 24 (18-35) years, and control group: 22 women and 8 men, mean (range) age 28 (15-47) years). All patients were fully informed about the operation preoperatively, and their anxiety recorded on a visual analogue scale (VAS). The local anaesthetic was given and the patients waited for 10minutes, during which those in the experimental group were asked to listen to binaural beats through stereo earphones (200Hz for the left ear and 209.3Hz for the right ear). No special treatment was given to the control group. In both groups anxiety was then recorded again, and the tooth removed in the usual way. The paired t test and t test were used to assess the significance of differences between groups. The degree of anxiety in the control group was unchanged after the second measurement (p=0.625), while that in the experimental group showed a significant reduction in anxiety (p=0.001). We conclude that binaural beats may be useful in reducing preoperative anxiety in dentistry.

The purpose of this study was to examine effects of art and music therapy on depression and cognitive function of the elderly. This was one group pre-test, post-test design. Data were collected from January to March, 2013, from 94 elderly. The results were collected as followers: 1. Art therapy was revealed a statistical significant difference between before and after treatment on the depression of participants. 2. Music therapy was revealed a statistical significant at previous and after treatment on the depression of participants. 3. Treatment according to the severity of depression than the music therapy and art therapy were examined statistically significantly lower. This study will be provided basic information in order to develop program for success healthy life of elderly.

OBJECTIVE: The purpose of the present study was to investigate the effect of listening to soft music or inhaling Citrus bergamia aroma on autonomic nervous system activity in young healthy individuals. STUDY DESIGN, LOCATION, AND SUBJECTS: This single-institution study was an open-label randomized controlled trial carried out on 114 healthy undergraduate students at a university located in south Taiwan. INTERVENTION: Participants were randomly allocated to one of four study groups including (1) a music group, (2) an aroma group, (3) a combined music and aroma group, and (4) a control group. Participants in the music group were asked to listen to preselected soft music for 15 minutes, and those in the aroma group were asked to inhale Citrus bergamia essential oil vapor generated from an ultrasonic atomizer for 15 minutes. OUTCOME MEASURE: The outcome measure involved heart rate variability (HRV) indices measured before and after the intervention. The low frequency (LF) and high frequency (HF) components of the HRV were used to quantify modulation of the sympathetic and parasympathetic branches of the autonomic nervous system. RESULTS: The percentage changes of normalized LF (p = 0.003), normalized HF (p = 0.001), and the ratio of LF to HF (p < 0.001) were significantly different among the four groups. Tukey's post hoc analysis revealed that the percentage change of normalized LF and HF were significantly different between the control group and the music group. For the percentage change of the ratio of LF to HF, the negative change in the music group, the aroma group, and the combined group was significantly different from that of the increase in the control group. In addition, no significant differences were found in the percentage changes in systolic blood pressure, diastolic blood pressure, and mean heart rate in the four groups. CONCLUSIONS: Listening to soft music and inhaling Citrus bergamia essential oil was found to be an effective method of relaxation, as indicated by a shift of the autonomic balance toward parasympathetic activity in young healthy individuals.

BACKGROUND:Approximately one-third of patients with epilepsy continue to experience seizures despite adequate therapy with antiepileptic drugs. Drug-resistant epilepsy is even more frequent in subjects with intellectual disability. As a result, several non-pharmacological interventions have been proposed to improve quality of life in patients with intellectual disability and drug-resistant epilepsy. A number of studies have demonstrated that music can be effective at reducing seizures and epileptiform discharges. In particular, Mozart's sonata for two pianos in D major, K448, has been shown to decrease interictal EEG discharges and recurrence of clinical seizures in patients with intellectual disability and drug-resistant epilepsy as well. The aim of this study is to investigate the influence of Mozart's music on seizure frequency in institutionalized epileptic subjects with profound/severe intellectual disability.

SUBJECTS AND METHODS:Twelve patients (10 males and 2 females) with a mean age of 21.6 years were randomly assigned to two groups in a cross-over design; they listened to Mozart K448 once a day for six months.

RESULTS:A statistically significant difference was observed between the listening period and both baseline and control periods. During the music period, none of the patients worsened in seizure frequency; one patient was seizure-free, five had a greater than 50% reduction in seizure frequency and the remaining showed minimal (N=2) or no difference (N=4). The average seizure reduction compared to the baseline was 20.5%. Our results are discussed in relation to data in the literature considering differences in protocol investigation.

CONCLUSIONS:Music may be considered a useful approach as add-on therapy in some subjects with profound intellectual disability and drug-resistant epilepsy and can provide a new option for clinicians to consider, but further large sample, multicenter studies are needed to better understand the characteristics of responders and non-responders to this type of non-pharmacological intervention.

Music therapy (MT) has been used in geriatric nursing hospitals, but there has been no extensive research into whether it actually has beneficial effects on elderly patients with cerebrovascular disease (CVD) and dementia. We investigated the effects of MT on the autonomic nervous system and plasma cytokine and catecholamine levels in elderly patients with CVD and dementia, since these are related to aging and chronic geriatric disease. We also investigated the effects of MT on congestive heart failure (CHF) events.Eighty-seven patients with pre-existing CVD were enrolled in the study. We assigned patients into an MT group (n = 55) and non-MT group (n = 32). The MT group received MT at least once per week for 45 minutes over 10 times. Cardiac autonomic activity was assessed by heart rate variability (HRV). We measured plasma cytokine and catecholamine levels in both the MT group and non-MT group. We compared the incidence of CHF events between these two groups. In the MT group, rMSSD, pNN50, and HF were significantly increased by MT, whereas LF/HF was slightly decreased. In the non-MT group, there were no significant changes in any HRV parameters. Among cytokines, plasma interleukin-6 (IL-6) in the MT group was significantly lower than those in the non-MT group. Plasma adrenaline and noradrenaline levels were significantly lower in the MT group than in the non-MT group. CHF events were less frequent in the MT group than in the non-MT group (P < 0.05). These findings suggest that MT enhanced parasympathetic activities and decreased CHF by reducing plasma cytokine and catecholamine levels.

OBJECTIVE:To examine the effectiveness of music listening on pain, anxiety, and vital signs among patients after thoracic surgery in China.

DESIGN AND SETTING:A randomized controlled clinical trial was conducted in the thoracic surgery department of two tertiary hospitals in Wuhan, China. 112 patients were recruited and randomly assigned to either experimental (n=56) or control (n=56) group respectively.

INTERVENTION:The experimental group received standard care and a 30-min soft music intervention for 3 days, while the control group received only standard care. Measures include pain, anxiety, vital signs (blood pressure, heart rate and respiratory rate), patient controlled analgesia, and diclofenac sodium suppository use.

RESULTS:The experimental group showed statistically significant decrease in pain, anxiety, systolic blood pressure and heart rate over time compared to the control group, but no significant difference were identified in diastolic blood pressure, respiratory rate, patient controlled analgesia and diclofenac sodium suppository use.

CONCLUSION:The findings provide further evidence to support the practice of music therapy to reduce postoperative pain and anxiety, and lower systolic blood pressure and heart rate in patients after thoracic surgery in China.

Context• According to the National Institutes of Health, in 2011, chronic pain affected from approximately 10% to>50% of the adult population in the United States, with a cost of $61 billion to US businesses annually. Objective• The pilot study assessed the effects that an external, audio, neural stimulus of theta binaural beats (TBB) had on returning the brain neurosignature for chronic pain to homeostasis. Methods • The quantitative, experimental, repeated-measures crossover study compared the results of 2 interventions in 2 time-order sequences. An a priori analysis indicated a sample size of 28 participants was needed for a 2-way repeated-measures analysis of variance (ANOVA). Setting • The study was conducted in Richmond, VA, USA, with participants recruited from the financial sector. Participants • Thirty-six US adults with various types of chronic pain, and with a median age of 47 y, ranging in ages from 26-69 y, participated in the study. The study experienced 4 dropouts. Intervention • Participants listened to 2 recordings-one using TBB at 6 Hz (TBB intervention) and one using a placebo of anonbinaural beat tone of 300 Hz (sham intervention) for 20 min daily. Both interventions lasted 14 successive days each, with some participants hearing the TBB intervention first and the sham intervention second and some hearing them in the reverse order. Participants listened to the interventionsvia a Web site on the Internet or via a compact disc. Interviews were conducted either in person or telephonically with e-mail support. Outcome Measures • Using the West Haven-Yale Multidimensional Pain Inventory (MPI), potential changes in perceived severity of chronic pain were measured (1) at baseline; (2) after the first test at 14 d, either TBB or sham intervention; and (3) after the second test at 28 d-either TBB or sham intervention. The analysis compared the average mean for pretest and first and second posttest scores. Results • The analysis indicated a large main effect for the TBB intervention in reducing perceived pain severity, P<.001 (F2,60 = 84.98, r = 0.74). Although the TBB and the placebo interventions both reduced the pain scores, a post hoc Bonferroni correction that compared pairs of MPI scores found a 77% larger drop in the mean for the TBB intervention, from M = 4.60 at pretest to M = 2.74 at the end of both TBB periods than in the mean for the sham intervention, with a change from M = 4.60 at pretest to M = 4.17 at the end of both sham periods. Conclusions• The results supported the hypothesis that an external audio protocol of TBB was effective in reducing perceived pain severity for participants.