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Doppler study of precordial musical murmurs.

Using phonocardiography, continuous- and pulsed-wave Doppler, 51 patients with precordial "musical" murmurs (49 with cardiac abnormalities) and 21 patients with noisy murmurs were examined. With M-mode echocardiography, fine fluttering of the structure generating the murmur was evident in 23 patients with musical murmurs and in 5 with noisy murmurs. A continuous-wave Doppler spectral signal characterized by parallel harmonics (Doppler musical signal) was evident in all patients with musical murmurs and in none with a noisy murmur. With pulsed-wave Doppler, the musical signal had less defined spectral features because of range ambiguity. Such a signal was experimentally reproduced by activating a diapason bathed in saline solution. The source of the musical murmur was established in all 51 patients by Doppler. The musical signal was associated with a valvular regurgitation signal in 36 patients and with a ventricular septal defect in 1 patient. The musical signal always disappeared when the pulsed-wave Doppler sample volume was placed 2 cm away from the generating structure. In 11 patients with musical murmur examined by color Doppler, no abnormal bidirectional flow signal was observed in the structures generating the signal. In 6 of the patients without valvular regurgitation, no flow disturbance was found. In conclusion, Doppler is valuable in determining the source of musical murmurs, and musical murmurs are caused by a vibrating structure even in the absence of flow turbulence.

Aortic Valve Insufficiency↗

Perception of tension in music: musicians versus nonmusicians.

Music therapists are often highly trained musicians who deal with diverse populations, most of whom do not have formal musical training. Questions may arise regarding the issue of a therapist's ability to understand, and predict, the musical perceptions and preferences of a client when their own background is so different. The current work is a look at a series of studies using various musical stimuli and comparing responses of musicians and nonmusicians to perceived "musical tension." Subjects (N = 126) included adult musicians and nonmusicians as well as a case study of a father/daughter. All subjects listened to recordings through individual headphones and were physically isolated from other subjects to ensure individuality of responses. Subjects, whether adults or children, were given instructions telling them that they were about to hear a piece of music and that they would be using a Continuous Response Digital Interface (CRDI) dial to trace the musical tension they heard. No specific definition of musical tension was given to any of the subjects. In effect, individual subjects supplied their own definition, either knowingly or unknowingly, in the absence of a formal one. Results indicated that group perceptions of the points at which tension and its release were strongest are remarkably similar between musicians and nonmusicians (correlations ranged from r =.71 to r =.95). Within at least the western art music tradition the likelihood that perceptions of group responses to tension and release in music could be predicted is high. These data indicate that therapists, trained as musicians, might be able to predict with some accuracy the responses of their clients who are not trained musicians.

Adult↗

The effects of music listening after a stressful task on immune functions, neuroendocrine responses, and emotional states in college students.

The purpose of this study was to examine the effects of listening to high-uplifting or low-uplifting music after a stressful task on (a) immune functions, (b) neuroendocrine responses, and (c) emotional states in college students. Musical selections that were evaluated as high-uplifting or low-uplifting by Japanese college students were used as musical stimuli. Eighteen Japanese subjects performed stressful tasks before they experienced each of these experimental conditions: (a) high-uplifting music, (b) low-uplifting music, and (c) silence. Subjects' emotional states, the Secretory IgA (S-IgA) level, active natural killer (NK) cell level, the numbers of T lymphocyte CD4+, CD8+, CD16+, dopamine, norepinephrine, and epinephrine levels were measured before and after each experimental condition. Results indicated low-uplifting music had a trend of increasing a sense of well-being. High-uplifting music showed trends of increasing the norepinephrine level, liveliness, and decreasing depression. Active NK cells were decreased after 20 min of silence. Results of the study were inconclusive, but high-uplifting and low-uplifting music had different effects on immune, neuroendocrine, and psychological responses. Classification of music is important to research that examines the effects of music on these responses. Recommendations for future research are discussed.

Adult↗

The effects of live music groups versus an educational children's television program on the emergent literacy of young children.

Research suggests that music is beneficial in teaching both social and academic skills to young children. The purpose of this study was to examine the effects of a music therapy program designed to teach reading skills versus the "Between the Lions" television program on the early literacy behaviors of Kindergarten children from a low socioeconomic background. Subjects (n = 86) were children, aged 5-7 years, enrolled in one of four different Kindergarten classes at a public elementary school in Northwest Florida. Each class was assigned one of four treatment conditions: Music/Video (sequential presentation of each condition), Music-Only, Video-Only, and no contact Control group. Growth in early literacy skills was measured using the Dynamic Indicators of Basic Early Literacy Skills (DIBELS) and 3 subtests of the Test of Early reading Ability-3rd edition (TERA-3). Teachers' perceptions of classroom literacy behaviors were measured using a pre and poststudy survey. This study also compared on- and off-task behavior of students during video versus music conditions. Results of the 7 subtests measuring early literacy were varied. The Music/Video and Music-Only groups achieved the highest increases in mean scores from pre to posttest on 4 of the 7 subtests. Students in the Video-Only group scored significantly better on the phonemic segmentation portion of the DIBELS than peers in the Music/Video condition. Furthermore, strong correlations were found between the Letter Naming, Initial Sounds Fluency tests, and total raw score of the TERA-3 tests for both pre and posttesting. Additionally, graphic analysis of mean off-task behavior per session indicated that students were more off-task during both video conditions (video alone and video portion of Music/Video condition) than during the music conditions. Off-task behavior was consistently lower during music sessions for the duration of the study. This study confirmed that music increases the on-task behavior of students. Additionally, the combination of music and video enrichment showed gains in 4 of the 8 tests used to measure students' progress. This pattern supports the need for further investigation regarding benefits of enrichment programs specifically designed to enhance curricula for students from low socioeconomic backgrounds, particularly programs that incorporate music activities.

Child↗

[How does music affect the human body?].

Music therapy has developed its practice and research approaches within a qualitative framework more related to humanistic traditions than to medical science. Music medicine has therefore developed as a separate discipline, endeavouring to incorporate the legitimate therapeutic use of music within a medical framework. This paper argues that more extensive communication and collaboration between the methods developed within the music therapy community, and research based on medical science, could lead to a better understanding of the place of music as a therapeutic tool, both as regards its efficacy and its limits. Research has shown that music may influence central physiological variables like blood pressure, heart rate, respiration, EEG measurements, body temperature and galvanic skin response. Music influences immune and endocrine function. The existing research literature shows growing knowledge of how music can ameliorate pain, anxiety, nausea, fatigue and depression. There is less research done on how music, and what type of music, is utilized and administered specifically for optimum effect in specific clinical situations.

Acoustic Stimulation↗

Neuronal activity in the human lateral temporal lobe. III. Activity changes during music.

During open brain surgery under local anesthesia for the treatment of medically intractable temporal lobe epilepsy we have recorded neuronal activity from the lateral temporal lobe with microelectrodes while the patients listened to short pieces of music. Three groups of music were tested: A) Simple familiar or unknown classical tunes at a simple rhythm and harmony, played on piano; B) Orchestrated folk music; C) Drumming without a tune. All types of music lead to changes of neuronal discharge rate. Musical pieces of type A produced a decrease in 48% of the recordings, an increase in about 17% and had no effect in 30%. A similar distribution of effects was found during type B-music (48%, 22%, 30%, respectively). During type C, only 26% showed a decrease and 74% an increase. When music was turned off, usually the reverse change from that caused by music was seen. In addition to changes of discharge rate, a slight entrainment of activity by single, regularly appearing notes (rhythm) was seen in some neurons. A few neurons showed a change of activity related to musical phrases (activation towards the end of a 4-bar 4/4 phrase). In contrast to the effects of verbal stimuli and overt speech, the effects of music on discharge rates did not show obvious topographical differences between superior, middle and inferior temporal gyrus. They also were bilateral with no significant right-left differences.

Acoustic Stimulation↗

[Effects of music therapy in intensive care unit without sedation in weaning patients versus non-ventilated patients].

OBJECTIVES: Music has been found to be an effective nonpharmacologic adjunct for managing anxiety and promoting relaxation in limited trials of critically ill patients. However, its effects have not been compared in intubated patients during weaning from mechanical ventilation with non-intubated patients spontaneously breathing. STUDY DESIGN: A cross-over randomized experimental design. PATIENTS AND METHODS: Thirty patients were studied (intubated group n = 15, non-intubated group n = 15). Patients were randomized to receive either 20 minutes of uninterrupted rest or then 20 minutes of music therapy or the music therapy first and then the uninterrupted rest period. Patients selected a relaxing music of their choice from a selection including different types of music. Heart rate (HR), systolic blood pressure (SAP), respiratory rate (RR) and bispectral index (BIS score) were recorded each 5-min intervals throughout both periods (rest and music). Agitation/sedation state and pain were evaluated by the Richmond-Agitation-Sedation-Scale (RASS) and the Numerical-Rating-Scale (NRS) respectively, before and after each studied periods. Music have not been performed in five patients (5/35 = 14%). RESULTS: Music significantly decreased HR (88+/-15 vs 82+/-15, P<0.05), SAP (137+/-17 vs 128+/-14, P<0.05), RR (25+/-3 vs 22+/-4, P<0.05), BIS (94+/-5 vs 81+/-10, P<0.01), RASS (+0.1+/-0.7 vs -0.7+/-0.9, P<0.05) and NRS (4.4+/-1.7 vs 1.9+/-1.3, P<0.01) in both intubated and non-intubated groups whereas no significant change was observed during the rest period. The variations level studied parameters induced by music were comparable for the two groups. CONCLUSION: A single music therapy session was found to be effective for decreasing anxiety and promoting relaxation, as indicated by decreases in heart rate, blood pressure, BIS and respiratory rate over the intervention period in intubated patients during weaning phase.

Adult↗

Are there pre-existing neural, cognitive, or motoric markers for musical ability?

Adult musician's brains show structural enlargements, but it is not known whether these are inborn or a consequence of long-term training. In addition, music training in childhood has been shown to have positive effects on visual-spatial and verbal outcomes. However, it is not known whether pre-existing advantages in these skills are found in children who choose to study a musical instrument nor is it known whether there are pre-existing associations between music and any of these outcome measures that could help explain the training effects. To answer these questions, we compared 5- to 7-year-olds beginning piano or string lessons (n=39) with 5- to 7-year-olds not beginning instrumental training (n=31). All children received a series of tests (visual-spatial, non-verbal reasoning, verbal, motor, and musical) and underwent magnetic resonance imaging. We found no pre-existing neural, cognitive, motor, or musical differences between groups and no correlations (after correction for multiple analyses) between music perceptual skills and any brain or visual-spatial measures. However, correlations were found between music perceptual skills and both non-verbal reasoning and phonemic awareness. Such pre-existing correlations suggest similarities in auditory and visual pattern recognition as well a sharing of the neural substrates for language and music processing, most likely due to innate abilities or implicit learning during early development. This baseline study lays the groundwork for an ongoing longitudinal study addressing the effects of intensive musical training on brain and cognitive development, and making it possible to look retroactively at the brain and cognitive development of those children who emerge showing exceptional musical talent.

Awareness↗

Playing piano in the mind--an fMRI study on music imagery and performance in pianists.

Reading of musical notes and playing piano is a very complex motor task which requires years of practice. In addition to motor skills, rapid and effective visuomotor transformation as well as processing of the different components of music like pitch, rhythm and musical texture are involved. The aim of the present study was the investigation of the cortical network which mediates music performance compared to music imagery in 12 music academy students playing the right hand part of a Bartok piece using functional magnetic resonance imaging (fMRI). In both conditions, fMRI activations of a bilateral frontoparietal network comprising the premotor areas, the precuneus and the medial part of Brodmann Area 40 were found. During music performance but not during imagery the contralateral primary motor cortex and posterior parietal cortex (PPC) bilaterally was active. This reflects the role of primary motor cortex for motor execution but not imagery and the higher visuomotor integration requirements during music performance compared to simulation. The notion that the same areas are involved in visuomotor transformation/motor planning and music processing emphasizes the multimodal properties of cortical areas involved in music and motor imagery in musicians.

Adult↗

Adults and children processing music: an fMRI study.

The present study investigates the functional neuroanatomy of music perception with functional magnetic resonance imaging (fMRI). Three different subject groups were investigated to examine developmental aspects and effects of musical training: 10-year-old children with varying degrees of musical training, adults without formal musical training (nonmusicians), and adult musicians. Subjects made judgements on sequences that ended on chords that were music-syntactically either regular or irregular. In adults, irregular chords activated the inferior frontal gyrus, orbital frontolateral cortex, the anterior insula, ventrolateral premotor cortex, anterior and posterior areas of the superior temporal gyrus, the superior temporal sulcus, and the supramarginal gyrus. These structures presumably form different networks mediating cognitive aspects of music processing (such as processing of musical syntax and musical meaning, as well as auditory working memory), and possibly emotional aspects of music processing. In the right hemisphere, the activation pattern of children was similar to that of adults. In the left hemisphere, adults showed larger activations than children in prefrontal areas, in the supramarginal gyrus, and in temporal areas. In both adults and children, musical training was correlated with stronger activations in the frontal operculum and the anterior portion of the superior temporal gyrus.

Acoustic Stimulation↗

A randomized, controlled trial of the use of music during laceration repair.

STUDY OBJECTIVES: To determine whether music significantly reduces the pain and anxiety associated with laceration repair in the emergency department. PARTICIPANTS AND SETTING: Adult patients presenting to the ED at an urban teaching hospital for laceration repair. Exclusion criteria included patients less than 18 years old, having received analgesics, with suspected alcohol or substance intoxication, and in whom laceration repair was complicated by treatment of a more serious medical condition. DESIGN AND INTERVENTIONS: This was a randomized, controlled trial. After giving informed consent, patients were randomly assigned to receive standard laceration repair without music (control) or standard laceration repair with music. Patients assigned to the music group chose an audio tape from 50 available styles and artists. Patients received the music through a headset, and they controlled the volume. Intradermal lidocaine was used in all patients. Data were collected on heart rate, blood pressure, and respirations just before and immediately after wound repair. Psychological variables included the state subscale of the Spielberger State Trait Anxiety Inventory (STAI), a visual analog pain scale rating, and a brief questionnaire. STAI and pain scale ratings were analyzed with Wilcoxon's rank-sum test with an alpha error of .05. RESULTS: Thirty-eight patients (19 per group) completed the protocol. Pain scores were significantly (P less than .05) lower in the music group (mean, 2.09) than in controls (mean, 3.31). Anxiety after the procedure was reduced in both groups, but STAI reduction scores were not significantly different between groups (music, 17.7; control, 18.5). Seventeen of 19 patients (89%) rated music "very beneficial," and 100% said they would use music again. CONCLUSION: Music provides a safe, inexpensive, and effective adjunct for the management of pain in the ED but does not significantly affect anxiety.

Adult↗

The making of "The Genoma Music.".

Both genetic and musical sequences are ordered structures composed of combinations of a small number of elements, of nucleotides and musical notes. In the case of the genome, the emergence of cellular functions makes the order meaningful; in the case of musical sequences, the consequence of order is the production of mysterious esthetical effects in the human mind. Can any musical significance be found in DNA sequence? In this work, we present the technique used to convert DNA sequences into musical sequences. The musical equivalent of the sequence of a number of genes, either of fungal origin, such as Candida albicans or Sacharomyces cerevisiae (SLT2), or belonging to the human genome (genes involved in Alzheimer syndrome, blindness, and deafness such as Connexine 26 gene) has been obtained. Non-coding sequences are also important in life and music. The non-coding alphoid sequence has also been translated into a musical sequence, in this case using Fibonacci golden number basic series as structural helper. The elementary musical sequence derived from DNA sequence has served as an imposing frame in which rhythms, sounds, and melodies have been harmonically inserted. The Genoma Music Project is essentially a creative metaphor of the basic unity between the human mind and the natural ordered structure of life.

Amyloid beta-Protein Precursor↗

Stress reduction and analgesia in patients exposed to calming music postoperatively: a randomized controlled trial.

BACKGROUND AND OBJECTIVES: This randomized controlled trial was designed to evaluate, first, whether intra- or postoperative music therapy could influence stress and immune response during and after general anaesthesia and second, if there was a different response between patients exposed to music intra- or postoperatively. METHOD: Seventy-five patients undergoing open hernia repair as day care surgery were randomly allocated to three groups: intraoperative music, postoperative music and silence (control group). Anaesthesia and postoperative analgesia were standardized and the same surgeon performed all the operations. Stress response was assessed during and after surgery by determining the plasma cortisol and blood glucose levels. Immune function was evaluated by studying immunoglobulin A (IgA) levels. Patients' postoperative pain, anxiety, blood pressure (BP), heart rate (HR) and oxygen saturation were also studied as stress markers. RESULTS: There was a significantly greater decrease in the level of cortisol in the postoperative music group vs. the control group (206 and 72 mmol L(-1) decreases, respectively) after 2 h in the post anaesthesia care unit. The postoperative music group had less anxiety and pain and required less morphine after 1 h compared with the control group. In the postoperative music group the total requirement of morphine was significantly lower than in the control group. The intraoperative music group reported less pain after 1 h in the post anaesthesia care unit. There was no difference in IgA, blood glucose, BP, HR and oxygen saturation between the groups. CONCLUSION: This study suggests that intraoperative music may decrease postoperative pain, and that postoperative music therapy may reduce anxiety, pain and morphine consumption.

Adult↗

Effects of individualized versus classical "relaxation" music on the frequency of agitation in elderly persons with Alzheimer's disease and related disorders.

Confusion and agitation in elderly patients are crucial problems. This study tested Gerdner's mid-range theory of individualized music intervention for agitation. An experimental repeated measures pretest-posttest crossover design compared the immediate and residual effects of individualized music to classical "relaxation" music relative to baseline on the frequency of agitated behaviors in elderly persons with Alzheimer's disease and related disorders (ADRD). Thirty-nine subjects were recruited from six long-term-care facilities in Iowa. The sample consisted of 30 women and 9 men (mean age 82 years) with severe cognitive impairment. Baseline data were collected for 3 weeks. Findings from the Modified Hartsock Music Preference Questionnaire guided the selection of individualized music. Group A (n = 16) received individualized music for 6 weeks followed by a 2-week "washout" period and 6 weeks of classical "relaxation" music. Group B (n = 23) received the same protocol but in reverse order. Music interventions were presented for 30 minutes, two times per week. The Modified Cohen-Mansfield Agitation Inventory measured the dependent variable. A repeated measures analysis of variance with Bonferroni post hoc test showed a significant reduction in agitation during and following individualized music compared to classical music. This study expands science by testing and supporting a theoretically based intervention for agitation in persons with ADRD.

Aged↗

Improved recovery after music and therapeutic suggestions during general anaesthesia: a double-blind randomised controlled trial.

PURPOSE: This study was designed to determine whether music or music in combination with therapeutic suggestions in the intra-operative period under general anaesthesia could improve the recovery of hysterectomy patients. METHODS: In a double-blind randomised clinical investigation, 90 patients who underwent hysterectomy under general anaesthesia were intra-operatively exposed to music, music in combination with therapeutic suggestion or operation room sounds. The anaesthesia was standardised. Postoperative analgesia was provided by a patient-controlled analgesia (PCA). The pain scores were recorded by means of a visual analogue scale. Nausea, emesis, bowel function, fatigue, well-being and duration of hospital stay were studied as outcome variables. RESULTS: On the day of surgery, patients exposed to music in combination with therapeutic suggestions required less rescue analgesic compared with the controls. Patients in the music group experienced more effective analgesia the first day after surgery and could be mobilised earlier after the operation. At discharge from the hospital patients in the music and music combined with therapeutic suggestion group were less fatigued compared to the controls. No differences were noted in nausea, emesis, bowel function, well-being or length of hospital stay between the groups. CONCLUSION: This double-blind study has demonstrated that intra-operative music and music in combination with therapeutic suggestions may have some beneficial effects on postoperative recovery after hysterectomy. Further controlled studies are necessary to confirm our results.

Analgesics, Opioid↗

Effects of music therapy on anxiety in ventilator-dependent patients.

OBJECTIVE: The purpose of this study was to assess the effectiveness of music therapy in decreasing anxiety in ventilator-dependent patients. DESIGN: A crossover repeated measures design with random assignment was used. SETTING: The intensive care unit of a university hospital in Hong Kong was used as the setting for this study. PATIENTS: Twenty patients who were ventilator-dependent were recruited for the study. They were all Chinese with a mean age of 58.25 years (range, 19-84 y). Most (75%) were men. OUTCOME MEASURES: Physiologic measures of anxiety assessed in this study were mean blood pressure and respiratory rate. An additional measure was the Chinese version of the Spielberger State-Trait Anxiety Inventory. INTERVENTION: Patients were randomized to receive either 30 minutes of uninterrupted rest and then 30 minutes of music therapy or the music therapy first and then the uninterrupted rest period. Patients listened to relaxing music by using audiocassette players and headphones. Subjects selected the music of their choice from a selection including both Chinese and Western music. Subjects had physiologic measures taken immediately before the intervention (or rest period) and at 5-minute intervals throughout the intervention. The Chinese version of Spielberger's State-Trait Anxiety Inventory was completed before the intervention and immediately after the intervention. RESULTS: Findings indicated that music therapy was more effective in decreasing state anxiety than was an uninterrupted rest period (P <.01). As measured by analysis of variance with repeated measures, blood pressure and respiratory rate showed no significant differences in the 2 conditions over time. However, significant differences were observed at the end of the intervention (after 30 minutes) between the 2 conditions, with music therapy being superior to the rest period. CONCLUSION: Music therapy is an effective nursing intervention in decreasing anxiety in ventilator-dependent patients and its use should be incorporated into the care of mechanically ventilated patients. For the Chinese patients, culture and language were the predominant factors in their choice of music.

Adult↗

Music therapy in the age of enlightenment.

As music therapists continue to discover more about the therapeutic powers of music, it is interesting now and then to look to the past in order to seek the roots of our contemporary practices. In this regard, the writings of eighteenth-century physicians are pivotal in the development of music therapy, for it was these individuals who first began to depend greatly upon scientific experimentation and observation to formulate their procedures. Representative of this stage in the history of music therapy are the findings of the renowned London physician Richard Brocklesby, the only doctor to write a treatise on music therapy in eighteenth-century England. The subjects treated by Brocklesby in his Reflections on the Power of Music (1749) include his musical remedies for the excesses of various emotions-particularly fear, excessive joy, and excessive sadness. He also discusses his musical remedies for diseases of the mind recognized in the eighteenth century-delirium, frenzy, melancholia, and maniacal cases. He considers music as well an aid to the elderly and to pregnant women. In short, Brocklesby provides a lively account of the curative powers of music as viewed in the mid-eighteenth century by an excellent medical mind.

Affect↗

The effect of instrumental and vocal music on adherence to a physical rehabilitation exercise program with persons who are elderly.

This study compared live, instrumental music, vocal music, and no music on the repetition frequencies for 14 prescribed physical therapy rehabilitation exercises. Male (N = 4) and female (N = 15) residents of care centers for older adults served as subjects. They ranged in age from 65 to 90 years (M= 84.3), and were either referred to physical therapy or were already involved in a physical therapy exercise pro-gram. All subjects (N = 19) participated in 6 treatment sessions under 3 conditions: Two sessions with live instrumental music, two with live vocal music, and two with no music. In all music sessions, familiar and recognizable songs were paired with specific exercises. Each exercise in all conditions had the same duration, and a metronome established consistent tempos. Each session was videotaped for later review and data collection. Analyses of variance were calculated for treatment effects and mean differences among the three conditions which yielded significant treatment effects and treatment differences among conditions for 6 of the 14 exercises. Unsolicited comments from subjects indicated preference for music over no music conditions while exercising. Further study is required to establish the relationship between music enhanced exercises and adherence to exercise regimens in populations of older adults.

Aged↗