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The Effects of Music Intervention in the Management of Chronic Pain: A Single-Blind, Randomized, Controlled Trial
Guétin S, Giniès P, Siou DK, Picot MC, Pommié C, Guldner E, Gosp AM, Ostyn K, Coudeyre E, Touchon J.
*Service de Neurologie, Centre Mémoire de Ressources et de Recherches, INSERMU 888 ‡Centre d'Evaluation et de Traitement de la Douleur §Département d'Information Médicale (DIM), CHRU Montpellier †Laboratoire de Psychologie Clinique et Psychopathologie (LPCP) EA 4056, Université Paris-Descartes, Sorbonne Paris Cite´, Paris ∥CHU Clermont-Ferrand, Service de Médecine Physique et de Réadaptation, Clermont-Ferrand, France.
A music intervention method in the management of pain was recently developed while taking account of recommendations in the scientific literature. The objective of this study was to assess the usefulness of this music intervention to the management of patients with chronic pain.
A controlled, single-blind, randomized trial was used. Eighty-seven patients presenting with lumbar pain, fibromyalgia, inflammatory disease, or neurological disease were included in the study. During their hospitalization, the intervention arm (n=44) received at least 2 daily sessions of music listening between D0 and D10, associated with their standard treatment, and then pursued the music intervention at home until D60 using a multimedia player in which the music listening software program had been installed. The control arm received standard treatment only (n=43). The end points measured at D0, D10, D60, and D90 were: pain (VAS), anxiety-depression (HAD) and the consumption of medication.
At D60 in the music intervention arm, this technique enabled a more significant reduction (P<0.001) in pain (6.3±1.7 at D0 vs. 3±1.7 at D60) when compared with the arm without music intervention (6.2±1.5 at D0 vs. 4.6±1.7 at D60). In addition, music intervention contributed to significantly reducing both anxiety/depression and the consumption of anxiolytic agents.
These results confirm the value of music intervention to the management of chronic pain and anxiety/depression. This music intervention method appears to be useful in managing chronic pain as it enables a significant reduction in the consumption of medication.
Mounting evidence suggests that musical training benefits the neural encoding of speech. This paper offers a hypothesis specifying why such benefits occur. The “OPERA” hypothesis proposes that such benefits are driven by adaptive plasticity in speech-processing networks, and that this plasticity occurs when five conditions are met. These are: (1) Overlap: there is anatomical overlap in the brain networks that process an acoustic feature used in both music and speech (e.g., waveform periodicity, amplitude envelope), (2) Precision: music places higher demands on these shared networks than does speech, in terms of the precision of processing, (3) Emotion: the musical activities that engage this network elicit strong positive emotion, (4) Repetition: the musical activities that engage this network are frequently repeated, and (5) Attention: the musical activities that engage this network are associated with focused attention. According to OPERA, when these conditions are met neural plasticity drives the networks in question to function with higher precision than needed for ordinary speech communication. Yet since speech shares these networks with music, speech processing benefits. The OPERA hypothesis is used to account for the observed superior subcortical encoding of speech in musically trained individuals, and to suggest mechanisms by which musical training might improve linguistic reading abilities.
The OPERA hypothesis suggests that five essential conditions must be met in order for musical training to drive adaptive plasticity in speech processing networks. This hypothesis generates specific predictions, for example, regarding the kinds of musical training that could benefit reading skills. It also carries an implication regarding the notion of “musical training.” Musical training can involve different skills depending on what instrument and what aural abilities are being trained. This hypothesis states that the benefits of musical training depend on the particular acoustic features emphasized in training, the demands that music places on those features in terms of the precision of processing, and the degree of emotional reward, repetition and attention associated with musical activities. Simply giving an individual music lessons may not result in any benefits for speech processing. Indeed, depending on the acoustic feature being trained (e.g., amplitude envelope), learning a standard musical instrument may not be an effective way to enhance neural processing of that feature. Instead, novel digital instruments may be necessary, which allow controlled manipulation of sound features. Thus, OPERA raises the idea that in the future, musical activities aimed at benefiting speech processing should be purposely shaped to optimize the effects of musical training. From a broader perspective, OPERA contributes to the growing body of research aimed at understanding the relationship between musical and linguistic processing in the human brain. Understanding this relationship will likely have significant implications for how we study and treat a variety of language disorders, ranging from sensory to syntactic processing.
26 July, 2011. Published in Frontiers of Psychology, 29 June 2011.
Debbie Honeycutt, email@example.com
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