The Effects of Music on Neuromodulation of Pain Responses Mark Jude Tramo, MD PhD
Disclosure
Nothing to Disclose
Learning Objectives Review a recent randomized-controlled clinical trial whose results indicate that music can decreased pain and stress in premature infants following blood sampling via heel-stick Discuss candidate neuromodulatory mechanisms mediating music’s effects in these patients Develop neurobiologically-based hypotheses that could account for the beneficial effects of music
Apollo
Ἀπόλλων, Apóllōn, Ἀπέλλων, Apellōn
God, Music & Healing Director, Choir of The Muses Son of Zeus & Leto Brother of Hermes (Mercury) Father of Asclepius
Asclepius
Delphic Hymn
Oracle at the sanctuary of Apollo in Delphi. c. 725 BCE
Music Therapy Today Large number of anecdotal reports accrued over centuries about music’s ability to ameliorate pain and suffering across a wide range of ages, diseases, and clinical settings Growing body of evidence for music’s efficacy based on randomized-controlled clinical trials, including pain
Tramo et al 2011 Music & Medicine
Heart Rate
Population Data (N=13) • Increase 19% (p=.02) • 8/13 (62%) >160 bpm
Heart Rate
Single-Patient Data (Test Group)
Tramo et al 2011 Music & Medicine
PHYSIOLOGICAL RESULTS
(No Music)
Heart Rate
Lullabies • 6% decrease (p=.25) • 3/6 (50%) decrease by ≥10 bpm
• 17% decrease (p=.02) • 6/7 (86%) decrease by ≥10 bpm
BEHAVIORAL RESULTS Data from 9 infants 8/9 cried during heel-stick 4/4 stopped crying during lullabies 2/4 stopped crying without lullabies
Tramo et al 2011 Music & Medicine
Music Improves Dopaminergic Neurotransmission: Demonstration Based On The Effect Of Music On Blood Pressure Regulation
Sutoo & Akiyama Brain Research 2004
Sutoo & Akiyama Brain Research 2004
Dopamine Intensity Music >NonMusic in CPl (p <.01)
No Music
Mozart, Adagio from Divertimento No.7 in D Major, K. 205, played repeatedly for 120 min Sutoo & Akiyama Brain Research 2004
Neuroanatomical-chemical Model For The Effect Of Music On Increased Heart Rate Caused By Pain Pain
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Increased Sympathetic Tone
Activation of Auditory CNS with Music Calmodulin-Dependent Increase in Tyrosine Hydroxylase Activity in Lateral Caudate-Putamen Increased Dopamine Concentration in Lateral Caudate-Putamen D2 Receptor Binding Decreased Sympathetic Tone
Acknowledgements
Miiriam Lense MS
Inst for Music & Brain Sci Vanderbilt Univ
Caitlin Van Ness MST Inst for Music & BrainSci
Jonathan Cronin MD
Harvard Medical School Massachusetts General Hosp
The Institute for Music & Brain Science www.BrainMusic.org
Jerome Kagan PhD Harvard University
Margaret Settle RN
Massachusetts General Hosp
Verne Caviness MD PhD Inst for Music & BrainSci Harvard Medical School Massachusetts General Hosp