Purpose: To investigate the feasibility, acceptability, and preliminary efficacy of a 6-session music therapy protocol on self-efficacy, quality of life, and coping skills in adults with sickle cell disease (SCD). Patients and Methods: Using a mixed-methods intervention design, adults with SCD (ages 21-57; mean age 32.33) were randomized (1:1) to either 1) a 6-session music therapy (MT) intervention (n = 12) or 2) waitlist control (WLC) (n = 12) using stratified randomization where factors were age in years (≤30 vs >30), and sex (male, female). All participants completed two weeks of daily electronic pain diary entries and self-efficacy, quality of life, and coping skills measures before and after their assigned study condition to explore preliminary efficacy. MT participants were taught music exercises accessed via smartphone and subsequently interviewed to determine feasibility and acceptability. Results: The enrollment rate was 89%. All study measures were completed, with high rates of electronic pain diary completion at baseline (70%) and 2-week follow-up (66%). Interviews revealed two overall themes related to MT participants' experience: 1) participants learned new self-management skills and 2) MT improved participants' ability to cope with pain. MT participants demonstrated 100% attendance. In preliminary analyses, MT participants demonstrated significant improvements (means ± SD) in self-efficacy (5.42 ± 5.43, p = 0.008, d = 1.20), PROMIS sleep disturbance (−1.49 ± 6.68, p = 0.023, d = −0.99), PROMIS pain interference (−2.10 ± 4.68, p = 0.016, d = −1.06), and ASCQ-Me social functioning impact scores (2.97 ± 6.91, p = 0.018, d = 1.05) compared to WLC participants. Conclusion: Preliminary findings support the feasibility and acceptability of music therapy for home use in adults with SCD. While music therapy may assist adults with SCD in improving self-efficacy and quality of life, subsequent, fully-powered clinical research is needed to determine its efficacy.

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Comprehending how the brain functions requires an understanding of the dynamics of neuronal assemblies. Previous work used a mean-field reduction method to determine the collective dynamics of a large heterogeneous network of uniformly and globally coupled theta neurons, which are a canonical formulation of Type I neurons. However, in modeling neuronal networks, it is unreasonable to assume that the coupling strength between every pair of neurons is identical. The goal in the present work is to analytically examine the collective macroscopic behavior of a network of theta neurons that is more realistic in that it includes heterogeneity in the coupling strength as well as in neuronal excitability. We consider the occurrence of dynamical structures that give rise to complicated dynamics via bifurcations of macroscopic collective quantities, concentrating on two biophysically relevant cases: (1) predominantly excitable neurons with mostly excitatory connections, and (2) predominantly spiking neurons with inhibitory connections. We find that increasing the synaptic diversity moves these dynamical structures to distant extremes of parameter space, leaving simple collective equilibrium states in the physiologically relevant region. We also study the node vs. focus nature of stable macroscopic equilibrium solutions and discuss our results in the context of recent literature.

The authors have advised there is an error in the headings of Table 5 on pages 85 and 86 of the published paper. The heading "Waitlist Control (n=12)" should read "Music Therapy (n=12)" and "Music Therapy (n=12)" should read "Waitlist Control (n=12)". This error was introduced by the Editorial staff during the publication process.