Effect of Long-Term Music Therapy Intervention on Autonomic Function in Anthracycline-Treated Breast Cancer Patients

Abstract

Anthracyclines are potent antineoplastic agents associated with cardiotoxicity, which may lead to congestive heart failure, causing impairment of autonomic cardiovascular function as assessed by heart rate variability (HRV). This decreases survival rates. This study aimed to determine whether music therapy intervention improves autonomic function in anthracycline-treated breast cancer patients, and if so, whether such improvements persist after cessation of the intervention. Participants were 12 women with breast cancer who had undergone mastectomy or breast-conserving treatment and adjuvant chemotherapy; they attended 8 weekly music therapy sessions, each lasting 2 hours. Electrocardiogram traces (5 minutes) for HRV analysis were recorded 4 times: prior to the first music session, T1; after the fourth music session, T2; after the eighth music session, T3; and 4 weeks after the completion of music therapy, T4. HRV parameters were subjected to a nonparametric Friedman test on the differences between T1 and T2, T3, and T4. The standard deviation of normal intervals and the total power of HRV parameters, related to global autonomic function, were significantly higher at T3 than at T1. The root-mean-square differences of successive normal R-R intervals and high-frequency (HF) HRV parameters, related to parasympathetic activity, were significantly increased, but no change was seen in the LF/HF ratio of HRV parameters (which is related to sympathetic activity) during the music therapy. Global autonomic function and parasympathetic activity had not changed significantly at T4 relative to T1. The authors provide preliminary evidence of the benefits of music therapy for anthracycline-treated breast cancer survivors.

Cardiac autonomic regulation during exposure to auditory stimulation with classical baroque or heavy metal music of different intensities

“…[1] A previous study demonstrated that auditory stimulation with a relaxant musical style two hours per day, two days per week over eight weeks improved cardiac autonomic regulation in subjects treated with a cardiotoxic drug; [2] however, its acute effects are still controversial. [1] Conversely, heavy metal musical style was indicated to present negative effects that are associated with stress, including sleep disorders, fatigue, exhaustion, and immunologic activity impairment.…”

Global Chaotic Parameters of Heart Rate Variability During Exposure to Musical Auditory Stimulation

“…In contrast, a different style of relaxant music was reported to chronically increase the parasympathetic modulation of the heart [2]. The authors observed that music therapy during eight months with popular Taiwanese songs with moderate, pleasant rhythms and tempos improved HRV of the patients treated with an anti-neoplasic cardiotoxic drug.…”

“…The common intensity used to induce a startle reflex is 110 dB, and this intensity is much louder than environmental noise. Nevertheless, subjects repeatedly exposed to between 60 dB and 110 dB white-noise stimuli were seen to become habituated over time with regard to their cardiac response [1,2,16].…”

“…1 Центр изучения автономной нервной системы, Департамент патологии речи, факультет наук, Университет Марилья, сан-Паоло, Бразилия; 2 Кардиореспи-раторная исследовательская группа, Отделение биологических и медицин-ских наук, факультет наук о жизни, Университет Оксфорд Брукс, Оксфорд, соединённое Королевство; 3 Школа медицины, Университет сан-Паоло, сан-Паоло, Бразилия; 4 Лаборатория Дизайна исследований и научного письма, Департамент фундаментальных наук, Школа медицины, санто Андре, сан-Паоло, Бразилия; 5 Школа общественного здоровья, санто Андре, сан-Паоло, Бразилия.…”

“…As mentioned above, the literature indicates the beneficial effects of musical auditory stimulation for a protracted time on HRV 2 . However, no previous study investigated the shortterm effects of music on global chaotic parameters of HRV.…”