Neonatal Music Therapy and Cerebral Oxygenation in Extremely and Very Preterm Infants: a Pilot Study

Abstract

Music therapy is a novel intervention that may minimize neonatal stress. The mechanism of action is still largely unknown. We hypothesized that one mechanism of action regards altered brain oxygenation (either due to altered cerebral perfusion or altered cerebral oxygen consumption). We measured cerebral oxygenation before, during and after music therapy sessions using Near-Infrared Spectroscopy (NIRS). We extracted data on cerebral oxygen saturation (rcSO2) and calculated cerebral fractional tissue oxygen extraction (cFTOE). In addition, we measured heart rate. We included 20 infants, receiving 44 music therapy sessions. Median gestational age was 27 weeks, the majority were males. We identified two distinct reactions: in one group rcSO2 increased and cFTOE decreased during therapy compared with before therapy, whereas in the other group rcSO2 decreased and cFTOE increased during therapy compared with before therapy. The first may indicate a sedative effect, whereas the second may reflect a hyperalert state. The observed changes in heart rate may contribute to these observations through altered cerebral perfusion. The clinical significance of these two distinct reactions for music processing and (future) neurological functioning in these infants warrants further investigation.

Concept and considerations of a medical device: the active noise cancelling incubator

“…Fundamental knowledge and monitoring of human foetal development ≥28 weeks guides the development and research of the influence of clinically administered auditory stimuli including music-based therapies and interventions ( 22 , 23 ). Detailed information regarding the influence of nutrition, diurnal (day/night) rhythm, maternal and familial stimuli, and cardiovascular, respiratory, intestinal, and neurological foetal development is necessary for successful development and application of the ANC-incubator.…”

“…Understanding the influence of music-based therapies and interventions on early brain development has received increasing interest over the past few decades. Neural biomarkers through DNA methylation in combination with haemodynamic measurements and near infrared spectroscopy show to be promising candidates in determining neural development in very young patients in the neonatal intensive care unit ( 22 ).…”

“…Research studying the influence of a live music-based therapeutic intervention on neural and physical development in extremely preterm born children and beyond has shown that music therapy, when administered by specially trained NICU music therapists, has beneficial results on haemodynamic markers, i.e., blood pressure and heart rate, sedation, oxygenation, and neural development as measured with near infrared spectroscopy ( 11 , 22 – 25 ). Furthermore, the research has demonstrated that live music therapy has a much more profound effect on the wellbeing of the child than recorded music, as the music therapist can adapt to the vital signs of the child, tailoring the music-based therapeutic approach to each infant individually.…”

“…Furthermore, the research has demonstrated that live music therapy has a much more profound effect on the wellbeing of the child than recorded music, as the music therapist can adapt to the vital signs of the child, tailoring the music-based therapeutic approach to each infant individually. This music therapeutic approach indicated a trend in the improvement of neural activation and connectivity reducing neurodevelopmental problems and improving speech and language, which provides NICU patients with better chances to participate in the society, improving their quality of life and public healthcare ( 22 ).…”

The Role of Music Therapy with Infants with Perinatal Brain Injury

“…Whilst the evidence base to support the use of MT in neonatal units is still growing, the limited research undertaken with preterm infants highlights that MT can improve an infant's physiological parameters, behaviour states, weight gain and feeding ability [18,23]. Research has also demonstrated beneficial effects for preterm infants' functional brain activity and connectivity [24] and cerebral oxygenation [25] due to MT's ability to create social connectivity [26] and its potential to provide a stimulating or sedative effect as appropriate.…”