The Effect of Music on aEEG Cyclicity in Preterm Neonates

Abstract

Several methods can be used in the neonatal intensive care unit (NICU) to reduce stress and optimize the quality of life during this period of hospitalization. Among these, music could play an important role. We investigated the effect of different kinds of music therapies on the brain activity of very preterm infants using amplitude-integrated EEG. Sixty-four patients were included and randomly assigned to three different groups: live music group, recorded music group, and control group. In both intervention groups, music was started after the appearance of the first quiet-sleep phase, with a subsequent duration of 20 min. Changes between the first and second quiet-sleep epochs were analyzed using the amplitude-integrated EEG. When looking at single parameters of the amplitude-integrated EEG trace, no differences could be found between the groups when comparing their first and second quiet-sleep phase regarding the parameters of change from baseline, quality of the quiet-sleep epoch, and duration. However, when looking at the total cyclicity score of the second quiet-sleep phase, a difference between both intervention groups and the control group could be found (live music therapy vs. control, p = 0.003; recorded music therapy vs. control, p = 0.006). Improvement within the first and second quiet-sleep epochs were detected in both music groups, but not in the control group. We concluded that our study added evidence of the beneficial effect of music on the amplitude-integrated EEG activity in preterm infants.

The Role of Music Therapy with Infants with Perinatal Brain Injury

“…Van Dokkum et al, 2021 suggest that stimulation levels should be gradually increased starting with kangaroo care and then introducing voice with a Remo Ocean drum before later moving to voice and guitar after three sessions. A gradual approach has been used in other studies with preterm infants [24,64]. This suggests that the immediate use of lullabies accompanied by another voice or guitar in Epstein et al's study may have created a heightened alert state and increased maternal anxiety.…”

“…This is likely due to the music therapist's ability to create music that is reflective of the infant's state and behavioural responses. It would appear that whilst pre-recorded interventions have immediate behavioural responses such as reductions in pain scores [36], sleep cycles [64] and synchronization of sucking [41], neurological benefits are most likely with live music that is infant-directed. Two studies provided evidence for supporting parent education in order for the benefits of interventions to be continued after discharge.…”

The relationship between crying of premature infants with Monro-kellie hypothesis and increase of ventricular CSF Based on Doppler ultrasound findings

“…The Monro-Kellie hypothesis (MKH) states that volumetric changes in each intracranial component (blood, brain tissue, cerebrospinal uid) must be balanced by a simultaneous contrast change to maintain intracranial pressure at a constant cranial volume, resulting in a decrease in CSF (14,15). Some studies have shown that electrical stimulation of the anterior insula in the brain plays an important role in the biology of emotion especially when this region is evoked by repeated crying (16,17). Crying in the rst hours of life may be a re ux caused by the electrical activity of the brain via the accumulation of carbon dioxide in the cerebral arteries, rather than just respiratory re ux.…”