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Evaluation of the Short-Term Music Therapy on Brain Functions of Preterm Infants Using Functional Near-Infrared Spectroscopy.

ABSTRACT: Music contains substantial contents that humans can perceive and thus has the capability to evoke positive emotions. Even though neonatal intensive care units (NICUs) can provide preterm infants a developmental environment, they still cannot fully simulate the environment in the womb. The reduced maternal care would increase stress levels in premature infants. Fortunately, music intervention has been proved that it can improve the NICU environment, such as stabilize the heart rate and the respiratory rate, reduce the incidence of apnea, and improve feeding. However, the effects of music therapy on the brain development of preterm infants need to be further investigated. In this paper, we evaluated the influence of short-term music therapy on the brain functions of preterm infants measured by functional near-infrared spectroscopy (fNIRS). We began by investigating how premature babies perceive structural information of music by calculating the correlations between music features and fNIRS signals. Then, the influences of short-term music therapy on brain functions were evaluated by comparing the resting-state functional connectivity before and after the short-term music therapy. The results show that distinct brain regions are responsible for processing corresponding musical features, indicating that preterm infants have the capability to process the complex musical content. However, the results of network analysis show that short-term music intervention is insufficient to cause the changes in cerebral functional connectivity. Therefore, long-term music therapy may be required to achieve the deserved effects on brain functional connectivity.

SUBMITTER: Ren H

PROVIDER: S-EPMC8505667 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:ObjectiveTo determine if it is possible to stabilise the cerebral oxygenation of extremely preterm infants monitored by cerebral near infrared spectroscopy (NIRS) oximetry.DesignPhase II randomised, single blinded, parallel clinical trial.SettingEight tertiary neonatal intensive care units in eight European countries.Participants166 extremely preterm infants born before 28 weeks of gestation: 86 were randomised to cerebral NIRS monitoring and 80 to blinded NIRS monitoring. The only exclusion criterion was a decision not to provide life support.InterventionsMonitoring of cerebral oxygenation using NIRS in combination with a dedicated treatment guideline during the first 72 hours of life (experimental) compared with blinded NIRS oxygenation monitoring with standard care (control).Main outcome measuresThe primary outcome measure was the time spent outside the target range of 55-85% for cerebral oxygenation multiplied by the mean absolute deviation, expressed in %hours (burden of hypoxia and hyperoxia). One hour with an oxygenation of 50% gives 5%hours of hypoxia. Secondary outcomes were all cause mortality at term equivalent age and a brain injury score assessed by cerebral ultrasonography.RandomisationAllocation sequence 1:1 with block sizes 4 and 6 in random order concealed for the investigators. The allocation was stratified for gestational age (<26 weeks or ≥ 26 weeks).BlindingCerebral oxygenation measurements were blinded in the control group. All outcome assessors were blinded to group allocation.ResultsThe 86 infants randomised to the NIRS group had a median burden of hypoxia and hyperoxia of 36.1%hours (interquartile range 9.2-79.5%hours) compared with 81.3 (38.5-181.3) %hours in the control group, a reduction of 58% (95% confidence interval 35% to 73%, P<0.001). In the experimental group the median burden of hypoxia was 16.6 (interquartile range 5.4-68.1) %hours, compared with 53.6 (17.4-171.3) %hours in the control group (P=0.0012). The median burden of hyperoxia was similar between the groups: 1.2 (interquartile range 0.3-9.6) %hours in the experimental group compared with 1.1 (0.1-23.4) %hours in the control group (P=0.98). We found no statistically significant differences between the two groups at term corrected age. No severe adverse reactions were associated with the device.ConclusionsCerebral oxygenation was stabilised in extremely preterm infants using a dedicated treatment guideline in combination with cerebral NIRS monitoring.Trial registration ClinicalTrial.gov NCT01590316.

Project description:BACKGROUND:Cerebral oxygenation monitoring may reduce the risk of death and neurologic complications in extremely preterm infants, but no such effects have yet been demonstrated in preterm infants in sufficiently powered randomised clinical trials. The objective of the SafeBoosC III trial is to investigate the benefits and harms of treatment based on near-infrared spectroscopy (NIRS) monitoring compared with treatment as usual for extremely preterm infants. METHODS/DESIGN:SafeBoosC III is an investigator-initiated, multinational, randomised, pragmatic phase III clinical trial. Inclusion criteria will be infants born below 28?weeks postmenstrual age and parental informed consent (unless the site is using 'opt-out' or deferred consent). Exclusion criteria will be no parental informed consent (or if 'opt-out' is used, lack of a record that clinical staff have explained the trial and the 'opt-out' consent process to parents and/or a record of the parents' decision to opt-out in the infant's clinical file); decision not to provide full life support; and no possibility to initiate cerebral NIRS oximetry within 6?h after birth. Participants will be randomised 1:1 into either the experimental or control group. Participants in the experimental group will be monitored during the first 72?h of life with a cerebral NIRS oximeter. Cerebral hypoxia will be treated according to an evidence-based treatment guideline. Participants in the control group will not undergo cerebral oxygenation monitoring and will receive treatment as usual. Each participant will be followed up at 36?weeks postmenstrual age. The primary outcome will be a composite of either death or severe brain injury detected on any of the serial cranial ultrasound scans that are routinely performed in these infants up to 36?weeks postmenstrual age. Severe brain injury will be assessed by a person blinded to group allocation. To detect a 22% relative risk difference between the experimental and control group, we intend to randomise a cohort of 1600 infants. DISCUSSION:Treatment guided by cerebral NIRS oximetry has the potential to decrease the risk of death or survival with severe brain injury in preterm infants. There is an urgent need to assess the clinical effects of NIRS monitoring among preterm neonates. TRIAL REGISTRATION:ClinicalTrial.gov, NCT03770741. Registered 10 December 2018.

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Evaluation of the Short-Term Music Therapy on Brain Functions of Preterm Infants Using Functional Near-Infrared Spectroscopy.

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