This application requests support for an R-21 level program of research on music analgesia in response to PA-02-124, Basic and Pre-Clinical Research on Complementary and Alternative Medicine (CAM). Its key themes are pain measurement and non-pharmacological analgesia in the CAM areas of mind-body intervention and music therapy. The investigators will introduce music engagement, a new theoretical approach to non-pharmacological analgesia. We define engagement in the framework of consciousness studies as a dynamical, complex process of constructing models of reality, or which pain is one, and we reason that engagement prevents the construction of pain. Degree of engagement depends on factors such as ability to sustain activity, complexity of input, and individual differences. A marker of blocked pain construction is reduction in the psychophysiological arousal that normally accompanies the perception of painful events. It is a correlate of pain, whereas pain itself is a subjective experience. While subjective pain -report is a standard measure, it poses a paradox: To provide pain ratings subjects must elicit the very experience they are engaged in preventing. Study One will investigate normal volunteers undergoing painful fingertip shocks while engaged in music listening tasks. It will evaluate the effects of concurrent, retrospective, and no report on reduction of psychophysiological arousal to painful stimuli while testing the hypotheses that pain report will 1) increase psychophysiological arousal to painful stimuli; concurrent report will produce greater increase; 2) reduce task engagement; concurrent report will produce greater reduction; and 3) interact with task difficulty, producing reduced psychophysiological arousal to painful stimuli during retrospective but not concurrent report during music tasks. Study Two will address the hypotheses that 1) task engagement reduces response to painful stimuli; 2) greater signal complexity contributes to greater engagement and thereby greater reduction in response; and 3) task difficulty and signal complexity combine to increase engagement and thereby greater reduction in response. Results of Study One will guide choice of outcome measures for Study Two. This research program will inform choices of appropriate pain measures in research on cognitive-behavioral methods for pain control and will provide a basis for subsequent research on direct clinical intervention for pain reduction through music engagement.
| Bradshaw, David H; Chapman, C Richard; Jacobson, Robert C et al. (2012) Effects of music engagement on responses to painful stimulation. Clin J Pain 28:418-27 |
