中国神经再生研究(英文版) ›› 2021, Vol. 16 ›› Issue (7): 1266-1272.doi: 10.4103/1673-5374.301021

• 原著:神经损伤修复保护与再生 • 上一篇    下一篇

选择性音乐声频刺激对意识障碍患者自主神经系统激活有积极作用:随机对照试验

  

  • 出版日期:2021-07-15 发布日期:2021-01-07
  • 基金资助:

    北京市自然科学基金项目(Z181100001718066

Positive effects of music therapist’s selected auditory stimulation on the autonomic nervous system of patients with disorder of consciousness: a randomized controlled trial

Xiao-Ying Zhang1, 2, 3, 4, 5, Jian-Jun Li1, 2, 3, 4, *, Hai-Tao Lu1, 6, Wen-Jia Teng1, 5, Song-Huai Liu1, 5   

  1. 1 School of Rehabilitation Medicine, Capital Medical University, Beijing, China;  2 China Rehabilitation Science Institute, Beijing, China;  3 Beijing Key Laboratory of Neural Injury and Rehabilitation, Beijing, China;  4 Center of Neural Injury and Repair, Beijing Institute for Brain Disorders, Beijing, China;   5 Music Therapy Center, Department of Psychology, China Rehabilitation Research Center, Beijing, China;  6 Department of Neurorehabilitation, China Rehabilitation Research Center, Beijing, China
  • Online:2021-07-15 Published:2021-01-07
  • Contact: Jian-Jun Li, MD, crrclijj@163.com.
  • Supported by:
    This study was supported by the Beijing Science and Technology Project Foundation of China, No. Z181100001718066 (to HTL).

摘要:

音乐听觉刺激是唤醒重度意识障碍患者的重要治疗方法。既往研究者通常使用患者喜爱的音乐作为刺激条件,但是研究者对此有着不一样的意见。此项在中国康复研究中心完成的随机对照试验对20例唤醒重度意识障碍患者分别以治疗师选择的音乐(n=10;男6女4;43.33±18.76岁)和偏好音乐(n = 10;男5女5;48.83±18.79岁)两种音乐声频听觉刺激进行治疗,每天30min,每周5次,共进行6周。结果发现2种刺激方法对患者与心率变异性相关的指标心率、所有心跳间期的标准偏差以及相邻正常心跳间期差值平方和的均方根的影响没有差异。但与偏好音乐刺激患者相比,以治疗师选择的音乐进行刺激的患者相邻正常心跳间期差值超过 50 ms的百分比、低高频功率的比值、标准化低频功率和总功率较高,而标准化高频功率和极低频范围带较低。表明与偏好音乐声频刺激相比,意识障碍患者在聆听由专业人员选择的音乐声频刺激时,其自主神经系统有更高的交互活跃性。因此对于唤起意识障碍患者的自主神经系统,应使用经过遴选的音乐声频刺激。该研究于2018年3月12日获得中国康复研究中心伦理委员会批准(批准号2018-022-1),并于2018年8月15日在中国临床试验注册中心注册(注册号ChiCTR1800017809)。

https://orcid.org/0000-0002-8441-7537 (Jian-Jun Li); 

https://orcid.org/0000-0002-6329-2958 (Xiao-Ying Zhang)

关键词: 自主神经系统, 意识障碍, 音乐疗法, 听觉, 心率, 修复, 保护, 主观评分, 误诊

Abstract: The current randomized controlled trial was performed at the China Rehabilitation Science Institute, China to test the hypothesis that musical auditory stimulation has positive effects on the autonomic nervous system of patients with disorder of consciousness. Although past studies have recommended that patients with disorder of consciousness listen to patient-preferred music, this practice is not universally accepted by researchers. Twenty patients with severe disorder of consciousness listened to either therapist-selected (n = 10, 6 males and 4 females; 43.33 ± 18.76 years old) or patient-preferred (n = 10, 5 males and 5 females, 48.83 ± 18.79 years old) musical therapy, 30 minutes/day, 5 times/week for 6 weeks. The results showed no obvious differences in heart rate variability-related parameters including heart rate, standard deviation of normal-to-normal R-R intervals, and the root-mean-square of successive heartbeat interval differences of successive heartbeat intervals between the two groups of patients. However, percentage of differences exceeding 50 ms between adjacent normal number of intervals, low-frequency power/high-frequency power, high-frequency power norm, low-frequency power norm, and total power were higher in patients receiving therapist-selected music than in patients receiving their own preferred music. In contrast, this relationship was reversed for the high-frequency power and very-low-frequency band. These results suggest that compared with preferred musical stimulation, therapist-selected musical stimulation resulted in higher interactive activity of the autonomic nervous system. Therefore, therapist-selected musical stimulation should be used to arouse the autonomic nervous system of patients with disorder of consciousness. This study was approved by the Institutional Ethics Committee of China Rehabilitation Research Center, China (approval No. 2018-022-1) on March 12, 2018 and registered with the Chinese Clinical Trial Registry (registration number ChiCTR1800017809) on August 15, 2018. 

Key words: auditory, autonomic nerve system, disorder of consciousness, heart rate, misdiagnosis, music therapy, protection, repair, subjective score