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IntroductionMethodResultsDiscussionIn recent years, music-based therapeutic interventions have evolved to integrate technological supports, bridging the gap between more traditional music therapy practices (linked to active or receptive relational settings) and other music-based practices that focus on therapeutic/rehabilitative aspects through the direct action of sound on the patient/client. These novel approaches maintain the characteristics of therapeutic interventions while differentiating themselves from more traditional music therapy through the integration of technological supports, directly or indirectly facilitating its implementation.The article reports some application and research experiences carried out in a music therapy research laboratory. For each experience, the therapeutic rationale and possible clinical applications are described, and results obtained from some studies are presented.The first example involves the use of sonification techniques mediated by the use of sensors and applied in the context of neuromotor rehabilitation. The second example involves the use of an algorithm (Melomics-Health) designed to create music specifically for therapeutic purposes. The third example refers to the possibility of employing machine learning techniques and/or artificial neural networks to identify predictive factors of success or relevance in therapeutic interventions with music.The paper shows how technologies can support music therapy but, more importantly, how they can create new application possibilities and potential future developments. From this perspective, the music therapist assumes a role that goes beyond music interaction and explores novel technology applications with the idea of discovering new resources applicable to therapeutic music interventions. [ABSTRACT FROM AUTHOR]

Background: The use of music in cognitive interventions represents a possibility with potential worthy of further investigation in the field of aging, both in terms of prevention from dementia, in the phase of mild cognitive impairment, and in the treatment of overt dementia. Objectives: Currently, the types of music-based interventions proposed in the literature are characterized by wide heterogeneity, which is why it is necessary to clarify which interventions present more evidence of effectiveness in stimulating different cognitive domains. Method: The study was conducted in accordance with PRISMA guidelines for scoping reviews. By searching two different databases, PubMed and the Web of Science, all studies evaluating the cognitive effects of music-based interventions on people at early stages of cognitive decline (MCI or mild-to-moderate dementia) were selected. Results: The study selection included a total of 28 studies involving n = 1612 participants (mean age ranged from 69.45 to 85.3 years old). Most of the studies analyzed agree with the observation of an improvement, or at least maintenance, of global cognitive conditions (mainly represented by the results of the MMSE test) following music-based interventions, together with a series of other positive effects on verbal fluency, memory, and executive processes. Conclusions: The results of this review suggest the introduction of music-based interventions as complementary approaches to usual cognitive treatments. Also, the use of standardized and well-defined protocols, in addition to strong methodological research approaches, is suggested. Music-based interventions are recommended in the early stages of dementia, in MCI, and in a preventive sense in healthy older adults. [ABSTRACT FROM AUTHOR]

Background: Movement sonification has been recently introduced into the field of neuromotor rehabilitation alongside Neurologic Music Therapy and music-based interventions. This study introduces the use of musical auditory cues encompassing the melodic-harmonic aspect of music. Methods: Nineteen patients with Parkinson's disease were randomly assigned to the experimental (n = 10) and control (n = 9) groups and underwent thrice-weekly sessions of the same gait training program, with or without sonification. Functional and motor parameters, as well as fatigue, quality of life, and the impact of intervention on patients' well-being, were assessed at baseline (PRE), the end of treatment (POST), and at follow-up (FU). Between-group differences were assessed for each outcome measure using linear mixed-effects models. The outcome measure was entered as the dependent variable, group and time as fixed effects, and time by group as the interaction effect. Results: Mini BESTest and Dynamic Gait Index scores significantly improved in the experimental group (p = 0.01 and p = 0.03, respectively) from PRE to FU, demonstrating a significant impact of the sonification treatment on balance. No other significant differences were observed in the outcome measures. Conclusions: Larger sample sizes are needed to confirm the effectiveness of sonification approaches in Parkinson's disease, as well as in other neurological disorders. [ABSTRACT FROM AUTHOR]

Background: Fibromyalgia patients can benefit from music approaches as complementary treatments. In the literature, it was shown that these interventions managed pain conditions as well as reduced complaints, increased relaxation, and improved moods.Objective: This study aimed at evaluating music therapy, in the form of therapeutic music listening, specifically for patients with fibromyalgia, to treat chronic pain by reducing pain perception, increasing well-being, and improving quality of life.Methods: Twenty-four patients with fibromyalgia were recruited to take part in this feasibility pilot study that adopted a between-subject and within-subject design. Participants were randomised into three groups: (1) standard care, (2) standard care plus preferred music listening, (3) standard care plus Melomics-Health music listening, composed by an algorithm. Participants in experimental groups listened to 30 min of music at home, twice a day for a month. Patients' perceptions of changes following the listening, the intensity of pain and its interference in their lives, physical and mental well-being, and reported attitudes towards listening to music were evaluated respectively through the patients' global impression of change, the brief pain inventory, the Short Form Healthy Survey-12, and the cognitive behavioural assessment-outcome evaluation.Results: The study showed that music listening can significantly affect mental well-being compared to no music. Moreover, the effects in the Melomics-Health group are maintained at follow-up. No significant effect on pain perception was noted.Conclusions: The study provides information supporting a possible role of music listening in improving well-being of patients with fibromyalgia. [ABSTRACT FROM AUTHOR]

It is proven that music listening can have a therapeutic impact in many clinical fields. However, to assume a curative value, musical stimuli should have a therapeutic logic. This study aimed at assessing short-term effects of algorithmic music on cardiac autonomic nervous system activity. Twenty-two healthy subjects underwent a crossover study including random listening to relaxing and activating algorithmic music. Electrocardiogram (ECG) and non-invasive arterial blood pressure were continuously recorded and were later analyzed to measure Heart Rate (HR) mean, HR variability and baroreflex sensitivity (BRS). Statistical analysis was performed using a general linear model, testing for carryover, period and treatment effects. Relaxing tracks decreased HR and increased root mean square of successive squared differences of normal-to-normal (NN) intervals, proportion of interval differences of successive NN intervals greater than 50 ms, low-frequency (LF) and high-frequency (HF) power and BRS. Activating tracks caused almost no change or an opposite effect in the same variables. The difference between the effects of the two stimuli was statistically significant in all these variables. No difference was found in the standard deviation of normal-to-normal RR intervals, LFpower in normalized units and LFpower/HFpower variables. The study suggests that algorithmic relaxing music increases cardiac vagal modulation and tone. These results open interesting perspectives in various clinical areas. [ABSTRACT FROM AUTHOR]

Background: Literature showed the effects of music therapy on behavioral disturbances, cognitive functions, and on quality of life in people with dementia. Especially, relational active music therapy approach is oriented to reduce behavioral disturbances increasing communication, especially non-verbal communication. Objective: This study aimed at exploring the connection between the baseline characteristics of responders and the positive outcome of the intervention, but also the close relationship between the behavioral disturbances and the core of the therapeutic intervention (the relationship/communication improvement). Method: Linear correlation index between input variables and the presence of a critical improvement of behavioral symptoms according Neuropsychiatric Inventory and a semantic connectivity map were used to determine, respectively, variables predictive of the response and complex connections between clinical variables and the relational nature of active music therapy intervention. The dataset was composed of 27 variables and 70 patients with a moderate-severe stage of dementia and behavioral disturbances. Results: The main predictive factor is the Barthel Index, followed by NPI and some of its sub-items (mainly, Disinhibition, Depression, Hallucinations, Irritability, Aberrant Motor Activity, and Agitation). Moreover, the semantic map underlines how the improvement in communication/relationship is directly linked to "responder" variable. "Responder" variable is also connected to "age," "Mini Mental State Examination," and sex ("female"). Conclusions: The study confirms the appropriateness of active music therapy in the reduction of behavioral disturbances and also highlights how unsupervised artificial neural networks models can support clinical practice in defining predictive factors and exploring the correlation between characteristics of therapeutic-rehabilitative interventions and related outcomes. [ABSTRACT FROM AUTHOR]

After a stroke event, most survivors suffer from arm paresis, poor motor control and other disabilities that make activities of daily living difficult, severely affecting quality of life and personal independence. This randomized controlled trial aimed at evaluating the efficacy of a music-based sonification approach on upper limbs motor functions, quality of life and pain perceived during rehabilitation. The study involved 65 subacute stroke individuals during inpatient rehabilitation allocated into 2 groups which underwent usual care dayweek) respectively of standard upper extremity motor rehabilitation or upper extremity treatment with sonification techniques. The Fugl-Meyer Upper Extremity Scale, Box and Block Test and the Modified Ashworth Scale were used to perform motor assessment and the McGill Quality of Life-it and the Numerical Pain Rating Scale to assess quality of life and pain. The assessment was performed at baseline, after 2 weeks, at the end of treatment and at follow-up (1 month after the end of treatment). Total scores of the Fugl-Meyer Upper Extremity Scale (primary outcome measure) and hand and wrist sub scores, manual dexterity scores of the affected and unaffected limb in the Box and Block Test, pain scores of the Numerical Pain Rating Scale (secondary outcomes measures) significantly improved in the sonification group compared to the standard of care group (time*group interaction < 0.05). Our findings suggest that music-based sonification sessions can be considered an effective standardized intervention for the upper limb in subacute stroke rehabilitation. [ABSTRACT FROM AUTHOR]

Background Music therapy (MT) interventions are aimed at creating and developing a relationship between patient and therapist. However, there is a lack of validated observational instruments to consistently evaluate the MT process. Aim The purpose of this study was the validation of Music Therapy Session Assessment Scale (MT-SAS), designed to assess the relationship between therapist and patient during active MT sessions. Methods Videotapes of a single 30-min session per patient were considered. A pilot study on the videotapes of 10 patients was carried out to help refine the items, define the scoring system and improve inter-rater reliability among the five raters. Then, a validation study on 100 patients with different clinical conditions was carried out. The Italian MT-SAS was used throughout the process, although we also provide an English translation. Results The final scale consisted of 7 binary items accounting for eye contact, countenance, and nonverbal and sound-music communication. In the pilot study, raters were found to share an acceptable level of agreement in their assessments. Explorative factorial analysis disclosed a single homogeneous factor including 6 items (thus supporting an ordinal total score), with only the item about eye contact being unrelated to the others. Moreover, the existence of 2 different archetypal profiles of attuned and disattuned behaviours was highlighted through multiple correspondence analysis. Conclusions As suggested by the consistent results of 2 different analyses, MT-SAS is a reliable tool that globally evaluates sonorous-musical and nonverbal behaviours related to emotional attunement and empathetic relationship between patient and therapist during active MT sessions. [ABSTRACT FROM AUTHOR]

Guidelines in stroke rehabilitation recommend the use of a multidisciplinary approach. Different approaches and techniques with music are used in the stroke rehabilitation to improve motor and cognitive functions but also psychological outcomes. In this randomized controlled pilot trial, relational active music therapy approaches were tested in the post-acute phase of disease. Thirty-eight hospitalized patients with ischemic and hemorrhagic stroke were recruited and allocated in two groups. The experimental group underwent the standard of care (physiotherapy and occupational therapy daily sessions) and relational active music therapy treatments. The control group underwent the standard of care only. Motor functions and psychological aspects were assessed before and after treatments. Music therapy process was also evaluated using a specific rating scale. All groups showed a positive trend in quality of life, functional and disability levels, and gross mobility. The experimental group showed a decrease of anxiety and, in particular, of depression (p = 0.016). In addition, the strength of non-dominant hand (grip) significantly increased in the experimental group (p = 0.041). Music therapy assessment showed a significant improvement over time of non-verbal and sonorous-music relationships. Future studies, including a greater number of patients and follow-up evaluations, are needed to confirm promising results of this study. [ABSTRACT FROM AUTHOR]

Aim of the study: The aim of this research is to evaluate the effects of active music therapy (MT) based on free-improvisation (relational approach) in addition to speech language therapy (SLT) compared with SLT alone (communicative-pragmatic approach: Promoting Aphasic's Communicative Effectiveness) in stroke patients with chronic aphasia.Materials and methods: The experimental group (n= 10) was randomized to 30 MT individual sessions over 15 weeks in addition to 30 SLT individual sessions while the control group (n= 10) was randomized to only 30 SLT sessions during the same period. Psychological and speech language assessment were made before (T0) and after (T1) the treatments.Results: The study shows a significant improvement in spontaneous speech in the experimental group (Aachener Aphasie subtest:p= 0.020; Cohen'sd= 0.35); the 50% of the experimental group showed also an improvement in vitality scores of Short Form Health Survey (chi-square test = 4.114;p= 0.043).Conclusions: The current trial highlights the possibility that the combined use of MT and SLT can lead to a better result in the rehabilitation of patients with aphasia than SLT alone. [ABSTRACT FROM PUBLISHER]

Objectives To assess the effects of active music therapy ( MT) and individualized listening to music (LtM) on behavioral and psychological symptoms of dementia ( BPSDs) in persons with dementia ( PWDs). Design Randomized controlled trial. Setting Nine Italian institutions. Participants Persons with moderate to severe dementia and BPSDs (N = 120) were randomized to one of three treatments. Interventions All groups received standard care ( SC), and two groups attended 20 individualized MT or LtM sessions, twice a week, in addition to SC. Measurements The Neuropsychiatric Inventory ( NPI), Cornell Scale for Depression in Dementia ( CSDD), and Cornell-Brown Scale for Quality of Life in Dementia ( CBS-QoL) were administered before treatment, after treatment, and at follow-up to evaluate behavioral and psychological outcomes. A specific coding scheme (Music Therapy Check List-Dementia) was used to evaluate the MT process. Results Behavioral assessment did not show significant differences between groups. All groups showed a reduction over time in NPI global score ( P ≤ .001), CSDD ( P = .001), and CBS-QoL ( P = .01). The NPI global score fell 28% in the MT group, 12% in the LtM group, and 21% in the SC group at the end of treatment. An exploratory post hoc analysis showed similar within-group improvements for the NPI Delusion, Anxiety, and Disinhibition subscales. In the MT group, communication and relationships between the music therapists and PWDs showed a positive albeit nonsignificant trend during treatment. Conclusion The addition of MT or LtM to standard care did not have a significant effect on BPSDs in PWDs. Further studies on the effects of the integration of standard care with different types of music interventions on BPSD in PWD are warranted. [ABSTRACT FROM AUTHOR]

Summary Aim of the study To review the modalities of cognitive rehabilitation (CR), outcome endpoints, and the levels of evidence of efficacy of different interventions. Methods A systematic research in Pubmed, Psychinfo, and SCOPUS was performed assessing the articles written in the entire period covered by these databases till December 2013. Articles in English, Spanish or French were evaluated. A manual research evaluated the references of all of the articles. The experimental studies were classified according to the level of evidence of efficacy, using a standardized Italian method (SPREAD, 2007), adopting the criteria reported by Cicerone et al. (2000, 2011). Results Eighteen papers were classified into two reviews, four papers dealing with the principles and efficacy of CR in epilepsy, a methodological paper, a single-case report, a multiple-case report, and nine experimental papers. Most studies involved patients with temporal lobe epilepsy. Different types of CR were used to treat patients with epilepsy. A holistic rehabilitation approach was more useful than selective interventions to treat memory and attention disturbances. Conclusions CR may be a useful tool to treat cognitive impairment in patients with epilepsy. However, the modalities of treatment and outcome endpoints are important concerns of clinical care and research. Controlled studies are needed to determine the efficacy of rehabilitation in well-defined groups of patients with epilepsy. [ABSTRACT FROM AUTHOR]

The article presents a study which investigates the effect of sound and music on the autonomic control of the heart which induces emotions. The study involves several methods, which include the assessment of cardiac physiological parameters and psychological responses to a music therapy session, electrocardiography (ECG) Holter recordings, and behavioral analysis of the music therapist and subjects. The study reveals that mean heart rate was decreased by p-0.05 after the therapy.

Autism is a pathology in which the communicative and relational deficit is quite clear. After giving an up-to-date general view to the nosographic aspects and to the interpretative models of the Autistic Disorder, the authors focus on an improvisational music therapy approach in an intersubjective theoretical perspective. Coherently, with the theoretical frame and the clinical evidence, important process indicators were extrapolated into the analysed session. By using an appropriate coding scheme made to evaluate the music therapeutic process, the authors present an example analysis about the coding of some music therapy's sessions of a clinical case of infantile autism. Such analysis highlighted the occurred changes within the sessions and it can be considered a useful tool for a longitudinal evaluation of the music therapeutic treatments. [ABSTRACT FROM AUTHOR]

Music listening is a widespread approach in the field of music therapy. In this study, the effects of music listening on anxiety and stress in patients undergoing radiotherapy are investigated. Sixty patients with breast cancer who were candidates for postoperative curative radiotherapy were recruited and randomly assigned to three groups: Melomics-Health (MH) group (music listening algorithmically created, n = 20); individualized music listening (IML) group (playlist of preferred music, n = 20); no music group (n = 20). Music listening was administered for 15 min immediately before simulation and during the first five radiotherapy sessions. The State-Trait Anxiety Inventory (STAI) and the Psychological Distress Inventory (PDI) were administered before/after treatment. Cochran's Q test and McNemar test for paired proportions were performed to evaluate if the proportion of subjects having an outcome score below the critical value by treatment and over time was different, and if there was a change in that proportion. The MH group improved in STAI and PDI. The IML group worsened in STAI at T1 and improved STAI-Trait at T2. The IML group worsened in PDI at T2. The No music group generally improved in STAI and PDI. Clinical and music listening-related implications are discussed defining possible research perspectives in this field. [ABSTRACT FROM AUTHOR]

Music influences many physiological parameters, including some cardiovascular (CV) control indices. The complexity and heterogeneity of musical stimuli, the integrated response within the brain and the limited availability of quantitative methods for non-invasive assessment of the autonomic function are the main reasons for the scarcity of studies about the impact of music on CV control. This study aims to investigate the effects of listening to algorithmic music on the CV regulation of healthy subjects by means of the spectral analysis of heart period, approximated as the time distance between two consecutive R-wave peaks (RR), and systolic arterial pressure (SAP) variability. We studied 10 healthy volunteers (age 39 ± 6 years, 5 females) both while supine (REST) and during passive orthostatism (TILT). Activating and relaxing algorithmic music tracks were used to produce possible contrasting effects. At baseline, the group featured normal indices of CV sympathovagal modulation both at REST and during TILT. Compared to baseline, at REST, listening to both musical stimuli did not affect time and frequency domain markers of both SAP and RR, except for a significant increase in mean RR. A physiological TILT response was maintained while listening to both musical tracks in terms of time and frequency domain markers, compared to baseline, an increase in mean RR was again observed. In healthy subjects featuring a normal CV neural profile at baseline, algorithmic music reduced the heart rate, a potentially favorable effect. The innovative music approach of this study encourages further research, as in the presence of several diseases, such as ischemic heart disease, hypertension, and heart failure, a standardized musical stimulation could play a therapeutic role. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented which discusses a study on the effects of active music therapy (AMT) on physiological parameters and behavioural responses in Disorders of Consciousness (DoC).

A letter to the editor is presented which is concerned with research which investigated the use of active music therapy in patients with behavioral disturbances caused by dementia.

• Music listening is widely used in clinical settings to modulate arousal levels. • Which and how music can be selected in therapeutic treatments are unclear points. • Decision trees enable finding therapeutic predictivity factors of music interventions in healthy participants. • Machine learning techniques can support music therapy practice. The literature shows the effectiveness of music listening, but which factors and what types of music produce therapeutic effects, as well as how music therapists can select music, remain unclear. Here, we present a study to establish the main predictive factors of music listening's relaxation effects using machine learning methods. Three hundred and twenty healthy participants were evenly distributed by age, education level, presence of musical training, and sex. Each of them listened to music for nine minutes (either to their preferred music or to algorithmically generated music). Relaxation levels were recorded using a visual analogue scale (VAS) before and after the listening experience. The participants were then divided into three classes: increase, decrease, or no change in relaxation. A decision tree was generated to predict the effect of music listening on relaxation. A decision tree with an overall accuracy of 0.79 was produced. An analysis of the structure of the decision tree yielded some inferences as to the most important factors in predicting the effect of music listening, particularly the initial relaxation level, the combination of education and musical training, age, and music listening frequency. The resulting decision tree and analysis of this interpretable model makes it possible to find predictive factors that influence therapeutic music listening outcomes. The strong subjectivity of therapeutic music listening suggests the use of machine learning techniques as an important and innovative approach to supporting music therapy practice. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented that discusses the therapeutic use of music in ensuring mental well-being of individuals.

The article presents the discussion on best care integrating different interventions. Topics include persons with dementia often present anxiety and depression, remembering only negative events and generalizing all of their memories; and promoting well-being, improving depressive mood, and stimulating autobiographical memory.

A letter to the editor is presented in response to the article about the use of melomics music medicine to reduce the pain and the use of drugs during pediatric prick test procedure in the previous issue.