Abstract
Music has pain-relieving effects, but its mechanisms remain unclear. We sought to verify previously studied analgesic components and further elucidate the underpinnings of music analgesia. Using a well-characterized conditioning-enhanced placebo model, we examined whether boosting expectations would enhance or interfere with analgesia from strongly preferred music. A two-session experiment was performed with 48 healthy, pain experiment-naïve participants. In a first cohort, 36 were randomized into 3 treatment groups, including music enhanced with positive expectancy, non-musical sound enhanced with positive expectancy, and no expectancy enhancement. A separate replication cohort of 12 participants received only expectancy-enhanced music following the main experiment to verify the results of expectancy-manipulation on music. Primary outcome measures included the change in subjective pain ratings to calibrated experimental noxious heat stimuli, as well as changes in treatment expectations. Without conditioning, expectations were strongly in favor of music compared to non-musical sound. While measured expectations were enhanced by conditioning, this failed to affect either music or sound analgesia significantly. Strongly preferred music on its own was as pain relieving as conditioning-enhanced strongly preferred music, and more analgesic than enhanced sound. Our results demonstrate the pain-relieving power of personal music even over enhanced expectations.Trial InformationClinicaltrials.gov NCT01835275.
Highlights
Music is a treatment that can affect pain perception through a complex set of past and present cues
Amongst more recent music analgesia studies, positive emotions to music were seen to be a modulator of pain [12], but others did not find that music’s cognitive and emotional effects were as influential on pain ratings as treatment expectancy [13]
We studied 12 participants in each of four groups for a total of 48 participants (32 females), with average age 2767. 36 of these comprised the initial cohort for which the main experiment was conducted. 12 participants served as a replication sample for the music conditioning group
Summary
Music is a treatment that can affect pain perception through a complex set of past and present cues. Juslin and Vastfjall (2008), Salimpoor et al (2011), and Koelsch (2009), among others, posited many ways through which music may activate regional brain networks mediating reward and anxiolytic effects that overlap with regions involved in analgesia [1,2,3,4,5,6,7,8,9]. Music is an enactor of strong perceptual and behavioral responses, such as action tendency and emotional regulation [10], which may contribute to modulation of pain perception. Amongst more recent music analgesia studies, positive emotions to music were seen to be a modulator of pain [12], but others did not find that music’s cognitive and emotional effects were as influential on pain ratings as treatment expectancy [13]. Specific factors contributing to music analgesia have still not been established definitively [14]
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