Calming Effect of Clinically Designed Improvisatory Music for Patients Admitted to Epilepsy Monitoring Unit during COVID-19 Pandemic

ABSTRACT

Objective: To evaluate the efficacy and mechanism of Clinically Designed Improvisatory Music (CDIM) to induce calmness and stress relief in patients admitted to the Epilepsy Monitoring Unit (EMU). Background: Epilepsy monitoring requires simulating seizure-inducing conditions which frequently causes discomfort to EMU patients. COVID-19 hospital restrictions added another layer of stress upon hospital admission. The purpose of this research was to provide evidence that CDIM brings relief to EMU patients. Design/Methods: Five individuals with epileptic seizures in the EMU during the COVID-19 lockdown participated in the study (average age+ SD=30.2 + 6). Continuous video EEG and heart tracing were obtained before, during, and after live CDIM. CDIM consisted of 40 minutes of virtual calming music played by a music practitioner on viola. Post-intervention surveys assessed patients' emotional state. Alpha/beta power spectral density ratio was calculated for each subject across the brain and was evaluated using one-way repeated analysis of variance, comparing 20 minutes before, during, and 20 minutes after CDIM. Post-hoc analysis was performed using paired t-test. Results: Patients reported enhanced emotional state (9.25/10), contentment (9.5/10), and decreased restlessness (8.75/10) on a 10-point Likert scale. Compared to baseline, all experienced decreases in heart rate during CDIM. Alpha/beta ratio increased at whole-brain and regional levels during CDIM and persisted post-intervention. There was a significant main effect of CDIM on alpha/beta ratio (p < 0.05). Conclusions: Consistent with investigations in patients with depression and anxiety, we found positive effects of music as reported by patients, a decrease in heart rate, an increased alpha/beta ratio due to calming effect in response to CDIM. These effects persisted for at least 20 minutes post-intervention. Our study provides proof of concept that live CDIM provided demonstrable comfort for patients admitted in the EMU during the COVID-19 pandemic.