Effects of a music intervention on patients undergoing cerebral angiography: a pilot study.

PURPOSE: To test the effect of a music intervention on procedural anxiety, stress response and medication requirements in participants with a cerebral aneurysm or arteriovenous malformation (AVM) undergoing cerebral angiography. METHOD AND MATERIALS: A prospective pilot study was conducted using an experimental two group pre-test, post-test design. 48 participants were randomly assigned to a control group (standard care) or experimental group (standard care plus self-selected music via overhead stereo system). The stress response was measured by heart rate (HR) and systolic blood pressure (SBP) at baseline, and during and following the procedure. Anxiety was measured by the State Trait Anxiety Inventory for Adults (STAI) before and after the procedure, and total medications administered periprocedurally were recorded. RESULTS: 24 participants in each group were enrolled. R-ANCOVA revealed non-significant findings for HR (F=1.4; p=0.27; power=0.38) and SBP (F=2.1; p=0.10; power=0.57). The ANCOVA for anxiety revealed significantly lower STAI scores in the control group (F=3.8; p=0.003) compared with the experimental group. Independent t test analysis for the total doses of fentanyl and midazolam were found to be F=0.08, p=0.78 and F=0.38, p=0.54, respectively. CONCLUSION: A music intervention on participants with a brain aneurysm or AVM undergoing cerebral angiography did not have a statistically significant impact on reducing the stress response, anxiety or medication requirements. Interestingly, participants in the control group had significantly less anxiety after their angiogram than did participants in the experimental group. This pilot study sets the stage for future research to further examine these findings.

In vivo 3-T MR spectroscopy in the distinction of recurrent glioma versus radiation effects: initial experience.

PURPOSE: To determine if 3-T magnetic resonance (MR) spectroscopy allows accurate distinction of recurrent tumor from radiation effects in patients with gliomas of grade II or higher. MATERIALS AND METHODS: This blinded prospective study included 14 patients who underwent in vivo 3-T MR spectroscopy prior to stereotactic biopsy. All patients received a previous diagnosis of glioma (grade II or higher) and high-dose radiation therapy (>54 Gy). Prior to MR spectroscopy, conventional MR imaging was performed at 1.5 T to identify a gadolinium-enhanced region within the irradiated volume. Diagnosis was assigned by means of histopathologic analysis of the biopsy samples. RESULTS: Sixteen of 17 biopsy locations could be classified as predominantly tumor or predominantly radiation effect on the basis of the ratio of choline at the biopsy site to normal creatine level by using a value greater than 1.3 as the criterion for tumor. The remaining case, classified as recurrent tumor on the basis of MR spectroscopy results, was diagnosed as predominantly radiation effect on the basis of histopathologic findings. Disease in this patient progressed to biopsy-proven recurrence within 3 months. Overall, the ratio of choline at the biopsy site to normal creatine level was significantly elevated (unpaired two-tailed Student t test, P <.002) in those biopsy samples composed predominantly of tumor (n = 9) compared with those containing predominantly radiation effects (n = 8). The ratio was not significantly different between the two histopathologic groups. CONCLUSION: In vivo 3-T MR spectroscopy has sufficient spatial resolution and chemical specificity to allow distinction of recurrent tumor from radiation effects in patients with treated gliomas.