A cross-cultural randomized pilot trial of western-based and five elements music therapy for psychological well-being.

BACKGROUND: Music therapy and culture are interconnected. It is unclear whether the therapeutic effects of music can be exerted in diverse cultural contexts. Both Western-based and Chinese Five elements music therapy (FEMT) have shown effectiveness in improving the perception of stress, anxiety and depression in their respective cultures. FEMT is a commonly used traditional Chinese Medicine approach; however, it has not been investigated with non-Chinese participants. PURPOSE: To investigate the impact of FEMT and of Western-based music therapy on stress and related outcomes and explore cross-cultural comparisons in participants from Chinese and Canadian contexts. METHODS: This pre-post randomized controlled study was conducted with 35 participants, 23 from Canada and 12 from China. Participants from the two cultural groups were randomly divided into two groups: a FEMT group (n = 20), a western art music therapy (WAMT) group (n = 15). The main outcome was self-rated stress, evaluated by a 10-point numeric rating question. Secondary outcomes included anxiety/depression (Hospital Anxiety and Depression Scale (HADS), pulse rate and qualitative comments. Cross-sectional, pre-post and longitudinal comparisons were pursued. RESULTS: We observed comparable effects of FEMT and WAMT in both the Chinese and Canadian samples. There was a statistically significant decrease in self-rated stress over time, especially after the conclusion of the four-week music therapy intervention (p = 0.001), regardless of type of music therapy, and in both cultural contexts. We observed a statistically significant decrease in anxiety and depression scores in the FEMT group only (p<0.001), but no effect on pulse rate. CONCLUSION: This is the first study to report evidence of feasibility, acceptability and effectiveness of FEMT in non-Chinese participants. Further investigation of the observed differences is warranted.

Does Acupuncture Therapy Alter Activation of Neural Pathway for Pain Perception in Irritable Bowel Syndrome?: A Comparative Study of True and Sham Acupuncture Using Functional Magnetic Resonance Imaging

BACKGROUND/AIMS: Patients with irritable bowel syndrome (IBS) are characterized by abnormal central processing with altered brain activation in response to visceral nociceptive signals. The effect of electroacupuncture (EA) on IBS patients is unclear. The study is set to study the effect of EA on brain activation during noxious rectal distension in IBS patients using a randomized sham-controlled model. METHODS: Thirty IBS-diarrhea patients were randomized to true electroacupuncture or sham acupuncture. Functional MRI was performed to evaluate cerebral activation at the following time points: (1) baseline when there was rectal distension only, (2) rectal distension during application of EA, (3) rectal distension after cessation of EA and (4) EA alone with no rectal distension. Group comparison was made under each condition using SPM5 program. RESULTS: Rectal distension induced significant activation of the anterior cingulated cortex, prefrontal cortex, thalamus, temporal regions and cerebellum at baseline. During and immediately after EA, increased cerebral activation from baseline was observed in the anterior cingulated cortex, bilateral prefrontal cortex, thalamus, temporal regions and right insula in both groups. However, true electroacupuncture led to significantly higher activation at right insula, as well as pulvinar and medial nucleus of the thalamus when compared to sham acupuncture. CONCLUSIONS: We postulate that acupuncture might have the potential effect of pain modulation in IBS by 2 actions: (1) modulation of serotonin pathway at insula and (2) modulation of mood and affection in higher cortical center via ascending pathway at the pulvinar and medial nucleus of the thalamus.