A pilot study into the effects of music therapy on different areas of the brain of individuals with unresponsive wakefulness syndrome.

The global cerebral network allows music " to do to us what it does." While the same music can cause different emotions, the basic emotion of happy and sad songs can, nevertheless, be understood by most people. Consequently, the individual experience of music and its common effect on the human brain is a challenging subject for research. Various activities such as hearing, processing, and performing music provide us with different pictures of cerebral centers in PET. In comparison to these simple acts of experiencing music, the interaction and the therapeutic relationship between the patient and the therapist in Music Therapy (MT) provide us with an additional element in need of investigation. In the course of a pilot study, these problems were approached and reduced to the simple observation of pattern alteration in the brains of four individuals with Unresponsive Wakefulness Syndrome (UWS) during MT. Each patient had three PET investigations: (i) during a resting state, (ii) during the first exposure to MT, and (iii) during the last exposure to MT. Two patients in the MT group received MT for 5 weeks between the 2nd and the 3rd PET (three times a week), while two other patients in the control group had no MT in between. Tracer uptake was measured in the frontal, hippocampal, and cerebellar region of the brain. With certain differences in these three observed brain areas, the tracer uptake in the MT group was higher (34%) than in the control group after 5 weeks. The preliminary results suggest that MT activates the three brain regions described above. In this article, we present our approach to the neuroscience of MT and discuss the impact of our hypothesis on music therapy practice, neurological rehabilitation of individuals in UWS and additional neuroscientific research.

Neuroscientific and neuroanthropological perspectives in music therapy research and practice with patients with disorders of consciousness.

A growing understanding of music therapy with patients with disorders of consciousness (DOC) has developed from observing behavioral changes and using these to gain new ways of experiencing this research environment and setting. Neuroscience provides further insight into the effects of music therapy; however, various studies with similar protocols show different results. The neuroanthropological approach is informed by anthropological and philosophical frameworks. It puts emphasis on a research with and not just on human beings concerning the subject/object question within a research process. It examines relational aspects and outcomes in the context of working in an interdisciplinary team. This allows a broader view of music therapy in a reflective process and leads to a careful interpretation of behavioral reactions and imaging results. This article discusses the importance of the neuroanthropological perspective on our way of obtaining knowledge and its influence on therapeutic practice. It is important to consider how knowledge is generated as it influences the results. Data from two cases will be presented to illustrate the neuroanthropological approach by comparing quantitative PET data with qualitative results of video analyses.

Background, reasons and benefits using the vienna protocol for the treatment of painful bone recurrences with 153Samarium-EDTMP.

153Samarium-ethylendiaminetetramethylenephosphonate (EDTMP) has become a treatment of choice for painful bone recurrences. The reasons and the background of the Vienna protocol in 1994 are outlined. A 30 mCi (1.1 GBq) dose exhibits comparable pain palliation with less hematotoxicity as compared to 1 mCi/kg, the conventional dose widely used, the 3 months interval as most of the patients (around 80%) show pain palliation for that period of time. Repeated administration furthermore allows lesion stabilization/regression and a tumor marker response. Other reasons are outlined in detail. The earlier (153)Sm-EDTMP is started the better; patients not only experience effective bone pain palliation, but also improved quality of life, lesion stabilization/regression and a prolonged survival.

Radiation synovectomy with (166)Ho-ferric hydroxide: a first experience.

UNLABELLED: Radiation synovectomy (RS) is indicated when conventional pharmacologic treatment of chronic synovitis has not relieved its symptoms. The use of radionuclides that are bound to ferric hydroxide (FH) particles has been shown to be effective and safe for this procedure. (166)Ho-FH macroaggregates offer promising properties for RS but there is a lack of clinical data. We investigated the efficacy and safety of (166)Ho-FH in a prospective clinical trial in patients suffering from chronic synovitis. METHODS: Twenty-four intraarticular injections were performed in 22 patients receiving a mean activity of 1.11 GBq (range, 0.77-1.24 GBq) (166)Ho-FH. Blood activity measurements and monitoring of activity distribution were performed by whole-body gamma-camera imaging for control of leakage 3 and 24 h after injection of (166)Ho-FH. The patients were evaluated clinically before RS, 1 wk and 1 mo after the treatment, and thereafter in 3-mo intervals by assessing joint effusion, pannus, local pain, range of motion, and the patient's satisfaction. RESULTS: In 18 of 24 treatments, no leakage to nontarget organs was visible, whereas small amounts of activity could be detected in the local inguinal lymph nodes in 6 patients and to the lungs and to the liver in 1 patient (<0.1%). In all cases leakage to the lymph nodes was <1%. Leakage to the blood was negligible. Clinically, 17 patients (71%) exhibited a complete or partial response. CONCLUSION: RS with (166)Ho-FH was safe and effective in patients with chronic synovitis of different origin. Controlled clinical trials are necessary to evaluate the therapeutic efficacy and safety compared with the treatment with other radionuclides and glucocorticosteroids.