Music-Based Interventions for Brain Disorders of Aging

In recent years, a growing body of medical literature has described various benefits of music-based interventions (MBIs) for human health. However, the relatively low quality of the research published to date has slowed the development of this field of inquiry. The article by Edwards et al presents a framework (NIH Music-Based Intervention Toolkit) for studies that use MBIs to promote human health, with a focus on diseases of aging, including Parkinson's disease, Alzheimer's disease and related dementias, and stroke. It is the culmination of a multi-year effort from the Trans-NIH Music and Health Working Group, the Foundation for the NIH, the Renée Fleming Foundation, and an interdisciplinary scientific expert panel to create guidelines for research on music and health that would meet the rigorous standards required for NIH-funded studies. The toolkit defines the building blocks of MBIs, including a set of common data elements for MBI protocols, core datasets of specific outcome measures, and biomarkers that can be included in future studies. The authors note the importance of evaluating the impact of the MBI on multiple domains and thinking carefully about the intervention type, mode of delivery of the intervention, the target population, the study design, and data collection and management. An important and often challenging aspect of clinical trial development is the selection of appropriate control groups, and the authors advise using the Pragmatic Model for Comparator Selection in Health-Related Behavioral Trials¹ to help in this regard. In addition, for the selection of appropriate study outcomes, the Patient-Reported Outcomes Measurement Information System (PROMIS)² and the NIH Toolbox³ can complement the NIH MBI Toolkit and are freely available online. Finally, the authors emphasize that a team science approach is required to successfully complete an impactful MBI study and describe key members of interdisciplinary MBI study teams.

Highlighting the promise of MBIs for human health, the authors note that “MBIs have the potential to influence patient-relevant target outcomes, such as manage symptoms, slow disease progression, rehabilitate, and improve the quality of life in many disease conditions across the lifespan.” This effort represents an important step toward advancing the fields of music medicine and music therapy in the twenty-first century and beyond.

References

1. Freedland KE, King AC, Ambrosius WT, et al. The Selection of Comparators for Randomized Controlled Trials of Health-Related Behavioral Interventions: Recommendations of an NIH Expert Panel. J Clin Epidemiol. 2019;110:74-81. https://doi.org/10.1016/j.jclinepi.2019.02.011.
2. Cella D, Yount S, Rothrock N, et al. The Patient-Reported Outcomes Measurement Information System (PROMIS): Progress of an NIH Roadmap Cooperative Group During its First Two Years. Med Care. 2007;45(5 Suppl 1):S3-S11. https://doi.org/10.1097/01.mlr.0000258615.42478.55
3. Gershon RC, Wagster MV, Hendrie HC, et al. NIH Toolbox for Assessment of Neurological and Behavioral Function. Neurology. 2013;80(11 Suppl 3):S2-S6. https://doi.org/10.1212/wnl.0b013e3182872e5f