Eduardo A. Garza-Villarreal

Music reduces pain and increases functional mobility in fibromyalgia

The pain in Fibromyalgia (FM) is difficult to treat and functional mobility seems to be an important comorbidity in these patients that could evolve into a disability. In this study we wanted to investigate the analgesic effects of music in FM pain. Twenty-two FM patients were passively exposed to (1) self-chosen, relaxing, pleasant music, and to (2) a control auditory condition (pink noise). They rated pain and performed the “timed-up & go task (TUG)” to measure functional mobility after each auditory condition. Listening to relaxing, pleasant, self-chosen music reduced pain and increased functional mobility significantly in our FM patients. The music-induced analgesia was significantly correlated with the TUG scores; thereby suggesting that the reduction in pain unpleasantness increased functional mobility. Notably, this mobility improvement was obtained with music played prior to the motor task (not during), therefore the effect cannot be explained merely by motor entrainment to a fast rhythm. Cognitive and emotional mechanisms seem to be central to music-induced analgesia. Our findings encourage the use of music as a treatment adjuvant to reduce chronic pain in FM and increase functional mobility thereby reducing the risk of disability.

Do musicians with perfect pitch have more autism traits than musicians without perfect pitch? An empirical study.

Perfect pitch, also known as absolute pitch (AP), refers to the rare ability to identify or produce a musical tone correctly without the benefit of an external reference. AP is often considered to reflect musical giftedness, but it has also been associated with certain disabilities due to increased prevalence of AP in individuals with sensory and developmental disorders. Here, we determine whether individual autistic traits are present in people with AP. We quantified subclinical levels of autism traits using the Autism-Spectrum Quotient (AQ) in three matched groups of subjects: 16 musicians with AP (APs), 18 musicians without AP (non-APs), and 16 non-musicians. In addition, we measured AP ability by a pitch identification test with sine wave tones and piano tones. We found a significantly higher degree of autism traits in APs than in non-APs and non-musicians, and autism scores were significantly correlated with pitch identification scores (r = .46, p = .003). However, our results showed that APs did not differ from non-APs on diagnostically crucial social and communicative domain scores and their total AQ scores were well below clinical thresholds for autism. Group differences emerged on the imagination and attention switching subscales of the AQ. Thus, whilst these findings do link AP with autism, they also show that AP ability is most strongly associated with personality traits that vary widely within the normal population.

Gray- and White-Matter Anatomy of Absolute Pitch Possessors

Absolute pitch (AP), the ability to identify a musical pitch without a reference, has been examined behaviorally in numerous studies for more than a century, yet only a few studies have examined the neuroanatomical correlates of AP. Here, we used MRI and diffusion tensor imaging to investigate structural differences in brains of musicians with and without AP, by means of whole-brain vertex-wise cortical thickness (CT) analysis and tract-based spatial statistics (TBSS) analysis. APs displayed increased CT in a number of areas including the bilateral superior temporal gyrus (STG), the left inferior frontal gyrus, and the right supramarginal gyrus. Furthermore, we found higher fractional anisotropy in APs within the path of the inferior fronto-occipital fasciculus, the uncinate fasciculus, and the inferior longitudinal fasciculus. The findings in gray matter support previous studies indicating an increased left lateralized posterior STG in APs, yet they differ from previous findings of thinner cortex for a number of areas in APs. Finally, we found a relation between the white-matter results and the CT in the right parahippocampal gyrus. In this study, we present novel findings in AP research that may have implications for the understanding of the neuroanatomical underpinnings of AP ability.

Music reduces pain and increases resting state fMRI BOLD signal amplitude in the left angular gyrus in fibromyalgia patients.

Music reduces pain in fibromyalgia (FM), a chronic pain disease, but the functional neural correlates of music-induced analgesia (MIA) are still largely unknown. We recruited FM patients (n = 22) who listened to their preferred relaxing music and an auditory control (pink noise) for 5 min without external noise from fMRI image acquisition. Resting state fMRI was then acquired before and after the music and control conditions. A significant increase in the amplitude of low frequency fluctuations of the BOLD signal was evident in the left angular gyrus (lAnG) after listening to music, which in turn, correlated to the analgesia reports. The post-hoc seed-based functional connectivity analysis of the lAnG showed found higher connectivity after listening to music with right dorsolateral prefrontal cortex (rdlPFC), the left caudate (lCau), and decreased connectivity with right anterior cingulate cortex (rACC), right supplementary motor area (rSMA), precuneus and right precentral gyrus (rPreG). Pain intensity (PI) analgesia was correlated (r = 0.61) to the connectivity of the lAnG with the rPreG. Our results show that MIA in FM is related to top-down regulation of the pain modulatory network by the default mode network (DMN).

The effect of crack cocaine addiction and age on the microstructure and morphology of the human striatum and thalamus using shape analysis and fast diffusion kurtosis imaging

The striatum and thalamus are subcortical structures intimately involved in addiction. The morphology and microstructure of these have been studied in murine models of cocaine addiction (CA), showing an effect of drug use, but also chronological age in morphology. Human studies using non-invasive magnetic resonance imaging (MRI) have shown inconsistencies in volume changes, and have also shown an age effect. In this exploratory study, we used MRI-based volumetric and novel shape analysis, as well as a novel fast diffusion kurtosis imaging sequence to study the morphology and microstructure of striatum and thalamus in crack CA compared to matched healthy controls (HCs), while investigating the effect of age and years of cocaine consumption. We did not find significant differences in volume and mean kurtosis (MKT) between groups. However, we found significant contraction of nucleus accumbens in CA compared to HCs. We also found significant age-related changes in volume and MKT of CA in striatum and thalamus that are different to those seen in normal aging. Interestingly, we found different effects and contributions of age and years of consumption in volume, displacement and MKT changes, suggesting that each measure provides different but complementing information about morphological brain changes, and that not all changes are related to the toxicity or the addiction to the drug. Our findings suggest that the use of finer methods and sequences provides complementing information about morphological and microstructural changes in CA, and that brain alterations in CA are related cocaine use and age differently.

Similar clinical improvement and maintenance after rTMS at 5 Hz using a simple vs. complex protocol in Alzheimer's disease

BRACKGROUND Current treatments for Alzheimers disease (AD) have a limited clinical response and methods, such as repetitive transcranial magnetic stimulation (rTMS), are being studied as possible treatments for the clinical symptoms with positive results. However, there is still seldom information on the type of rTMS protocols that deliver the best clinical improvement in AD. Objetive: To compare the clinical response between a simple stimulation protocol on the left dorsolateral prefrontal cortex (lDLPFC) against a complex protocol using six regions of interest. METHODS 19 participants were randomized to receive any of the protocols. The analysis of repeated measures evaluated the change. RESULTS Both protocols were equally proficient at improving cognitive function, behavior and functionality after 3 weeks of treatment, and the effects were maintained for 4 weeks more without treatment. CONCLUSION We suggest rTMS on the lDLPFC could be enough to provide a clinical response, and the underlying mechanisms should be studied.

Music-induced analgesia in chronic pain conditions: a systematic review and meta-analysis

Music is increasingly used as an adjuvant for chronic pain management as it is not invasive, inexpensive, and patients usually report positive experiences with it. However, little is known about its clinical efficacy in chronic pain patients. In this systematic review and meta-analysis, we investigated randomized controlled trials (RCTs) of adult patients that reported any type of music intervention for chronic pain, chosen by the researcher or patient, lasting for any duration. Searches were performed using PsycINFO, Scopus and PubMed for RTCs published until the end of May 2016. The primary outcome was reduction in self-reported pain using a standardized pain measurement instrument reported post-intervention. The secondary outcomes were: quality of life measures, depression and anxiety measures, among others. The study was pre-registered with PROSPERO (CRD42016039837) and the meta-analysis was done using RevMan. We identified 768 titles and abstracts, and we included 14 RTCs that fulfilled our criteria. The sample size of the studies varied between 25 and 200 participants. We found that music reduced chronic pain, and depression, with higher effect size on pain and depression. We also found music had a higher effect when the participant chose the music in contrast with researcher-chosen music. The sample size of RCTs was small and sometimes with different outcome measures. Our analysis suggests that music may be beneficial as an adjuvant for chronic pain patients, as it reduces self-reported pain and its common co-morbidities. Importantly, the analgesic effect of music appears higher with self-chosen over researcher-chosen music.

Patterns of reduced cortical thickness and striatum pathological morphology in cocaine addiction.

Substance addiction is regarded as an important public health problem, perpetuated by fronto-striatal circuit pathology. A usual finding in neuroimaging human and murine studies is cortical thinning and lower volume when compared to healthy controls. In this study we wished to replicate cortical thinning findings and find if striatum morphology may explain the cortical pathology. For this we analyzed T1w neuroimaging data from an ongoing addiction Mexican dataset. This dataset includes cocaine addicts diagnosed by expert psychiatrists and healthy controls. For the analysis we used voxel-based morphometry, cortical thickness and volumetric analysis of the basal ganglia, and we correlated striatum volume with cortical thickness to find pathological patterns. Our group contrast showed cortical thinning and striatum volume differences in cocaine addicts correlated to their years of substance use, craving and age. Our correlation between striatum-cortex morphology showed higher significant correlations in healthy controls, not observed in cocaine addicts. The correlation between striatum volume and cortical thickness in healthy controls involved similar areas as those shown with less cortical thickness in cocaine addicts. We suggest that striatum morphological changes in addiction may explain the pattern of cortical thinning observed across several substances addiction studies.

Borderline Personality Disorder With Cocaine Dependence: Impulsivity, Emotional Dysregulation and Amygdala Functional Connectivity

Background: Borderline personality disorder is present in 19% of cocaine dependence cases; however, this dual pathology is poorly understood. We wished to characterize the dual pathology and find its functional connectivity correlates to better understand it. Methods: We recruited 69 participants divided into 4 groups: dual pathology (n = 20), cocaine dependence without borderline personality disorder (n = 19), borderline personality without cocaine dependence (n = 10) and healthy controls (n = 20). We used self-reported instruments to measure impulsivity and emotional dysregulation. We acquired resting state fMRI and performed seed-based analyses of the functional connectivity of bilateral amygdala. Results: Borderline personality disorder and cocaine dependence as factors had opposing effects in impulsivity and emotional dysregulation, as well as on functional connectivity between left amygdala and medial prefrontal cortex. On the other hand, in the functional connectivity between right amygdala and left insula, the effect of having both disorders was instead additive, reducing functional connectivity strength. The significant functional connectivity clusters were correlated with impulsivity and emotional dysregulation. Conclusions: In this study, we found that clinical scores of dual pathology patients were closer to those of borderline personality disorder without cocaine dependence than to those of cocaine dependence without borderline personality disorder, while amygdala-medial prefrontal cortex functional connectivity patterns in dual pathology patients were closer to healthy controls than expected.

Functional connectivity of music-induced analgesia in fibromyalgia

Listening to self-chosen, pleasant and relaxing music reduces pain in fibromyalgia (FM), a chronic central pain condition. However, the neural correlates of this effect are fairly unknown and could be regarded as a more direct measure of analgesia. In our study, we wished to investigate the neural correlates of music-induced analgesia (MIA) in fibromyalgia patients. To do this, we studied 20 FM patients and 20 matched healthy controls (HC) acquiring rs-fMRI with a 3T MRI scanner, and pain data before and after two 5-min auditory conditions: music and noise. We performed resting state functional connectivity (rs-FC) seed-based correlation analyses (SCA) using pain and analgesia-related ROIs to determine the effects before and after the music intervention in FM and HC, and its correlation with pain reports. We found significant differences in baseline rs-FC between FM and HC. Both groups showed changes in rs-FC in several ROIs after the music condition between different areas, that were left lateralized in FM and right lateralized in HC. FM patients reported MIA that was significantly correlated with rs-FC decrease between the angular gyrus, posterior cingulate cortex and precuneus, and rs-FC increase between amygdala and middle frontal gyrus. These areas are related to autobiographical and limbic processes, and auditory attention, suggesting MIA may arise as a consequence of top-down modulation, probably originated by distraction, relaxation, positive emotion, or a combination of these mechanisms.