Neonatal music therapy and cerebral oxygenation in extremely and very preterm infants: A pilot study

Objectives: Music therapy is a novel intervention that may minimize neonatal stress. The mechanism of action is still largely unknown. We hypothesized that one mechanism of action regards altered brain oxygenation (either due to altered cerebral perfusion or altered cerebral oxygen consumption). Study design: Pilot study Methods: We measured cerebral oxygenation before, during and after music therapy sessions using Near-Infrared Spectroscopy (NIRS). We extracted data on cerebral oxygen saturation (r_cSO₂) and calculated cerebral fractional tissue oxygen extraction (_cFTOE). In addition, we measured heart rate. Results: We included 20 infants, receiving 44 music therapy sessions. Median gestational age was 27 weeks, the majority were males. We identified two distinct reactions: in one group r_cSO₂ increased and_cFTOE decreased during therapy compared with before therapy, whereas in the other group r_cSO₂ decreased and_cFTOE increased during therapy compared with before therapy. The first may indicate a sedative effect, whereas the second may reflect a hyperalert state. The observed changes in heart rate may contribute to these observations through altered cerebral perfusion. Conclusion: Our findings suggest that there are two distinct reactions in cerebral oxygenation to music therapy in extremely and very preterm infants. The clinical significance of these two reactions for music processing and future neurological functioning in these infants warrants further investigation.