To evaluate the efficacy and mechanism of Clinically Designed Improvisatory Music (CDIM) to induce calmness and stress relief in patients admitted to the Epilepsy Monitoring Unit (EMU).

Epilepsy monitoring requires simulating seizure-inducing conditions which frequently causes discomfort to EMU patients. COVID-19 hospital restrictions added another layer of stress upon hospital admission. The purpose of this research was to provide evidence that CDIM brings relief to EMU patients. 

Five individuals with epileptic seizures in the EMU during the COVID-19 lockdown  participated in the study (average age+ SD=30.2 + 6). Continuous video EEG and heart tracing were obtained before, during, and after live CDIM. CDIM consisted of 40 minutes of virtual calming music played by a music practitioner on viola. Post-intervention surveys assessed patients’ emotional state. Alpha/beta power spectral density ratio was calculated for each subject across the brain and was evaluated using one-way repeated analysis of variance, comparing 20 minutes before, during, and 20 minutes after CDIM. Post-hoc analysis was performed using paired t-test. 

Patients reported enhanced emotional state (9.25/10), contentment (9.5/10), and decreased restlessness (8.75/10) on a 10-point Likert scale. Compared to baseline, all experienced decreases in heart rate during CDIM. Alpha/beta ratio increased at whole-brain and regional levels during CDIM and persisted post-intervention. There was a significant main effect of CDIM on alpha/beta ratio (p < 0.05). 

Consistent with investigations in patients with depression and anxiety, we found positive effects of music as reported by patients, a decrease in heart rate, an increased alpha/beta ratio due to calming effect in response to CDIM. These effects persisted for at least 20 minutes post-intervention. Our study provides proof of concept that live CDIM provided demonstrable comfort for patients admitted in the EMU during the COVID-19 pandemic.