It is increasingly recognized that music therapy can help improve your health – whether it is reducing anxiety, blood pressure or pain. However, the biological mechanisms by which that happens is growing to be understood. An NIH-funded project led by two Samueli Institute researchers aims to establish a collaborative network of experts to help expand the scientific evidence for how music-based interventions (MBIs) help relieve pain.
Jeffery Dusek, PhD, director of outcomes research at the Samueli Institute, is the principal investigator on the project, called “Effective Network to advance Scientific Evidence related to Mechanisms of music-Based interventions for pain and support coLlaborative Efforts” (ENSEMBLE). It is funded by a five-year U24 grant from the National Institutes of Health’s (NIH) National Center for Complementary and Integrative Health (NCCIH).
ENSEMBLE has three main goals:
- Promote interdisciplinary collaboration between music therapists, scientists studying biological mechanisms, and researchers across the country who are exploring pain and integrative health therapies
- Develop a comprehensive framework for conducting research on the mechanisms of MBIs for pain management
- Advance pilot projects that explore novel biological mechanisms behind the effects of MBIs on diverse types of pain
“It’s really building the foundation of getting people to talk that may not have talked previously and to be able to explore possible mechanisms of action,” said Dusek.
One way ENSEMBLE plans to advance pilot projects is through a pilot grant program starting in 2025.
Other lead investigators include Shaista Malik, MD, PhD, MPH, founding executive director of the Samueli Institute; Joanne Loewy, DA, LCAT, MT-BC, professor at Mount Sinai Icahn School of Medicine and founding director of the Louis Armstrong Center for Music and Medicine at Mount Sinai Health System; Manoj Bhasin, PhD, director of genomics, proteomics, bioinformatics and systems biology at Children’s Healthcare of Atlanta.
Until now, there have been several barriers to fully understanding the mechanisms of MBIs for pain management. These include a lack of effective collaboration between music therapists and scientists studying the biological mechanisms of pain, inconsistent ways of defining and applying MBIs, measuring patient outcomes, and collecting biological data, as well as insufficient funding and infrastructure to support collaborative research projects.
This gap has helped keep MBIs separate from other evidence-informed integrative health pain therapies, such as acupuncture or meditation. But Dusek wants to help bring MBIs under the same umbrella as these other therapies.
And that would be a significant development for pain patients. Chronic pain is a serious public health challenge, one that can lead to a decreased quality of life and the worsening of other health conditions for people who experience it. While these patients can find meaningful relief with opioids and other medications, it is critical to provide more options for them and help reduce their pharmacologic burden – an important goal for Dusek.
“What I’ve been doing for my whole career is studying the use of non-pharmacologic approaches for mental health relief or pain relief,” said Dusek.
If ENSEMBLE can help build the scientific evidence for the mechanisms of MBIs for pain management, it would help open the door for combining MBI with medication to effectively manage pain and improve quality of life.
“We make music therapy more accessible to clinicians, other researchers, and other individuals because they say, ‘There really is something there.’ It is not just that listening to music makes you feel happy. There is an underlying physiology changing in a positive way,” said Dusek.
The ENSEMBLE team is looking at sickle cell pain as an early model, highlighting the goal to create a truly collaborative network environment. Dusek said this focus aligns with other projects across the UC Irvine campus, as well as the work of Kalpna Gupta, PhD, who is a co-investigator on ENSEMBLE and a Samueli Scholar. Gupta, a professor of medicine at UC Irvine, has done foundational research on the mechanisms of pain associated with sickle cell disease, which can lead to decreased blood flow. Her expertise will be critical in understanding the biological process of sickle cell pain and how MBIs affect it.
Dr. Gupta has said she views her role as a Samueli Scholar as a catalyst for advancing integrative health research and care. She aims to investigate biomarkers of treatment response to complementary interventions and use bioinformatics to analyze the effects of environmental and social factors. Additionally, her research will explore global and indigenous therapeutic agents as novel treatments.
ENSEMBLE also has plans to offer opportunities for students to gain research experience by completing a summer intensive in an investigator’s lab.
Dusek comes to the Samueli Institute with 25 years of experience leading innovative integrative health and medicine research at prominent research and healthcare institutions, with significant funding from NIH and the Centers for Disease Control and Prevention. He was previously associate professor at Case Western Reserve University, director of research at Connor Whole Health University Hospitals, director of behavioral sciences research at Massachusetts General Hospital, and instructor in medicine at Harvard Medical School.
“As a proud integrative health researcher, I find that being able to share the magnificent work being done at the Samueli Institute is a great privilege. When I started my career back in 1998, the work that we were doing was marginalized by other researchers at the institution. However, by doing solid work, getting manuscripts published in peer-reviewed medical journals and obtaining funding by the NIH, the reception that integrative health researchers garner has dramatically improved. Indeed, one of my greatest pleasures is collaborating with emergency medical physicians, heart surgeons, orthopedic surgeons, hypertension specialists, nurses, acupuncturists, and music therapists to name a few,” said Dusek.
BraveNet
Since July 2022, the Samueli Institute has been leading BraveNet as the Network/Data Coordinating Center. BraveNet is the first practice-based research network in the U.S. and is composed of integrative medicine clinical sites around the world that have joined together to help advance integrative medicine by combining their clinical outcomes data that have previously not been available to the medical and scientific communities. This allows for large-scale studies that produce comprehensive evidence on the efficacy, safety, and cost-effectiveness of integrative health interventions. Increased collaboration and shared resources lead to standardized methodologies, stronger evidence bases, and more informed healthcare policies, ultimately improving patient outcomes and advancing the legitimacy of integrative health practices.
This year, BraveNet grew to 29 member sites, bringing on the University of California Los Angeles, the University of North Carolina Chapel Hill, Columbia University, and the Brazilian Academic Consortium for Integrative Health (CABSIN) in Sao Paulo, Brazil. These 29 institutions offer whole-health services to more than 150,000 patients a year.
“As a member of BraveNet for many years, I personally find it very rewarding to be able to collaborate with like-minded individuals on important research in integrative medicine,” said Gene Kallenberg, MD, executive director of UC San Diego Centers for Integrative Health. “On an institutional level, I feel that the ability to combine the data from our UCSD site with other BraveNet members leverages our ability to demonstrate the impact of integrative therapies.”
He added, “Being able to participate in the NIH funded acupuncture in the emergency department study called ACUITY has been very instructive and rewarding, and participating in federally funded (NCCIH) team research has enhanced the reputation of our IM research efforts within UCSD. I look forward to participating in future BraveNet multi-site studies.”
Samantha Simmons, MPH, chief executive officer of the Academic Consortium for Integrative Health and Medicine, said she looks to BraveNet as “the key player in the conduct of large scale multi-institutional research.”
“Whether it is observational research in outpatient clinics or a multi-site randomized trial in the emergency department, BraveNet is uniquely positioned to conduct impactful research for integrative health and medicine. As BraveNet continues to attract NIH funding and grow its membership, I can envision a strong partnership between the ACIMH and BraveNet,” Simmons said.
With BraveNet, the Samueli Institute is focused on creating an international collaborative environment that didn’t exist before, in order to expand and share the clinical evidence supporting integrative health practices.
“My desire is to continue to grow the membership of BraveNet to allow for future multi-center research of inpatient and ambulatory integrative health therapies,” Dusek said. “The recent success of the PRIMIER study in which we recruited over 2,500 patients in 17 BraveNet member clinics as just the start. With that knowledge and our increased membership, I can now envision that BraveNet is ready to conduct a much larger study to provide the evidence that integrative medicine can significantly improve the health of patients of various health conditions.”
