BACKGROUND Epilepsy is a common pediatric neurologic disease in Thailand. However, the mainstay antiepileptic pharmacotherapies can induce severe side effects. While the benefit of playing Mozart K.448 music has been studied as an alternative, supplementary, nonpharmacologic treatment for epilepsy, the literature features limited few randomized controlled trial studies of children. OBJECTIVE We aimed to study the effect of Mozart K.448 for two pianos on interictal epileptiform discharges (IEDs), quantitative electroencephalogram (qEEG), and heart rate variability (HRV) in patients with epilepsy. METHODS We employed a single-blinded randomized trial design with a placebo control. The treatment group listened to the first 8 min of Mozart K.448 for two pianos during EEG recording. The control group underwent an EEG recording of the same duration in a quiet environment. Interictal epileptiform discharges were manually counted for 8 min before, during, and after the song was plated. Quantitative electroencephalogram and HRV were analyzed in each period. RESULT A total of 32 patients aged 0-18 years were enrolled. There were 12 patients in the music group and 14 patients in the control group; 67% of the patients in the former exhibited significantly decreased IEDs while listening to the music compared with 42% of the patients in the quiet group (RR [Relative Risk Reduction]: 0.72, p-value: <0.001, 95% confidence interval [CI]: 0.69-0.74). During music exposure, qEEG demonstrated an increase in the delta/theta to alpha/beta ratio relative to that of controls (median in music: +3% and control: -6%, p-value: 0.520). Heart rate variability analyses showed a decrease in the ratio of low frequency to high frequency (LF/HF), which represents parasympathetic activity during music exposure (decrease of 34%, p-value: 0.382). CONCLUSION The present study showed that Mozart K.448 reduced the number of IEDs in children with epilepsy and that Mozart K.448 could enhance parasympathetic activity. However, possibly because of the small study population, statistical significance was not reached. Our study revealed the considerable potential of music in the treatment of pediatric epilepsy.

中文翻译：

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莫扎特 K.448 对癫痫患儿发作间期癫痫样放电的影响：一项随机对照试验研究

背景癫痫是泰国常见的儿科神经系统疾病。然而，主要的抗癫痫药物疗法会引起严重的副作用。虽然播放莫扎特 K.448 音乐的好处已被研究作为癫痫的替代、补充、非药物治疗，但文献中很少有针对儿童的随机对照试验研究。目的我们旨在研究莫扎特 K.448 用于两架钢琴对癫痫患者发作间期癫痫样放电 (IED)、定量脑电图 (qEEG) 和心率变异性 (HRV) 的影响。方法 我们采用单盲随机试验设计和安慰剂对照。治疗组在脑电图记录期间听了两架钢琴的莫扎特 K.448 的前 8 分钟。对照组在安静的环境中进行相同持续时间的脑电图记录。在歌曲播放前、播放中和播放后 8 分钟内手动计数发作间期癫痫样放电。在每个时期分析定量脑电图和HRV。结果 共纳入 32 名 0-18 岁的患者。音乐组12例，对照组14例；前者中 67% 的患者在听音乐时表现出显着降低的 IED，而安静组中的这一比例为 42%（RR [相对风险降低]：0.72，p 值：<0.001，95% 置信区间 [ CI]：0.69-0.74）。在音乐暴露期间，qEEG 表现出相对于对照的 delta/theta 与 alpha/beta 比率的增加（音乐中位数：+3% 和对照：-6%，p 值：0.520）。心率变异性分析显示低频与高频的比率 (LF/HF) 下降，这代表了音乐暴露期间的副交感神经活动（下降 34%，p 值：0.382）。结论 本研究表明，莫扎特 K.448 可减少癫痫儿童 IED 的数量，并且莫扎特 K.448 可增强副交感神经活动。然而，可能由于研究人群较小，未达到统计显着性。我们的研究揭示了音乐在治疗小儿癫痫方面的巨大潜力。448 减少了癫痫儿童 IED 的数量，莫扎特 K.448 可以增强副交感神经活动。然而，可能由于研究人群较小，未达到统计显着性。我们的研究揭示了音乐在治疗小儿癫痫方面的巨大潜力。448 减少了癫痫儿童 IED 的数量，并且莫扎特 K.448 可以增强副交感神经活动。然而，可能由于研究人群较小，未达到统计显着性。我们的研究揭示了音乐在治疗小儿癫痫方面的巨大潜力。