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Authors
Abstract(s)
A dor é uma sensação desagradável com função protetora. Porém, quando se torna crónica perde esta função protetora e torna-se apenas nociva e prejudicial aos 30% da população mundial com esta condição. A Organização Mundial da Saúde (OMS) reconhece a necessidade e importância do controlo e alívio da dor. Nesse sentido, a prescrição de terapia farmacológica é a primeira linha de tratamento. No entanto, esta tem riscos associados como a adição, o abuso, a sobredosagem e a morte acidental. Como tal, torna-se pertinente o estudo de terapias não farmacológicas que possam funcionar como terapia adjuvante e diminuir as doses da terapia farmacológica. Neste sentido, realizou-se uma scoping review com o objetivo de descrever as áreas cerebrais e mecanismos responsáveis pelo efeito analgésico da música em adultos com dor crónica. Foi elaborada a questão de investigação de acordo com a metodologia Joanna Briggs Institute (JBI) com base na mnemónica PCC – População, Contexto e Conceito. Foi elaborada a frase booleana e realizada a pesquisa nas bases de dados: PUBMED, CINAHL, PSYINFO, SCOPUS, WEB OF SCIENCE E MEDICALATINA. Foram incluídos dez artigos nesta revisão, quatro revisões narrativas, cinco estudos experimentais e um estudo piloto. Os artigos apresentam grande diversidade de métodos imagiológicos, intervenções musicais e métodos de avaliação da dor. Os resultados desta revisão sugerem o envolvimento do sistema modulatório descendente, principalmente do córtex pré-frontal dorsolateral, do córtex cingulado, da substância cinzenta periaquedutal e da circunvolução angular. Os resultados mostram ainda a prevalência de atividade no hemisfério esquerdo. Este trabalho destaca a importância de aprofundar o estudo dos mecanismos cerebrais que fundamentam a eficácia da música na redução de perceção da dor, no sentido do desenvolvimento de terapia não farmacológicas adjuvantes à intervenção farmacológica.
Pain is an unpleasant sensation with a protective function. However, when it becomes chronic, it loses this protective function and becomes only harmful and damaging to the 30% of the world's population with this condition. The World Health Organization (WHO) recognizes the need and importance of pain control and relief. In this sense, the prescription of pharmacological therapy is the first line of treatment. However, this has associated risks such as addiction, abuse, overdose and accidental death. It is therefore important to study nonpharmacological therapies that can act as adjuvant therapy and reduce the doses of pharmacological therapy. With this in mind, a scoping review was carried out with the aim of describing the brain areas and mechanisms responsible for the analgesic effect of music in adults with chronic pain. The research question was developed according to the Joanna Briggs Institute (JBI) methodology based on the PCC mnemonic - Population, Context and Concept. The Boolean phrase was drawn up and a search was carried out in the following databases: PUBMED, CINAHL, PSYINFO, SCOPUS, WEB OF SCIENCE E MEDICALATINA. Ten articles were included in this review, four narrative reviews, five experimental studies and one pilot study. The articles present a wide variety of imaging methods, musical interventions and pain assessment methods. The results of this review suggest the involvement of the descending modulatory system, mainly the dorsolateral prefrontal cortex, the cingulate cortex, the periaqueductal gray matter and the angular circumvolution. The results also show a prevalence of activity in the left hemisphere. This work highlights the importance of further studying the brain mechanisms that underlie the effectiveness of music in reducing the perception of pain, with a view to developing non-pharmacological therapies as an adjunct to pharmacological intervention.
Pain is an unpleasant sensation with a protective function. However, when it becomes chronic, it loses this protective function and becomes only harmful and damaging to the 30% of the world's population with this condition. The World Health Organization (WHO) recognizes the need and importance of pain control and relief. In this sense, the prescription of pharmacological therapy is the first line of treatment. However, this has associated risks such as addiction, abuse, overdose and accidental death. It is therefore important to study nonpharmacological therapies that can act as adjuvant therapy and reduce the doses of pharmacological therapy. With this in mind, a scoping review was carried out with the aim of describing the brain areas and mechanisms responsible for the analgesic effect of music in adults with chronic pain. The research question was developed according to the Joanna Briggs Institute (JBI) methodology based on the PCC mnemonic - Population, Context and Concept. The Boolean phrase was drawn up and a search was carried out in the following databases: PUBMED, CINAHL, PSYINFO, SCOPUS, WEB OF SCIENCE E MEDICALATINA. Ten articles were included in this review, four narrative reviews, five experimental studies and one pilot study. The articles present a wide variety of imaging methods, musical interventions and pain assessment methods. The results of this review suggest the involvement of the descending modulatory system, mainly the dorsolateral prefrontal cortex, the cingulate cortex, the periaqueductal gray matter and the angular circumvolution. The results also show a prevalence of activity in the left hemisphere. This work highlights the importance of further studying the brain mechanisms that underlie the effectiveness of music in reducing the perception of pain, with a view to developing non-pharmacological therapies as an adjunct to pharmacological intervention.
Description
Keywords
Neuropsicologia Dor crónica Musicoterapia Áreas cerebrais Neuropsychology Chronic pain Music therapy Brain areas