Personalized music improves epileptiform activity, REM sleep and quality of life in children with epilepsies

PURPOSE: There is an indication for EEG entrainment of rhythm, in particular in association with the regulation of frequencies related to epileptic seizures. We present the X-System model, which may predict the neurophysiological effects of music. We suggest that this may "entrain" healthy electrical brain activity more effectively than previously-used, intuitive choices of music. METHODS: We enrolled 19 subjects (5-17 years old) with epilepsy. All children had overnight video/EEG monitoring and polysomnography before, upon starting and three weeks after starting all-night music treatment. A section of the EEG from the area contralateral to the epileptic region was audified to produce an audio representation of healthy brain activity. Using the X-System model to find the closest musical equivalents, tracks were selected from culturally relevant repertoires and processed into a personalized, all-night playlist for each individual subject. QOLIE-31 and ELDQOL were used to assess their quality of life. RESULTS: The mean age was 10.74 years (range 5-17 years), 63% were male. The mean spike reduction for the whole group, n = 19, was 28.42%. The mean spike reduction in patients with focal epilepsies, n = 6, was 28.46%, and with generalized epilepsies, n = 13, was 28.33%. Polysomnography showed improvement in REM sleep in all patients (p = 0.0006) and an increase in sleep spindles along with reduced awakenings and improved sleep efficiency. During music treatment, melatonin saliva levels increased, on average, by 52.70%, p < 0.0017. QOLIE-31 showed improvements in the Overall Score, Seizure Worry, Energy/Fatigue and Emotional Well-Being domains. In ELDQOL, the Total Average score and the Side-Effect Profile domain significantly improved. CONCLUSION: Personalized music treatment was associated with changes suggestive of decreased epileptiform activity, improved REM sleep, and improved quality of life in this uncontrolled study. This may expand possibilities for adjunctive epilepsy treatment. Further research is needed in larger, randomized trials to confirm this association and evaluate for potential confounding factors.