D'Alessandro Patrizia, Giuglietti Marta, Baglioni Antonella, Verdolini Norma, Murgia Nicola, Piccirilli Massimo, Elisei Sandro
Istituto Serafico, via G. Marconi 6, 06081 Assisi, Perugia, Italy,
Psychiatr Danub. 2017 Sep;29(Suppl 3):399-404.
Approximately one-third of patients with epilepsy continue to experience seizures despite adequate therapy with antiepileptic drugs. Drug-resistant epilepsy is even more frequent in subjects with intellectual disability. As a result, several non-pharmacological interventions have been proposed to improve quality of life in patients with intellectual disability and drug-resistant epilepsy. A number of studies have demonstrated that music can be effective at reducing seizures and epileptiform discharges. In particular, Mozart's sonata for two pianos in D major, K448, has been shown to decrease interictal EEG discharges and recurrence of clinical seizures in patients with intellectual disability and drug-resistant epilepsy as well. The aim of this study is to investigate the influence of Mozart's music on seizure frequency in institutionalized epileptic subjects with profound/severe intellectual disability.
Twelve patients (10 males and 2 females) with a mean age of 21.6 years were randomly assigned to two groups in a cross-over design; they listened to Mozart K448 once a day for six months.
A statistically significant difference was observed between the listening period and both baseline and control periods. During the music period, none of the patients worsened in seizure frequency; one patient was seizure-free, five had a greater than 50% reduction in seizure frequency and the remaining showed minimal (N=2) or no difference (N=4). The average seizure reduction compared to the baseline was 20.5%. Our results are discussed in relation to data in the literature considering differences in protocol investigation.
Music may be considered a useful approach as add-on therapy in some subjects with profound intellectual disability and drug-resistant epilepsy and can provide a new option for clinicians to consider, but further large sample, multicenter studies are needed to better understand the characteristics of responders and non-responders to this type of non-pharmacological intervention.
尽管使用抗癫痫药物进行了充分治疗，但仍有大约三分之一的癫痫患者继续发作。耐药性癫痫在智力残疾患者中更为常见。因此，人们提出了几种非药物干预措施来改善智力残疾和耐药性癫痫患者的生活质量。多项研究表明，音乐可以有效减少癫痫发作和癫痫样放电。特别是，莫扎特的《D大调双钢琴奏鸣曲》K448已被证明可以减少智力残疾和耐药性癫痫患者的发作间期脑电图放电以及临床癫痫发作的复发。本研究的目的是调查莫扎特音乐对机构化的重度/极重度智力残疾癫痫患者癫痫发作频率的影响。
12名平均年龄为21.6岁的患者（10名男性和2名女性）采用交叉设计随机分为两组；他们每天听一次莫扎特K448，持续6个月。
在聆听期与基线期和对照期之间观察到统计学上的显著差异。在音乐期，没有患者的癫痫发作频率恶化；1名患者无癫痫发作，5名患者的癫痫发作频率降低了50%以上，其余患者癫痫发作频率降低最少（2例）或无差异（4例）。与基线相比，癫痫发作平均减少了20.5%。我们根据考虑到方案调查差异的文献数据对结果进行了讨论。
音乐可被视为对一些重度智力残疾和耐药性癫痫患者进行辅助治疗的有用方法，可为临床医生提供一个新的选择，但需要进一步的大样本、多中心研究，以更好地了解对这类非药物干预有反应者和无反应者的特征。
