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Wayne State's School of Medicine exploring alternative therapies to reduce anxiety in children undergoing MRIs
DETROIT— Three Wayne State University School of Medicine researchers will explore complementary and alternative medicine therapies to reduce anxiety in children undergoing magnetic resonance imaging studies.
Ambika Mathur, Ph.D., associate dean of WSU’s Graduate School and professor of pediatrics in the School of Medicine; Deepak Kamat, M.D., Ph.D., professor and vice chairman of education in pediatrics; and Prashant Mahaja, M.D., associate professor of pediatrics, will use an $894,493 grant from the National Institutes of Health to fund their two-year study, “Comparison of the Effectiveness of CAM Therapies in Pediatric Patients Undergoing Sedation.” The grant comes via the National Center for Complementary and Alternative Medicine under the American Recovery and Reinvestment Act economic stimulus bill.
The goal of the study, Dr. Mathur said, is to compare the effectiveness of three complementary and alternative medicine therapies in reducing the level of stress and anxiety in pediatric patients ages 1 through 12 who are undergoing sedation for imaging studies. If the therapies work, they could reduce the need for higher doses of intravenous sedation medicines or multiple sedation medications in young children.
“We hope to find that non-invasive complementary and alternative therapies reduce the need for intravenous sedative medications in children undergoing multiple MRIs for conditions such as brain tumors because these sedative medications have several adverse effects on the children,” said Dr. Mathur, who also serves as assistant dean of the combined degree programs and postdoctoral affairs. “For MRIs, children in this age group are sedated to reduce anxiety and to keep them still, because if they move even a bit the MRI does not work.”
The drugs used to sedate children in this age group, she said, present a higher side effect risk, and have been associated with a number of adverse reactions, including airway obstruction, cardiovascular problems such as brachycardia and syncope, respiratory distress, allergic reactions and mental confusion.
The three methods that will be tested in the study include passive music therapy, active music therapy with a certified music therapist and distraction procedures conducted by a child life specialist. Passive music therapy involves listening to music of one’s choice via headphones while an intravenous line is placed. In active music therapy, a certified therapist engages the child in making or playing music or singing. The goals of the music therapy are to promote relaxation and reduce stress and anxiety before and during intravenous line placement. The therapist and child may use any number of instruments and song selections based on the patient’s musical preference. The therapist will vary tempo, volume and melody to meet the patient’s level of agitation and bring them to a more relaxed state.
Distraction therapy involves the use of items or techniques appropriately matched to the child’s age and development. A child life specialist might use bubbles, a View Master, I-Spy book, squeeze ball, a handheld game, board games or counting and deep breathing during IV placement.
Dr. Mathur said the research team anticipates that the distraction therapy will be the most effective of the methods to be tested in reducing anxiety.
The study will involve 400 children undergoing multiple MRI studies at Children’s Hospital of Michigan. The researchers will assess the outcomes of the alternative therapies by measuring the amount of sedative medications administered compared to controls as well as the effect on immunological markers such as inflammatory and pre-inflammatory cytokines and on the levels of the stress hormone cortisol.
“In addition, we will determine if the reduction in the sedative medication use will result in reduced recovery time and reduced length of stay in the hospital, thereby resulting in net cost savings to the families and to the health care providers,” Dr. Mathur said.
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