Music-in-Medicine Relaxation Playlist: Compositional Elements of Relaxation

Dr. Mei Rui, Piano
Music is one of the most powerful modulators of the human stress response.  Previous research has identified the neurohumoral pathway by which music exerts its anxiolytic mechanism on pre-, intra-, and post-operative patients, especially in acute-care cohorts including ICU patients.  Notably, in critically ill ICU patients, listening to slow movements of classical piano works increased serum levels of growth hormone (GH) by 60% and reduced inflammatory cytokines interleukin-6 and epinephrine by 83% and 55% respectively (Conrad et al).  Exposure to relaxing music also reduced instabilities in the hypothalamic-anterior pituitary-peripheral hormone axes that produce cortisol and impacted dopaminergic neurotransmission (Sutoo et al).

Addressing individual, inherent disparities in musical preference has been a major challenge in selecting the optimal stress-reducing music for clinical studies.  A knowledge gap is that prior music intervention studies employed vague, genre-based, and subjective music selection methods that lack precise and replicable theoretical frameworks.  
We aim to increase the reproducibility and scientific rigor of future music intervention clinical studies.  Harnessing CPAM’s multidisciplinary expertise of a Grammy-noted composer, professional musicologists, concert artists, and health care providers with a background in music, we isolated and defined 16 compositional elements.  Our central hypothesis is that a combination of these 16 qualitative, culturally-neutral, and time period-independent compositional elements work synergistically to universally optimize the impact of music-induced relaxation in listeners from diverse backgrounds.

Our long-term goal is to implement and disseminate defined and scientifically reproducible stress-mitigating music interventions at the clinic and policy level that may alleviate psychophysiological stress and reduce the severity and prevalence of stress and burnout in all health care providers, patients, and families.

J. Todd Frazier: American Sketches III

Music is one of the most powerful modulators of the human stress response.  Music intervention has effectively served as a low cost, noninvasive, easy-to-implement, and non-pharmacological technique to alleviate physiological and psychological stress in various clinical cohorts.  Previous research has identified the neurohumoral pathway by which music exerts its anxiolytic mechanism on pre-, intra-, and post-operative patients, especially in acute-care cohorts including ICU patients.  Notably, in critically ill ICU patients, listening to slow movements of classical piano works increased serum levels of growth hormone (GH) by 60% and reduced inflammatory cytokines interleukin-6 and epinephrine by 83% and 55% respectively (Conrad et al).  Exposure to relaxing music also reduced instabilities in the hypothalamic-anterior pituitary-peripheral hormone axes that produce cortisol and impacted dopaminergic neurotransmission (Sutoo et al).

Addressing individual, inherent disparities in musical preference has been a major challenge in selecting the optimal stress-reducing music for clinical studies.  A knowledge gap is that prior music intervention studies employed vague, genre-based, and subjective music selection methods that lack precise and replicable theoretical frameworks.  
We aim to increase the reproducibility and scientific rigor of future music intervention clinical studies.  Harnessing CPAM’s multidisciplinary expertise of a Grammy-noted composer, professional musicologists, concert artists, and health care providers with a background in music, we isolated and defined 16 compositional elements.  Our central hypothesis is that a combination of these 16 qualitative, culturally-neutral, and time period-independent compositional elements work synergistically to universally optimize the impact of music-induced relaxation in listeners from diverse backgrounds.

Our long-term goal is to implement and disseminate defined and scientifically reproducible stress-mitigating music interventions at the clinic and policy level that may alleviate psychophysiological stress and reduce the severity and prevalence of stress and burnout in all health care providers, patients, and families.

J.S. Bach: Goldberg Variations Aria

Rachmaninoff: Prelude G Major

Schumann: Traumerei

Chopin Nocturne in C# Minor

Dr. Rui Anxiolytic Music Prescription

Bach-Busoni: Ich ruf zu dir Herr Jesu Christ, BWV 639

Brahms Intermezzo Op. 118 No. 2 in A Major

Schumann Sonata In G Minor Op. 22, Movt II

Dr. Mei Rui is Director, Music-in-Medicine and Assistant Professor in the Department of Neurosurgery at The University of Texas MD Anderson Cancer Center in Houston, Texas. A Yale-trained molecular biochemist and internationally award-winning concert pianist, Dr. Rui is a pioneer in Music Medicine. She spearheads MD Anderson's Music-in-Medicine Initiative and serves as Artist Collaborator at the Shepherd School of Music at Rice University. Other academic appointments include Visiting Assistant Professor of Chemistry at the Sophie Davis Biomedical School at the City University of New York, at Yale University, and Yale School of Music. Dr. Rui was previously Assistant Professor of Music Medicine at Weill Cornell Medical College and in the Department of Surgery at Houston Methodist. She founded the MUSICARE Initiative, which brought over 400 live bedside concerts performed by Yo-Yo Ma and eminent musicians from the Houston Symphony to ICU patients, their families and providers. Dr. Rui studies the neurophysiological mechanisms and impact of defined music intervention in clinical cohorts. Her research uses evidence-based repertoire-selection methodologies to mitigate intra- and peri-operative stress, alleviate pain, reduce anxiety, diminish sedative and analgesic needs, and improve sleep in cancer patients. Her investigations also harness music—a powerful modulator of the human stress response—to mitigate burnout and enhance empathy in healthcare providers. Dr. Rui’s performances have been praised by the Boston Globe, Boston Musical Intelligencer, and New York Classical Review. In 2015, she was Bronze Medalist of the World Piano Competition. She has performed at prestigious concert venues worldwide, including the Louvre Auditorium in Paris.Dr. Rui’s research career started in 2015 at MD Anderson Cancer Center, where she led a clinical study involving 400 pre-operative cancer patients, health care providers and volunteers to investigate the role of live musical intervention on stress using proteomic analysis, fMRI and EKG.  Last year her scientific research titled "Enhancing Surgical Performance by Adopting Expert Musicians' Practice and Performance Strategies” was published in the journal “Surgery.” 
As the Principal Investigator of multiple IRB-approved music intervention clinical studies at CPAM, Dr. Rui investigates the neurological and psychophysiological impact of targeted music intervention on patients and health care providers.  Awards include Sheffield Scientific Scholar for the Excellence in Sciences, Bruce Simonds Fellowship, George Miles Fellowship, and Joseph Seldon Memorial Award.  When she is not conducting research, performing or teaching, she enjoys traveling the world, scuba diving, and teaching or practicing yoga as a Yoga-alliance certified instructor.  She lives in Houston with her husband, who invented single-cell sequencing, their two young kids, and a dachshund named Ludwig.

Dr. Rui, Director of Music-in-Medicine@MD Anderson

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