Multisensory Therapy Alleviating MRI-Related Anxiety in Cancer Patients Via Brain-Autonomic Network Modulation: A Randomized Clinical Trial
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 152
- 试验地点
- 1
- 主要终点
- Change in Hospital Anxiety and Depression Scale anxiety subscale score
研究概览
简要总结
MRI-related anxiety is prevalent among cancer patients and frequently undermines imaging quality by inducing motion artifacts or causing premature examination termination. Safe, non-pharmacological supportive interventions have the potential to alleviate procedural anxiety, yet the underlying neurobiological mechanisms remain unclear. This study aimed to investigate the anxiolytic effect of a combined multisensory intervention integrating music therapy and aromatherapy during MRI procedures, and to further explore its potential neurophysiological mechanisms via autonomic nervous system monitoring and resting-state functional magnetic resonance imaging (rs-fMRI).
This study adopted a prospective, single-center, parallel-group randomized controlled trial design and was conducted at Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, between April 2025 and April 2026. Eligible participants were randomly allocated to four groups in equal proportions to receive routine care, music therapy alone, aromatherapy alone, or combined music and aromatherapy interventions. All study interventions were delivered consistently throughout the pre-MRI waiting period and the formal MRI scanning procedure, while participants in the control group received only standard clinical care without additional supportive intervention.
详细描述
Cancer patients frequently experience significant anxiety during MRI examinations. The confined scanning environment, persistent acoustic noise, and mandatory prolonged immobilization inherent to MRI protocols collectively induce intense procedural stress. Such anxiety commonly causes motion artifacts, impairs diagnostic image quality, and may lead to premature scan termination. Beyond compromising imaging efficiency and accuracy, MRI-triggered psychological distress aggravates the overall psychological burden of cancer patients and may perturb systemic neuroendocrine and immune homeostasis, potentially affecting long-term disease prognosis.
Procedural anxiety arises from dynamic crosstalk between central neural circuits and peripheral autonomic regulatory systems. Chronic stress in oncological populations hyperactivates sympathetic tone and the hypothalamic-pituitary-adrenal axis, driving neuroendocrine dysfunction and immunosuppression. Multiple core brain networks, including the default mode, salience, and executive control networks, govern anxiety processing, with disrupted functional connectivity closely linked to anxiety severity. Concurrent HRV and neuroimaging research further confirms that acute MRI stress distorts bidirectional communication between cortical emotional regulatory regions and subcortical autonomic control centers.
Complementary interventions have emerged as safe, scalable strategies for mitigating cancer-related psychological distress. The 2023 joint clinical guidelines from the Society for Integrative Oncology and the American Society of Clinical Oncology endorse music therapy and aromatherapy for relieving cancer-associated anxiety. Each modality exerts independent anxiolytic effects via distinct neural and physiological pathways. Preliminary clinical evidence suggests that combined auditory and olfactory multisensory interventions may yield superior anxiolytic outcomes compared with single-modality approaches during stressful medical procedures.
Current literature lacks systematic evidence regarding the synergistic neurobiological mechanisms of combined music and aromatherapy for MRI-specific anxiety in cancer patients. Existing studies predominantly rely on subjective psychological assessments without synchronized objective autonomic and brain network profiling. This prospective randomized controlled trial addresses these research gaps by adopting a multi-dimensional evaluation system to characterize the behavioral, physiological, and neural effects of integrated multisensory intervention, aiming to provide mechanistic evidence for standardized supportive care protocols in oncological imaging practice.
This prospective, single-center, four-arm parallel-group randomized controlled trial was conducted at Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, from April 2025 to April 2026. The study protocol was ethically approved (SKSY-2024-480-03), implemented in strict accordance with the Declaration of Helsinki and CONSORT 2025 guidelines, and pre-registered in the National Medical Research Registration and Information System of China (MR-44-25-034307). All participants provided written informed consent prior to enrollment.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Factorial
- 主要目的
- Supportive Care
- 盲法
- Single (Outcomes Assessor)
入排标准
- 年龄范围
- 18 Years 至 60 Years（Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Aged 18 to 60 years
- •Pathologically confirmed malignant tumor
- •Require clinically indicated MRI examination
- •Baseline HADS anxiety subscale score ≥ 8
- •Able to understand study procedures and provide written informed consent
排除标准
- •Severe cognitive impairment or preexisting neurological disorders that compromise neuroimaging data quality
- •Confirmed olfactory or auditory dysfunction
- •Known hypersensitivity to aromatic essential oils
- •MRI contraindications (implanted metallic devices, severe claustrophobia) or unstable cardiovascular conditions
- •Concurrent enrollment in other interventional clinical trials
结局指标
主要结局
Change in Hospital Anxiety and Depression Scale anxiety subscale score
时间窗: Baseline (pre-MRI) and within 30 minutes immediately after completion of MRI examination
Difference in anxiety severity quantified using the full Hospital Anxiety and Depression Scale (HADS) anxiety subscale. The subscale ranges from 0 (minimum, no anxiety symptoms) to 21 (maximum, severe anxiety); higher scores correspond to worse anxiety status. Anxiety scores are captured at two distinct time points to compute the pre-to-post MRI score change.
次要结局
- Change in low-frequency heart rate variability parameter(Baseline (pre-MRI), during MRI scanning, and within 30 minutes immediately after completion of MRI examination)
- Change in high-frequency heart rate variability parameter(Baseline (pre-MRI), during MRI scanning, and within 30 minutes immediately after completion of MRI examination)
- Standardized amplitude of low-frequency fluctuations from resting-state functional MRI(Within 30 minutes after completion of clinical MRI scan and assigned study intervention)
- Standardized z-score degree centrality from resting-state functional MRI(Within 30 minutes after completion of clinical MRI scan and assigned study intervention)