PROJECT SUMMARY/ABSTRACT This U24 application is written in response to RFA-AT-23-009 to establish a high-priority research network exploring potential mechanisms and novel technologies in music-based intervention (MBI) and pain research. Pain is a multidimensional experience that leads to significant personal and societal costs. Pharmacological, surgical treatments, and anesthesia pain procedures provide some relief; however, they each have significant risks and do not address the psychosocial, behavioral, and/or neurophysiological factors influencing chronic pain conditions. As such, adults are turning to non- pharmacological, lower risk methods to manage pain –include integrative therapies such as MBIs. Meta- analytic results suggest the effectiveness of MBIs is highly variable, with tentative clinical importance. Two issues are especially relevant to the current state of MBI science: 1) it is unclear how researchers decide which components to include in MBIs to address the biopsychosocial nature of pain, and 2) the reliance on subjective measures that lack psychometric rigor and that are overly sensitive to extraneous psychosocial factors. MBI research has not followed the traditional development pathway, but focused on effectiveness trials, omitting essential development and optimization studies. A framework linking psychosocial, behavioral, and/or neurophysiological, in parallel with the development and testing of technologies to complementing patient- reported outcomes, will provide the foundation for rigorous, prospective trials. This U24 network will assemble cross disciplinary group of scientists to significantly advance our understanding of the mechanisms underlying music’s capacity to alleviate pain, and to develop novel technologies to complement patient-reported outcomes. The network will consist of scientists and clinicians from a broad range of fields including music therapy, psychology, engineering, neuroscience, social work, and medicine. The core investigative team will solicit participation of additional scientists through professional and scientific organizations and academic consortiums. The network will focus on the following major aims: Aim 1: To address major gaps in our understanding of the biopsychosocial mechanisms, including biomarkers, of MBIs in chronic pain. Aim 2: Explore novel technologies and methods to enhance the objective, unobtrusive measurement of pain within the context of music experiences. Aim 3 Implement a pilot program to fund pilot intervention studies specifically focusing on the mechanisms and technologies to advance music-based pain research. The network will establish cross disciplinary teams and bring new investigators into this field to bridge gaps in basic, applied, and clinical research, disseminate a conceptual framework for understanding the mechanisms and measurement of pain within MBIs, and establish preliminary datasets for use in grant applications. In these ways, the network will dramatically accelerate programs focused on the optimization of MBI research.

Project Narrative The proposed research is relevant to public health because it seeks to create a research network to expand our understanding of how music-based interventions (MBIs) work to alleviate pain. The research network, comprised of a cross disciplinary team comprised music therapists, engineers, psychologists, social workers, and basic scientists, will also explore new, interesting ways to measure pain during music experiences. Thus, the proposed research is relevant to the part of the NIH’s mission to understanding and optimizing the use of MBIs to improve health.