The Sedative Effects of Music Listening on Pain During Cold Pressor Test (ESEMP)

Evaluation of the Sedative Effect of Music Listening on Pain Induced by a Thermal Stimulus (Cold Pressor Test)

This study aims to understand whether listening to music can reduce pain and anxiety caused by a cold-temperature stimulus in healthy young adults (n = 30). It also seeks to identify which musical and neurocognitive factors can produce a calming, analgesic (reduce pain), and anxiolytic (reduce anxiety) effect.

The main questions it aims to answer are:

• Does music based on universal musical features (such as melodic structure, modal scales, intervals, and tempo) help reduce pain and anxiety, regardless of culture or personal taste?
• Does music that reflects the participant's cultural rhythmic background-especially rhythmic styles from the Levant-change how pain and anxiety are perceived during the cold test?
• Does music selected according to each participant's personal listening habits and musical preferences have a sedative, analgesic, and anxiolytic effect?
• Are the calming effects of music the result of multiple combined factors-universal musical traits, cultural influences, and personal preferences-and how do these factors interact to create an overall therapeutic effect during the cold test?

Participants will:

• Take part in 1 session of 7 or 8 phases of cold pressor test
• Give their feedback in a qualitative questionnaire after each phase
• Answer brief questions about their musical background and preferences

This study aims to deepen our understanding of how musical and neurocognitive elements contribute to the sedative effect of music during care situations, and to support the development of a more precise and personalized musical model for use in dental procedures.

Study Overview

• Status: Completed
• Conditions: Analgesic Effects of Music
• Intervention / Treatment: Behavioral: Phase 1 - Silence (Baseline); Behavioral: Phase 2 - Happy Mode with Measured Rhythm; Behavioral: Phase 3 - Sad Mode with Measured Rhythm; Behavioral: Phase 4 - Happy Mode with Non-Measured Rhythm; Behavioral: Phase 5 - Sad Mode with Non-Measured Rhythm Type: Behavioral; Behavioral: Phase 6 - Participant-Selected from Predefined Set; Behavioral: Phase 7 - Silence (Post-Exposure); Behavioral: Phase 8 - Participant's Own Choice

• Study Type: Interventional
• Enrollment (Actual): 40
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Lebanon
  • Baabda, Lebanon
    • Antonine University

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult
• Accepts Healthy Volunteers: Yes

Description

Inclusion Criteria:

• Healthy volunteers aged 18 to 35 years.
• Ability to provide written informed consent.
• Willingness to comply with the study protocol and attend the session.

Exclusion Criteria:

• Participants with acute or chronic pain.
• Participants with a history of cardiovascular disorders.
• Participants currently taking analgesic medications.
• Participants with a recent wound on either hand.
• Participants with a history of hand fracture.
• Participants with dermatological conditions affecting the hand.
• Participants with a history of frostbite.
• Participants currently taking neuropsychiatric medications.
• Participants able to keep their hand immersed for 4 minutes during the silence (control) phase of the cold pressor test.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Supportive Care
• Allocation: N/A
• Interventional Model: Single Group Assignment
• Masking: None (Open Label)

Number of Arms

1

Arms and Interventions

Participant Group / Arm

Intervention / Treatment

Experimental: Contextualized Music; All participants undergo eight sequential experimental conditions (phases) of the cold pressor test under different controlled conditions (silence, happy music with measures rhythm, sad music with measured rhythm, happy music with non measured rhythm, sad music with non measured rhythm, their own music, music chosed from a palette).

Behavioral: Phase 1 - Silence (Baseline); Participants undergo the cold pressor test in complete silence without any auditory stimulation. This baseline condition serves as a control for comparison with subsequent music conditions.; Behavioral: Phase 2 - Happy Mode with Measured Rhythm; Participants undergo the cold pressor test while listening to music characterized by a happy emotional mode and a regular, measured rhythmic structure.; Behavioral: Phase 3 - Sad Mode with Measured Rhythm; Participants undergo the cold pressor test while listening to music characterized by a sad emotional mode and a regular, measured rhythmic structure.; Behavioral: Phase 4 - Happy Mode with Non-Measured Rhythm; Participants undergo the cold pressor test while listening to music characterized by a happy emotional mode and a non-measured (free) rhythmic structure.; Behavioral: Phase 5 - Sad Mode with Non-Measured Rhythm Type: Behavioral; Participants undergo the cold pressor test while listening to music characterized by a sad emotional mode and a non-measured (free or irregular) rhythmic structure.; Behavioral: Phase 6 - Participant-Selected from Predefined Set; Participants undergo the cold pressor test while listening to a piece of music selected by themselves from a predefined set of musical options provided by the researchers.; Behavioral: Phase 7 - Silence (Post-Exposure); Participants undergo the cold pressor test in silence following prior experimental conditions. This control condition is included to assess potential changes in pain tolerance over time and to distinguish music effects from habituation or adaptation.; Behavioral: Phase 8 - Participant's Own Choice; Optional intervention : participants undergo the cold pressor test while listening to a self-selected piece of music of their own choosing.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Pain Tolerance Duration	Pain tolerance will be measured as the total duration (in seconds) that participants are able to keep their hand immersed in cold water during each phase. A stopwatch will be used to record immersion time.	Within a single study session (approximately 90 minutes); measured (from hand immersion to withdrawal) during 8 distinct cold pressor test phases, with each phase lasting up to a maximum of 4 minutes.

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Reaction Time to Pain	The time elapsed between the onset of hand immersion in cold water and the participant's first reported perception of pain will be recorded. This measure provides insight into how musical conditions may influence the temporal perception of pain onset.	Within a single study session (approximately 90 minutes); measured from initial hand immersion to the onset of pain perception during each of the 8 distinct cold pressor test phases (each phase lasting a maximum of 4 minutes).
Pain Intensity	Pain intensity is assessed using a Visual Analog Scale (VAS), where participants rate their perceived pain during each phase of the cold pressor test. The scale ranges from 0 to 10, where 0 represents "no pain" and 10 represents "the worst possible pain."	Within a single study session (approximately 90 minutes); assessed continuously during 8 distinct cold pressor test phases, with each phase lasting up to 4 minutes.
Qualitative Feedback	A study-specific, 15-item multi-dimensional questionnaire designed to evaluate participants' subjective experience across: Pain and Anxiety Perception (e.g., categorical rating from "Mild" to "Intense").; Emotional Response to Music (e.g., 5-point scale from "Very Relaxed" to "Anxious").; Music Preference and Familiarity (e.g., selection of preferred musical mode).; Cumulative Experience (e.g., comparative assessment of pain tolerance). For the scaled items (such as Question 7: "Effect of music on pain level"), scores range from 1 (No effect) to 5 (Very significant effect), where higher scores indicate a better outcome (greater perceived music effectiveness). Qualitative open-ended responses regarding emotional tone and rhythm are collected to provide contextual depth to the physiological data.	Within a single study session (approximately 90 minutes); assessed after each of the 8 cold pressor test phases (each phase lasting a maximum of 4 minutes) and at the conclusion of the session.

Collaborators and Investigators

• Sponsor: Rawane El Dimachki
• Collaborators: Sorbonne University

Publications and helpful links

General Publications

• von Baeyer C, Piira T, Chambers C, Trapanotto M & Zelter L (2005). Guidelines for the cold pressor task as an experimental pain stimulus for use with children The Journal of Pain, 6, 218-227
• La Cesa S, Tinelli E, Toschi N, Di Stefano G, Collorone S, Aceti A, Francia A, Cruccu G, Truini A, and Caramia F. fMRI pain activation in the periaqueductal gray in healthy volunteers during the cold pressor test. Magnetic resonance imaging. 2014; vol. 32, no. 3: 236-240. https://doi.org/10.1016/j.mri.2013.12.003
• Alisa J. Johnson & Gary R. Elkins (2020) Effects of Music and Relaxation Suggestions on Experimental Pain, International Journal of Clinical and Experimental Hypnosis, 68:2, 225-245, DOI: 10.1080/00207144.2020.1719842
• Choi S,Park SG,Lee HH
• Mitchell LA, MacDonald RA, Brodie EE. A comparison of the effects of preferred music, arithmetic and humour on cold pressor pain. Eur J Pain. 2006 May;10(4):343-51. doi: 10.1016/j.ejpain.2005.03.005.

Study record dates

Study Major Dates

• Study Start (Actual): November 14, 2025
• Primary Completion (Actual): January 15, 2026
• Study Completion (Actual): January 15, 2026

Study Registration Dates

• First Submitted: March 25, 2026
• First Submitted That Met QC Criteria: March 31, 2026
• First Posted (Actual): April 7, 2026

Study Record Updates

• Last Update Posted (Actual): April 7, 2026
• Last Update Submitted That Met QC Criteria: March 31, 2026
• Last Verified: March 1, 2026

More Information

Terms related to this study

• Keywords: Pain; Analgesia; Anxiety reduction; Music therapy; Cold pressor test; Music-induced sedation; Cultural music context; Musical structure
• Additional Relevant MeSH Terms: Neurologic Manifestations; Nervous System Diseases; Neurobehavioral Manifestations; Perceptual Disorders; Pathological Conditions, Signs and Symptoms; Signs and Symptoms; Pain; Agnosia; BaseLine dental cement
• Other Study ID Numbers: 2431-2025

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No