The allowed to be inserted natural sounds

 The study was approved by the NuclearMedicine and Molecular Imaging Research Center, Shiraz University of MedicalSciences, shiraz, Iran (Study Code No. 1396-01-95-15022).The study comprised 290 patients who volunteered to participate inour study and were needed to take nuclear medicine imaging at the Department ofthe Nuclear Medicine, Al-Zahra Hospital, Shiraz University of Medical Sciences, Iran, from April 2016 toOctober 2017.In the study, patients were not eligible if they have: (I) heartproblems such as atrial fibrillation (AF) etc.; (II) hearing problems; (III)history of epilepsy. Our patients were divided intothree groups: Group I: patients who listened to the music with binaural beat(MBB); Group II: patients who listened to the music without binaural beat(MWBB) and Group III: patients who only wore headphones without music called thecontrol group. A Digital Player MP870 (Transcend, Taipei, Taiwan) MP3 playerand stereo headphones (Sony, Bangkok, Thailand) were applied to play music forboth and groups I and II. 2 min before scanning procedure, headphones were locatedin both ears of the patients.

We asked all patients for closing their eyes whilescanning as well. Moreover, we allowed to be inserted natural sounds such aswaterfall ocean, bird chirping, river and forest sounds. Binaural beats weresynthesized with a plain music by Neuro-Programmer version 3. The carrier tonesat 200 and 215 Hz were applied to generate binaural beats with a frequency of15Hz in the first 3 min. The binaural beat placed-audio with high quality was delivered intoMP3 format to apply in the group I. A simple music audio without binaural beatwas created to use in the group II. It is worth mentioning that listeners couldnot detect which one is with binaural beat and which one is without binauralbeat.before and after nuclear medicine scan, the subjects were requestedto fill the Depression Anxiety Stress Scales questionnaires (DASS-21).

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The DASSmeasures anxiety and stress with the state subscale and the trait subscale thatthe state subscale measures temporary anxiety and stress.  The DASS Inventory is a validated 21-itemsself-report measure that includes measuring state of anxiety, stress anddepression. Scores for state and trait components each range from zero to 21with a higher score corresponding to higher anxiety levels. Also, measurementof heart rate was done before scan, in the beginning of scan and after scan.

The results of the study were represented as the mean ± standarddeviation (SD) by using SPSS 21 and comparison between three groups was done with Fisher Exact test aswell. Univariate analysis of anxiety and stress-associated factors between allgroups (difference DASS-scores, motion artifact scales, heart rate) wereperformed with Sidak analysis.     

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