Definition, prevalence and treatment of MPA: current state of research
heart disease, anxiety, dizziness, tachycardias, complaints or disorders of the cervical spine, muscle pain, Panic Disorder, DSM-5
PMR, HEART DISEASE
Music performance anxiety (MPA) can be defined as a subentity (“performance only” subtype) of social anxiety according to DSM-5 (F40.10) or as specific phobia as coded by the ICD-10 (F40.2)[Cardiac stress with tachycardias and a mean heart rate of 130–160 bpm are very common in solo performances by instrumentalists [Furthermore, no studies have been performed on blood-based therapy-related biomarkers in MPA. However, blood is currently the medium that is available for diagnostic purposes with little expenditure of time and personnel, as well as not being burdensome for the patient. Some first evidence of the potential utility of such blood-based biomarkers for the prediction of exposure therapy response comes from metabolomic and epigenetic studies in patients with Panic Disorder [With regard to therapy of MPA, there exist manifold coping strategies and therapeutic interventions in the field of evidence based medicine such as cognitive behavioral therapy (CBT), medication with beta blockers but also complementary therapy methods like music therapy or Alexander technique described in detail by Fernholz et al. [Considering all of the above, this study aims to close the existing gap by investigating therapeutic effects of cognitive-behavioral exposure therapy using virtual reality compared to a relaxation training. Besides psychological measures, physiological measures such as parameters for sympathetic activity measurable in the peripheral blood and cardiovascular reactivity will be considered as therapeutic outcomes.With regard to benefits and harms, in the best case, the therapeutic interventions lead to an immediate and short-term reduction of music performance anxiety and could also provide an individual coping tool to increase self-efficacy in performance situations. Direct harms of the therapies are not to be expected. Of course, VR exposure may lead to experiencing anxiety and therefore to an increase in heart rate and blood pressure. For this reason, participants with a history of heart disease are not included in the study. Furthermore, the VR could lead to a simulation sickness in form of transient dizziness. In the case of PMR, there may be short-term muscle pain in some parts of the body. If complaints or disorders of the cervical spine are known ahead to the PMR intervention, the cervical muscle group is being omitted. Overall, these potential benefits could help promote participant retention and to motivate participants to complete follow-up.