Objective:
While a growing body of research is indicating a positive association between arts-participation – particularly music – and measures of general health and wellbeing, there is an incomplete understanding of the mechanisms by which positive health outcomes are achieved. This pilot project aimed to investigate the importance of performance setting and audience presence/absence on the magnitude of change in biomarkers of health and wellbeing. Performing arts activities studied were: choral singing, wind ensemble, string ensemble, and straight-play acting. The goal is to isolate elements of the activities that are potentially drivers of biological responses: creativity (all groups), musical expression (all groups except acting), voice use (singing, and acting), and regulated breathing (all activities except string ensemble and acting).

Methods:
Subjects/Procedures: Human subject volunteers (N=20) were recruited to participate in this research from 4 performing arts groups (experimental): choral singing, wind ensemble, string ensemble, and straight-play theatre. A control group (N=5) was also recruited from volunteers who were not participating in any performing arts activities. Subjects in the experimental groups were followed over the course one week leading up to a performance. The period included 3 conditions: regular rehearsal (practice with no audience), dress rehearsal (performance with familiar audience), and a performance (with unfamiliar audience). Subjects wore a heart rate monitor (ECG) throughout their participation period, and saliva samples were collected before and after each practice/performance period.
Outcome Measures: Heart rate variability (HRV) was derived from the ECG as an indicator of emotion regulation. RNA was extracted from the saliva samples for measurement of cytokine and endocrinological markers: TNF-alpha, IL-6, IL-1beta, prolactin, cortisol, and oxytocin.

Results:
Preliminary analysis of HRV indicates that HRV is upregulated (improved emotion regulation) after dress rehearsals and performances, but not after regular rehearsal. Further, the effect appears to be greater in groups with regulated breathing (wind ensemble, singing) than for acting or string ensemble. RNA analysis from saliva is ongoing.

Conclusion:
This work is providing initial data to illuminate the underlying mechanisms of change relating to arts and health.