Orchestra in Class, a Novel Booster for Executive Functions and Brain Development in Young Primary School Children

Study Overview
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Brief Summary
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How to optimally stimulate the developing brain is still unclear. Executive functions (EF) exhibited substantially stronger far transfer effects in children who learned to play a musical instrument than in children who acquired other arts. What is crucially lacking is a large-scale, long-term genuine randomized controlled trial (RCT) in cognitive neuroscience, comparing musical instrumental training (MIP) to another art form and a control group. Collected data of this proposal will allow, using machine learning, to build a data-driven multivariate model of children's interconnected brain and EF development over the first 2 years of their academic curriculum (6-8 years), with or without music or other art training.

Detailed Description
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This cognitive neuroscience study, employing a randomized controlled trial (RCT), aims to investigate the potential cognitive and brain development benefits in young school children from two-year interventions: Orchestra in Class (OC, music practice, experimental group) compared with Visual Arts (VA, second experimental group) versus Standard Education (active control group (CG)). The CG will be offered six cultural outings per year (concerts, museums, theatres, etc.). Both nonverbal art interventions will be given weekly interventions for 1 hour and 30 minutes in school class sized groups. The VA groups serve to control for the influences of regular stimulating group interventions and homework, and also to compare specific effects in visual mode with the auditory mode in OC. The CG controls for overall child development and test-retest effects. We plan to recruit 150 children aged 6-8 years from public elementary schools, ensuring a random and therefore equal distribution among the three groups. Data collection will involve annual comprehensive psychometric testing (baseline, after 1 year, after 2 years) of executive functions, i.e., far transfer and near transfer, musicality, drawing, academic achievement, and multimodal structural and functional magnetic resonance imaging (fMRI), including fMRI with auditory and visual domain working memory tasks. By utilizing multivariate analyses and integrating behavioral and brain data through machine learning, we aim to create a data-driven model of the development of executive functions at the behavioral and brain levels in young children at the beginning of their school careers (6 to 8 years old), both without and with an enriched environment (musical practice versus visual arts)

Official Title
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Orchestra in Class, a Novel Booster for Executive Functions and Brain Development in Young Primary School Children

Conditions
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Development, Child, Executive Functions, Interventions, Music, Arts, Brain Plasticity, Behavior, Brain Imaging, Magnetic Resonance Imaging, Functional Magnetic Resonance Imaging, Structural Brain Connectivity

Intervention / Treatment
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* Behavioral: Orchestra in Class


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: School grade 3P/4P (3rd and 4th year of elementary school (6-8-year-old children) Right-handedness Sufficient Mastery of the French Language Able to give oral informed consent (child) Able to give written informed consent (parent) Exclusion Criteria: Non-consent (children and or parents) Repeated or skipped a class with respect to standard curriculum Not corrected/severe hearing deficits Not corrected/severe vision deficits Severe neurodevelopmental disorders (eg. severe dyslexia, severe ADHD) Older than 7 at the beginning of the school year if 3P Older than 8 at the beginning of the school year if 4P Protocolled music instrumental practice in the preceding year Protocolled visual arts courses in the preceding year MRI incompatibility (physical or psychological) Psychometric battery incompatibility (psychological)

Ages Eligible for Study
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Minimum Age: 6 Years
Maximum Age: 8 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Other
Allocation: Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: The study is a 1) block-randomized, 2) 3-arm, 3) open, 4) monocentric (primary schools in Geneva) 5) national (Switzerland) 6) intervention study.
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Orchestra in Class<br>Children will receive music practice lessons in groups, Orchestra in Class (4 different string instruments, violin, viola, cello, double bass) in school class size groups over 2 full years. Interventions, given by 2 professional teachers per class, take place for 1 hour and 30 minutes per week, completed by daily homework (20-30 minutes). | Behavioral: Orchestra in Class<br>* See arm/group descriptions<br>* Other names: Visual Arts;|
| Experimental: Visual Arts<br>Children will receive visual arts lessons in school class size groups over 2 full years. Interventions, given by 2 professional teachers per class, take place for 1 hour and 30 minutes per week, completed by daily homework (20-30 minutes). | Behavioral: Orchestra in Class<br>* See arm/group descriptions<br>* Other names: Visual Arts;|
| Placebo Comparator: Culture<br>The children will receive six cultural outings per year (museums, concerts, theatre, etc.) and pass all measurements | Behavioral: Orchestra in Class<br>* See arm/group descriptions<br>* Other names: Visual Arts;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Working Memory | Working memory (WM) will be assessed by 3 tests: 2 fMRI tests: a visual and an auditory WM test (Vuontela et al., 2003) and the Digit Span Backward from the WISC V (Wechsler Intelligence Scale for Children; Wechsler, 2014). We expect the progress of the mean WM score to show the following evolution after 2 years: Orchestra in Class > Visual Arts > Passive Control Group | 2 years | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Plasticity of gray matter brain volume | Gray matter brain plasticity, measured by T1-weighted MRI MP2RAGE (magnetization prepared 2 rapid acquisition gradient echoes; Marques & Gruetter, 2013) We expect greater gray matter volume change after 2 years according to the following gradient: Orchestra in Class > Visual Arts > Passive Control Group For the following brain areas: notably in a set of temporal (medial and lateral (auditory)), prefrontal, superior parietal areas, the basal ganglia (striatum), the cerebellum and the corpus callosum (supporting Working Memory, Executive Functions and attention) | 2 years | 
| Functional brain connectivity | Functional brain connectivity, measured with resting-state functional MRI (Leonardi,et al., 2013) We anticipate greater Functional Connectivity (FC) changes following the same gradient Orchestra in Class > Visual Arts > Passive Control Group In the following brain networks: The Default Mode Network (DMN), Central Executive Network (CEN) and Salience Network (SN) | 2 years |