study was approved by the Nuclear Medicine and
Molecular Imaging Research Center, Shiraz University of Medical Sciences,
shiraz, Iran (Study Code No. 1396-01-95-15022).

study comprised 290 patients who volunteered to participate in our study and
were needed to take nuclear medicine scan at Department of the Nuclear
Medicine, Al-Zahra Hospital, Shiraz University of
Medical Sciences, Iran, from April 2016 to October 2017.

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In our study, patients were not eligible if: (I) they have heart
problems such as atrial fibrillation (AF) etc.; (II) they have hearing
problems; (III) they have history of epilepsy.

patients were divided into three 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 wore headphones without music
called the control group

subjects were asked to complete the Depression Anxiety Stress Scales
questionnaires (DASS-21) before and after of nuclear medicine scan. 

comprised to one of the three groups: group I, group II and group III. A
Digital Player MP870 (Transcend, Taipei, Taiwan) MP3 player and stereo
headphones (Sony, Bangkok, Thailand) were applied to play music for both and groups
I and II. 2 min before scanning, headphones were located in both ears of the
patients. We asked all patients for closing their eyes while scanning as well. Moreover,
we allowed to be inserted natural sounds such as waterfall ocean, bird chirping,
river and forest sounds. The binaural beat placed-audio with high quality was delivered
into MP3 format to apply in the group I. A simple music audio without binaural
beat was created to use in the group II. It is worth mentioning that listeners could
not detect which one is with binaural beat and which one is without binaural




DASS measures anxiety and stress with the state subscale and the trait
subscale. The state subscale measures temporary anxiety and stress.  The DASS Inventory is a validated 21-items
self-report measure that includes measuring state of anxiety, stress and

for state and trait components each range from zero to 21 with a higher score
corresponding to higher anxiety levels. DASS questioner was asked before and
after scan, and the measurement of heart rate was done before scan, in the
beginning of scan and after scan.

beats were synthesized with a plain music by Neuro-Programmer version 3. The
carrier tones at 200 and 215 Hz were applied to generate binaural beats with a
frequency of 15Hz in the first 3 min.





In the
beginning of the nuclear medicine scan, heart rate and DASS questionnaire were
recorded, and as well as that heart rate and motion artifact were recorded at
the end of scan. After scanning, patients moved to the waiting room and completed
the DASS questionnaire.


The results of the study were represented as the
mean±standard deviation (SD) by using SPSS 21 and also

between three groups was done with Fisher Exact test. Univariate analysis of
anxiety and stress-associated factors between all groups (difference
DASS-scores, motion artifact scales, heart rate) were performed with Sidak





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