Music As Medicine

Here's a short article based on a survey Daniel Levitin did of 400 scientific papers having to do with music as medicine. There's nothing really new, but it's a nice roundup of where we are.

. . . They found that music had documented effects on brain chemistry and associated mental and physical health benefits in four areas:

Management of mood.
Stress reduction.
Boosting immunity.
As an aid to social bonding. . . 

. . . One paper even compared patients at a hospital before surgery who were randomly assigned to either listen to music or take an anti-anxiety drug such as Valium. "People who received the music had lower anxiety levels than people who had the drugs and without side effects," Levitin said. . .

. . . Studies showed that slower music tends to be more relaxing than faster music, but familiar music is more relaxing, regardless of the type and tempo. That brings up an important point about the use of music in a medical setting, Levitin said. "Rather than the doctor saying, 'Oh, you've got depression — take two Joni Mitchells and call me in the morning,' I think what we need to have is recognition that people need to have control over what they are listening to.". . .

11 Problems Music Can Solve

This listicle over on Mental Floss has some things I've seen before and some I hadn't. Some of the items have only one study listed as back-up, so it's not really authoritative. Putting up the link mostly to indicate how there's broader acceptance these days to music's ability to affect us.

Music Making and Seniors

This brief article is about a preliminary study that suggests music making is of cognitive benefit to older people.

. . . Researchers Brenda Hanna-Pladdy and Alicia MacKay at the University of Kansas Medical Center surveyed 70 healthy people aged 60 to 83, giving them a series of neuropsychological tests. Those with at least 10 years of musical experience had “better perfor­mance in nonverbal memory… and executive processes” compared to non-musicians, the investigators wrote. . .

. . . It has already been known that “intensive repetitive musical practice can lead to bilateral cortical reorganization,” or wide spread changes in brain wiring, Hanna-Pladdy and MacKay wrote. But it has been un­clear, they added, whether musical abilities “transfer to nonmusical cognitive abilities” throughout life.

Music & Parkinson's Disease

A while back I mentioned a proposed study on whether listening to a classical music concert would have an effect on the symptoms of Parkinson's disease. Preliminary results are in and are looking positive. The thinking seems to be that the effect is due to music causing a release of dopamine, low levels of which cause the Parkinson's symptoms.

The study involved three concerts, one by a string quartet, one by a wind quintet and one by a brass quintet. I wish more symphonic organizations would put more effort into chamber music and looking for new ways to serve their communities as the Fort Wayne Philharmonic has done in this case. This post by Jeffrey Agrell touches on classical organizations needing to be more versatile.

Live Music in Hospitals

One of the very first posts on this blog linked a BBC story on how live music was helpful to patients in hospital. Then for the longest time there were no other stories, but now two have popped up. In a Washington Post article discussing music and neuroscience there's mention of live music:

"We have musicians here who play for people who've just come out of surgery - a flautist goes up and plays for them and these patients, who are in tremendous pain, at the end of the playing, they are almost pain-free. Now we know that perhaps dopamine is playing a role."

This article from Pittsburgh talks about a program providing music in public spaces in a hospital. 

Another Testimonial

This article talks about how music therapy, specifically "neurologic music therapy" (a term I've not seen before) has been part of the wonderful recovery Congresswoman Gabrielle Giffords seems to be having.

. . . When Miss Giffords mouthed the words of Twinkle Twinkle Little Star as her music therapist Maegan Morrow sang the ditty and strummed a guitar, it brought tears to those gathered at her bedside. She has now progressed to sing-alongs of jazz and rock classics such as I Can't Give You Anything But Love and American Pie. . .

. . . Miss Gifford's mother, Gloria, has told friends that her daughter's transformation from a "limp noodle" after the attack owes much to music sessions where family and friends "clap and hoot" as back-up chorus and band. The neurologic music therapy - an integral part of her packed daily routine of physical, occupational and speech therapy - "really flipped the switch" for the congresswoman, Mrs Giffords said. . . 

Anecdotal Testimonial

Here's a brief story with nothing new in it,  just a nice summation of how music can benefit someone recovering from brain surgery. In this case the patient was a critical care surgeon who is also an amateur musician. (In my experience there are a lot more medical people who are amateur musicians than you'd find in other professions.)

"The surgery had discombobulated my brain, and you can't have that and be a surgeon in a critical-care unit. I was trying to recover, but things weren't working right. I didn't think I'd have the mental skills again that I needed to return to my profession." 

"And gradually, sitting at the piano, I started getting some of that feeling back in my brain. What I recognize now . . . was that music involves every part of the human brain. To play music requires rhythm, melody, timing, timbre, harmonics, physical manipulation and responses."

What was happening, Fratianne said, was that he "was being forced to integrate all parts of brain function. As it came back, I regained my ability to do other things that the rehab therapists were asking me to do." Fratianne's mental and physical skills came back, and three months after his brain surgery he was able to operate again (the first time, he did so with a backup surgeon next to him, ready to take over.) "For a surgeon, that's an incredibly short amount of time to come back, and I can't help but think that it was music therapy that turned the corner for me".

Psychological/Physiological Interface

This article discusses new research indicating meditation improves one's health down on the cellular level. Music is not mentioned, but there's this (emphasis added):

"The take-home message from this work is not that meditation directly increases telomerase activity and therefore a person's health and longevity," Saron said. "Rather, meditation may improve a person's psychological well-being and in turn these changes are related to telomerase activity in immune cells, which has the potential to promote longevity in those cells. Activities that increase a person's sense of well-being may have a profound effect on the most fundamental aspects of their physiology."

Brain Wiring : Nano-level

A lot of the articles I've linked to talk about "rewiring" the brain. This article discusses how the neuroscientists are getting down to the nitty gritty on how that happens. 

In experiments with neurons in culture, the researchers can distinguish two separate steps during long-term potentiation, an enhancement of communication between neurons thought to lie behind learning and memory. Both steps involve the remodeling of the internal "skeletons" of dendritic spines, small protrusions on the surface of a neuron that receive electrical signals from neighboring cells.

The results hint at why people with Williams syndrome, a developmental disorder caused by a deletion of several genes, including one that alters dendritic spine remodeling, have such an unusual blend of cognitive strengths and weaknesses.

Music and Exercise

This story in the NYT talks about the effects of listening to music while exercising. 

Some snips:

. . . The up-tempo music didn’t mask the discomfort of the exercise. But it seemed to motivate them to push themselves. As the researchers wrote, when “the music was played faster, the participants chose to accept, and even prefer, a greater degree of effort.” . . . 

. . . In fact, it’s music’s dual ability to distract attention (a psychological effect) while simultaneously goosing the heart and the muscles (physiological impacts) that makes it so effective during everyday exercise. Multiple experiments have found that music increases a person’s subjective sense of motivation during a workout, and also concretely affects his or her performance. The resulting interactions between body, brain and music are complex and intertwined. . .

. . . “Our bodies,” Dr. Kraus concluded, “are made to be moved by music and move to it.”

Music and Alzheimer's

Two new articles just popped up on music and Alzheimer's. This one covers familiar ground on music helping retrieve memories from earlier periods of patients' lives.

It has long been known that even after patients no longer recognize names and faces, they can sing along to a favorite tune. “Auditory processing seems to be the last skill to go,” said Tomaino, who has worked in the field for 32 years.

This article talks about using music as a mnemonic tool for remembering things like what pills to take when.

“One thing we do know about the way the brain processes music is that it’s more of a global process,” he says. “While the parts of the brain where we make memories — the medial temporal lobes like the hippocampus — are the first parts to be ravaged as Alzheimer’s develops, music pulls from the cortical and subcortical areas, which aren’t as damaged by the disease.” As a result, neuroscientists believe that music may allow patients to code information using much more of the brain. Or it may be that music stimulates people and helps them pay more attention, he says, adding that even with healthy older adults, lack of focus plays a role in memory impairment. Whatever the mechanism, the therapeutic value of music is accepted by the medical establishment, and some forms of music therapy are covered by health insurance.

Singing "Rewires" Damaged Brain

Here's an article from the BBC on the use of singing to help stroke victims regain speech. Nothing particularly new, just the growing awareness of the benefits of music therapy.

By singing, patients use a different area of the brain from the area involved in speech. If a person's "speech centre" is damaged by a stroke, they can learn to use their "singing centre" instead. Most of the connections between brain areas that control movement and those that control hearing are on the left side of the brain. "But there's a sort of corresponding hole on the right side," said Professor Schlaug. "For some reason, it's not as endowed with these connections, so the left side is used much more in speech. "If you damage the left side, the right side has trouble [fulfilling that role]." But as patients learn to put their words to melodies, the crucial connections form on the right side of their brains. 

Dr Aniruddh Patel from the Neurosciences Institute in San Diego, said the study was an example of the "explosion in research into music and the brain" over the last decade.

Visual Neglect

This BBC story talks about how someone who has "visual neglect" due to a stroke can have improved vision by simply listening to music they like.

>>> Neglect occurs when the right parietal lobe of the brain, which affects space and navigation, is affected. . .  those affected would behave as if the left side of sensory space were nonexistent.
In extreme cases, they might not eat the food on the left side of their plate, or if asked to draw a clock, their drawing might only show the numbers 12 and one to six, the other half being distorted or left blank. This changed when they listened to their favourite music.

"They became aware of things on their bad side that were often missed if they were not listening to it," he said.

"We also did some functional brain imaging - and what we showed was that activity, around where the stroke had been, increased." <<<

Emotional Substrate

This brief article talking about the effect of music on emotions has a quote suggesting something I'd not seen before, that it seems part of what might be happening is that music has a physical effect that the body translates into an emotional effect.

>>> “Music induces a continuous, dynamic—and to some extent predictable—change in the cardiovascular system,” said Luciano Bernardi, M.D., lead researcher of the study and professor of Internal Medicine at Pavia University in Pavia, Italy. “It is not only the emotion that creates the cardiovascular changes, but this study suggests that also the opposite might be possible, that cardiovascular changes may be the substrate for emotions, likely in a bi-directional way.” <<<

Music Therapy in the WSJ

This article in the Wall Street Journal is the best summary of the current state of music therapy I can remember coming across. Here are a few quotes:

>>>   Dr. Tomaino says she frequently sees dementia patients make gains in cognitive function after music therapy. In one unpublished study she led a few years ago, with funding from the New York State Department of Health, 45 patients with mid- to late-stage dementia had one hour of personalized music therapy, three times a week, for 10 months, and improved their scores on a cognitive-function test by 50% on average. One patient in the study recognized his wife for the first time in months. . . 

. . . decades of studies have demonstrated that music can help premature infants gain weight, autistic children communicate, stroke patients regain speech and mobility, dental, surgical and orthopedic patients control chronic pain and psychiatric patients manage anxiety and depression . . .

. . . There's no single center for music in the mind—the brain appears to be wired throughout for music, since it engages a wide variety of functions, including listening, language and movement. But Petr Janata, a cognitive neuroscientist at the University of California, Davis's Center for Mind and Brain, recently located an area of the brain—the medial prefrontal cortex, just behind the forehead—that seems to serve as a hub for music, memory and emotions. . . . <<<

I am increasingly confident that in just a decade or two or three, music therapy will be much better understood, much more widely used, and simply accepted as a valued resource for healing the mind and body, and for helping people to stay healthy in the first place. The effects of music have been talked about since at least the time of Plato, but we've finally got the research tools to go beyond the intuitive and to have concrete data. 

Music and Memory

Here's a brief story on music being used to help patients with physical traumas of various types regain memories. The key is that music related memories are stored in more than one place in the brain. It's the same principle that allows people with dementia connect with music when they can connect with little else. Here's the concluding paragraph of the article:

>>Experts say that with modern brain imaging, they can actually see that music memories are stored all over the brain, not in just one area. There are studies showing that memories brought back with music can slow the progression, and even improve some types of memory loss.<<

Mantra Medicine

Here's a Reuters story on a doctor making CDs mixing mantras with meditative music to be used in conjunction with regular allopathic treatments. No new research, just anecdotal results. Reads more like a press release than a news story. Great title.

Great Quote

Here's an article on a memoir by Tim Page the music critic, who was diagnosed in his 40's as having Asperger's syndrome. When he was 21 and heard Steve Reich's Music for 18 Musicians, he stayed up all night writing out his impressions. About the experience he says:

>>Today I find myself wondering if I would have responded so profoundly to this starkly reiterative, rigidly patterned music had I not had Asperger's syndrome. As the Quakers might say, this music spoke to my condition; it was what my insides sounded like.<<

Music & Hearing

This article discusses research showing musicians are better able than non-musicians to hear and understand speech in a noisy environment.

>>The findings strongly support the potential therapeutic and rehabilitation use of musical training to address auditory processing and communication disorders throughout the life span. . . 

 . . . Such populations could benefit from the reordering of the nervous system that occurs with musical training, according to the study. Because the brain changes with experience, musicians have better-tuned circuitry—the pitch, timing and spectral elements of sound are represented more strongly and with greater precision in their nervous systems. . . 

 . . . The results imply that musical training enhances the ability to hear speech in challenging listening environments by strengthening auditory memory and the representation of important acoustic features.<<

Cardiovascular Benefits of Music

Here's a study from the University of Maryland on a physical benefit of listening to music.

>>Music, selected by study participants because it made them feel good and brought them a sense of joy, caused tissue in the inner lining of blood vessels to dilate (or expand) in order to increase blood flow. This healthy response matches what the same researchers found in a 2005 study of laughter. On the other hand, when study volunteers listened to music they perceived as stressful, their blood vessels narrowed, producing a potentially unhealthy response that reduces blood flow. . .

. . . . “We don’t understand why somebody may be drawn to certain classical music, for example. There are no words in that, and yet the rhythm, the melody and harmony, may all play a role in the emotional and cardiovascular response.”

That physiological impact may also affect the activity of brain chemicals called endorphins. “The emotional component may be an endorphin-mediated effect,” says Dr. Miller. “The active listening to music evokes such raw positive emotions likely in part due to the release of endorphins, part of that mind-heart connection that we yearn to learn so much more about.<<