Music Therapy and Neuroplasticity: Treatment of Various Types of Diseases

Introduction

Music is one of the things we find in life that transcends time, space, culture or background, and even language. It is an art that evokes emotion and communication very different from the regular, more popular means of communication, language. There are several studies and research being done to understand music and its effects from a biological perspective. These studies are done by combining varying fields such as genetics, psychology, developmental research, and neuroscience. Understanding the biological processes involved in music may have much-needed implications in health care, education, and other areas as we are already beginning to witness.

When it comes to studying the effects of music from the neurological perspective, there are many areas that have been explored. Some of these areas include the prospect of neuroplasticity due to music therapy, music-evoked emotions, language and music processing in the brain, the effects of music on pain, music, and memory, music as medicine, and many others. This paper attempts to research into each of these areas and provide a sound understanding of how exactly music is able to influence the brain, and why this might be such a necessary thing.

We may be tempted to believe that music therapy is more of a recent idea or concept explored in the world of medicine today. This is in fact a wrong idea. Music therapy has been explored and practiced as early as the 1700s and 1800s after world war I. The earliest record of music therapy is found with professional and amateur musicians who played music for veterans from the war who may have suffered trauma (physical or emotional) due to the constraints of the war.

The brains of musicians have been studied for quite a while as the ideal case studies of brain adaptation and the development of structural and functional neuroplastic changes that occur due to extensive or long-term musical training. The cognitive difference in musicians’ brains compared to non-musicians' brains have been found due to these neuroplastic changes.

Another aspect to look into is not just that music helps to build connections and improve brain function, but the idea of individual preference and how that does a lot more than just any kind of music. As we are aware, there are many different kinds or forms of music. Yes, the music evokes emotions and builds connections generally, but is perhaps more effective when the music used for these things is based on the preference of the individual it is used on. We may also know of people who are completely disconnected from the idea of music and are okay to spend their lives without listening to music. As impossible as this may seem, there are people like this around us. An interesting idea to explore or consider is what goes or doesn’t go on in their brains when music is played.

Some keywords, phrases, or ideas should be defined before further venturing into this research of music and the brain.

• Neuroplasticity: The ability of the brain to form and reorganize synaptic connections, especially in response to learning or experience or following injury.
• Language: The method of human communication, either written or spoken, consisting the use of words in a structured and conventional way.
• Memory: The faculty by which the mind stores and remembers information.
• Pain: Physical or mental suffering or discomfort caused by illness or injury
• Emotion: A natural, instinctive state of mind deriving from one’s circumstances, mood, or relationships with others.
• Music Therapy: An intervention involving a relationship between a client and a therapist, a therapeutic process, with a carefully planned music experience.
• Music Medicine: Pre-recorded music listening experiences administered by medical personnel.

With this relevant background information, we are now able to dive into the research of music and its effects on the brain.

Music Evoke Emotion

The first idea we explore is the ability of music to evoke emotion. It is very relevant to understand what exactly emotion is and how it is processed. Much unlike the very popular idea that we feel with our hearts, it is known that emotions are processed in the brain. The heart, in fact, has no ability whatsoever to process any kind of emotion. Emotion is processed in an area of the brain (more specifically the temporal lobe) referred to as the limbic system. The limbic system is made up of many parts including the hippocampus, hypothalamus, cingulate gyrus, ventral tegmental area (VTA), prefrontal cortex, and amygdala. The amygdala is the center of the limbic system for emotional processing, which also receives input from functions such as memory and attention. Our perception of emotions such as love, hate, joy, fear, and many others comes from chemical changes in this limbic system that are associated with thoughts, feelings, behavioral responses, and a degree of pleasure or displeasure.

In an attempt to find a correlation between music-evoked emotion, and emotions we experience in everyday life, studies have now proven that music can cause changes in some major reaction components of emotion such as subjective feeling, physiological arousal, motoric expression of emotion, and action tendencies. The research has also discovered that the amygdala plays a central role in processing stimuli such as music and that music-evoked pleasure is associated with the activity of the dopaminergic mesolimbic reward pathway. A meta-analysis of the brain correlates of music-evoked emotions revealed specific brain structures that are involved in music-evoked emotions. These structures include:

• The superficial amygdala (SF) and medial nucleus of the amygdala (MeA): are sensitive to socio-affective information and modulate approaches.
• The laterobasal amygdala (LA): codes the positive or negative reward value of music.
• The central nuclei of the amygdala (CeA): are involved in autonomic, behavioral, and endocrine responses and expression of emotion.
• The hippocampal formation (HF): is vulnerable to emotional stressors and generates attachment-related emotions.
• Mediodorsal thalamus (MD): modulates corticocortical communication, movement control and approach.
• Auditory Cortex
• Broadman area 7: processing conscious appraisal.
• Broadman area 8: involved in response competition.
• Pre-supplementary motor area (SMA): complex cognitive motor programming and preparing of voluntary action plans.
• Rostral cingulate zone (RCZ): convergence zone for interceptive awareness.
• Insula: involved in autonomic regulation.
• Head of caudate nucleus (hCN): involved in initiation and patterning of somatomotor behavior.
• Nucleus accumbens (NAc): sensitive to rewards and motivates, initiates and invigorates behaviors to obtain and consume rewards.
• Orbitofrontal cortex (OFC): involved in control of emotional behavior.

While the list above only provides a basic summary of the structures involved in music-evoked emotion and how they work, the meta-analysis goes into further detail about the role of the amygdala, nucleus accumbens, and hippocampus in music-evoked emotion. The figures below show the results of functional imaging studies that were analyzed and that show the activity of these above-listed areas of the brain in response to music stimulus.

The overall idea of the meta-analysis proved that there is indeed a correlation between music and emotion. This idea is very essential for the potential use in therapy for a variety of psychiatric and neurological disorders.

Language and Music Processing in the Brain

The next idea to explore is the processing of language and music in the brain. Language is a very complex process in the brain. It involves attention, memory, processing of morphology, phonology, semantics, syntax, and pragmatics. Looking into the correlation between language and music processing in the brain, I’ve decided to focus specifically on the speech aspect of language. Although language and music are processed in overlapping areas of the brain, it might be difficult to see how music would correlate with the speech aspect of language. Music is also a complex process in the brain involving rhythm, melody, and harmony. However, expressing or discussing the present, past, and future events in words using speech-language is not something we would always imagine to be possible with music. For example, it might be hard to ask an actual question using just a few notes of music and receive a response. Though this correlation between music and speech is not explicit, it has been proven to exist. Music extends far beyond the analysis of the structure of sounds to more abstract representations of the speech signal. There is a strong correlation between musical expertise and speech processing. Research conducted by Mireille Besson et al dug into this correlation between musical expertise and speech processing. The researchers analyzed the brains of musicians vs. non-musicians in many different instances and found that speech processing was much more effective in musicians compared to non-musicians.

The study above explored the idea of pitch processing. There are languages often referred to as tone language in countries of Africa and Asia. In these languages, you could have one word that could mean completely different things depending on the tone used in pronouncing the word. In their study, they found that musicians perform better when it comes to learning words like these and repeating the words appropriately. They looked into several processes that are similar in music and speech. These processes include intonation and melodic contour, lexical pitch processing, meter processing, rhythm, and acoustic parameters such as frequency, duration, intensity, and timbre. Recognizing that these processes are the same for speech and in music, it becomes easier to see how music and language are very well correlated. The idea is not that music will replace speech where speech is lost or broken but consider how impaired speech may be improved with musical training that sharpens the brain's ability to process several aspects of speech including the aforementioned.

An interesting idea is an idea that music has the ability to reduce pain. Several studies have been conducted to test this idea. One of these is a meta-analysis done by Jin Hyung Lee of the Ewha Women’s University, Seoul, Korea. Experiments were done to test the idea of music and its influence on pain. About 97 trials were conducted and involved a total of 9,184 participants. From the experiments conducted, it was observed that “music interventions do have beneficial effects on pain intensity, emotional distress from pain, use of anesthetic, opioid and non-opioid agents, heart rate, systolic and diastolic blood pressure, and respiration rate.” It was found that music therapy showed significant effects on both acute/procedural pain and chronic/cancer pain. Children also benefit more from music interventions than adults do.

Another study on the effects of music on pain focused on fibromyalgia, which is a chronic pain syndrome characterized by multifocal pain, fatigue, sleep disturbances, depression, cognitive and memory issues, and alterations in sensory processing such as vision, touch, and audition. The purpose of the study was to test if music would reduce pain and increase functional mobility in fibromyalgia patients. 22 patients diagnosed with FM participated in the study. The patients were placed in a soundproof room with no windows and sat in a comfortable chair in front of a computer. The patients stared at a cross on the computer screen throughout the experiment which consisted of 10 minutes of one auditory background, 10 minutes of a washout condition, and 10 minutes of another auditory background. After each auditory background, the patients were asked to rate their pain, and their functional mobility was recorded. One of the auditory backgrounds was control music. The other auditory background was a piece of music the patients had identified as a favorite in a phone interview before the experiment.

Music has been found to improve cognitive performance in tasks of verbal and episodic memory. Some of us remember some tricks teachers used with us as kids in classes to help us remember certain things. Most of these tricks were pneumonitis made into songs. In fact, for me, till this day, there are some things I still remember because of the songs I was taught. I memorized the first 30 elements of the periodic table when I was in the 7th grade and still remember it till now because of a song I learned. A lot of us find that it is so much easier for us to remember lyrics to songs that anything else. Even when a song we haven’t heard in a very long time comes on, we somehow remember the words and are able to sing along. These things show that there is a strong correlation between music and memory. A couple of the aspects explored with this idea include the emotional aspect and the overlap of music and memory processing in the brain. The emotional aspect might have to do with the synchronization of certain connections in the brain. It is proven that memory and emotion are connected in the brain and that certain memories can trigger certain emotions or vice versa. As has been discussed earlier, music is also connected with emotion in the brain, and certain kinds of may trigger certain emotional responses. Putting it all together, music may trigger emotions that in turn trigger the retrieval of certain memories. Perhaps this is what we experience when we hear a song from our childhood or from so long ago. The song first triggers the emotions that we felt at the time we learned those songs, and those emotions in turn lead to a retrieval of the memory.

The overlap of music and memory processing in the brain comes from neuroimaging studies which have shown that “music engages a large scale bilateral network of temporal, frontal, parietal, cerebellar, and limbic/paralimbic brain areas that are associated with the perception of complex acoustic features such as melody and timbre, syntactic and semantic processing, attention and working memory, episodic and semantic memory, motor and rhythm processing, and experiencing emotion and rewards.

Studying the effects of music on memory may be very beneficial in music therapy treatments for patients who suffer from Alzheimer’s, dementia, and other ailments that might lead to memory loss.

Music Therapy and Neuroplasticity

Music therapy is becoming more and more popular in the world of medicine today due to the positive and successful results that have come from it where practiced. Music therapy is used for a wide range of patient populations including autism spectrum disorder, Alzheimer’s disease and dementia, Parkinson’s disease, traumatic brain injury, mental health and mood disorders, pain management, cancer, movement disorders, and strokes, and hospice care. Music therapists have a few focuses, but one of the main focuses they aim at is neuroplasticity. The neuroplasticity model for music therapy has a few areas that it focuses on including music and dopamine, music and the Hebbian principle, and music versus noise. This model can then be applied to clinical practice for the effective treatment of the aforementioned patient populations.

Music and dopamine: It has been mentioned before that music is associated with the activity of the dopaminergic mesolimbic reward pathway. Dopamine is a neurotransmitter in the brain that is associated with motivation and reward-seeking behavior, as well as working memory and reinforcement learning. Research has shown that the response of dopamine neurons can be transferred to stimuli during learning. In other words, the dopaminergic system may be responsible for predicting with temporal precision future rewarding events. The idea here is that paired stimulation of dopaminergic neurons in the VTA with sensory stimuli may result in cortical remapping. It is well known that dopamine plays a big role in neuroplasticity as a result of this. Listening to music stimulates dopaminergic neurons in the NAc and VTA and this suggests that music may stimulate the same neural network involved in reinforcement learning and reward. Music can be paired with a task to be learned or relearned and it will stimulate the dopaminergic neurons leading to the neuroplasticity needed for strong connections in those tasks for patients.

Music and the Hebbian principle: The Hebbian principle in simple terms is the principle that neurons that fire together within less than tens of milliseconds wire together. Music, which has a huge component of rhythm, paired with activities such as movement, vocalization, breathing, and heart rate, can follow this Hebbian principle. This is one big focus in music therapy. Music is paired with non-music tasks in an attempt to synchronize neural populations of the brain involved in perceiving the music and the control of non-music tasks or behavior.

Music versus Noise: According to research, noise does the opposite of music for neuroplasticity. It increases stress which impairs cognition and memory. Music does just the opposite of this. Recognizing that noise suppresses neuroplasticity and music promotes neuroplasticity, music therapists are able to eliminate noise and promote music around patients. For example, a therapist might sing a text knowing it would be processed better than spoken text.

Now tying these to clinical practices, the neuroplasticity of music therapy aims at helping patients promote social connections, emotional expression, cognitive abilities and awareness, speech and communication, movement, and other things that are beneficial for the patient.

Conclusion

Music has a very powerful influence. Its effects are beginning to be recognized more and more. We have the opportunity to use music in the treatment of a wide variety of things. We may also be able to use music to strengthen our minds and advance our society.

References

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