World Science Festival: Reawakening the Brain through Music

Friday marked the second World Science Festival appearance for the renowned neuroscientist Oliver Sacks, M.D. In 2008, Sacks spoke about vision, but this year’s event focused on the multiple applications of music therapy to help treat patients with diseases and disorders including stroke, Parkinson’s disease, and Alzheimer’s disease.

Sacks was joined on the panel by Grammy Award-winning musician and music therapy student Stanley Jordan, cognitive neuroscientist Petr Janata, Ph.D., and pioneering music therapist Concetta M. Tomaino, D.A. [Janata and Tomaino have both written articles for the Dana Foundation.] “60 Minutes” correspondent Lesley Stahl moderated the panel.

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The Music Never Stopped

A film about the powerful connection between music and memory—The Music Never Stopped described by the New York Post as “a mash-up of Awakenings and Almost Famous”—is now open, following its debut earlier this year at Sundance.

Music is the fictionalized account of the real-life patient—Gabriel is his name in the film—profiled in the essay “The Last Hippie” by the neurologist and best-selling author Oliver Sacks, M.D.,  known for his published collections of case studies. The film traces the story of a 30-something Gabriel, who, estranged from his family for nearly 20 years, returns home (in 1986) with a long-neglected brain tumor. We learn that the tumor has destroyed Gabriel’s ability to form new memories, and that many of the intervening years have been lost to him. His father Henry (J.K. Simmons) researches potential treatments and finds promise in music therapy, which does indeed end up “unlocking” Gabriel.

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Music as a healer

We’ve come a long way in incorporating evidence-based methods into music therapy, and we’ve only just begun, said Concetta M. Tomaino, of the Institute for Music and Neurologic Function in the Bronx, New York, in her recent “Music and the Brain” lecture at the Library of Congress in Washington, D.C.

When she started working as a music therapist 32 years ago, “there was no neuroscience in music therapy,” she said. No one could explain why the people with severe dementia she worked with would respond to music and little else. But “lucky for us,” she said, the neuroscience community grew intrigued with the idea of using music as therapy and started investigating it, and “it’s only now that we’re able to say how this works.”

Tomaino is the latest in a string of lecturers at the Library this season who have described the power of music to improve,
maintain, and retrain brain function. She referred to the research presented by Gottfried Schlaug in December and Petr Janata in January while concentrating on how what we are learning has improved therapy in the real world for people with stroke, Parkinson’s disease, aphasia, and other motor and speech troubles. [She also wrote a piece for Cerebrum in 2002, “How Music Can Reach the Silenced Brain.”]

“Music is a whole-brain exercise,” she said. Because it is processed in many parts of the brain and uses many brain networks, music can offer
alternate gateways to an area that might have become cut off. For example, networks for rhythm and timing are, if not innate, laid down before a child is born. At four months’ gestation, a fetus can respond to “beat induction” (matching movement to a beat); as early as two days after birth, babies can distinguish the beat in a piece of music. This is a critical function, Tomaino said, because “sound gives instruction to the world around us.” Babies must quickly learn to respond to verbal commands, tone, speech patterns, and other aural cues. They also must learn to move in time, including the basic rhythm of walking.

That this capacity is so ingrained also means that if people lose their ability to move, as when their motor networks are damaged by Parkinson’s or after a stroke, their subcortical regions might be tapped to retrain or rewire the motor system. “Using auditory cues, we can reimbue them with this ability,” she said. Tomaino showed a video clip of a woman with Parkinson’s shuffling toward the camera; when the music starts, the woman’s posture straightens, her stride improves, her arms swing in time, and she executes a pivot-turn, all movements she hadn’t seemed able to do moments before. Part of the improvement may be due to where the command to move is processed, Tomaino suggested. By
“letting music take over,” the patient may be dimming her conscious processing of a now-difficult maneuver and letting the brain automatically fill in the proper form. [more examples in a video by of the Institute for Music and Neurologic Function]

In therapy, “we bypass, believe it or not, fear,” Tomaino said. “When they stop their thinking about it, making it less conscious, their fluidity of movement comes back. It looks amazing, and it is. But this is so true with many people with Parkinson’s disease.”

It also can
help process language and speech. People with speech difficulties can improve their breath control by singing, and music’s rhythmic cues can help extend a person’s phrasing and access lost pockets of memory. Tomaino showed a video of a woman who could string together only three syllables at a time; after two months of twice-a-week training, she could speak 19 syllables at a time. “The motor timing, the contour and the timing of the singing, helped retrain the ability of speech,”Tomaino said. And the breath-control exercise helped her regain strength enough that doctors could remove her tracheal tube and she
could breathe on her own.

“I don’t think that everyone with aphasia is singing, but they should be," she said.

–Nicky Penttila

AAAS: Brain-changing power of music prompts calls for more education, therapy

Growing evidence that music training can enhance certain mental abilities, can alleviate the symptoms of learning disorders, and can restore lost functions in people with neurological damage has prompted calls to increase school music programs and therapeutic treatments.

At a press conference Saturday at the annual meeting of the American Association for the Advancement of Science, Nina Kraus, a communications disorder professor at Northwestern University, and Gottfried Schlaug, an associate professor of neurology at Beth Israel Deaconess Medical Center and Harvard Medical School, summarized recent research outlining the profound ability of music to enhance or restore brain pathways and the implications of those findings for health and education.

Kraus pointed out that music is reflected literally by the brain. After hearing a sound, a person's brain waves come to mirror that melody, she said, playing several pairs of music sequences and brain waves to demonstrate. But music exerts its most profound effects after extensive training, by increasing not just the ability to learn and play music but also facility with memory, attention, and pattern recognition. In fact, she said, her work suggests that intensive music training may be key to treating or ameliorating childhood learning disabilities, as it greatly enhances the abilities that suffer the most in those conditions.

In a recent study, for instance, she found that trained musicians have a much greater ability to discern speech in noisy situations, such as crowded restaurants or bars, than those without any musical experience, a kind of pattern-recognition task some children also have great difficulty with. The finding, which appeared in the December 2009 issue of the journal Ear and Hearing, echoes research her group presented at the 2009 Society for Neuroscience meeting showing that trained musicians have enhanced abilities to focus on and memorize sounds, other abilities lacking in people with dyslexia, autism, and related disorders. This suggests, she said, that elementary and secondary schools are making a mistake when they cut out music programs. "The education and remediation possibilities of music training are very encouraging," she said.

Schlaug played several videos showing the power of melodic intonation therapy (MIT) to rewire seriously damaged brains. As we have described previously, MIT is a technique developed for treating nonfluent aphasia, or an inability to speak due to damage, usually from a stroke, to the language-processing regions in the brain's left hemisphere. During the treatment, a music therapist teaches the patient to feel out the melody of specific phrases by tapping his or her hand and then to repeat the phrases aloud in a singsong voice. Typically, the treatment course is intense, consisting of 70 to 80 sessions over several weeks.

The results can be spectacular; most patients, Schlaug said, recover significant amounts of speaking ability, and one patient even felt comfortable enough to make a short public speech. In one particularly compelling video clip, a man went from mumbling nonsense phrases to being able to recite his full mailing address after 75 therapy sessions. "These kinds of music-making therapies are very useful for patients suffering from strokes and other neurological disorders," Schlaug said. "It engages parts of the brain that are not normally engaged and links parts of the brain that are not normally linked."

Although the therapy has shown promising results, it is still in the early stages of testing, Schlaug added. If it pans out, tens of thousands of stroke victims could benefit from the therapy each year in the United States alone. The true challenge then, he said, would be gaining widespread traction for the treatment, by getting therapists to feel comfortable with the oddness of singing with their patients and by ensuring that insurance companies reimburse people for MIT sessions.

Schlaug has been a pioneer in the field of music and the brain studies; some of his research is funded by the Dana Foundation. Mentioned only obliquely in his presentation, for instance, was a four-year study he is helping to conduct that compares the cognitive abilities of children undergoing regular music training with those who are not. Not surprisingly, he and his colleagues have found that, after 15 months, children who practice music showed more improvements in motor skills and melody and rhythm identification tasks related directly to music. But after 30 months, the results seem more in line with those of Kraus and her lab, with the children beginning to show suggestive, though not significant, signs of "far transfer" benefits—increases in most distantly related skills, such as vocabulary and abstract reasoning.

–Aalok Mehta

How music rewires the brain

Evidence continues to grow that musical training may not
only serve as a powerful tool for treating mental illnesses but may also rewire
the brain to be more nimble at learning math and other subjects.

This ability to alter brain connections was the focus of a
recent “Music and the Brain” lecture at the Library of Congress in Washington,
D.C. Gottfried Schlaug, an associate professor
of neurology at Beth Israel Deaconess Medical Center and Harvard Medical
School, outlined three lines of neurological research into musical experience
and explained why scientists are optimistic about its potential for education
and rehabilitation.

“Music making engages quite a lot of real estate in the
brain,” he said. “We wanted to know if everyone has the potential to become an
accomplished musician, or if [musicians] start off with an atypical brain.”

In adults, for instance, he said, musicians with a long
history of practice tend to have bigger corpus callosa—the bundles of fibers
that connect the right and left halves of the brain—as well as enhanced motor
and auditory processing areas than do non-musicians.
Many of these changes were specific to the primary type of instrument used by a
musician. But everyone seems able to benefit: Adult non-musicians who took a
crash course in piano showed changes in their sequencing, musical and math
abilities even after just two weeks.

Schlaug also outlined results from a four-year study of
young children he is conducting with Ellen
Winner
, a psychology professor at Boston University. After 15 months,
children who began practicing music showed, as expected, improvements in motor
skills and melody and rhythm identification tasks. There were also suggestive,
but not statistically significant, evidence that the children were beginning to
excel in nonmusical tasks such as vocabulary and abstract reasoning. This type
of extension into a nonrelated mental ability is known as “far transfer.”

We have covered many of these findings in the context of
neuroeducation, a new field that seeks to use neuroscience findings to improve
teaching practices. Schlaug and Winner, for instance, were featured speakers
at the “Learning, Arts and the
Brain
” summit in May, where they presented their 15-month data.

Since then, however, data from 30 months into the child
study has been collected; although it is still in the process of being
analyzed, far transfer trends seem to be continuing, Schlaug said, increasing
interest in music’s potential educational benefits. Since the May conference,
Schlaug and his colleagues have also compiled videos demonstrating the extent
and rate of improvement in musical ability in their study participants.

Schlaug also presented a video showing how extensive rhythm
and singing therapy helped a four-year old boy with autism speak his very first
words. “Music,” Schlaug said, “may provide alternative entry into broken brain
systems that may not be linking up properly.” (The use of music for autism is
just the tip of the iceberg; music is also being used as treatment for spinal
cord injuries, stroke and other conditions. Look for more extensive coverage of
these therapies in the coming weeks.)

Schlaug’s presentation was the final “Music and the
Brain
” lecture of 2009. The series, presented by the Library of Congress
and the Dana Foundation, will resume on Jan. 21 with “Music, Memories, and the
Brain,” in which Petr Janata of the University of California, Davis, will outlining
brain imaging results from people who have experienced musical “trances.” As an
early Christmas present, the LOC has released free podcasts
of earlier lectures in the series.

-Aalok Mehta

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