This blog is a continuation of my mini-series examining the value of music on our overall wellbeing. The next two instalments will look at the physical benefits of music as a means of healing and rehabilitation.
As always, if you have any comments, suggestions or would like any further information regarding any of the research provided below, please do not hesitate to drop me a line! Music therapy is still a relatively new field (especially when looking at the wider sphere of medicine), and a lot of this might be new information to some. However, there exists a huge array of prior research and reading material on the subject. If reading these articles has sparked an interest in learning more about music therapy, but unsure about the best place to start, I would be more than happy to point you in the right direction!
I got rhythm: Music & Movement
Levitin (2006, p. 174) states that the cerebellum, as one of the earliest parts of our brain to evolve, is responsible for motor functions, including timing:
The Cerebellum is the part of the brain that is involved closely with timing and with coordinating movements of the body…From phylogenetic studies – studies of brains of different animals up and down the genetic ladder – we’ve learned that the cerebellum is one of the oldest parts of the brain, evolutionarily speaking. In popular language, it is sometimes referred to as the reptilian brain. Although it weighs only 10 per cent as much as the rest of the brain, it contains 50 to 80 per cent of the total number of neurons. The function of this oldest part of the brain is something that is crucial to music: timing (Levitin, 2006, p. 174)
As one of our oldest brain functions, our propensity for rhythm is therefore hardwired into us. Combine these automatic functions with the reward-centre activation we experience when listening to music (Salimpoor et al, 2015), and it goes quite some way to explaining our natural need to set things in order; an ‘unconscious propensity to impose a rhythm even when one hears a series of identical sounds at constant intervals’ (Sacks, 2008, p. 264).
Sacks (2008) discusses studies which demonstrated that the motor cortex and subcortical motor systems were activated when listening to music, or even merely imagining it. He argued that keeping time, in both a mental sense and as a physical act, depends ‘on interactions between the auditory and the dorsal premotor cortex’ (Sacks, 2008, p. 262). The human mind is unique in its ‘functional connection between these two motor activations’ (Sacks, 2008, p. 262) which are so intricately integrated with each other. Further to this, when listening to music is coupled with a physical activity, such as finger-tapping or any other movement in the body, several more areas of the brain are utilised. These include the cerebellum and the areas of the frontal lobes commonly associated with ‘higher perceptual and cognitive control’ (Thaut, 2005, p. 179).
According to Thompson (2015), utilizing music’s effects on the brain has yielded a positive response in stroke patients with impaired motor skills:
Patients who engaged in this intervention, called music-supported training, showed greater improvement in the timing, precision and smoothness of fine motor skills than did patients who relied on conventional therapy. The researchers postulated that the gains resulted from an increase in connections between neurons of the sensorimotor and auditory regions…the hope now is that active music making-singing, moving and synchronizing to a beat-might help restore additional skills, including speech and motor functions in stroke patients (Thompson, 2015)
Thaut (2005) has also recorded positive results when using ‘rhythmic auditory stimulation to facilitate walking’ in patients who have been partially paralysed following a stroke (Sacks, 2008, p. 276). Again, we see rhythm at play here to increasingly useful effect. Similar research carried out by Jun, Roh, & Kim (2013) investigated the benefits of music therapy in rehabilitating stroke patients. They discovered that better results, and improved mood, were increased by providing music-based movement treatments on a more regular basis (Jun, Roh, & Kim, 2013, P. 29).
Parkinson’s Disease is another condition in which music has been proven to help in alleviating symptoms. Parkinson’s Disease is a progressive neurological condition (www.parkinsons.org) caused by the ‘degeneration of cells in the midbrain that feed dopamine to the basal ganglia, an area involved in the initation [sic] and smoothness of movements’ (Thompson, 2015). These symptoms worsen as the disease progresses (Ross & Singer, 2014). In later stages of the disease, it is not only movement which is slowed down, but also the ‘flow of perception, thought, and feeling’ (Sacks, 2008, p. 274). This highlights the roots of the disease in the brain rather than in other parts of the body, much in the same way that the body can be affected after a stroke. Most studies conclude that music supplants a rhythm where the patient’s brain has stopped carrying out movement functions automatically (Jun, Roh, & Kim, 2013; Sacks, 2008; Thaut, 2005; Thompson, 2015).
As we saw when looking at musical interventions on stroke patients, one of the key factors to the success of music therapy in patients with Parkinson’s Disease is down to timing. In regard to Parkinson’s Disease, there are particular observations to be made about the patient’s own perception of timing:
‘An observer may note how slowed a parkinsonian’s movements are, but the patient will say, “My own movements seem normal to me unless I see how long they take by looking at a clock. The clock on the wall of the ward seems to be going exceptionally fast.”’ (Gooddy, 1988, quoted in Sacks, 2008, p. 276)
Regarding this example of relative time, using music has a positive effect because it ‘imposes its own tempo’, effectively overriding the impulses to speed up or slow down that Parkinsonion patients experience (Sacks, 2008, p. 276). Sacks (2008) continued that for as long as the music lasts, the patients’ rhythms returned to pre-illness speeds of movement. In other cases, where one side of the body is operating at a different speed to the other, getting the patient to play on an organ brought his limbs back into synchronicity again (Sacks, 2008, p. 277).
In many of the case studies provided by Sacks (2008), he mentions that the patients ‘come alive’ and in some examples shake off all visible signs of Parkinson’s Disease; walking more fluidly; singing; and even dancing energetically. In one case, an especially motionless patient is seated at the piano and not only frees up in her movement, but plays beautifully from memory; the act of imagining the music has the same effect as physically hearing it (Sacks, 2008, p. 278).
The phrase ‘come alive’, to me, suggests a happier state of mind when music is present in these patients. This is similar to the stroke patients in Jun, Roh, & Kim’s (2013) study that experienced an ‘improved mood’. While music is being applied here seeking physical improvements, it is simultaneously improving the patient’s mental wellbeing. Therefore, music can be seen to have an overall positive effect on the patients’ combined wellbeing. I agree with the research in these chapters, and believe that further implementation of music-based interventions within the National Health Service will show quicker recovery times in patients. This, in turn, should lead to a greater overall mental wellbeing in the patients as their health improves. As for the National Health Service, they are optimistic about the positive use of music as a means for treating stroke and Parkinson’s patients. However, they wish to see larger studies with more varied groups of patients. (National Health Service, 2008).
Jun, E., Roh, Y., & Kim, M. (2013) ‘The effect of music-movement therapy on physical and psychological states of stroke patients’, Journal of Clinical Nursing, Vol. 22, No. 1/2, pp. 22-31. Available from: 10.1111/j.1365-2702.2012.04243.x.
Levitin, D. (2006). This is your brain on music: understanding a human obsession. Great Britain: Atlantic Books.
National Health Service (2008) Music aids stroke recovery. Available at: http://www.nhs.uk/news/2007/January08/Pages/Musicaidsstrokerecovery.aspx (Last accessed: 07/05/2012).
Parkinson’s Society (2015). Available at: www.parkinsons.org
Sacks, O. (2008). Musicophilia: tales of music and the brain. 2nd Edition. United Kingdom: Vintage Books.
Salimpoor, V., Zald, D., Zatorre, R., Dagher, A., & McIntosh, A. (2015) ‘Review: Predictions and the brain: how musical sounds become rewarding’, Trends in Cognitive Sciences, vol. 19, pp. 86-91. Available from: 10.1016/j.tics.2014.12.001.
Thaut, M. (2005) ‘Rhythm, human temporality, and brain function’, in Miell, D., MacDonald, R. & Hargreaves, D. (Eds.) Musical communication. United States: Oxford University Press, pp. 171-191.
Thompson, W. (2015) ‘The Healine [sic] Power of Music’, Scientific American Mind, vol. 26, no. 2, pp. 32-41.