Music and the Brain: A Therapeutic Duet?

"Zip-a-dee doo dah, Zip-a-dee-ay ..."

--A. Wrubel, R. Gilbert

"Do-wah diddy-diddy dum diddy-do ..."

--The Moffats

"Super-cali-fragilistic-expialidocious ..."

--The Sherman Brothers

"What an odd thing it is to see an entire species--billions of people--playing with, listening to, meaningless tonal patterns, occupied and preoccupied for much of their time by what they call 'music."'

--Oliver Sacks, Musicophilia

"Music is playing inside my head, I Over and over and over again, My friend, there's no end to the music ..."

--Carole King

Throughout human history and in all known cultures, people have been immersed in music. Humans passionately create, listen to and dance to it. We Americans, most of whom have no particular musical talent, spend hours daily listening to music on car radios and MP3 players, and as background in offices, homes, TV shows and movies.

The fact that music is such an integral part of being human raises intriguing questions, some of which are relevant to MS. Does the brain have specific regions that respond to music? Could people who have conditions that affect the brain, such as MS, obtain therapeutic effects from music?

The neuroanatomy of music

Music is experienced through the simultaneous activation of a remarkable number of brain regions. Listening to music involves two major processes--perception and emotional response. Through perception we recognize music's physical characteristics--the rhythm, harmony and tone. Our emotional response evokes feelings--sadness, happiness, relaxation and more. The two processes, perceiving and feeling, activate multiple brain regions that are interconnected through complex and vast networks. They range from the front of the brain (frontal lobes) to the back (cerebellum), from top (motor cortex) to the bottom (amygdala), and from outer surface (auditory cortex) to the inner core (nucleus accumbens and hippocampus). Creating or dancing to music activates an even greater number of brain regions.

Importantly, perceiving and feeling music are two distinct processes. For example, there are people who are gifted at perceiving music, such as those with absolute pitch, but who are indifferent to its emotional effects. The reverse is true as well (and is more common)--there are many people who have little or no musical talent, including those who are tone-deaf, who are passionate about music. In other words, you don't need to be musical to be strongly affected by music and potentially to benefit from its therapeutic effects.

Why do we like music?

"I know it's only rock 'n' roll but I like it, like it, yes I do ..."--The Rolling Stones

The widespread activity in the brain that music arouses suggests that music serves a critical role in human existence. Some have proposed that music actually preceded language in human evolution, thus making it a core characteristic or instinct. There is considerable evidence that music is involved in sexual attraction, especially for men trying to attract women. (However, playing the clarinet in my high school band didn't seem to make me a chick magnet.) Music may, in a more general sense, promote social bonding and may also be important for cognitive development.

Music as medicine: studies in MS and other conditions

"'Cause music's been my therapy, Taking the pain from all my anatomy ..."--Marvin Gaye

"Music is the medicine of the mind."--John Logan

It is thought that music may act as a sort of tonic or jump-starter to activate or improve neurological function. MS may be particularly well-suited to respond to music therapy. Each person with MS has a unique collection of brain lesions that produces a unique collection of symptoms.

Music may be capable of accessing diverse brain regions in an individualized way.

Researchers have studied music therapy in MS and other neurological conditions, but most of the studies done so far have had limitations, such as small numbers of participants. Even so, it appears that music might alleviate a remarkably wide range of MS-related symptoms:

* Stress (music may be combined with other relaxation strategies-see Summer 2009 Momentum)

* Emotional problems such as anxiety and sadness, and difficulties with self-esteem, self-acceptance and coping

* Cognitive issues, including problems with memory, speech, or communication

* Weakness, poor coordination and walking difficulties

* Pain

To determine whether music therapy has definite therapeutic effects in MS, larger and more rigorous studies are needed.

What can you do now?

Music therapy is generally safe. The only precaution is that excessive noise (greater than 90 decibels) may increase blood pressure and impair hearing. Although studies of music in MS are limited at this time, music is readily available, and for those who are interested, it is certainly a reasonable approach to try. Music may be pursued on one's own or by consulting a professional music therapist.

Examples of approaches to try on your own include:

Listening

* Although many people listen casually, it may be helpful to be more thoughtful about the types of music one chooses and to be more attentive to them.

Creating music

* Play an instrument.

* Make simple movements, such as tapping a drumstick, along with music.

* Join a chorus or choir.

* Even if you're not musical, have a jam session with friends.

Moving or dancing

* Take dancing lessons.

* Just dance or move parts of the body to music.

Additional Information

Two outstanding lay books on music and the brain have been published recently:

* Musicophilia, by Dr. Oliver Sacks (New York: Alfred A. Knopf, 2007).

* This Is Your Brain on Music, by Dr. Daniel J. Levitin (New York: Penguin, 2006).

by Allen C. Bowling, MD, PhD

Suzanne Darley, MA, REACE, reviewed and provided valuable input to this article.

Dr. Allen C. Bowling is the medical director of the Multiple Sclerosis Service and director of the Complementary and Alternative Medicine Service at the Colorado Neurological Institute. He is also clinical associate professor of Neurology at the University of Colorado-Denver Health Sciences Center and author of Complementary and Alternative Medicine and Multiple Sclerosis (2nd edition, Demos Medical Publishing). For more on CAM, visit his Web site, NeurologyCare.net.