Our understanding of music therapy and its curative or preventative effect on illness changes over time. Our current assessment is that music is a ‘powerful tool’ to engage and induce changes in ‘multi-sensory and motor networks’, which link and strengthen regions of the brain.(133) This is notably true of music’s ability to alleviate emotional symptoms such as anxiety, depression and agitation - although it is worth noting that many studies use subjective criteria when grading these responses rather than objective assessment.(134) Fundamental to music therapy is the desire to improve the quality of life(135) of patients who have a neurodegenerative, psychological or physical illness.
As our understanding of the role and function of brain regions increases, so does our understanding of how music therapy can elicit changes in the brain. For instance, we know that the frontal lobe and cerebellum are activated in response to musical practice(136), and it is these regions that result in increased attention and motor-cognitive coordination(137), respectively. We comprehend that thanks to musical practice, these particular regions (and many others) are ‘trained’ and synapses ‘strengthened’(138), resulting in an improvement in cognitive skill following a trial of listening to Mozart, for example. Our insight into the relationship between music, its therapeutic effects and its neurological representation will only continue to grow with this information.
Another interesting avenue is that of brain plasticity. With an increased interest in preventing neurodegenerative disease and Alzheimer’s in the media due to an ageing population(139), the topic is becoming more potent. Current research shows that musical training, particularly musical training beginning at a young age, induces positive changes in brain plasticity(140) - this research has included many reputable and often longitudinal large-scale studies to support this claim. This ‘brain plasticity’ important because ‘music-induced brain plasticity’ holds many ‘benefits’ in helping to restore or activate dysfunctional brain networks, regulate hormone levels in the brain and allow for healthy ‘cognitive and emotional processes’.(141)
Whilst much attention is given to the increase in grey matter associated with musical training(142), a recent medium-sized long-scale study showed us that white matter density also increases with music practice along with an ‘enlargement’ of myelin-sheath cells, which give insulation to allow for ‘rapid firing’ of electrical impulses, resulting in better and faster motor control.(143) This could make the difference between a patient with Parkinson’s who is unable to hold even a spoon for example and having the autonomy to walk around the house, dramatically improving quality of life.
Music has a ‘whole-brain effect’.(144) Unlike languages, which are mostly localised to the left-hemisphere(145), music activates both the right and the left hemisphere , which explains why the corpus callosum in musicians is larger and more active than non-musicians (this research has been heavily supported and cited).(146) Given that neurodegenerative diseases such as dementia, Alzheimer’s and Creutzfeldt-Jakob Disease(147) - with the exception of stroke - affect the whole brain, music may be more effective in preventing these diseases than language training, for example. Music does not only alter the cortical level but also the subcortical level.(148) It does not only alter grey matter but white matter also.(149) Music therapy induces activity level changes in ‘almost all’ brain structures(150) and modifies dopamine-pathway ‘circuitry’(151) and these are reputable studies with objective assessment (brain scanning). We can see how music elicits a number of changes in the brain which may, for example, be positive in the treatment and prevention of dementia for instance.
Whilst there is a great deal of supportive data for the use of music therapy, there is still more that can be done. More time could be spent on addressing the issues with music therapy mentioned previously and finding solutions: by using a reading group as a control activity, by controlling for external factors and by having a greater number of larger longitudinal studies.(152) Scientists can also use new imaging technology to trace the progress of dementia(153), with and without music therapy, whilst considering ethical and economic dilemmas, if present.
We have seen that music therapy has a broad and extensive history, that it is has a dynamic relationship with the brain, offers unique advantages in comparison to a drug trial, has a range of positive effects on numerous illnesses or disorders and diseases (both physical and psychological) and we can also note that the science of music therapy continues to be explored in new and exciting ways. Although there is always more research that can be done - as with any area of science, this paper shows that there exists substantial evidence to support the use of music therapy alongside standard care in the prevention and treatment of illness in order to improve the lives of patients and caregivers worldwide.
© 2017 Nat Barrett. Published by teoria.com