Saturday, November 14, 2009

Alzheimer’s and Musical Memories

Summary: In mid October, I was watching the Bravo channel documentary titled The Musical Brain. This W-Five documentary highlighted interviews with several neuroscientists working in the area of the brain and music, as well as interviews with famous musicians such as Sting, Michael Buble, and Feist. Some of the scientists’ work caught my eye, specifically the work of Dr. Lola Cuddy and Dr. Petr Janata. There were many common threads through the commentaries but one thread in particular was about music, memory, and emotion.

Dr. Cuddy discussed an Alzheimer’s patient who would forget her husband but could remember all the songs from the time that she was a nurse in World War II, and that “preservation of the moment in music, the emotion in music even when they forget everything else”. Dr. Janata indicated that music is a “retrieval cue” and is the last part of the brain that goes in Alzheimer’s patients. Although I knew, at the moment I was watching this documentary, what Dr. Janata was generally referring to in the interview, I either did not make specific enough notes or the documentary producers clipped and snipped information that would give more specifics - so off I went in search of more detail in this area.

An article I found, Your brain on music highlights some fairly recent work of Janata,

Janata discusses the area of the brain known as the medial prefrontal cortex and how it relates to memory and emotion, in both the younger population and Alzheimer’s patients. He explains that in Alzheimers, this area of the brain, the medial prefrontal cortex, is the last to atrophy so patients “brighten up, dance, sing, and can even recognize wrong notes in music from their past” which concurs with what Cuddy found in her patient. Music appears to be a “trigger to retrieve memories”.

So, stepping back in time to a younger life, one might ask how the connection between music, memories, and emotion becomes so intertwined in youth, and so sustaining into adult life and in the case of Alzheimers, in brain degeneration. One of Janata’s experiments, noted in this article, used 13 UC Davis undergrad student subjects. Comfortably resting in an MRI machine with headphones on, Janata exposed the student to snippets of popular and R&B musics that would have been popular during their adolescent and teen years (7-19). Since undergrad and age 19 might be concurrent, it appears that he also used music that would be part of their current repertoire. He used music that related to them during these years because he felt that this hormonal and change-intensive time in their lives is more connected to music they listen to - the music becomes more involved in their social life and “sense of self”. It is the connection of the music to our memories, some of them strong emotional memories, that may “maintain a sense of self as we age”.

Janata also believes that there is a “hub” in our brain for music, memory, and emotions, and this hub is the medial prefrontal cortex. His first test results clearly pointed to this hub when “the medial prefrontal cortex lit up like a Christmas tree whenever strong autobiographical memories were evoked”, but a second data-test result showed activity throughout the brain (in MRI scans). Apparently, the second test results were showing non-music brain activity that was also transpiring. So Janata refined his test and the third results supported his first findings that located a hub. What this highlights for him is that a way to give happiness, even for a short time, to patients suffering from Alzheimers is through music and perhaps more specifically, music that evokes personal memories and emotions.

Reflection: Every time I read a study related to the brain, or specifically to music and the brain, I am in awe. Our brains are so incredibly complex and sophisticated, and I often take for granted how everything just works the way we expect it to, until of course it doesn’t work how we expect it to. Our brains may not operate at ‘full’ capacity due to serious illness such as Alzheimers or Parkinsons, or age and hormones, or accident and injury, or genetics, or various other reasons. But then, I wonder what is full capacity any way and how would we know that we have ever reached it. How do we know that are brains are ‘telling’ us what full capacity is? What potential is still left uncovered? It appears to me that discovering this and other answers to questions about the brain involves research, study, and a great deal of speculation.

I also think about how music, memories, ideas, and experiences etc. get locked away from our consciousness until some outside event, whether positive or negative, triggers them again. How much information is actually stored in our brains? What information is stored in our brains that we may have no recollection of, and that may never be triggered and brought to our consciousness again? Even in a relatively 'healthy' brain, what thoughts and experiences did we have that we might never remember we had?

Getting back to Janata’s research, as noted in this article, it appears to compliment other research and findings in in this area. Through his work, we have discovered a little bit more about the physiology of the brain, but perhaps more importantly, it can guide us in routes of discovery in music therapy. We can investigate ways, through music, that may improve the quality of life for those suffering from illnesses of this kind, and for the family and friends who love and support them.

Wednesday, November 11, 2009

Musical Training, Brain Structures, and Behaviour

Hyde, K. L., Lerch, J., Norton, A., Forgeard, M., Winner, E., Evans, A. & Schlaug, G. (2009). Musical Training Shapes Structural Brain Development. The Journal of Neuroscience, 29(10), 3019-3025. doi: 10.1523/JNEUROSCI.5118-08.2009.

The purpose of this study was to examine brain structure changes and correlated musical behaviour in two groups of children. The "instrumental" group was made up of 15 children (mean age: 6.32 years) and the "control" group was made up of 16 children (mean age: 5.9 years). For 15 months, the instrumental group received half-hour weekly keyboard lessons while the control group participated in a weekly 40-minute group music class that involved singing and playing with drums and bells. Before and after the 15-month period, MRI scans were done and each child was given music behaviour tests. These tests consisted of

Near-transfer measures (These test skills that are directly related to music participation.)
a) a 4-finger motor skill test for each hand
b) a melodic and rhythmic discrimination test

Far-transfer measures (These test skills that are further removed from music participation.)
a) object assembly test
b) block design test
c) vocabulary test

Researchers found that the students in the instrumental group experienced greater structural changes in motor-related areas of the brain. This was correlated and predicted by improvements in left-hand motor skills. Changes in the right auditory area were correlated and predicted by improvements in melodic/rhythmic discrimination. No advantage was gained by the instrumental group over the control group in the far-transfer skills. These findings support results of tests on musicians and non-musicians.

They also found structural changes in the brain outside of the motor and auditory areas. Researchers were particularly excited by changes observed in the left posterior pericingulate region, since this is in the vicinity of Brodmann area 31, which is involved in the integration of visual information and the limbic system. Musical notation and its emotional interpretation is an example of this type of integration.

In reading this study, I did wonder, "So what if the brain can change in just 15 months?" Will this make a difference in how I do things now? In what I choose to do? How I choose to teach?

To be honest, I don’t know, but perhaps it ought to. There are already many reasons, not specifically conceived as brain development reasons, why I make decisions as it is. In particular, my reasons for choosing to focus on music-related issues did not come from a consideration of how it would change or help my brain, per se. But, admittedly, since the brain controls everything, I guess indirectly, this is what I’ve done. More precisely, it seems to me that music provides access to a part of people that other means don’t seem to get at the same way.

Indeed, this study shows that music changes the brain, even in areas that are just beyond the direct music/motor-related centres. In reading both Jourdain’s Music, The Brain, and Ecstasy and Levitin’s This Is Your Brain on Music, there appears to be much evidence that music involves the whole body, the whole brain. Even without such proof, I think most of us have experienced this.

What significance does that have? It seems to me, that development of the whole person in many different ways allows for a more varied way of thinking, and maybe a different way of looking at day-to-day problems---personally, socially, globally. Not that by listening to or playing music, we can look at, say, environmental issues, and solve them “musically”, but by developing as many parts of ourselves, our brains, as we can, we’ll have that many more tools at our disposal for collaborating on issues.*

It therefore interested me to see that the Toronto Star ran a series of articles about brain science-informed education: as I had wondered for some time whether knowing what's happening in the brain could someday allow me to teach and play the piano more effectively by targeting areas known to be developed by certain tasks. A new movement is beginning to look at exactly how neuroscience can improve education.

An instinctive concern of mine in reading the summary of this study is that focus on brain structure and resultant behaviour may end up sidestepping other important factors in the learning environment. In this study, for example, factors such as teacher experience and interaction with each of the groups was not mentioned; neither was interaction between students in the group class. Perhaps the instrumental group developed more, in part, because of the one-on-one attention that was given.

Nonetheless, the idea that the brain remains malleable even into old age is such a remarkable discovery. It's a liberating thought that change is possible at every stage. It gives me a sense of motivation---there's always a reason to learn and to teach. The application of neuroscience to education, if done in dialogue and collaboration with those who influence and are influenced by the field---philosophers, educators, parents, students, etc.---, seems another important tool in improving the field.

*I should note that though far-transfer skill did not seem greatly affected in this study, the authors surmise that this may have been due to a) too short a duration for the effects to be seen, b) varying intensities of keyboard practice among the children), c) perhaps the sample being too small.