Music as Medicine

Reference

Lane, D. (2011) Music as Medicine, Music and the Brain. [podcast]. Available at: http://www.loc.gov/podcasts/musicandthebrain/podcast_lane.html

Summary
Dr. Deforia Lane is the Director of Music Therapy at the University Hospitals of Cleveland. She grew up surrounded with classical music because her mother was a pianist and her father sang. From an early age, she saw in music the ability to transform people, specifically in the church setting. She got into the Curtis Institute of Music where she studied voice and performed in operas. She wanted to be a performer at first, but switched to music therapy after taking an introductory course in music therapy. She wanted to combine the art and the science of music. She now uses music therapy in the treatment of cancer patients. She herself experienced cancer twice so she tries to help others going through similar experiences.

Pain management in cancer patients
Pain can be a major for people suffering a variety of illnesses, but it can be particularly difficult for cancer patients. There can be fear of needles in the process of chemotherapy, bone marrow aspirations and emesis. Music has an effect on blood pressure, heart rate and respiration. It can lower muscle tension and anxiety. Music therapy can help patients relax so that the needle may be inserted without constricting of the veins. The therapy seems to be particularly useful when playing music of the patient’s choice. The live aspect allows for the music to be altered as needed. In a surgical setting, it was found that patients who had access to their preferred music used 43% less anesthesia than those without the access.

Depression in cancer patients
A music therapist can help the patient put his/her feelings on paper and together they make a song to express what the patient is thinking using a variety of instruments. The aim is to increase self-worth and self-esteem.


Music therapy as preventative medicine
Currently music therapists bill on a case by case basis. She insists that more research is needed to show the measurable differences that music therapy produces so that the billing process changes. For example, sometimes patients are discharged sooner, sometimes they lose less medication, sometimes they become more cooperative and they may experience higher spirits and so get well sooner. She believes that collaboration between music therapists and physicians is very important. She conducted a research and found that a single music therapy session can have positive impact on the immune system, measured by the level of an antibody naturally in our saliva.

Toddler Rock
Rock and Roll Hall of Fame wanted contacted her because they wanted her help them start a program to help at risk preschoolers. She and the other music therapists focused on literacy and tests have shown a great improvement in literacy skills.

Reflection
It is disappointing to hear that music therapy is waiting to be validated in the health care community. Just like in other areas of study, extensive quantitative research will be needed in order to justify the need for music therapists. Then it will probably take a while to convince the general public of its validity and professionalism. It surprises me that it is going to take so much research to convince people. After all, almost everyone has experienced the benefits of listening to music so it should not be that difficult to believe that music therapy can help relax cancer patients or elevate their spirits. I suppose the general public, including me before taking this course, is not aware of exactly what it is that music therapists do. They may think that a music performer is the same as a music therapist. It is encouraging to see that music therapists are reaching out and conducting scientific research themselves and also collaborating with doctors to make advancement in the field. The goal of quantitative research however should not be to justify the work but rather to provide useful information as to how the music therapy is working and to help improve the treatments.

BCI shows levels oxyhemoglobin in brain

Tom Chau
http://www.youtube.com/watch?v=1aNy0eVoa7k&context=C4fc7df5ADvjVQa1PpcFO0GvJOymgAJBOMEV16HT7oJtlXkFPvQhI=
Tom Chau uses a Brain Computer Interface to monitor music listening in children that are non-verbal. This machine connects to the brain and measures the oxygen and hemoglobin levels in the brain using colored light. The information is shown on the computer interface as red light when the brain is registering the stimuli and becoming oxygenated. This process is used to harness whether the children are responding to music. First, they play brown noise to differentiate between the music and the noise and what they find is that the oxygen in the brain dissipates, to show to the lack of response through negative valence. Then they play a Sarah McLaughlin song and the topographic map of oxyhemoglobin in the brain is heavy on the left side and the blood flow increases through a lateralization of hemodynamic blood flow. There are significantly different responses to music through negative and positive valences as the child responds accordingly. With these oxy hemoglobin increases in the brains Tom Chau is able to conclude that the machine can detect whether the child is having a negative or positive experience in the brain or if they are responding at all to the stimuli.
This machine can be used to gauge a child’s emotional response to music and it seems successful at improving cognitive function in people with motor dysfunction. Beginning in the 1990s, research showed that the brain actually remains flexible even into old age. This concept is referred to as cortical plasticity, meaning that the brain is able to adapt in amazing ways to new circumstances. Learning something new or partaking in novel activities forms new connections between neurons and reduces the onset of age-related neurological problems. If an adult suffers a brain injury, other parts of the brain are able to take over the functions of the damaged portion.
This means that an adult can learn to use their brain forming new connections and adapting to this new use of neurons. In some circumstances where brain dysfunction occurs or there is grey regions in the brain, these new findings conclude that our brains can accommodate changes to increase use in these regions to repair brain function and rehabilitate otherwise injured patients. This is exciting research as performer’s injury, motor skill disability and other forms of injury can be rehabilitated through the concept of cortical plasticity. Imagine if these children can begin to use their motor skills through the monitoring of electromagnetic currents on these computers.
This new imaging tool for brain development is exciting because it measures an improtant factor in the working of our brains, oxyhemoglobin. Now that Chau has discovered this new brain imaging tools there can occur real evidence that certain parts of the brain are reacting to stimuli or not reacting. Exciting new brain imaging tool!

Music Changes Brains

Dr. Gottfried Schlaug Director of the Music, Neuroimaging and Stroke Recovery Laboratories at the Beth Deaconess Israel Medical Centre and Harvard School

file://localhost/Users/aimszamps/Desktop/Making%20Music%20Changes%20Brains.mp3Medical

In this ITunes podcast Steve Menscher interviews Dr. Schlaug to explain the differences between musician and non-musician brains.

          Dr.Schlaug begins on a personal note telling his training on the organ, beginning of course, with JS Bach and later French-romantic Cesar Frank, Marcel Dupre. Obviously with all of the research he’s involved with, he doesn’t have enough time to practice as much anymore. He actually began with the recorder, then harmonium and finally his father built an organ and then he played organ for the church.
He says he wanted to be a musician when he grew up and during university he had more joy from helping people and he decided that medical school was more appropriate. It occurred afterwards when imaging for brains, magnetic resonance imaging was invented, and he realized the new exposure to these great tools and combined his love of music and these new imaging tools.

Beginning with the hypothesis at Beth Israel in the 1980’s that music might be in the right side of the brain: both sides of the brain are not equal.  In the temporal lobe on the right side of the brain there is more dominance in language processing. If people deviate from brain laterality then they may be talented in music. Individuals that have symmetrical brains or have dominant right side of the brain may be talented in music.

This hypothesis was wrong. They found a sub group with symmetry towards the left side of the brain. These people had absolute pitch (they can name the note without any tool or perceive tones as belonging to certain pitch classes.) This subgroup of musicians was extremely lateralized towards the left side of the brain. This was the first study and research found a brain correlate of absolute pitch.
Doctors began to see musicians as if they were auditory motor athletes. Musicians train their systems by discriminating sounds, making skills with both hands. Doctors began to hypothesize: the motor and auditory system develops more and the lateralization develops more in musicians.

Does music help with their skills such as language math etc.? Yes, musicians show differences with higher order functions integrating in auditory motor visual region with more complicated tasks. One region particularly shows precedence in musicians called the inferior frontal gyrus. Musicians develop rich connections with auditory and motor regains and changes occur in multi modal integrations in brain. If you take a task that is not musical in nature and if that test relies on these regions then music positively affects the task.

Is there an importance of art education for young people? Yes, music lessons are important. Funding is a problem.  Arts education benefits intrinsic value and may have extra musical or arts effects. Dr. Schlaug is a strong advocate of arts funding in education programs. Arts show a general increase of cognition and there is evidence that music leads to specific enhancements in specific domains. There is enough data that arts need a strong role in education!

Can music help people who have damaged brains? Yes, Dr. Schlaug is doing a study on music making and singing with rehabilitating stroke patients and it helps them regain language functions. A second study uses forms of music making and singing to develop language and communication skills in nonverbal children to become more active in their environment with their surrounding friends, therapists and families.

Reflection:
           The research that Dr. Schlaug is currently doing is revealing of the brain regions affected with musicians and music making. The fact that stroke victims can rehabilitate their language functions after a stroke using music or singing is stunning evidence. This may also lead to research showing that musicians may have less likelihood of suffering stroke. I feel Dr. Schlaug is on the verge of incredible research! Furthermore, the dopamine and serotonin release after music making enhances brain function and now research is informing something occurs to defend the brain from degeneration with musicians.

Also, the benefits he states of arts education is a point that educators alike need to hear. Music helps with higher motor functioning and auditory functions when people practice music making on a regular basis. For students when they have opportunities to sing, play and instruments in arts education it not only provides for creative outlet but as research shows it improves other higher motor, visual and auditory skills. This is great advocacy to not cut funding in the arts, which is done especially during fiscally trying times like today. As a music teacher, I know the benefits are great for my students, as they seem happier when they leave my classroom. But the question for me still remains: why isn’t music education and other art educations included in core curriculum planning? I still see numeracy and literacy having more importance but what about music and arts literacy?

As a musician I wonder what specifically are these higher motor functions just better spatial and visual reasoning or is there more to it?  I definitely have a keen ear but I wonder if there is a strengthening or defense mechanism in place throughout the brain in musicians?

Why Do Listeners Enjoy Music that Makes them Weep?

Mencher, S. (Host). (29 April 2010). Why Do Listeners Enjoy Music that Makes them Weep? On Music and the Brain [Online sound recording]. D. Huron (Interviewee). Library of Congress Podcasts. Retrieved December 5, 2012, from http://www.loc.gov/podcasts/musicandthebrain/podcast_huron.html

In this podcast, Host Steven Mencher interviews Professor David Huron, Head of Ohio State University’s Cognitive and Systematic Musicology Laboratory and author of “Sweet Anticipation – Music and the Psychology of Expectation”. Huron explains how his research path began in the humanities and led him to cognitive and systematic musicology.  He suggests that the amount of knowledge in musicology doubles every eight years, making it an exciting field in which to be involved.  When musicologists follow questions about music through, it may lead them into various unfamiliar disciplines, such as endocrinology and neuroscience.  Musicologists must thus be willing to work extremely hard to learn new skills in order to be able to find answers to the questions they have about music.

         Next, Huron describes the basic premise of his book, “Sweet Anticipation – Music and the Psychology of Expectation”.  He explains that one of the reasons music is pleasurable is the relationship between expectation and the deviation from expected outcomes.  We are exposed to typical cultural patterns in music, such as scales, so many times that the both the deviation from the expected outcome and the expected outcome are pleasurable.  The brain is highly attuned to deviations from expectations in both music and speech.  The anticipation of what we think will happen is a large part of the pleasure of music.

         The absence of patterns that the brain can anticipate in abstract music is one of the reasons audiences often find new music un-enjoyable.  Experimental research shows that there are two kinds of novel situations– those in which the subject is aware of diversion from the expectation, and those where the subjects are not consciously aware of the change. Subjects only prefer novelty if they are consciously aware of the manipulation. Novelty is less important for maintaining interest than previously thought. Huron uses the analogy of ordering a new item off the menu at your favourite restaurant.  Although you may enjoy your meal, there is likely a slight tinge of disappointment on missing out on your favourite dish, which you always order.

         Huron explains that the pleasure of expectation makes a piece of music that much more pleasurable when it is listened to for a second time.  Historically, this was the reason for the encore, which was literally playing a piece for the second time in a performance. This second hearing was of vital importance for the enjoyment of the piece, because this performance would likely be the first and last time one would hear it.  The encore allowed for “sweet anticipation” to build. 

         Next, Mencher asks Huron to explain why humans enjoy sad music, beginning with this quote from Oscar Wilde: “In playing Chopin I feel as if I am weeping over sins I haven’t committed and mourning over losses that are not my own.”  Huron suggests that music creates a kind of sham psychological pain where part of the brain is fooled into thinking something tragic has happened, leading to the experience of grief or sadness.  The conscious part of the brain then assessed the situation and realizes the situation is not dire. This leads to a feeling of catharsis, or false pain that gives way to relief.  Huron explains that cathartic experiences are linked to the hormone prolactin, which is a hormone that soothes the body.  Prolactin is released through the act of crying, and can even be measured in tears.  The release of prolactin is the one of the body’s ways of taking care of itself and maintaining homeostasis by not allowing the physiology of crying to continue for too long.   

         In the final portion of the podcast, Huron and Mencher marvel at the mind’s ability to infer emotional information from the abstract sounds that are present in music.  Somehow our brains are so attuned to emotions that they are able to infer emotional information from even abstract auditory input.

Reflection:

Although this podcast piqued my interest, I found the amount of information it provided rather limited.  I would like to understand the complexities of emotional reaction to music further.  I would especially like to know more about why listening to sad music can be so pleasurable.  Often I have found myself drawn to sad music, finding it cathartic even when I am feeling happy.  It is odd that I would feel happier after listening to sad music than after listening to a cheerful song.  I suspect that there is more at play here than the hormone prolactin, although it is interesting to note its role.

         Another interesting part of this podcast was the explanation of the role of expectation in the enjoyment of music. I have found this to ring true in my music listening. Often when I first listen to a new album, even from one of my favourite artists, I am slightly displeased.  I feel somewhat disoriented, and apathetic about the work.  Upon listening to the album a second, then a third time my appreciation for the music grows and I find myself waiting for certain favourite moments.  I will play the passage leading up to those moments repeatedly. The “high point” is not satisfying on its own, which supports the idea that the pleasure of music is in the moments of anticipation.  Has anyone else experienced this?

Child Prodigies and Autism

References:

What Genius and Autism Have in Common. Maia Szalavitz. 2012.

http://healthland.time.com/2012/07/10/what-child-prodigies-and-autistic-people-have-in-common/

Child prodigy: A novel cognitive profile places elevated general intelligence, exceptional working memory and attention to detail at the root of prodigiousness. Joanne Ruthsatz & Jourdan B. Urbach. 2012.

http://scottbarrykaufman.com/wp-content/uploads/2012/07/Ruthsatz-Urbach-2012.pdf

Summary:

Time Magazine author Maia Szalavitz begins her article with this statement: “Child prodigies evoke awe, wonder and sometimes jealousy: how can such young children display the kinds of musical or mathematical talents that most adults will never master, even with years of dedicated practice?” (Szalavitz 2012) This is, in truth, the feeling I think many musicians would echo regarding the existence of child prodigies, but now there is research being done that is trying to figure out why this children have these unbelieveable abilities.

The study performed by Joanne Ruthsatz and Jourdan B. Urbach looks at 8 different prodigies – 6 of whom are still children and 2 of whom are adults – and attempts to compare them and discover the similarities in their neurological functions.

One major factor appears to be an increase in working memory: whereas most people can hold a maximum of 7 numbers in their head at a time – mercifully, the same number of digits in a phone number – prodigies are capable of holding many more, as well as being able to put them to use in mathematical functions. This does not apply only to numbers – in the case of musicians, it would also mean patterns of notes, which is why many child prodigy musicians can play a complex piece of music by memory after only seeing it once.

A surprising outcome was that the prodigies were not necessarily linked to exceptionally high IQ’s. They all had higher-than-average intelligence, but their IQ scores were clearly not in correlation to their prodigious abilities.

The most striking thing found in the study was the correlation to autism – prodigies were found to score high on the autistic scale, especially in terms of their great attention to detail (which was even higher than many people diagnosed with Aspergers would have.) They have two other major associations with autism – the higher likelihood of being male, and their mothers having had difficult pregnancies.

One school of though regarding how autism functions in the brain is that higher levels of local connectivity can heighten attention and perception, but diminished connections between more distant regions cause the sensory overload inherent in autism. The connection to prodigies might be that while the local connections remain more highly connected, the distant connections are not diminished, leaving them with the high level of perception without the sensory overload effect.

Reflection:

As a musician, I can’t say I didn’t find the fact that these prodigies are certainly thought to be “born” as opposed to “created”, since I have difficulty imagining how any amount of practicing might lead to the unbelievable musical skills required to do some of the things these prodigies are capable of doing.

I found it very interesting that there might be links between autism and child prodigies, since the two are so oppositionally placed in terms of society – the child prodigy revered and the autistic child sometimes discouraged. If anything, this should be leading the scientific community, and honestly, everyone to be re-examining how we look at the education and treatment of children with severe autism. If they do in fact share the same level of heightened perception as child prodigies, then there’s nothing saying they can’t use the same fantastic abilities very constructively if we’re able to figure out how to strengthen the connections to these more distant regions. 

Induced savant skill?

Explaining and inducing savant skills: privileged

access to lower level, less-processed information

Allan Snyder (2006)

 

Abstract:

 

I argue that savant skills are latent in us all. My hypothesis is that savants have privileged access to lower level, less-processed information, before it is packaged into holistic concepts and meaningful labels. Owing to a failure in top-down inhibition, they can tap into information that exists in all of our brains, but is normally beyond conscious awareness. This suggests why savant skills might arise spontaneously in otherwise normal people, and why such skills might be artificially induced by low-frequency repetitive transcranial magnetic stimulation. It also suggests why autistic savants are atypically literal with a tendency to concentrate more on the parts than on the whole and why this offers advantages for particular classes of problem solving, such as those that necessitate breaking cognitive mindsets. A strategy of building from the parts to the whole could form the basis for the so-called autistic genius. Unlike the healthy mind, which has inbuilt expectations of the world (internal order), the autistic mind must simplify the world by adopting strict routines (external order).

 

This abstract of Allan Snyder’s research paper proposes that savant skills can be induced in the neurotypical population. In his paper, Snyder first proposes that savant skills may be latent in every individual and even includes absolute pitch and synaesthesia in the list of possible latent qualities. Then, he deals with the issue of inhibition, stating that savant syndrome is a failure of top-down inhibition. He admits that due to lack of supplemental research, the exact neuranatomical mechanisms for savant skills are unknown, but he states that these mechanisms "may be associated with an atypical hemispheric imbalance wherein concept networks are bypassed or inhibited" (page 1399).

Snyder out rightly states that savant cognitive strategies lend themselves to certain types of problem solving because they are less biased in nature. Savants process information in a part-to-whole sequence. However, this information is acquired in an implicit manner, and savant individuals can rarely give insight into the manner in which their skills were obtained. Snyder also claims that the theory of the latent nature of savant skills in everyone is further supported by the fact that in many instances, savant skill emerges spontaneously as opposed to having developed over a period of time. He also postulates that some individuals may develop savant skills in the face of neural damage, as in some instances of frontotemporal dementia.

Snyder discusses the issue of competing hemispheres in considerable detail, stating that the issue of inhibition or disinhibition in some areas of the brain may be important conditions for inducing savant behaviour. He discusses his experimental research using low frequency rTMS (magnetic pulses) to inhibit the LATL (lower anterior temporal lobe) in an attempt to induce savant tendencies in neurotypical individuals. This experiment yielded savant-like results in the areas of drawing, proofreading skills, numerosity, reducing false memories.

Snyder’s experiments led him to the conclusion that areas responsible for concept or Gestalt processing could inhibit neural areas concerned with processing detail and he describes this type of detail processing as being "uncontaminated by learned algorithms" (p 1403). He admits that his theory of privileged access is still in the experimental stage and that supplementary research is needed.

 

REFLECTION:

I was highly intrigued when I read this article, considering that the reason I started research on savant behaviour was to study its implications for music education. Snyder does not elaborate on the details of the rTMS process, but to a layman such as myself, the idea of someone artificially inhibiting a part of my brain is a little frightening! We have to ask ourselves if the process of investigating induced savant skill is worthwhile, and I think it is because if the research shows this process to be effective, we will have new and useful neurological insight into the cognitive processes of learning, especially when it comes to the considerably large population of individuals with atypical neural anatomy, functions and processes.

Synesthesia

Reference: http://www.loc.gov/podcasts/musicandthebrain/podcast_richardcytowic.html

Music and the Brain Podcast. Title: Wednesday is Indigo Blue: Discovering the Brain of Synesthesia. Speaker: Richard E. Cytowic, MD. October 30, 2009

Summary: 

The podcast entitled “Wednesday is Indigo Blue:Discovering the Brain of Synesthesia” featured neurologist at the George Washington Medical Centre named Richard E. Cytowic. The term synesthesia can be understood when comparing it against the word “anesthesia” which means no sensation. Therefore, synesthesia implies that there is an increase in sensation, more specifically that certain sensations/ senses are joined. For example when someone speaks, a person with synesthesia will hear and may also feel or taste simultaneously. The title of the podcast describes one of the most common tendencies of synesthetic people, to match days of the week or months with specific colors. Cytowic explained that the field was in “oblivion” in the 90’s when “behaviorism stated that all subjective experience is taboo.” The stats for the prevalence of this condition is that 1 in 23 people have synesthesia, and many are not aware of it until they say something which is quite unusual to other people. Composers to name a few that have been documented with synesthesia are: Franz Liszt, Amy Beach, Rimsky-Korsakov, Stevie Wonder and Olivier Messaien. Cytowic stated briefly that synesthesia is common in people who are blind, but he did not expand upon this. Synesthesia is often found in creative individuals such as musicians or artists. Olivier Messaien had a type of synesthesia that is bidirectional, meaning his senses of sight and sound could go both ways. He could see color and hear a sound and he could hear a sound and hear color. He explained after writing his piece for the Bryce Canyon, “From the Canyon to the stars” that the music “wrote itself” as his eyes surveyed the landscape. His invention of “modes of limited transposition” enabled him to compose specifically to convey colors of sounds. These modes are not chords or harmonies, but rather clusters of notes and for him, clusters of colors. Cytowic says that many orthodox thinkers did not accept the possibility of a condition such as this because they saw the brain as having modules specific to language, vision etc. The nature of synesthesia is that areas of the brain interact and are cross connected, thus the nature of the brain has been redefined. Cytowic continues, explaining that even when a person with synesthesia is asked to pick the color they are seeing from the 16 million shades on the computer, they are unable to find an “exact match.” This is due to the V4 area of the brain that perceives color, yet in people with this condition, it is being stimulated not only optically but by other sense as well. The question was posed “why are 1 in 23 people walking around with a mutation for a trait that is pretty yet useless?” Cytowic states that this must be a gene for metaphor and creativity as it hyper-connects different areas of the brain, and areas that are seemingly unrelated. The definition of a metaphor itself is seeing similar attributes in dissimilar things.

Reflection:

I chose this podcast for the reason that this topic interests me as I currently have a piano student with this condition. Previously, I had thought this condition was very rare and was surprised to hear that 1 in 23 people have synesthesia. When speaking of particular days of the week being “colored” I found myself remembering certain

associations I make unconsciously with particular days to colors. Perhaps there are varying degrees of synesthesia in everyone? When listening to Olivier Messaien’s works, one should be conscious of the fact that he had synesthesia and to analyze his music in terms of the colors and sounds he used to understand his language more fully. It would have been interesting to find out more why some people with this condition see a particular color with a note, yet another person with synesthesia sees a different color in relation to that note and to explore this realm of subjectivity further.