Music and the Brain Concetta Tomaino, DA, MT-BC, LCAT

Music predates recorded history, but its roots may lie in early human communication and rituals for healing. In traditional African cultures and rain forest cultures in other parts of the world, for example, music is connected with many of life’s vital patterns and occasions. In Western culture, however, as music became increasingly accepted as an art form, its therapeutic properties were mostly forgotten—rediscovered only when music therapy became an organized field in the 1950s.

We now know from clinical case studies that music can affect—in very specific ways—human neurological, psychological, and physical functioning in areas such as learning, processing language, expressing emotion, memory, and physiological and motor responses. How your brain perceives and processes music also differs depending on whether or not you are a musician. The effects of music raise intriguing questions about both early brain development and brain plasticity later in life.

Why Movement Responds to Rhythm

Michael Thaut, PhD, and his colleagues at Colorado State University suggest that the sensitivity of our motor systems to influences from sounds may have developed during human evolution so we could use the way we process what we hear to enhance our ability to organize and control our movements. Our basic auditory-arousal mechanisms (for example, our movements in reaction to a sudden loud noise) operate primarily through the amygdala in the brain’s limbic system and may have originated in adaptive evolutionary processes, namely, the fight-or-flight response. In any case, the auditory system has connections to the brain stem, midbrain, and higher cortical structures, and normal motor function requires that these subcortical and cortical regions work in concert with each other.

The basal ganglia, a brain region affected in Parkinson’s disease, provides a link to still other areas of the brain that connect mental processes and the initiation of movement. While the thought or wish to move depends on higher cortical processing, the actual ability to move depends on lower brain regions. If the higher cognitive processes that can initiate movement are damaged in traumatic brain injury or stroke, the will to move may nevertheless get a “jump-start” by stimulating motor nerves that are still functional. Does the patterned auditory cue supplied by musical rhythms excite the more primitive motor areas first, and only then recruit or drive higher cortical circuits into action?

Words Spoken and Sung

Because music has parallels to spoken language, much research on music and the brain has zeroed in on the similarities and differences between them. The similarities could be clues to more successful methods of using musical cueing to stimulate similar language responses in people with brain injuries. Because many clinicians assume a complete separation of function between singing and speaking, they give little attention to the potential for using music to aid speech. But there are several cases in which a patient has recovered speech through the systematic use of rhythmic patterning, leading first to recovery of familiar lyrics and words embedded in songs, then to self-initiation of normal, fluent speech. In each case, however, this remarkable change has been attributed not to the music but to spontaneous recovery during the early months after a stroke.

Out of Silence, a Remembered Song

Just as rhythm can affect motor function and the initiation of movement, a familiar tune or melody can reawaken in persons with dementia, or with traumatic brain injury, seemingly lost memories and feelings. We are so much the sum of our experiences and memories that we cannot help associating each new experience with something that came before it. Imagine how the world must seem to someone with no memory link from past to present. But sometimes music can provide a bridge.

We do not know specifically how music affects memory, but most of us experience that effect every time we hear a favorite song. Indeed, music is capable of arousing in us deep and significant emotions. Memories of music can be so well preserved that the merest fragment of a melody stimulates recall of the song’s title or lyrics. Emotionally charged responses to familiar music are probably the result of connections from the auditory nerve to key limbic structures in the brain. The limbic area, which is associated with emotion, includes the olfactory cortex, amygdala, and hippocampus. The amygdala gets its input from our senses and directly affects our autonomic responses; it is also involved with our moods through interconnections with the frontal cortex and thalamus. The hippocampus plays a significant role in storage of factual information, including conscious (declarative) memory

Because memories persist when they have personal significance, the emotional content of music seems to be processed immediately, even by people with severe dementia.

Famed neurologist and author of Musicophilia: Tales of Music and the Brain, Oliver Sacks, MD, writes that “it is the inner life of music which can still make contact with their inner lives which can awaken the hidden, seemingly extinguished soul; and evoke a wholly personal response of memory, associations, feelings, images, a return of thought and sensibility, an answering identity.”

Harnessing Music’s Power

Perhaps if we understood more about the relationship between the auditory system and other aspects of human cognitive function, we could reach more people. For those with neurologic impairments and diseases like Parkinson’s or Multiple Sclerosis, music therapy is only beginning to be recognized as a promising treatment. The discovery that new networks and connections may be formed in the brain every time we learn a new skill has implications not only for early childhood development, but also for potential recovery of function after injury.

Both basic research and clinical investigations on the underlying brain mechanisms stimulated by different elements of music will continue. It is fairly safe to predict that we will discover that certain elements of music are processed in “primitive” brain regions, including some that are highly resistant to the ravages of traumatic injury and disease. Then we must ask: How do these deeper regions of the silenced brain, reached by rhythms or melodies of music, in turn stimulate the brain’s higher regions (or bypass them) so as to switch on motor, cognitive, or emotion-related functions that had appeared lost forever? The answers will come, though no one can predict how rapidly, and then we may see more often—even routinely—what now seems (and is) a miracle: the man struggling to walk will dance; the haunted, weeping woman who walks the halls will rejoin us, singing; and the mind drained of its memories will know the comfort of a familiar old tune.

Concetta Tomaino, DA, MT-BC, LCAT, is a pioneer in the field of music therapy. She is the Director of the Institute for Music and Neurologic Function in NYC. She is internationally known for her research in the clinical applications of music and neurologic rehabilitation. Her work has been featured on 48 Hours and 60 Minutes; and in books on health and healing, including An Anthropologist on Mars, by Oliver Sacks, M.D.

Don’t miss Concetta Tomaino’s presentation of Music and the Brain, October 15, 2010.

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