The healing properties of music


In 2019, a study by Harvard University concluded that “music is in fact universal” [1]. While the popular genres of music may have drastically evolved over the last few decades, the consumption of music has been steadily increasing. A recent report by the Victorian Music Development Office revealed that Australians listen to 3-4 hours of music each day on average, with 1 in 3 people stating that music was their number one passion in life [2]. If so, wouldn't it be amazing if music could offer a therapeutic virtue to anyone, at any given time, only necessitating a musical source? This question has received a lot of interest in the past few years, and gave rise to the development of a new field of health research called “music therapy”.



The Benefits of Music Therapy

According to the Australian Music Therapy Association, music therapy is an allied health profession using music experiences to improve or restore mental or physical health. Music therapy interventions can be delivered in several ways and are usually tailored to the patient’s needs. Because various aspects of music are utilized, sessions can be very different from one another. Some sessions will have active components, where individuals play an instrument, compose a song or melody, improvise a rhythm, or use the drums, while other sessions are receptive and focused on listening to specific tones, harmonies or melodies. The list is endless [3].



Figure 1: An example of a music therapy session [4].



Music therapy has proven benefits for several diseases, including dementia [5], sleep disorder [6], and depression [7]. In addition, a meta-analysis from 2020 reported that anxiety, depression, and pain were reduced, and overall quality of life was improved, following several sessions of music therapy over 1 to 2 months in patients with cancer [8]. In a clinical trial conducted in Germany with patients suffering from different types of malignant cancer and receiving high dose chemotherapy, the administration of music therapy twice per week for 20 minutes improved the pain perception, though overall quality of life was unchanged [9].


Aside from its clinical applications, music therapy has also been shown to improve mental health in the general population, specifically in students. Several studies have shown that listening to relaxing music improves the quality of sleep [10], reduces stress and anxiety before a test [11], improves academic performance [12] and increases general self-esteem [13]. Last year, a research group in Italy used music therapy to help reduce stress levels and increase well-being in clinical staff working with COVID-19 patients. They showed that levels of tiredness, sadness, fear and worry were significantly reduced after receiving the music therapy interventions for 5 weeks [14].



How Does Music Therapy Work?

The act of playing an instrument or listening to a song is a highly multimodal process that activates visual, auditory and motor pathways all at once. In fact, several brain networks come into action: the primary auditory cortex, the attention network, the working memory, the episodic memory, and the reward system (ventral tegmental area, striatum, nucleus accumbens, prefrontal cortex) and limbic system (amygdala, hypothalamus, hippocampus, thalamus) [15]. When performing, the motor network is also activated [16,17]. Furthermore, listening to music has been shown to promote neuronal connectivity in several regions of the brain by activating different neural systems responsible for arousal, reward, or learning processes [15]. In addition, playing an instrument has been shown to favour neuroplasticity, and promote recovery (after a stroke for example) by activating various brain networks, and increasing blood flow in the medial cerebral artery [18].


While the cellular mechanism behind music therapy remains largely unknown, studies have shown that music activates the dopaminergic mesolimbic system [18], which plays a role in memory, attention, mood or pleasure and executive functions.


Figure 2. Key brain areas associated with music processing. [18]



New technologies for music therapy are being developed, aiming at creating more personalized medicine. For example, it is possible to utilize algorithms to compose songs with specified musical features, such as the pitch, tempo or timbre, and use them for specific therapeutic needs [19]. Recently, a research group used a machine learning decision tree to predict therapeutic effects of music therapy in the general population [20]. A group of 300 participants listened to music for 9 minutes, and their relaxation level was measured before and after. Using the decision tree, the study showed that the most important factors in predicting changes in relaxation levels were the relaxation level pre-listening, the types of music, and whether the participant had some education or musical training [20]. Overall, this suggests that the use of music therapy in combination with machine learning techniques could benefit clinical professionals, by allowing for the creation of more personalised targeted interventions.

In conclusion, while music and music therapy should not be seen as a silver bullet, it has been shown to have positive neurological effects for the general population, and is a good complementary therapy for a variety of serious illnesses. Overall, music therapy interventions are aimed at improving one’s well-being and mood. And so, whether you are a performer or a listener, every time you engage with music, your brain is secretly thanking you!


References:

[1] Mehr, S. A., Singh, M., Knox, D., Ketter, D. M., Pickens-Jones, D., Atwood, S., Lucas, C., Jacoby, N., Egner, A. A., Hopkins, E. J., Howard, R. M., Hartshorne, J. K., Jennings, M. V., Simson, J., Bainbridge, C. M., Pinker, S., O’Donnell, T. J., Krasnow, M. M., & Glowacki, L. Universality and diversity in human song. Science. 2019;366(6468), eaax0868.


[2] Victoria Musical Development Office, [Internet] VMDO Music Consumer Insights (updated 2019). Available from: https://www.vmdo.com.au/music-consumer-insights


[3] What is Music Therapy? [Internet] Australian Music Therapy Association. (n.d.) Available from: https://www.austmta.org.au/about-us/what-is-mt/


[4] Tirachard Kumtanom [Internet] Pexels (2017) Available from: https://www.pexels.com/photo/woman-wearing-black-sleeveless-dress-holding-white-headphone-at-daytime-1001850/


[5] Raglio, A., Bellelli, G., Traficante, D., Gianotti, M., Ubezio, M. C., Villani, D., & Trabucchi, M. . Efficacy of Music Therapy in the Treatment of Behavioral and Psychiatric Symptoms of Dementia. Alzheimer Disease & Associated Disorders, 2008; 22(2).


[6] Wang, C.-F., Sun, Y.-L., & Zang, H.-X. Music therapy improves sleep quality in acute and chronic sleep disorders: A meta-analysis of 10 randomized studies. International Journal of Nursing Studies, 2014; 51(1), 51-62.


[7] Aalbers, S., Fusar‐Poli, L., Freeman, R. E., Spreen, M., Ket, J. C. F., Vink, A. C., . . . Gold, C. Music therapy for depression. Cochrane Database of Systematic Reviews. 2017;(11).


[8] Li, Y., Xing, X., Shi, X., Yan, P., Chen, Y., Li, M., . . . Yang, K. The effectiveness of music therapy for patients with cancer: A systematic review and meta-analysis. Journal of Advanced Nursing. 2020; 76(5), 1111-1123.


[9] Tuinmann, G., Preissler, P., Böhmer, H., Suling, A., & Bokemeyer, C. The effects of music therapy in patients with high-dose chemotherapy and stem cell support: a randomized pilot study. Psycho-Oncology. 2017; 26(3), 377-384.


[10] Harmat, L., Takács, J., & Bódizs, R. Music improves sleep quality in students. Journal of Advanced Nursing, 2008; 62(3), 327-335.


[11] Ugwuanyi, C. S., Ede, M. O., Onyishi, C. N., Ossai, O. V., Nwokenna, E. N., Obikwelu, L. C., . . . Nweke, M. L. Effect of cognitive-behavioral therapy with music therapy in reducing physics test anxiety among students as measured by generalized test anxiety scale. Medicine. 2020; 99(17), e16406-e16406.


[12] Gallego-Gómez, J. I., Balanza, S., Leal-Llopis, J., García-Méndez, J. A., Oliva-Pérez, J., Doménech-Tortosa, J., . . . Rivera-Caravaca, J. M. Effectiveness of music therapy and progressive muscle relaxation in reducing stress before exams and improving academic performance in Nursing students: A randomized trial. Nurse Education Today. 2020; 84, 104217.


[13] Yücesan, E., & Şendurur, Y. Effects of music therapy, poetry therapy, and creative drama applications on self-esteem levels of college students. Journal of Poetry Therapy. 2018; 31(1), 26-39.


[14] Giordano, F., Scarlata, E., Baroni, M., Gentile, E., Puntillo, F., Brienza, N., & Gesualdo, L. Receptive music therapy to reduce stress and improve wellbeing in Italian clinical staff involved in COVID-19 pandemic: A preliminary study. The Arts in Psychotherapy. 2020; 70, 101688.


[15] Koelsch, S. Toward a Neural Basis of Music Perception – A Review and Updated Model. Frontiers in psychology. 2011; 2(110).


[16] Zatorre, R. J., Chen, J. L., & Penhune, V. B. When the brain plays music: auditory–motor interactions in music perception and production. Nature Reviews Neuroscience. 2007; 8(7), 547-558.


[17] Salimpoor, V. N., Benovoy, M., Larcher, K., Dagher, A., & Zatorre, R. J. Anatomically distinct dopamine release during anticipation and experience of peak emotion to music. Nature neuroscience. 2011; 14(2), 257.


[18] Sihvonen, A. J., Särkämö, T., Leo, V., Tervaniemi, M., Altenmüller, E., & Soinila, S. Music-based interventions in neurological rehabilitation. The Lancet Neurology. 2017; 16(8), 648-660.


[19] Raglio, A., & Vico, F. Music and Technology: The Curative Algorithm. Frontiers in psychology. 2017; 8(2055).


[20] Raglio, A., Imbriani, M., Imbriani, C., Baiardi, P., Manzoni, S., Gianotti, M., . . . Manzoni, L. Machine learning techniques to predict the effectiveness of music therapy: A randomized controlled trial. Computer Methods and Programs in Biomedicine. 2020; 185, 105160.






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