Across cultures and throughout history, music listening and music making have played a role in treating ailments of the mind and body. People in Ghana have used drumming for centuries to aid in healing ceremonies. Shamans in Peru, as well as many other religious traditions, use chanting as a tool for both deep personal exploration as well as the healing of others.
Currently there is an emerging music-based treatment that is based directly on the biology of neurological impairment and recovery. Studies have revealed that music can be a uniquely effective tool for treating neurological impairment because it helps restore functioning by enlisting healthy parts of the brain. In fact, music activates nearly every region of the brain. Brain imaging studies have shown that listening to and making music can activate and stimulate connections across brain regions involved in emotion, reward, cognition, sensation and movement.
A leading music-based treatment for neurological disorders is called melodic intonation therapy. Its development emerged from observing individuals who suffered a stroke. When a stroke damages the left hemisphere of the brain, it often also affects a region crucial for language production known as Broca’s area. This subsequently leaves patients with what is known as nonfluent aphasia, or the inability to speak fluently. However, over the years therapists have witnessed individuals with nonfluent aphasia often sing words that they would otherwise not be able to say.
Recognizing the implications of this rare ability, neurologist Martin Albert and speech pathologist Robert Sparks developed melodic intonation therapy wherein singing is a cornerstone. A typical therapy session involves patients singing words or short phrases while tapping each syllable with their left hand. As treatment progresses, the phrases get longer and the syllables per second increase. Each aspect of treatment is designed to increase fluency by recruiting undamaged areas of the brain; changes in pitch engage areas associated with perception in the right hemisphere and the rhythmic tapping with the left hand activates a part of the right hemisphere that controls movements associated with the vocal apparatus.
Benefits from melodic intonation therapy can be seen after even a single session. But when melodic intonation therapy is performed frequently over months, it produces significant and long-term gains in vocal ability. There is a case study of a young girl who experienced a stroke and the nonfluent aphasia that resulted. After 15 weeks of melodic intonation therapy and then several years practicing on her own, she is now a motivational speaker. These gains appear to arise from changes in neural circuitry that involve the creation of alternate pathways or even the reviving of dysfunctional circuitry. For patients with severe aphasia, singing trains structures and connections in the brains right hemisphere to assume permanent responsibility for what is usually handled by the left hemisphere. This was confirmed in MRI studies that revealed structural changes in an area of the right hemisphere associated with vocalization.
Music has also been able to help stroke victims with impaired motor skills. Neuropsychologist Sabine Schneider developed music-supported training, a treatment that asks patients to use their movement impaired hand to play melodies on the piano or tap a rhythm on a drum. Patients engaged in this therapy showed greater improvement in timing, precision, and smoothness of fine motor skills than those in conventional therapy. The researcher suggests that gains resulted from an increase in connections between neurons of the sensorimotor and auditory regions.
Another fascinating intersection between music and the brain is witnessed in individuals with autism spectrum disorder. Characteristics of autism include difficulties with social interaction, repetitive behaviors, and impaired communication. In fact, 30 percent of people with autism cannot make speech sounds at all, and many have a limited vocabulary. Another atypical feature of autism is the tendency to focus intensely on the fine details of sensory experience, which is believed to result from an overdevelopment of short-range connections in the brain. This intense focus is demonstrated in reports of children with autism who thoroughly enjoy making and learning music. This positive response to music opens the door to treatments that can help children with autism engage in activities with other people and develop social, language, and motor skills as a result. A new technique called auditory-motor mapping training (which involves a very similar protocol to that of melodic intonation therapy) was used on six completely nonverbal autistic children and after 40 sessions all were able to produce some speech sounds and some were able to voice meaningful and appropriate words.
These relatively new music-based treatments are showing promising benefit for neurological disorders such as a stroke, autism, tinnitus, Parkinson’s disease, and dementia. Of course enthusiasm cannot outpace evidence and these new treatments must prove their efficacy against more established therapies. But in terms of treatments for neurological disorders, these music-based interventions are definitely accessible, engaging, motivating, rewarding, and inexpensive. Music-based therapies seem unique in their capacity to help the brain construct alternative pathways through a process that is social and emotionally engaging.