Monday, September 20

Tunes to treat diseases: music remains in the brain even when there is almost nothing left


“Who am I?” Elena asks her mother, who, sitting in her chair, shrugs her shoulders in response. “What’s my name?”, He insists, with the same luck and getting that exasperating silence as an answer. Alzheimer’s long ago took her name and her status as a daughter. His mother knows he’s there for something, but she doesn’t know who he is.

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After a while, Elena begins to sing a song by Antonio Machín, from when she was young. He claps his hands, intons it, and even remembers part of the lyrics. Music provokes an almost miraculous reaction in women. Anyone would swear that the disease has not gone through her devastating everything.

But no miracles, behind this is science, which for some decades has begun to rigorously investigate what are the effects of music on our brain and why it is so important for humans.

Sound waves have reached operating rooms, where they are used to destroy kidney stones and detect tumors, and music is increasingly used to treat patients after a stroke, or diseases such as Parkinson’s or Alzheimer’s.

“When you do a magnetic resonance study, you see that there is a lot of activation in the brain when music is played or simply listened to,” explains Antoni Fornells, researcher at the Bellvitge Biomedical Research Institute (IDIBELL) and the Catalan Research and Research Institute. Advanced Studies (ICREA). Music is multisensory and incorporates the activation of many very broad areas and processes of the brain. Something that, together with its ability to influence reward circuits, makes it “stay in our species when it apparently has nothing special.”

Explain that the type of memory that we have associated with music “is stored in a different way” than what we call declarative or basic fact memory, where information about ourselves and what surrounds us is stored. Research indicates that music is associated with procedural learning (such as riding a bike) rather than declarative learning. In addition, “any type of learning associated with emotion will be remembered more.”

LifeSoundtrack, musical biographies against Alzheimer’s

Nina Gramunt, neuropsychologist at the Pasqual Maragall Foundation, talks about the “cognitive reserve” and its importance in neurodegenerative diseases: “All learning, like playing an instrument, confers greater resistance to the brain”. This can lengthen the preclinical phase of a disease such as Alzheimer’s, that silent period, which can last up to twenty years, in which the disease is already present, but in which the brain has the ability to bypass it.

A study published in 2015 in the journal Brain demonstrated through different neuroimaging techniques that certain brain areas are activated with emotionally significant music for the patient, such as those melodies by Antonio Machín that Elena puts on her mother, which are relatively preserved until very advanced stages of the disease.

The Pasqual Maragall Foundation has valued the importance of music in the treatment of the disease in projects such as LifeSoundtrack, in which some students accompany older people who suffer from this dementia to build a musical biography. “It is a very kind excuse to approach and sensitize young people with this reality, in addition to the cognitive and emotional benefits,” explains Gramunt.

Language also seems to improve with music

Finnish neurologist Teppo Särkämö has focused his research work on finding out how music can help patients who have lost communication skills. In a study he published in The Lancet In 2017, he tested the effectiveness of music as a rehabilitation factor. It was about asking the sick to listen to it for an hour a day for a few months. “As simple as it sounds,” he jokes. This listening was beneficial for cognitive recovery in terms of verbal memory and concentration and helped reduce negative moods such as depression or uncertainty that accompany the disease.

In a study he published last year in Annals of Clinical and Translational Neurology, found that vocal music, music that has lyrics, is especially effective for recovering verbal memory and improving basic language skills, especially for those patients with aphasia. In addition, it showed that daily listening to music increases the volume of gray matter in the frontal and temporal regions of the brain.

But music can not only be beneficial in aspects such as speech or memory, but it is also being used for people with motor deficits. “We started working with stroke 10 years ago,” says Fornells. The idea is that “when you learn music, the connection between the auditory and motor systems is activated a lot”, therefore, through the stimulation of the auditory cortex, thanks to the practice of music, the rehabilitation of the affected motor cortex would be facilitated.

This therapy is already a reality that the patient can take home in the form of an app, so it has not been affected by COVID-19. All you need is a tablet and a small keyboard to practice. “It’s as if they had a kind of challenge and they practice so that later they could play a song that they might like as a group,” Fornells explains.

Clément François, a researcher at the Institut de Neurosciences de la Méditerranée CNRS, believes that “the simple act of listening to music can help improve mobility”. When the subcortical system is bad, music allows to establish a rhythmic support for the movements of these patients, something that can help them improve their mobility.

This is, perhaps, the reason why Elena’s mother not only manages to remember the lyrics when listening to a melody, but is also able to clap her hands again or move to the rhythm set by the song. Something that, without music, he has stopped doing a long time ago.

These studies support the work of music therapists such as Fátima Pérez, who after finishing her piano studies decided to study a master’s degree in Music Therapy to bring music as a treatment to patients with various diseases. He says that these scientific advances are making this type of techniques “stop getting into the same bag as a pseudo-therapy.” Skepticism, he explains, disappears when patients and their families begin to notice the first positive effects.

In any case, Särkämö asks “to be realistic” and to be careful with the idea that these therapies can ‘cure everything’. In fact, in some people they will not work. For example, in musical anhedonics, a neurological condition that implies that an individual is unable to enjoy listening to music and, therefore, does not have physiological responses of pleasure with it. This affects between 3% and 5% of the population and is helping many scientists to better understand the mechanisms of the brain.

Music as a brain study tool

Sound is the first thing that a human being perceives with only 16 weeks of gestation, and also the last thing that is stopped perceiving at the end of life. It is even used in preterm units, where music is used to modulate parameters such as the rhythm of respiration, heart rate, quality of sleep or the baby’s own temperature.

In adult life, music also helps modulate moods. Cognitive psychology doctor Laura Ferreri is in the publication phase of a document on the effect of music during the pandemic in which more than a thousand people from Spain, Italy and the United States have participated. “The question is very simple”, explains the Italian researcher: “What are the reward activities that helped you to live the confinement phase?” Music is in the first place. “The more affected people were, the more music was sought.” Similarly, according to the same study, when music consumption increased, depressive symptoms decreased.

“It is known that there is a positive effect, but it is necessary to specify the optimal conditions to maximize it”, explains François about the next steps to take in this type of research. Särkämö adds that “larger studies” involving several centers from different countries are needed.

Plato said that “musical training is an instrument more powerful than any other”. For centuries humans have accompanied different moments of their lives with melodies. That is why Elena’s mother is activated with music, because she has heard it before, because it is part of her life and because Alzheimer’s has not managed to take her away. The melodies that we listen to throughout our lives not only transform us, but also accompany us, even to stay in our brain when there is almost nothing left.



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