Music shows promising potential for slowing the progression of dementia
In 2020 an extraordinary video went viral. It featured Marta Cinta González Saldaña, a former ballet dancer suffering from severe Alzheimer’s disease in her senior years. In the video, Saldaña is played a piece from Tchaikovsky’s Swan Lake and suddenly she flashes awake and begins moving to a dance routine she presumably rehearsed over and over in her younger days.
These kinds of clips have been shared for years, and they highlight the stunning way music can rekindle dormant neural pathways in elderly subjects experiencing serious forms of dementia. And while music therapy is now a common practice in nursing homes, little research has actually zoomed in on the neural mechanisms behind the phenomena, and in particular, what kinds of music could optimize the potential brain benefits.
A new study, led by Psyche Loui from Northeastern University’s Music Imaging and Neural Dynamics Lab, set out answer two specific questions in regards to this incredible music-triggered phenomenon. How does a controlled eight-week music therapy program influence the activity and connectivity between auditory and reward areas of the brain? And, are the beneficial effects of music amplified when the music is self-selected, focusing on songs that are particularly meaningful to an individual.
To investigate, the research team recruited a small cohort of cognitively healthy older adults. In conjunction with a music therapist, each volunteer created two playlists of music – one dubbed “energizing” and the other “relaxing.”
The cohort was tasked with listening to music from their self-selected playlists for one-hour every day, over the course of eight weeks. The one-hour daily music experience was designed to be focused, so each subject was asked to pay attention to their moods, emotions, and memories while listening to their playlists. This wasn't merely playing tunes in the background while doing daily chores.
At the beginning and end of the study, each participant also took part in a brain imaging test where they listened to 24 different audio excerpts. Six of those excepts were self-selected by the participant, while the rest were other pieces of music spanning many different genres selected by the researchers.
In an email to New Atlas, Loui explained how her team's findings revealed the eight-week music intervention did result in increased connectivity across some key brain regions.
“We saw changes in auditory connectivity to the reward system, specifically the connectivity between the auditory network and the medial prefrontal cortex (which is part of the reward system) was increased after intervention,” Loui noted. “We also saw that the right executive control network, which includes regions that are important for attention and executive function, became more accurate at representing music after the intervention.”
According to Loui, this study is the first time a music-based intervention has been shown to cause longitudinal improvements in connectivity between these particular brain networks. From a clinical standpoint these findings are exciting, as decreased connectivity and activity in the medial prefrontal cortex is seen in a number of neurodegenerative conditions, as well as psychiatric diseases such as schizophrenia and depression.
The other major finding in the study was that self-selected music is much more effective at engaging these brain pathways, compared to other kinds of more unfamiliar music. Loui also added, the most effective self-selected music seems to be songs linked to a participant’s younger years.
“… we had participants listen to about one third self-selected music, and two-thirds researcher-selected music, while getting their brains scanned, so that we could compare brain activity between self-selected and other-selected music, [and] we found that self-selected music was much more effective at engaging the brain,” Loui explained. “The most effective music tends to be from adolescent and early adulthood for the participant.”
The finding that the most effective music for rekindling neural pathways in older age is what was listened to in one’s youth interestingly recalls a large body of study illustrating how music and cultural taste is fundamentally formed in a person’s teenage years. Film theorist David Bordwell once referred to this phenomena as “the law of the adolescent window,” and these new brain imaging findings certainly affirm that certain neural pathways linked to cultural experiences are really locked down in these key formative years.
“Between the ages of 13 and 18, a window opens for each of us,” Bordwell wrote. “The cultural pastimes that attract us then, the ones we find ourselves drawn to and even obsessive about, will always have a powerful hold. We may broaden our tastes as we grow out of those years – we should, anyhow – but the sports, hobbies, books, TV, movies, and music that we loved then we will always love.”
A key takeaway from the study is that there cannot be a one-size-fits-all strategy to music therapy, Loui pointed out. So listening to music you like is important, but what this study cannot answer is exactly how clinically effective music therapy may be as treatment for patients with dementia.
A study published last year from researchers at the University of Toronto explored a similar intervention to Loui’s work, but in Alzheimer’s patients with very early-stage cognitive decline. It was a small study, and compared the effect between musicians and non-musicians of three-weeks of daily hour-long listening sessions with familiar music.
While brain activity was slightly different in those participants with a history of playing music, there were distinct signs of cognitive improvement in both groups after three weeks of music therapy. Senior author on the study Michael Thaut said listening to familiar music in one’s senior years could be thought of as a kind of brain gym.
“Whether you’re a lifelong musician or have never even played an instrument, music is an access key to your memory, your pre-frontal cortex,” Thaut said. “It’s simple: keep listening to the music that you’ve loved all your life. Your all-time favorite songs, those pieces that are especially meaningful to you. Make that your brain gym.”
It’s of course too early to suggest simply listening to your favorite music can help fight against the neurodegeneration associated with diseases like Alzheimer’s. Loui is, however, looking to further these new findings with some follow-up investigations to see if things can be added to a music listening session as a way to amplify the effects on the brain.
“We are looking to run a control intervention where there is no music listening involved,” Loui said. “We are also looking to augment this music-based intervention with multimodal stimulation, e.g. using lights to add to the music to enhance the experience of rhythmic stimulation on the brain.”
The new study was published in the journal Scientific Reports.