Saturday, February 28, 2015

Music changes the brain...stroke, gunshot, alzheimers, rap, autism, jazz

Brain neuroplasticity was shown in previous blogposts ("How the brain continually changes and reorganizes itself", "Pain...how the changing brain changes and (mis)manages it", and "How the changing brain turns our pleasures into addictions",... ) to have astonishing capabilities in healing severe trauma and disability.  

A recent Scientific American Mind article "The Healing Power of Music" discusses how music can plastically heal cognitive and motor functions and mental states. Research studies have generated musical approaches to generate alternative neural pathways around damaged centers.


Teppo Sarkamo
U of Helsinki
Music has a very rich history for our species and is unique in the range of characteristics it utilizes involving emotion, reward, cognition, sensation and movement in a compelling and engaging way.

Using music to treat neurological impairment had its landmark study in 2008, when Teppo Sarkamo evaluated it for treating stroke in the left medial cerebral artery.  For two months, patients and controls had daily sessions listening to music, or audio books, or nothing.

The music listening group recovered "significantly more" verbal memory and attention and was less confused and depressed than controls.  This was the first scientific demonstration "that music listening during the early post-stroke stage can enhance cognitive recovery and prevent negative mood".
Hemispheres from behind

How about being unable to speak fluently (aphasia) after a (left side) stroke?  Is actively "making" music different than passively listening to it?  "Melodic intonation therapy" (the other MIT) developed at the Boston VA hospital in the 1970s by Sparks, Helm and Albert explored that.  

MIT demonstrated that "increased use of the right hemisphere dominance for the melodic aspect of speech increases the role of that hemisphere...diminishing the language dominance of the damaged left hemisphere."

In MIT, patients sing slow pitch changes and phrases in a simple melody (engaging right hemisphere areas associated with perception) while tapping out each syllable with their left hand (engaging right hemisphere network which controls movement of the vocal apparatus).   
making music 

The right hemisphere neuroplastically takes up language processing for the damaged left hemisphere (Broca's area - speech) and increases the right-hemisphere's axon volume. (Schlaug, et al., 2009).

Singing, however, may not be the critical element; perhaps rhythm and lyrics are, which Stahl, et al. found in "Rhythm in disguise; why singing may not hold the key to recovery from aphasia" (Brain, 2011).  

This was confirmed by Stahl, et al., in "How to engage the right brain hemisphere in aphasics without even singing: evidence for two paths of speech recovery" (2013).  Schlaug, et al. (2014) demonstrated that MIT enabled patients to string together twice as many appropriate words per minute in answering questions.


Gabby Gifford
US House (ret)
MIT was used to restore Gabby Gifford's speech after a bullet from an assassination attempt in 2011 severely damaged her brain's left hemisphere.

Rhythm, in the form of rhythmic auditory stimulation (RAS) is a useful treatment for Parkinson's patients, which affects 1% of folk over 60.   In RAS, folk walk at a comfortable speed listening to rhythms.  As tempo is increased, significant improvements are seen in speed, cadence and stride length.

Music therapy has also demonstrated significant impacts on Alzheimer's patients.  There is a powerful documentary, "Alive Inside: A Story of Music and Memory" which follows social worker Dan Cohen as he uses music to unlock the memories of nursing-home Alzheimer's patients.  (Streamable on Netflix.)

Music works with Alzheimer's and dementia patients as it activates several parts of the brain, so the odds are greater that memories will be recalled.  Music stimulates normal emotional responses even in the face of general cognitive decline.
Dan Cohen
Music and Memory

Gagnon, et al. (2009) compared the ability of Alzheimer's patients to controls in judging the emotional connotations of different pieces of music and found that they were just as accurate, despite their other significant impairments.

Studies found that it is important for Alzheimer patients to select the music themselves so it will connect their memory and self.  Benefits vary and tend to be short-term, but the treatment reduces wandering and vocal outbursts and encourages cooperation and interaction with others.

Austism Spectrum Disorders (ASD) are increasingly manifesting with now 1 to 2% of children, mostly boys, having some aspects of impaired social interactions, communication difficulties and repetitive behaviors.  Some of this may be over-diagnosis, but there are many folk w/such maladies.  About 1/3 cannot make speech sounds and have limited vocabulary including gestures.  
Gottfried Schlaug
Beth Israel
and
Harvard Med 

ASD, neurobiologically, manifests w/overdeveloped short-range brain connections, causing a focus on fine details of sensory experience, including touch and sound, which makes music a great approach for working with it.   Schlaug developed an approach, auditory-motor mapping training (AMMT), which has many similarities w/MIT.

In AMMT, words and phrases are made with changing melodic pitch, and each hand taps alternately on drums while singing or speaking words and phrases.  Nonverbal ASD kids did 40 sessions for 8 wks, after which all could produce some speech sounds and some could say appropriate words during new tasks; this remained after 8 wks after training.

How do "free style rap" or jazz improv, clearly big musical challenges, "work"?  
Sometimes it doesn't, as in Eminen's "Lose Yourself", which is telling a rapper what to do when he "freezes" at the mike:  
Eminem

          "you better lose yourself in the music, the moment you own it, you better never let it go"

Kool Moe Dee describes two styles of free style rap in his book "There's A God In the Mike": "...old-school that's basically rhymes that you've just thought of on the spot, and freestyle where you come off the top of the head".  

But what's going on in the brain?  A recent article in Medical Daily discussed "Neural Substrates of Spontaneous Music Performance: An fMRI Study of Jazz Improvisation" by Limb and Braun.  


Deactivation - (LPFC)- blue/green
Activation (MPFC) - red/yellow

improvisation @ work
Limb, a "head and neck" surgeon @ Johns Hopkins, put professional rappers and jazz musicians into an fMRI and saw that:  
      
       "spontaneous improvisation was...associated with a highly congruous (coordinated) pattern of activations and deactivations in prefrontal cortex, sensorimotor and limbic regions of the brain...activations during improvisation were matched by deactivations during the control tasks, and vice versa" 


jazz control
not improvising
When not improvising, the brain relies on regions responsible for executive control and its recent stored learning and shuts down free thinking and language areas.  

jazz improvising
During improvisation, the executive control and self-monitoring region (lateral prefrontal cortex - LPFC) shuts down, and the brain uses the medial prefrontal cortex (MPFC) which governs self-expression, so the musicians can just feel the music and let go into the flow.  

There is a great TEDx vid by Limb, "Your Brain on Improv" on his work and what it means for creativity and innovation and the state of flow.  

So what does this have to do w/meditation and awakening???  As many of you know, i am a big advocate for chanting, especially of texts.   The MIT and AMMT approaches produced great benefits from singing, and "words and phrases made with changing melodic pitch" which is chanting.  As it produces such dramatic effects w/serious maladies, it can do good things for our plastic brains. 





BTW1, Rich Doyle and i will be holding Dialogues on Awakening Beyond Thought (DOABT) in Bryn Mawr (west Philadelphia) on March 28, and in Hamilton, NJ (next to Princeton) on Mar 29.   The satsangs will be from 2:00 - 5:00 or so, and are patterned after our live, open Q&A "First Sunday" SynchCast webcasts. The most recent is "Addictions, Attachments, Breath, Psychedelics".   

Bryn Mawr satsang is @ The New Leaf Club on 1225 Montrose Ave in Rosemont, 19010. Contact Laura or Meg at omhappenings@gmail.com.

Hamilton satsang is @ The Heart of Art @ 2374 Nottingham Way in Hamilton, 08619.  Contact Saima @ 609-865-1012 or HeartofArtStudio@gmail.com.  


BTW 2,  Rich and i have a book from Non-Duality Press of edited, footnoted, DOABTs from our youTube videos in final editing.  Out fairly soon. 


BTW3, The Fifth in our First Sunday live, open, donations only, Q&A satsangs with Rich and i is tomorrow, Mar 1 @ 3:00 pm EST/12:00 pm PST/8:00 pm GMT.  Sign up @ http://www.synchcast.net/#!awakening-beyond-thought/c1oe5.  





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