The Use of Therapeutic Music Training to Remediate Cognitive Impairment Following an Acquired Brain Injury: The Theoretical Basis and a Case Study

Cognitive impairment is the most common sequelae following an acquired brain injury (ABI) and can have profound impact on the life and rehabilitation potential for the individual. The literature demonstrates that music training results in a musician's increased cognitive control, attention, and executive functioning when compared to non-musicians. Therapeutic Music Training (TMT) is a music therapy model which uses the learning to play an instrument, specifically the piano, to engage and place demands on cognitive networks in order to remediate and improve these processes following an acquired brain injury. The underlying theory for the efficacy of TMT as a cognitive rehabilitation intervention is grounded in the literature of cognition, neuroplasticity, and of the increased attention and cognitive control of musicians. This single-subject case study is an investigation into the potential cognitive benefit of TMT and can be used to inform a future more rigorous study. The participant was an adult male diagnosed with cognitive impairment as a result of a severe brain injury following an automobile accident. Pre- and post-tests used standardized neuropsychological measures of attention: Trail Making A and B, Digit Symbol, and the Brown- Peterson Task. The treatment period was twelve months. The results of Trail Making Test reveal improved attention with a large decrease in test time on both Trail Making A (-26.88 s) and Trail Making B (-20.33 s) when compared to normative data on Trail Making A (-0.96 s) and Trail Making B (-3.86 s). Digit Symbol results did not reveal any gains and indicated a reduction (-2) in free recall of symbols. The results of the Brown-Peterson Task reveal improved attention with large increases in the correct number of responses in the 18-s delay (+6) and the 36-s delay (+7) when compared with normative data for the 18-s delay (+0.44) and the 36-s delay (-0.1). There is sparse literature regarding music based cognitive rehabilitation and a gap in the literature between experimental research and clinical work. The purpose of this paper is to present the theory for Therapeutic Music Training (TMT) and to provide a pilot case study investigating the potential efficacy of TMT to remediate cognitive impairment following an ABI.

Autodidacticism and Music: Do Self-Taught Musicians Exhibit the Same Auditory Processing Advantages as Formally Trained Musicians?

Multiple studies have demonstrated that musicians have enhanced auditory processing abilities compared to non-musicians. In these studies, musicians are usually defined as having received some sort of formal music training. One issue with this definition is that there are many musicians who are self-taught. The goal of the current study was to determine if self-taught musicians exhibit different auditory enhancements as their formally trained counterparts. Three groups of participants were recruited: formally trained musicians, who received formal music training through the conservatory or private lessons; self-taught musicians, who learned to play music through informal methods, such as with books, videos, or by ear; non-musicians, who had little or no music experience. Auditory processing abilities were assessed using a speech-in-noise task, a passive pitch oddball task done while recording electrical brain activity, and a melodic tonal violation task, done both actively and passively while recording electrical brain activity. For the melodic tonal violation task, formally trained musicians were better at detecting a tonal violation compared to self-taught musicians, who were in turn better than non-musicians. The P600 evoked by a tonal violation was enhanced in formally trained musicians compared to non-musicians. The P600 evoked by an out-of-key note did not differ between formally trained and self-taught musicians, while the P600 evoked by an out-of-tune note was smaller in self-taught musicians compared to formally trained musicians. No differences were observed between the groups for the other tasks. This pattern of results suggests that music training format impacts auditory processing abilities in musical tasks; however, it is possible that these differences arose due to pre-existing factors and not due to the training itself.

Music Form but Not Music Experience Modulates Motor Cortical Activity in Response to Novel Music

External cues, such as music, improve movement performance in persons with Parkinson’s disease. However, research examining the motor cortical mechanisms by which this occurs is lacking. Research using electroencephalography in healthy young adults has revealed that moving to music can modulate motor cortical activity. Moreover, motor cortical activity is further influenced by music experience. It remains unknown whether these effects extend to corticomotor excitability. Therefore, the primary aim of this study was to determine the effects of novel music on corticomotor excitability using transcranial magnetic stimulation (TMS) in a pilot study of healthy young adults. A secondary aim of this study was to determine the influence of music experience on corticomotor excitability. We hypothesized that corticomotor excitability will change during music conditions, and that it will differ in those with formal music training. Motor evoked potentials (MEPs) were recorded from the first dorsal interosseous using single-pulse TMS in three conditions: (1) No Music, (2) Music Condition I, and (3) Music Condition II. Both pieces were set to novel MIDI piano instrumentation and part-writing conventions typical of early nineteenth-century Western classical practices. Results revealed Music Condition II (i.e., more relaxing music) compared to rest increased MEP amplitude (i.e., corticomotor excitability). Music Condition II as compared to Music Condition I (i.e., more activating music) reduced MEP variability (i.e., corticomotor variability). Finally, years of formal music training did not significantly influence corticomotor excitability while listening to music. Overall, results revealed that unfamiliar music modulates motor cortical excitability but is dependent upon the form of music and possibly music preference. These results will be used to inform planned studies in healthy older adults and people with Parkinson’s disease.

Music Making and Neuropsychological Aging: A Review

Aging is associated with a decline in social understanding and general cognition. Both are integral to wellbeing and rely on similar brain regions. Thus, as the population ages, there is a growing need for knowledge on the types of activities that maintain brain health in older adulthood. Active engagement in music making might be one such activity because it places a demand on brain networks tapping into multisensory integration, learning, reward, and cognition. It has been hypothesized that this demand may promote plasticity in the frontal and temporal lobes by taxing cognitive abilities and, hence, increase resistance to age-related neurodegeneration. We examine research relevant to this hypothesis and note that there is a lack of intervention studies with a well-matched control condition and random assignment. Thus, we discuss potential causal mechanisms underlying training-related neuropsychological changes, and provide suggestions for future research. It is argued that although music training might be a valuable tool for supporting healthy neuropsychological aging and mental wellbeing, well-controlled intervention studies are necessary to provide clear evidence.

A Preliminary Study of the Effects of Attentive Music Listening on Cochlear Implant Users' Speech Perception, Quality of Life, and Behavioral and Objective Measures of Frequency Change Detection

Introduction

Most cochlear implant (CI) users have difficulty in listening tasks that rely strongly on perception of frequency changes (e.g., speech perception in noise, musical melody perception, etc.). Some previous studies using behavioral or subjective assessments have shown that short-term music training can benefit CI users’ perception of music and speech. Electroencephalographic (EEG) recordings may reveal the neural basis for music training benefits in CI users.

Objective

To examine the effects of short-term music training on CI hearing outcomes using a comprehensive test battery of subjective evaluation, behavioral tests, and EEG measures.

Design

Twelve adult CI users were recruited for a home-based music training program that focused on attentive listening to music genres and materials that have an emphasis on melody. The participants used a music streaming program (i.e., Pandora) downloaded onto personal electronic devices for training. The participants attentively listened to music through a direct audio cable or through Bluetooth streaming. The training schedule was 40 min/session/day, 5 days/week, for either 4 or 8 weeks. The pre-training and post-training tests included: hearing thresholds, Speech, Spatial and Qualities of Hearing Scale (SSQ12) questionnaire, psychoacoustic tests of frequency change detection threshold (FCDT), speech recognition tests (CNC words, AzBio sentences, and QuickSIN), and EEG responses to tones that contained different magnitudes of frequency changes.

Results

All participants except one finished the 4- or 8-week training, resulting in a dropout rate of 8.33%. Eleven participants performed all tests except for two who did not participate in EEG tests. Results showed a significant improvement in the FCDTs as well as performance on CNC and QuickSIN after training (p < 0.05), but no significant improvement in SSQ scores (p > 0.05). Results of the EEG tests showed larger post-training cortical auditory evoked potentials (CAEPs) in seven of the nine participants, suggesting a better cortical processing of both stimulus onset and within-stimulus frequency changes.

Conclusion

These preliminary data suggest that extensive, focused music listening can improve frequency perception and speech perception in CI users. Further studies that include a larger sample size and control groups are warranted to determine the efficacy of short-term music training in CI users.

Music Training, Working Memory, and Neural Oscillations: A Review

This review focuses on reports that link music training to working memory and neural oscillations. Music training is increasingly associated with improvement in working memory, which is strongly related to both localized and distributed patterns of neural oscillations. Importantly, there is a small but growing number of reports of relationships between music training, working memory, and neural oscillations in adults. Taken together, these studies make important contributions to our understanding of the neural mechanisms that support effects of music training on behavioral measures of executive functions. In addition, they reveal gaps in our knowledge that hold promise for further investigation. The current review is divided into the main sections that follow: (1) discussion of behavioral measures of working memory, and effects of music training on working memory in adults; (2) relationships between music training and neural oscillations during temporal stages of working memory; (3) relationships between music training and working memory in children; (4) relationships between music training and working memory in older adults; and (5) effects of entrainment of neural oscillations on cognitive processing. We conclude that the study of neural oscillations is proving useful in elucidating the neural mechanisms of relationships between music training and the temporal stages of working memory. Moreover, a lifespan approach to these studies will likely reveal strategies to improve and maintain executive function during development and aging.

The Effects of Music-Contingent Gait Training on Cognition and Mood in Parkinson Disease: A Feasibility Study

Background. In Parkinson disease (PD), gait impairments often coexist with nonmotor symptoms such as anxiety and depression. Biofeedback training may improve gait function in PD, but its effect on nonmotor symptoms remains unclear. This study explored the cognitive and global effects of Ambulosono, a cognitive gait training method utilizing step size to contingently control the real-time play of motivational music. Objective. This study examined the feasibility of music-contingent gait training and its effects on neuropsychological test performance and mood in persons with PD. Methods. A total of 30 participants with mild to moderate PD were semirandomized via sequential alternating assignment into an experimental training group or control music group. The training group received 12 weeks of music-contingent training, whereby music play was dependent on the user achieving a set stride length, adjusted online based on individual performance. The control group received hybrid training beginning with 6 weeks of noncontingent music walking, whereby music played continuously regardless of step size, followed by 6 weeks of music-contingent training. Global cognition, memory, executive function, attention, and working memory assessments were completed by blinded assessors at baseline, 6 weeks, and 12 weeks. Motor function, mood, and anxiety were assessed. Results. Average training adherence was 97%, with no falls occurring during training sessions. Improvements on cognitive measures were not clinically significant; however, significant decreases in depression and anxiety were observed in both groups over time (P < .05). Conclusions. Music-contingent gait training is feasible and safe in individuals with PD. Further investigation into potential therapeutic applications of this technology is recommended.

Practices and Attitudes That Enhance Music Engagement of Adult Cochlear Implant Users

BACKGROUND

Cochlear implants (CIs) are auditory prostheses designed to support spoken communication in persons with severe to profound hearing loss. Many post-lingually deaf adult CI users achieve good speech recognition in quiet; unfortunately, CI technology conveys a degraded representation of pitch and timbre, essential components of music. Not surprisingly, most CI users achieve significantly poorer perception and enjoyment of music compared with normal hearing listeners. Anecdotal evidence indicates that this impacts music engagement, particularly singing and playing instruments requiring ongoing tuning to external pitches or producing intervallic ratios. Interestingly, a small cohort of adult CI users has shown remarkable success in recovering or developing musical skills, but their success is poorly understood. Greater understanding of their efforts and attitudes may suggest potential rehabilitative approaches for other CI users.

PURPOSE

This article documented personal characteristics and experiences perceived to contribute to high level musicianship. Research questions included: (1) What forms of practice/experience have most contributed to (re)establishing satisfying music making? (2) What situations or musical tasks are most frustrating or challenging? (3) What attitudes, motivational factors, or forms of support help CI users persist in working toward improved music engagement?

METHODS

Qualitative and patient-engaged research methodologies were used. Our study involved a unique collaboration of six CI users engaged in high levels of musicianship and a researcher whose scholarship focuses on music and CIs. The CI recipients conveyed their experiences and attitudes regarding music and CIs through open-ended narratives. These narratives were analyzed using an integrative approach of inductive and deductive coding methods. The codes and themes that emerged through inductive methods were then organized within the Dynamic Problem Solving Model for Management of Music Listening Environments (Gfeller et al., 2019a).

OUTCOMES

This paper provides reflections of six CI users who successfully engage in active music making, including on-going tuning to external pitches and ensemble participation. Their perspectives emphasize the importance of pre-CI music instruction, extensive practice and immersion in music listening and playing, persistence and self-efficacy, and problem solving skills that optimize music engagement, and suggest possible strategies useful to other CI users interested in improving music experiences.

Practices and Attitudes That Enhance Music Engagement of Adult Cochlear Implant Users

BACKGROUND

Cochlear implants (CIs) are auditory prostheses designed to support spoken communication in persons with severe to profound hearing loss. Many post-lingually deaf adult CI users achieve good speech recognition in quiet; unfortunately, CI technology conveys a degraded representation of pitch and timbre, essential components of music. Not surprisingly, most CI users achieve significantly poorer perception and enjoyment of music compared with normal hearing listeners. Anecdotal evidence indicates that this impacts music engagement, particularly singing and playing instruments requiring ongoing tuning to external pitches or producing intervallic ratios. Interestingly, a small cohort of adult CI users has shown remarkable success in recovering or developing musical skills, but their success is poorly understood. Greater understanding of their efforts and attitudes may suggest potential rehabilitative approaches for other CI users.

PURPOSE

This article documented personal characteristics and experiences perceived to contribute to high level musicianship. Research questions included: (1) What forms of practice/experience have most contributed to (re)establishing satisfying music making? (2) What situations or musical tasks are most frustrating or challenging? (3) What attitudes, motivational factors, or forms of support help CI users persist in working toward improved music engagement?

METHODS

Qualitative and patient-engaged research methodologies were used. Our study involved a unique collaboration of six CI users engaged in high levels of musicianship and a researcher whose scholarship focuses on music and CIs. The CI recipients conveyed their experiences and attitudes regarding music and CIs through open-ended narratives. These narratives were analyzed using an integrative approach of inductive and deductive coding methods. The codes and themes that emerged through inductive methods were then organized within the Dynamic Problem Solving Model for Management of Music Listening Environments (Gfeller et al., 2019a).

OUTCOMES

This paper provides reflections of six CI users who successfully engage in active music making, including on-going tuning to external pitches and ensemble participation. Their perspectives emphasize the importance of pre-CI music instruction, extensive practice and immersion in music listening and playing, persistence and self-efficacy, and problem solving skills that optimize music engagement, and suggest possible strategies useful to other CI users interested in improving music experiences.

The Effects of Bimanual Coordination in Music Interventions on Executive Functions in Aging Adults

Music training programs have been shown to enhance executive functions in aging adults; however, little is known regarding the extent to which different types of bimanual coordination (i.e., fine and gross motor) in music instruction contribute to these outcomes. The aim of this study was to examine the effects of bimanual coordination in music interventions on cognitive performance in healthy older adults (60-80 years). Participants (N = 135) completed motor measures and battery of standardized cognitive measures, before and after a 16-week music training program with a 3 h practice requirement. All participants were matched by age, education, and estimate of intelligence to one of three training programs: piano training (fine motor); percussion instruction (gross motor), and music listening instruction (MLI) (no motor control condition). Results of a Repeated Measures ANOVA revealed significant enhancements in bimanual synchronization and visual scanning/working memory abilities for fine and gross motor training groups as compared to MLI. Pairwise comparisons revealed that piano training significantly improved motor synchronization skills as compared to percussion instruction or music listening. Results suggest that active music performance may benefit working memory, the extent of these benefits may depend upon coordination demands.

Effects of Music Training on Inhibitory Control and Associated Neural Networks in School-Aged Children: A Longitudinal Study

Inhibitory control, the ability to suppress an immediate dominant response, has been shown to predict academic and career success, socioemotional wellbeing, wealth, and physical health. Learning to play a musical instrument engages various sensorimotor processes and draws on cognitive capacities including inhibition and task switching. While music training has been shown to benefit cognitive and language skills, its impact on inhibitory control remains inconclusive. As part of an ongoing 5-year longitudinal study, we investigated the effects of music training on the development of inhibitory control and its neural underpinnings with a population of children (starting at age 6) from underserved communities. Children involved in music were compared with children involved in sports and children not involved in any systematic after-school program. Inhibition was measured using a delayed gratification, flanker, and Color-Word Stroop task, which was performed both inside and outside of an MRI scanner. We established that there were no pre-existing differences in cognitive capacities among the groups at the onset. In the delayed gratification task, beginning after 3 years of training, children with music training chose a larger, delayed reward in place of a smaller, immediate reward compared to the control group. In the flanker task, children in the music group, significantly improved their accuracy after 3 and 4 years of training, whereas such improvement in the sport and control group did not reach significance. There were no differences among the groups on behavioral measures of Color-Word Stroop task at any time point. As for differences in brain function, we have previously reported that after 2 years, children with music training showed significantly greater bilateral activation in the pre-SMA/SMA, ACC, IFG, and insula during the Color-Word Stroop task compared to the control group, but not compared to the sports group (Sachs et al., 2017). However, after 4 years, we report here that differences in brain activity related to the Color-Word Stroop task between musicians and the other groups is only observed in the right IFG. The results suggest that systematic extracurricular programs, particularly music-based training, may accelerate development of inhibitory control and related brain networks earlier in childhood.

Comparing the Effects of Rhythm-Based Music Training and Pitch-Based Music Training on Executive Functions in Preschoolers

Previous research has indicated the beneficial effects of music training on executive functions (EFs) in children. However, researchers have not clearly determined which component of music training produces these beneficial effects or whether different components exert different effects on EFs. In the present study, we examined the impact of rhythm-based music training compared to pitch-based music training and sports training as a control on EFs in preschoolers. Children aged between 5 and 6 years (N = 76) were randomly assigned to one of the three training groups and received training in small groups three times a week for 20 min in German kindergartens. Before and after training, children completed tests designed to assess inhibition, set-shifting, and visuospatial working memory. Parental education, family income, personality, and IQ served as control variables. We observed a significant training group × time interaction for the measure of inhibition. Children from the rhythm group exhibited significant improvements in inhibition from pre- to post-tests (d_RM = 0.56), whereas children from the other groups did not. Furthermore, children from the rhythm group significantly differed from the sports control group at post-test (d_corr = 0.82). Concerning the measures of set-shifting and visuospatial working memory, the descriptive data revealed similar results; however, we did not observe significant training group × time interactions. Based on our findings, rhythm-based music training specifically enhances inhibition in preschoolers and might affect other EFs, such as set-shifting and visuospatial working memory.

Auditory T-Complex Reveals Reduced Neural Activities in the Right Auditory Cortex in Musicians With Absolute Pitch

Absolute pitch (AP) is the ability to identify the pitch names of arbitrary musical tones without being given a reference pitch. The acquisition of AP typically requires early musical training, the critical time window for which is similar to that for the acquisition of a first language. This study investigated the left-right asymmetry of the auditory cortical functions responsible for AP by focusing on the T-complex of auditory evoked potentials (AEPs), which shows morphological changes during the critical period for language acquisition. AEPs evoked by a pure-tone stimulus were recorded in high-AP musicians, low-AP musicians, and non-musicians (n = 19 each). A balanced non-cephalic electrode (BNE) reference was used to examine the left-right asymmetry of the N1a and N1c components of the T-complex. As a result, a left-dominant N1c was observed only in the high-AP musician group, indicating "AP negativity," which has previously been described as an electrophysiological marker of AP. Notably, this hemispheric asymmetry was due to a diminution of the right N1c rather than enhancement of the left N1c. A left-dominant N1a was found in both musician groups, irrespective of AP. N1c and N1a exhibited no left-right asymmetry in non-musicians. Hence, music training and the acquisition of AP are both accompanied by a left-dominant hemispheric specialization of auditory cortical functions, as indexed by N1a and N1c, respectively, but the N1c asymmetry in AP possessors was due to reduced neural activities in the right hemisphere. The use of a BNE is recommended for evaluating these radially oriented components of the T-complex.

Music training is neuroprotective for verbal cognition in focal epilepsy

Focal epilepsy is a unilateral brain network disorder, providing an ideal neuropathological model with which to study the effects of focal neural disruption on a range of cognitive processes. While language and memory functions have been extensively investigated in focal epilepsy, music cognition has received less attention, particularly in patients with music training or expertise. This represents a critical gap in the literature. A better understanding of the effects of epilepsy on music cognition may provide greater insight into the mechanisms behind disease- and training-related neuroplasticity, which may have implications for clinical practice. In this cross-sectional study, we comprehensively profiled music and non-music cognition in 107 participants; musicians with focal epilepsy (n = 35), non-musicians with focal epilepsy (n = 39), and healthy control musicians and non-musicians (n = 33). Parametric group comparisons revealed a specific impairment in verbal cognition in non-musicians with epilepsy but not musicians with epilepsy, compared to healthy musicians and non-musicians (P = 0.029). This suggests a possible neuroprotective effect of music training against the cognitive sequelae of focal epilepsy, and implicates potential training-related cognitive transfer that may be underpinned by enhancement of auditory processes primarily supported by temporo-frontal networks. Furthermore, our results showed that musicians with an earlier age of onset of music training performed better on a composite score of melodic learning and memory compared to non-musicians (P = 0.037), while late-onset musicians did not differ from non-musicians. For most composite scores of music cognition, although no significant group differences were observed, a similar trend was apparent. We discuss these key findings in the context of a proposed model of three interacting dimensions (disease status, music expertise, and cognitive domain), and their implications for clinical practice, music education, and music neuroscience research.

Music and Visual Art Training Modulate Brain Activity in Older Adults

Cognitive decline is an unavoidable aspect of aging that impacts important behavioral and cognitive skills. Training programs can improve cognition, yet precise characterization of the psychological and neural underpinnings supporting different training programs is lacking. Here, we assessed the effect and maintenance (3-month follow-up) of 3-month music and visual art training programs on neuroelectric brain activity in older adults using a partially randomized intervention design. During the pre-, post-, and follow-up test sessions, participants completed a brief neuropsychological assessment. High-density EEG was measured while participants were presented with auditory oddball paradigms (piano tones, vowels) and during a visual GoNoGo task. Neither training program significantly impacted psychometric measures, compared to a non-active control group. However, participants enrolled in the music and visual art training programs showed enhancement of auditory evoked responses to piano tones that persisted for up to 3 months after training ended, suggesting robust and long-lasting neuroplastic effects. Both music and visual art training also modulated visual processing during the GoNoGo task, although these training effects were relatively short-lived and disappeared by the 3-month follow-up. Notably, participants enrolled in the visual art training showed greater changes in visual evoked response (i.e., N1 wave) amplitude distribution than those from the music or control group. Conversely, those enrolled in music showed greater response associated with inhibitory control over the right frontal scalp areas than those in the visual art group. Our findings reveal a causal relationship between art training (music and visual art) and neuroplastic changes in sensory systems, with some of the neuroplastic changes being specific to the training regimen.

Music Training Can Improve Music and Speech Perception in Pediatric Mandarin-Speaking Cochlear Implant Users

Due to limited spectral resolution, cochlear implants (CIs) do not convey pitch information very well. Pitch cues are important for perception of music and tonal language; it is possible that music training may improve performance in both listening tasks. In this study, we investigated music training outcomes in terms of perception of music, lexical tones, and sentences in 22 young (4.8 to 9.3 years old), prelingually deaf Mandarin-speaking CI users. Music perception was measured using a melodic contour identification (MCI) task. Speech perception was measured for lexical tones and sentences presented in quiet. Subjects received 8 weeks of MCI training using pitch ranges not used for testing. Music and speech perception were measured at 2, 4, and 8 weeks after training was begun; follow-up measures were made 4 weeks after training was stopped. Mean baseline performance was 33.2%, 76.9%, and 45.8% correct for MCI, lexical tone recognition, and sentence recognition, respectively. After 8 weeks of MCI training, mean performance significantly improved by 22.9, 14.4, and 14.5 percentage points for MCI, lexical tone recognition, and sentence recognition, respectively (p < .05 in all cases). Four weeks after training was stopped, there was no significant change in posttraining music and speech performance. The results suggest that music training can significantly improve pediatric Mandarin-speaking CI users’ music and speech perception.

Comparison of Two Music Training Approaches on Music and Speech Perception in Cochlear Implant Users

In normal-hearing (NH) adults, long-term music training may benefit music and speech perception, even when listening to spectro-temporally degraded signals as experienced by cochlear implant (CI) users. In this study, we compared two different music training approaches in CI users and their effects on speech and music perception, as it remains unclear which approach to music training might be best. The approaches differed in terms of music exercises and social interaction. For the pitch/timbre group, melodic contour identification (MCI) training was performed using computer software. For the music therapy group, training involved face-to-face group exercises (rhythm perception, musical speech perception, music perception, singing, vocal emotion identification, and music improvisation). For the control group, training involved group nonmusic activities (e.g., writing, cooking, and woodworking). Training consisted of weekly 2-hr sessions over a 6-week period. Speech intelligibility in quiet and noise, vocal emotion identification, MCI, and quality of life (QoL) were measured before and after training. The different training approaches appeared to offer different benefits for music and speech perception. Training effects were observed within-domain (better MCI performance for the pitch/timbre group), with little cross-domain transfer of music training (emotion identification significantly improved for the music therapy group). While training had no significant effect on QoL, the music therapy group reported better perceptual skills across training sessions. These results suggest that more extensive and intensive training approaches that combine pitch training with the social aspects of music therapy may further benefit CI users.

A Randomized Controlled Crossover Study of the Impact of Online Music Training on Pitch and Timbre Perception in Cochlear Implant Users

Cochlear implant (CI) biomechanical constraints result in impoverished spectral cues and poor frequency resolution, making it difficult for users to perceive pitch and timbre. There is emerging evidence that music training may improve CI-mediated music perception; however, much of the existing studies involve time-intensive and less readily accessible in-person music training paradigms, without rigorous experimental control paradigms. Online resources for auditory rehabilitation remain an untapped potential resource for CI users. Furthermore, establishing immediate value from an acute music training program may encourage CI users to adhere to post-implantation rehabilitation exercises. In this study, we evaluated the impact of an acute online music training program on pitch discrimination and timbre identification. Via a randomized controlled crossover study design, 20 CI users and 21 normal hearing (NH) adults were assigned to one of two arms. Arm-A underwent 1 month of online self-paced music training (intervention) followed by 1 month of audiobook listening (control). Arm-B underwent 1 month of audiobook listening followed by 1 month of music training. Pitch and timbre sensitivity scores were taken across three visits: (1) baseline, (2) after 1 month of intervention, and (3) after 1 month of control. We found that performance improved in pitch discrimination among CI users and NH listeners, with both online music training and audiobook listening. Music training, however, provided slightly greater benefit for instrument identification than audiobook listening. For both tasks, this improvement appears to be related to both fast stimulus learning as well as procedural learning. In conclusion, auditory training (with either acute participation in an online music training program or audiobook listening) may improve performance on untrained tasks of pitch discrimination and timbre identification. These findings demonstrate a potential role for music training in perceptual auditory appraisal of complex stimuli. Furthermore, this study highlights the importance and the need for more tightly controlled training studies in order to accurately evaluate the impact of rehabilitation training protocols on auditory processing.

The effects of background music on the work attention performance between musicians and non-musicians

For occupational safety and ergonomics, the relationship between work attention performance and background music is a trend for the future. Attention performance may be influenced by some personal factors, such as experience of music training. This investigation explores the difference between the attention performance of musicians and that of non-musicians based on a quasi-experimental design to gain a preliminary understanding of the possible effect of background music on the attention performance of both groups. This study found that a musician's attention performance is better than a non-musician's and that background music tends to improve the attention performance of both musicians and non-musicians, but to a greater extent for musicians.

Orff-Based Music Training Enhances Children's Manual Dexterity and Bimanual Coordination

How music training and expertise influence non-musical abilities is a widely researched topic. Most studies focus on the differences between adult professional musicians and non-musicians, or examine the effects of intensive instrumental training in childhood. However, the impact of music programs developed in regular school contexts for children from low-income communities is poorly explored. We conducted a longitudinal training study in such communities to examine if collective (Orff-based) music training enhances fine motor abilities, when compared to a homologous training program in sports (basketball), and to no specific training. The training programs in music and sports had the same duration, 24 weeks, and were homologous in structure. A pre-test, training, post-test and follow-up design was adopted. Children attending the 3rd grade (n = 74, 40 girls; mean age 8.31 years) were pseudorandomly divided into three groups, music, sports and control that were matched on demographic and intellectual characteristics. Fine motor abilities were assessed with the Purdue pegboard test (eye-hand coordination and motor speed, both subsumed under manual dexterity, and bimanual coordination) and with the Grooved pegboard (manipulative dexterity) test. All groups improved in manipulative dexterity that was not affected by type of training. On bimanual coordination and manual dexterity, however, a robust and stable advantage of music training emerged. At the end of training (post-test), children from the music group significantly outperformed children from the sports and control groups, an advantage that persisted at follow-up 4 months after training at the start of the following school year. Also, at follow-up none of the children from the music group were performing below the 20th percentile in the Purdue pegboard subtests and more than half were performing at the high end level (>80th percentile). Children from the sports group also improved significantly from pre- to post-test but their performance was not significantly different from that of the control group. These results show that an affordable, collective-based music practice impacts positively on fine-motor abilities, a finding that is relevant for a better understanding of the impact of music in childhood development, and that may have implications for education at the primary grade.

Effect of Long-Term Music Training on Emotion Perception From Drumming Improvisation

Long-term music training has been shown to affect different cognitive and perceptual abilities. However, it is less well known whether it can also affect the perception of emotion from music, especially purely rhythmic music. Hence, we asked a group of 16 non-musicians, 16 musicians with no drumming experience, and 16 drummers to judge the level of expressiveness, the valence (positive and negative), and the category of emotion perceived from 96 drumming improvisation clips (audio-only, video-only, and audiovideo) that varied in several music features (e.g., musical genre, tempo, complexity, drummer’s expressiveness, and drummer’s style). Our results show that the level and type of music training influence the perceived expressiveness, valence, and emotion from solo drumming improvisation. Overall, non-musicians, non-drummer musicians, and drummers were affected differently by changes in some characteristics of the music performance, for example musicians (with and without drumming experience) gave a greater weight to the visual performance than non-musicians when giving their emotional judgments. These findings suggest that besides influencing several cognitive and perceptual abilities, music training also affects how we perceive emotion from music.

Better late than never (or early): Music training in late childhood is associated with enhanced decision-making

Decision-making is critical to everyday life. Here we ask: to what extent does music training benefit decision-making? Supported by strong associations between music training and enhanced cross-domain skills, we hypothesize that musicians may show decision-making advantages relative to non-musicians. Prior work has also argued for a "critical period" for cross-domain plasticity such that beginning music training early enhances sensorimotor brain regions that mature early in life. Given that brain regions supporting decision-making begin maturing late in childhood, we hypothesized that an advantage in decision-making may only be present in musicians who began music training later in childhood. To test this hypothesis, young adults who began music training before and after 8 years of age (early-trained musicians, ET; late-trained musicians, LT, respectively) and non-musicians (NM) performed a decision-making task. We found a decision-making advantage in LT relative to ET and NM. To better understand the mechanism of the LT advantage, we conducted computational modeling on participant responses and found that LT were less biased by recent outcomes and incorporated longer strings of outcomes when deciding among the choice options. These results tentatively suggest that music training may confer decision-making enhancements, and carry strong implications for the utility of music training in childhood.

Evaluating predisposition and training in shaping the musician's brain: the need for a developmental perspective

The study of music training as a model for structural plasticity has evolved significantly over the past 15 years. Neuroimaging studies have identified characteristic structural brain alterations in musicians compared to nonmusicians in school-age children and adults, using primarily cross-sectional designs. Despite this emerging evidence and advances in pediatric neuroimaging techniques, hardly any studies have examined brain development in early childhood (before age 8) in association with musical training, and longitudinal studies starting in infancy or preschool are particularly scarce. Consequently, it remains unclear whether the characteristic "musician brain" is solely the result of musical training, or whether certain predispositions may have an impact on its development. Moving toward a developmental perspective, the present review considers various factors that may contribute to early brain structure prior to the onset of formal musical training. This review introduces a model for potential neurobiological pathways leading to the characteristic "musician brain," which involves a developmental interaction between predisposition and its temporal dynamics, environmental experience, and training-induced plasticity. This perspective illuminates the importance of studying the brain structure associated with musical training through a developmental lens, and the need for longitudinal studies in early childhood to advance our understanding of music training-induced structural plasticity.

Protocol for a randomized controlled trial of piano training on cognitive and psychosocial outcomes

Age-related cognitive decline and cognitive impairment represent the fastest growing health epidemic worldwide among those over 60. There is a critical need to identify effective and novel complex cognitive interventions to promote successful aging. Since piano training engages cognitive and bimanual sensorimotor processing, we hypothesize that piano training may serve as an effective cognitive intervention, as it requires sustained attention and engages an executive network that supports generalized cognition and emotional control. Here, I describe the protocol of a randomized controlled trial (RCT) to evaluate the impact of piano training on cognitive performance in adulthood, a period associated with decreased neuroplasticity. In this cluster RCT, healthy older adults (age 60-80) were recruited and screened to control for confounding variables. Eligible participants completed an initial 3-h assessment of standardized cognitive and psychosocial measures. Participants were stratified by age, education, and estimate of intelligence and randomly assigned to one of three groups: piano training, computer brain training, or a no-treatment control group. Computer brain training consisted of progressively difficult auditory cognitive exercises (Brain HQ; Posit Science, 2010). Participants assigned to training groups completed a 16-week program that met twice a week for 90 minutes. Upon program completion and at a 3-month follow-up, training participants and no-treatment controls completed a posttest visit lasting 2.5 hours.