The neurochemistry of music

Music in the workplace: A narrative literature review of intervention studies

Background Music is widely used in clinical and rehabilitative fields and recently also in the field of Occupational Medicine. This review aims at selecting the evidence-based studies regarding music interventions in workplaces. Methods In order to carry out a narrative literature review, two independent pairs of investigators searched in PubMed and PsycInfo databases to select Randomized Controlled Trials (RCTs) or Clinical Controlled Trials (CCTs) in English regarding music and music therapy interventions in workplaces; the trials were published in peer-reviewed journals from January 2000 to February 2017. Results Fourteen articles met the inclusion criteria and were included in this review. Among these, ten were RCTs and four CCTs. The vast majority of RCTs were conducted on students or medical personnel (n=8), while only a few RCTs (n=2) were carried out on air traffic controllers or sick leave workers. Firefighters, computer systems developers, nursing students and office workers were studied through a CCT study design (n=4). Conclusions Psychological factors, communication, rehabilitative outcomes and cognitive and work performances seem to be the principal areas of interest in the field of music and occupational medicine, with possible economic benefits. Future studies should adopt rigorous methodological criteria to carry out larger samples on a wide range of professional categories and music/music therapy interventions.

Does Listening to Music Regulate Negative Affect in a Stressful Situation? Examining the Effects of Self-Selected and Researcher-Selected Music Using Both Silent and Active Controls

BACKGROUND

Stress and anxiety are increasingly common among young people. The current research describes two studies comparing the effects of self-selected and researcher-selected music on induced negative affect (state anxiety and physiological arousal), and state mindfulness.

METHOD

In Study 1, 70 undergraduates were randomly assigned to one of three conditions: researcher-selected music, self-selected music, or a silent control condition. In Study 2, with 75 undergraduates, effects of music were compared to an active control (listening to a radio show). Negative affect was induced using a speech preparation and arithmetic task, followed by music listening or control. Self-reported anxiety and blood pressure were measured at baseline, post-induction, and post-intervention. Study 2 included state mindfulness as a dependent measure.

RESULTS

Study 1 indicated that participants who listened to music (self-selected and researcher-selected) reported significantly greater anxiety reduction than participants in the silent control condition. Music did not reduce anxiety compared to an active control in Study 2. However, music listening significantly increased levels of state mindfulness, which predicted lower anxiety after self-selected music listening.

CONCLUSIONS

Music may provide regulation in preparation for stressful events. Yet, the results of Study 2 indicate that other activities have similar benefits, and shows, for the first time, that music listening increases mindfulness following a stressor.

The default-mode network represents aesthetic appeal that generalizes across visual domains

Visual aesthetic evaluations, which impact decision-making and well-being, recruit the ventral visual pathway, subcortical reward circuitry, and parts of the medial prefrontal cortex overlapping with the default-mode network (DMN). However, it is unknown whether these networks represent aesthetic appeal in a domain-general fashion, independent of domain-specific representations of stimulus content (artworks versus architecture or natural landscapes). Using a classification approach, we tested whether the DMN or ventral occipitotemporal cortex (VOT) contains a domain-general representation of aesthetic appeal. Classifiers were trained on multivoxel functional MRI response patterns collected while observers made aesthetic judgments about images from one aesthetic domain. Classifier performance (high vs. low aesthetic appeal) was then tested on response patterns from held-out trials from the same domain to derive a measure of domain-specific coding, or from a different domain to derive a measure of domain-general coding. Activity patterns in category-selective VOT contained a degree of domain-specific information about aesthetic appeal, but did not generalize across domains. Activity patterns from the DMN, however, were predictive of aesthetic appeal across domains. Importantly, the ability to predict aesthetic appeal varied systematically; predictions were better for observers who gave more extreme ratings to images subsequently labeled as "high" or "low." These findings support a model of aesthetic appreciation whereby domain-specific representations of the content of visual experiences in VOT feed in to a "core" domain-general representation of visual aesthetic appeal in the DMN. Whole-brain "searchlight" analyses identified additional prefrontal regions containing information relevant for appreciation of cultural artifacts (artwork and architecture) but not landscapes.

Effects of music interventions on stress-related outcomes: a systematic review and two meta-analyses

Music interventions are used for stress reduction in a variety of settings because of the positive effects of music listening on both physiological arousal (e.g., heart rate, blood pressure, and hormonal levels) and psychological stress experiences (e.g., restlessness, anxiety, and nervousness). To summarize the growing body of empirical research, two multilevel meta-analyses of 104 RCTs, containing 327 effect sizes and 9,617 participants, were performed to assess the strength of the effects of music interventions on both physiological and psychological stress-related outcomes, and to test the potential moderators of the intervention effects. Results showed that music interventions had an overall significant effect on stress reduction in both physiological (d = .380) and psychological (d = .545) outcomes. Further, moderator analyses showed that the type of outcome assessment moderated the effects of music interventions on stress-related outcomes. Larger effects were found on heart rate (d = .456), compared to blood pressure (d = .343) and hormone levels (d = .349). Implications for stress-reducing music interventions are discussed.

Music to One's Ears: Familiarity and Music Engagement in People With Parkinson's Disease

Parkinson's disease (PD) is a complex diagnosis commonly associated with motor dysfunction, but known to comprise cognitive, psychiatric, and mood disturbances as well. Music has been successfully used to address motor and non-motor symptoms of PD. Still, little is known about the nature of an individual with PD's experience and relationship with music on conceptual and emotional levels, which may factor into their engagement in music-based techniques to ameliorate impairments. Two surveys were administered to 19 individuals with PD and 15 individuals without PD in order to gauge their subjective impressions and valuations of music. Participants completed The Brief Music Experience Questionnaire (BMEQ), a standard self-report measure pertaining to the role of music in one's life, prior to performing a perception task which involved listening to and making sound adjustments to three music recordings. Following the perception task, a custom Exit Survey was administered to evaluate the experience of listening to and engaging with the music in the perception task. In all six dimensions of the BMEQ, examining aspects of music experience including commitment to music, self-reported musical aptitude, social uplift, affective reactions, positive psychotropic effects, and reactive musical behavior (RMB, pertaining to actions or behaviors in response to music), the mean and the median were greater for the control group than for the PD group, but the difference was only statistically significant in the RMB dimension. On the Exit Survey, both groups assessed recent, specific, and interactive music listening more positively than the imagined, hypothetical or general music experiences addressed on the BMEQ. Additionally, familiarity had a greater effect on listening pleasure for participants with PD than those without PD. We conclude that people with PD may perceive less of an automatic connection between music and activity than their healthy peers. Additionally, they may receive more pleasure and value from music than they anticipate. Taken together, our results suggest that people with PD may require encouragement to participate as well as empowerment to choose familiar selections in order to better access music-based interventions and the benefits they can offer.

Listening to self-chosen music regulates induced negative affect for both younger and older adults

The current study evaluated the efficacy of self-chosen music listening for the function of affect regulation comparing effects in younger and older adults. Forty younger (18-30 years, M = 19.75, SD = 2.57, 14 males) and forty older (60-81 years, M = 68.48, SD = 6.07, 21 males) adults visited the laboratory and were randomised to either the intervention (10 minutes of listening to self-chosen music) or the active control condition (10 minutes of listening to an experimenter-chosen radio documentary). Negative affect (NA) was induced in all participants using a speech preparation and mental arithmetic task, followed by the intervention/control condition. Measures of self-reported affect were taken at baseline, post-induction and post-intervention. Controlling for baseline affect and reactivity to the NA induction, in comparison with the active control group the music listening group demonstrated greater reduction in NA. Supporting developmental theories of positive ageing, analyses also found significant main effects for age, with older adults experiencing greater reduction of NA than younger adults, regardless of condition. Results of the current study provide preliminary insights into the effects of self-chosen music on induced NA, however, additional experimental control conditions comparing self-chosen and experimenter-chosen music with self-chosen and experimenter-chosen active controls are needed to fully understand music listening effects for affect regulation.

Walking to Music and Metronome at Various Tempi in Persons With Multiple Sclerosis: A Basis for Rehabilitation

Background. Mobility dysfunctions are prevalent in persons with multiple sclerosis (PwMS), thus novel rehabilitation mechanisms are needed toward functional training. The effect of auditory cueing is well-known in Parkinson's disease, yet the application of different types of auditory stimuli at different tempi has not been investigated yet. Objectives. Investigating if PwMS, compared with healthy controls (HC), can synchronize their gait to music and metronomes at different tempi during walking and the effects of the stimuli on perceived fatigue and gait. Additionally, exploring if cognitive impairment would be a factor on the results. Methods. The experimental session consisted of 2 blocks, music and metronomes. Per block, participants walked 3 minutes per tempi, with instructions to synchronize their steps to the beat. The tempi were 0%, +2%, +4% +6%, +8%, +10% of preferred walking cadence (PWC). Results. A total of 28 PwMS and 29 HC participated. On average, participants were able to synchronize at all tempi to music and metronome. Higher synchronization was obtained for metronomes compared with music. The highest synchronization for music was found between +2% and +8% of PWC yet pwMS perceived less physical and cognitive fatigue walking to music compared with metronomes. Cognitive impaired PwMS (n = 9) were not able to synchronize at tempi higher than +6%. Conclusion. Auditory-motor coupling and synchronization was feasible in HC and PwMS with motor and cognitive impairments. PwMS walked at higher tempi than their preferred walking cadence, and lower fatigue perception with music. Coupling walking to music could be a promising functional walking training strategy.

Pain, Parental Involvement, and Oxytocin in the Neonatal Intensive Care Unit

Preterm infants (PTI) typically experience many painful and stressful procedures or events during their first weeks of life in a neonatal intensive care unit, and these can profoundly impact subsequent brain development and function. Several protective interventions during this sensitive period stimulate the oxytocin system, reduce pain and stress, and improve brain development. This review provides an overview of the environmental risk factors experienced by PTI during hospitalization, with a focus on the effects of pain, and early maternal separation. We also describe the long-term adverse effects of the simultaneous experiences of pain and maternal separation, and the potential beneficial effects of maternal vocalizations, parental contact, and several related processes, which appear to be mediated by the oxytocin system.

Music-Enhanced Analgesia and Antiseizure Activities in Animal Models of Pain and Epilepsy: Toward Preclinical Studies Supporting Development of Digital Therapeutics and Their Combinations With Pharmaceutical Drugs

Digital therapeutics (software as a medical device) and mobile health (mHealth) technologies offer a means to deliver behavioral, psychosocial, disease self-management and music-based interventions to improve therapy outcomes for chronic diseases, including pain and epilepsy. To explore new translational opportunities in developing digital therapeutics for neurological disorders, and their integration with pharmacotherapies, we examined analgesic and antiseizure effects of specific musical compositions in mouse models of pain and epilepsy. The music playlist was created based on the modular progression of Mozart compositions for which reduction of seizures and epileptiform discharges were previously reported in people with epilepsy. Our results indicated that music-treated mice exhibited significant analgesia and reduction of paw edema in the carrageenan model of inflammatory pain. Among analgesic drugs tested (ibuprofen, cannabidiol (CBD), levetiracetam, and the galanin analog NAX 5055), music intervention significantly decreased paw withdrawal latency difference in ibuprofen-treated mice and reduced paw edema in combination with CBD or NAX 5055. To the best of our knowledge, this is the first animal study on music-enhanced antinociceptive activity of analgesic drugs. In the plantar incision model of surgical pain, music-pretreated mice had significant reduction of mechanical allodynia. In the corneal kindling model of epilepsy, the cumulative seizure burden following kindling acquisition was lower in animals exposed to music. The music-treated group also exhibited significantly improved survival, warranting further research on music interventions for preventing Sudden Unexpected Death in Epilepsy (SUDEP). We propose a working model of how musical elements such as rhythm, sequences, phrases and punctuation found in K.448 and K.545 may exert responses via parasympathetic nervous system and the hypothalamic-pituitary-adrenal (HPA) axis. Based on our findings, we discuss: (1) how enriched environment (EE) can serve as a preclinical surrogate for testing combinations of non-pharmacological modalities and drugs for the treatment of pain and other chronic diseases, and (2) a new paradigm for preclinical and clinical development of therapies leading to drug-device combination products for neurological disorders, depression and cancer. In summary, our present results encourage translational research on integrating non-pharmacological and pharmacological interventions for pain and epilepsy using digital therapeutics.

Sex-specific Effects of Music Listening on Couples' Stress in Everyday Life

Music listening in daily life is associated with stress-reducing effects on the individual with increasing effects when music listening occurs in a social context. As little is known about effects on couples, we investigated whether beneficial effects can be found in couples. Forty heterosexual couples were investigated using ambulatory assessment. Participants completed six assessments on music listening and subjective stress per day for five consecutive days. With each assessment, saliva samples for the later analysis of cortisol and alpha-amylase were collected. Music listening affected biopsychological stress markers in women and men, however in different ways: While music listening reduced cortisol in women, it increased alpha-amylase in men. Dyadic effects of music listening on stress markers were found. Men showed lower secretion of cortisol if women listened to music which was more pronounced when couples shared musical preferences. Both men and women showed higher alpha-amylase activity when their partner had listened to music. Music listening influences couples’ psychobiological stress levels in a sex-dependent manner with evidence of dyadic co-variation in physiological responses to music. Interventions for promoting stress reduction should consider that women and men differ in their use of music in everyday life.

Listening to music prior to bronchoscopy reduces anxiety - a randomised controlled trial

Background: Listening to music as a means of relieving anxiety before and during endoscopy has been examined in several studies but results so far are contradictory and inconclusive.

Aims: We aimed to determine whether listening to music could reduce anxiety prior to and during bronchoscopy, and whether it is influenced by the patient’s preference in music.

Methods: 300 patients undergoing bronchoscopy for suspected lung cancer were randomly assigned to: self-selected music, specially-designed music (MusiCure^TM), or control (no sound). Spielberger’s State-Trait Anxiety Inventory (STAI) was administered three times: at admission, after 20 min with or without music (preceding bronchoscopy), and shortly before discharge. The primary outcome was STAI state score after 20 min, with or without exposure to music prior to bronchoscopy.

Results: On average, music reduced the STAI score by 2.5 points (95% CI, 1.1 to 4.0; p < 0.001) compared with the control group. This reduction was largest in the self-selected music group (3.4; 95% CI, 1.5 to 5.3; p < 0.001). In contrast, specially designed music did not significantly reduce STAI score (1.7; 95% CI, −0.3 to 3.6; p = 0.1).

Conclusion: Listening to music reduces anxiety in patients undergoing bronchoscopy, provided that the music complies with the patient’s preferences.

Computational elucidation of the effects induced by music making

Music making, in the form of free improvisations, is a common technique in music therapy, used to express one’s feelings or ideas in the non-verbal language of music. In the broader sense, arts therapies, and music therapy in particular, are used to induce therapeutic and psychosocial effects, and to help mitigate symptoms in serious and chronic diseases. They are also used to empower the wellbeing and quality of life for both healthy individuals and patients. However, much research is still required to understand how music-based and arts-based approaches work, and to eventually enhance their effectivity. The clinical setting employing the arts constitutes a rich dynamic environment of occurrences that is difficult to capture, being driven by complex, simultaneous, and interwoven behavioral processes. Our computational paradigm is designed to allow substantial barriers in the arts-based fields to be overcome by enabling the rigorous and quantitative tracking, analyzing and documenting of the underlying dynamic processes. Here we expand the method for the music modality and apply it in a proof of principle experimentation to study expressive behavioral effects of diverse musical improvisation tasks on individuals and collectives. We have obtained statistically significant results that include empirical expressive patterns of feelings, as well as proficiency, gender and age behavioral differences, which point to variation factors of these categorized collectives in music making. Our results also suggest that males are more exploratory than females (e.g., they exhibit a larger range of octaves and intensity) and that the older people express musical characterized negativity more than younger ones (e.g., exhibiting larger note clusters and more chromatic transitions). We discuss implications of these findings to music therapy, such as behavioral diversity causality in treatment, as well as future scientific and clinical applications of the methodology.

Insular function in autism: Update and future directions in neuroimaging and interventions

The insular cortex, hidden within the lateral sulcus of the human brain, participates in a range of cognitive, affective, and sensory functions. Autism spectrum disorder (ASD), a neurodevelopmental condition affecting all of these functional domains, has increasingly been linked with atypical activation and connectivity of the insular cortices. Here we review the latest research linking atypical insular function to a range of behaviors characteristic of ASD, with an emphasis on neuroimaging findings in the domains of social cognition and executive function. We summarize some of the recent work linking the insula to interventions in autism, including oxytocin-based pharmacological treatments and music therapy. We suggest that future directions likely to yield significant insights into insular pathology in ASD include the analysis of the dynamics of this brain region. We also conclude that more basic research is necessary on the use of oxytocin pharmacotherapy, and larger studies addressing participant heterogeneity are needed on the use of music therapy in ASD. Long-term studies are needed to ascertain sustained effects of these interventions.

Magic Moments: Determinants of Stress Relief and Subjective Wellbeing from Visiting a Cultural Heritage Site

We provide an experimental evaluation of the impact of aesthetic experiences in terms of stress reduction (cortisol levels) and wellbeing increase. The test experience is a visit to the vault of the Sanctuary of Vicoforte, Italy. Data have been collected using a double step method. A structured interview in relation to the individual subjective well-being has been administered to a sample of 100 subjects. In addition, a sample of their saliva has been taken, and its cortisol level measured, before and after the experience, and likewise for momentary wellbeing measured on a Visual Analogous Scale. Subjects reported an average increase of 40% in wellbeing and a decrease of the 60% in the cortisol level. The recorded cortisol level values dropped on average well beyond the decrease normally associated to its circadian cycle. The modulating role of various variables has been appreciated, and profiling of the typical subjects who are wellbeing respondents/non-respondents and cortisol respondents/non-respondents has been carried out. We conclude that aesthetic experience seems to have a noticeable impact on individual physical and mental health. In both dominions, cultural participation intensity is significantly correlated to the response. The study underlines the potential of the arts and culture as a new platform for public health practices and new approaches to welfare policy design.

An Explorative Study of Qualities in Interactive Processes with Children and Their Parents in Music Therapy during and after Pediatric Hematopoietic Stem Cell Transplantation

Background: Hematopoietic stem cell transplantation (HSCT) is an established treatment for severe disorders of the pediatric hematopoietic system. However, there is a need for supportive interventions due to physiological and psychological strain. Music therapy is used in health care to help patients through difficult experiences and enable well-being. Our previous randomized studies showed significantly reduced heart rates four to eight hours after intervention as well as increased health-related quality of life. Methods: The aim of this qualitative study was to explore the participants’ and parents’ own experiences of the interactive processes during the music therapy intervention. Six families were included. The data collection used collaborative research interviews. An independent psychologist facilitated the interviews with the children, the parents, and the music therapist and also performed the analysis. Results: Three main themes emerged: experiences of competency and recognition of self, interactive affect regulation as change potential, and importance of the therapeutic relationship. Conclusions: For the participants, music therapy developed into a significant and helpful experience, an important ingredient in coping with and managing the treatment period at the hospital.

Analyzing the Impact of Soft, Stimulating and Depressing Songs on Attention Among Undergraduate Students: A Cross-Sectional Pilot Study in Bangladesh

Music is strongly linked to attention and giving attention can boost intelligence. The purpose of this study was to scrutinize the impact of soft, stimulating, and depressing songs on the attention of students. The study was performed on 280 undergraduate students. Students were divided into 4 groups (i.e., control, soft, stimulating, and depressing) and subjected to 3 songs, soft (That’s My Name), stimulating (Rain Over Me) and depressing (Broken Angel) songs. The Uddin’s Numeral Finding (NF) and Typo Revealing (TR) tests were used to analyze the attention of the students. In the NF, 75.54% attention was exerted by students subjected to stimulating song followed by soft song’s group (i.e., 74.32%) with respect to control group. Amid all groups, the lowest percentage, 70.77% of attention was reported for students subjected to the depressing song. For TR test, stimulating song’s group exerted highest, 45.97% attention, soft song’s group exerted 45.27%, control group exerted 42.70%, and lowest (i.e., 41.54%) attention was exerted by depressing song’s group. In NF test, concerning sex, amid male and female, male exerted higher (77.04%) attention than female but for TR test female exerted higher (i.e., 48.15%) attention for students subjected to stimulating song. Regarding the age of the study in case of NF test for stimulating song’s group, 18–20 years age students exerted highest, 82.07% attention but for TR test highest, 48.75% attention was reported for 23–25 years age students. For NF test, regarding the age of the study 1st-year student exerted highest, 92.44% attention but for TR test highest, 57.33% attention was reported for 3rd-year students for stimulating song’s group. Concerning residential status in both NF and TR tests, for students lived with family subjected to stimulating song exerted highest, 77.93% and 48.6% attention, respectively with respect to students lived without family and remaining groups. This study suggested that song influences the neuronal circuits linked to alert and cognitive functions and the stimulating song has the acme power of increasing attention while depressing song reduces the attention. Therefore, the exciting song can be an operative intervention for enhancing attention, cognitive functions, and treatment of associated neuropsychological disorders.

A randomized controlled trial of bedtime music for insomnia disorder

Music is often used as a self-help tool to alleviate insomnia. To evaluate the effect of bedtime music listening as a strategy for improving insomnia, we conducted an assessor-blinded randomized controlled trial. Fifty-seven persons with insomnia disorder were included and randomized to music intervention (n = 19), audiobook control (n = 19) or a waitlist control group (n = 19). The primary outcome measure was the Insomnia Severity Index. In addition, we used polysomnography and actigraphy to evaluate objective measures of sleep, and assessed sleep quality and quality of life. The results showed no clear effect of music on insomnia symptoms as the group × time interaction only approached significance (effect size = 0.71, p = .06), though there was a significant improvement in insomnia severity within the music group. With regard to the secondary outcomes, we found a significant effect of the music intervention on perceived sleep improvement and quality of life, but no changes in the objective measures of sleep. In conclusion, music listening at bedtime appears to have a positive impact on sleep perception and quality of life, but no clear effect on insomnia severity. Music is safe and easy to administer, but further research is needed to assess the effect of music on different insomnia subtypes, and as an adjunctive or preventive intervention.

Psychological and Psychophysiological Effects of Recuperative Music Postexercise

PURPOSE

Few studies have examined the psychological and psychophysiological effects of recuperative music after exhaustive exercise. The main purpose of the present study was to examine the effects of two music conditions compared with a no-music control on psychological and psychophysiological recovery processes after exercise.

METHODS

A randomized, fully counterbalanced, crossover design was used. Core affect, salivary cortisol, heart rate, and blood pressure were measured before exhaustive exercise, immediately after, and in 10-, 20-, and 30-min intervals during passive recovery (21 women and 21 men; 20.9 ± 1.7 yr) over three separate trials (slow, sedative music; fast, stimulative music; no-music control). The exercise task entailed incremental cycle ergometry performed at 75 rpm with an increase in intensity of 22.5 W·min at the end of each minute until exhaustion. Data were analyzed using mixed-model 3 (condition) × 4 (time) × 2 (gender) MANOVA/ANCOVA.

RESULTS

The largest decline in affective arousal between active and passive recovery phases was evident in the slow, sedative condition (ηp = 0.50). Women had a more pronounced reduction in arousal than did men in the slow, sedative music condition. Heart rate measures showed that fast, stimulative music inhibited the return of heart rate toward resting levels (ηp = 0.06). Similarly, salivary cortisol levels tended to be lower in response to slow, sedative music (ηp = 0.11). There was a main effect of condition for affective valence indicating that the slow, sedative condition elicited more positive affective responses compared with the control and fast, stimulative conditions (ηp = 0.12).

CONCLUSIONS

The present findings support the notion that slow, sedative music can expedite the recovery process immediately after strenuous exercise.

Music Listening and Stress in Daily Life-a Matter of Timing

Purpose

Despite increasing evidence suggesting that music listening in daily life has stress-reducing effects, studies mostly rely on subjective, retrospective data on music listening. Thus, the temporal dynamics underlying the stress-reducing effect of music listening remain unclear. Therefore, we aimed to examine the temporal dynamics of the associations between stress and music listening by assessing subjective and objective data on music in daily life.

Design

An exploratory Ambulatory Assessment study examining a total of 60 participants (37 women), aged 18 to 34 years (M = 22.4 years, SD = 3.5) was conducted.

Methods

For 1 week, participants answered questions on music listening and stress six times per day via an electronic diary device, which additionally objectively sampled the exact time point of music listening and its duration.

Results

Self-reports on mere music listening were associated with lower stress reports, whereas objectively assessed data was not. However, concerning duration of music listening, both subjective and objective data on music listening showed associations between a minimum of 20 min of music listening and lower stress reports. Concerning the latency, objective data on music listening revealed that the association between stress reports and music listening occurs in a time-delayed manner.

Conclusions

Although the study design does not allow for causal inferences, substantial associations among subjectively and objectively assessed data on music listening were found to differentially affect the experience of stress after music listening. In particular, when focusing on the temporal dynamics, objectively assessed data allowed for a more fine-grained analysis. In consequence, subjectively and objectively reported data on music listening should be assessed jointly when investigating effects of music listening on health. Experimental research with rigorous methodological control is required in order to corroborate our findings in a laboratory setting.

Effects of group singing versus group music listening on hospitalized children and adolescents with mental disorders: A pilot study

Background

There is an emerging view that music-related interventions (MuRI) may play an important role for youth with mental disorders. Here, we assessed the potential neuroendocrine (cortisol), immune (IgA) and psychological (mood state, health-related quality of life (HRQOL), well-being) efficacy of a brief program of MuRI (group singing versus group music listening) in children and adolescents with mental disorders in a clinical setting.

Methods

We performed this observational pilot study with 17 patients (aged 11-18; 11 female) admitted to the Department for Child and Adolescent Psychiatry/PMU Salzburg, Austria between March 2015 and April 2016. Patients participated in either a singing program or a music listening program, delivered through five daily, consecutive 45-minute sessions in one week.

Outcomes

Saliva samples for cortisol and IgA, and subjective measures of mood were taken daily, pre- and post-MuRI. HRQOL and well-being were measured pre- and post-5-day-program of MuRI. The program in singing led to a significantly larger mean drop in cortisol than in music listening (mean difference: -0·32; 95% CI -0·57 to -0·07), while listening led to a significantly higher mean positive change in the dimension calmness (mean difference: -2·66, 95%CI -4·99 to -0·33) than singing. Moreover, singing was associated with an improvement in HRQOL, and listening with an improvement in well-being.

Interpretation

Our preliminary findings suggest that MuRI may provide benefits for children and adolescents with mental disorders. The differences in psychobiological responses to singing and music listening invite further investigations. A larger, suitably powered study is now needed to provide a precise estimate of the effects of MuRI for mental health promotion, both on psychological and biological experiences. Funding: Salzburg Festival, Austria, and Focus Area 'Science and Art', Salzburg, Austria.

A systematic review of the use of music interventions to improve outcomes for patients undergoing hip or knee surgery

AIM

To examine the effectiveness of music as an adjunct treatment for pain, anxiety, and/or postoperative delirium, for patients undergoing hip or knee surgery.

BACKGROUND

Patients undergoing hip or knee surgery are known to experience pain and anxiety before and after surgery and be prone to postoperative delirium.

DESIGN

Quantitative systematic review.

DATA SOURCES

CENTRAL, Embase, Ovid MEDLINE, CINAHL, and PsycINFO databases were systematically searched without time limits (to June 2018).

REVIEW METHODS

A systematic search yielded 10 randomized controlled trials and quasi-experimental designs. Studies were appraised using the Cochrane Risk of Bias Tool. Data were extracted using the Effective Practice and Organization of Care data extraction tool.

RESULTS

Mixed results were found for the effect of music on anxiety, pain, and postoperative delirium in patients undergoing hip or knee surgery. Six of 10 included studies provided evidence that music can improve anxiety, pain, or postoperative delirium outcomes for patients undergoing hip or knee surgery. Music effectively reduced anxiety in one of three studies. Three of seven studies reported benefits of music for reducing postoperative pain. Positive effects of music on postoperative delirium were reported in all three studies that evaluated this outcome. Within group improvements were observed in many of the studies.

CONCLUSION

Music has the potential to improve outcomes of anxiety, pain, and postoperative delirium, for patients undergoing hip or knee surgery. The low number of studies found indicates results should be treated with caution. Further studies are required to provide strong evidence generalizable to a broader population.

The music that helps people sleep and the reasons they believe it works: A mixed methods analysis of online survey reports

Sleep loss is a widespread problem with serious physical and economic consequences. Music can impact upon physical, psychological and emotional states, which may explain anecdotal reports of its success as an everyday sleep aid. However, there is a lack of systematic data on how widely it is used, why people opt for music as a sleep aid, or what music works; hence the underlying drivers to music-sleep effects remain unclear. We investigated music as a sleep aid within the general public via a mixed methods data online survey (n = 651) that scored musicality, sleep habits, and open text responses on what music helps sleep and why. In total, 62% of respondents stated that they used music to help them sleep. They reported fourteen musical genres comprising 545 artists. Linear modelling found stress, age, and music use as significant predictors of sleep quality (PSQI) scores. Regression tree modelling revealed that younger people with higher musical engagement were significantly more likely to use music to aid sleep. Thematic analysis of the open text responses generated four themes that described why people believe music helps sleep: music offers unique properties that stimulate sleep (Provide), music is part of a normal sleep routine (Habit), music induces a physical or mental state conducive to sleep (State), and music blocks an internal or external stimulus that would otherwise disrupt sleep (Distract). This survey provides new evidence into the relationship between music and sleep in a population that ranged widely in age, musicality, sleep habits and stress levels. In particular, the results highlight the varied pathways of effect between music and sleep. Diversity was observed both in music choices, which reflected idiosyncratic preferences rather than any consistent musical structure, and in the reasons why music supports good sleep, which went far beyond simple physical/mental relaxation.

Exposure to a musically-enriched environment; Its relationship with executive functions, short-term memory and verbal IQ in primary school children

BACKGROUND

Previous literature has shown a putative relationship between playing a musical instrument and a benefit in various cognitive domains. However, to date it still remains unknown whether the exposure to a musically-enriched environment instead of playing an instrument yourself might also increase cognitive domains such as language, mathematics or executive sub-functions such as for example planning or working memory in primary school children.

DESIGN

Cross-sectional.

METHOD

Exposure to a musically-enriched environment like listening to music at home, during play or when attending concerts was assessed using a comprehensive intake questionnaire administered to a sample of 176 primary school children. Furthermore, participants completed the verbal intelligence section of the Wechsler Intelligence Scale (WISC III), performed executive sub-function tasks such as planning (Tower of London), working memory (Klingberg Matrix backward span) and inhibition (Go/no-Go task), and a short-term memory task (Klingberg Matrix forward span).

RESULTS

Linear and multiple regression analyses showed no significant relationship between exposure to a musically-enriched environment, executive sub-functions (planning, inhibition and working memory), and short-term memory. The relationship between an enriched musical environment and verbal IQ has revealed trends.

DISCUSSION

Experiencing a musically enriched environment does not serve as predictor for higher performance on executive sub-functions, however, can influence verbal IQ.

Serotonin 2A Receptor Signaling Underlies LSD-induced Alteration of the Neural Response to Dynamic Changes in Music

Classic psychedelic drugs (serotonin 2A, or 5HT2A, receptor agonists) have notable effects on music listening. In the current report, blood oxygen level-dependent (BOLD) signal was collected during music listening in 25 healthy adults after administration of placebo, lysergic acid diethylamide (LSD), and LSD pretreated with the 5HT2A antagonist ketanserin, to investigate the role of 5HT2A receptor signaling in the neural response to the time-varying tonal structure of music. Tonality-tracking analysis of BOLD data revealed that 5HT2A receptor signaling alters the neural response to music in brain regions supporting basic and higher-level musical and auditory processing, and areas involved in memory, emotion, and self-referential processing. This suggests a critical role of 5HT2A receptor signaling in supporting the neural tracking of dynamic tonal structure in music, as well as in supporting the associated increases in emotionality, connectedness, and meaningfulness in response to music that are commonly observed after the administration of LSD and other psychedelics. Together, these findings inform the neuropsychopharmacology of music perception and cognition, meaningful music listening experiences, and altered perception of music during psychedelic experiences.

Hearing Loss, Tinnitus, Hyperacusis, and Diplacusis in Professional Musicians: A Systematic Review

Professional musicians (PMs) are at high risk of developing hearing loss (HL) and other audiological symptoms such as tinnitus, hyperacusis, and diplacusis. The aim of this systematic review is to (A) assess the risk of developing HL and audiological symptoms in PMs and (B) evaluate if different music genres (Pop/Rock Music—PR; Classical Music—CL) expose PMs to different levels of risk of developing such conditions. Forty-one articles including 4618 PMs were included in the study. HL was found in 38.6% PMs; prevalence was significantly higher among PR (63.5%) than CL (32.8%) PMs; HL mainly affected the high frequencies in the 3000-6000 Hz range and was symmetric in 68% PR PMs and in 44.5% CL PMs. Tinnitus was the most common audiological symptom, followed by hyperacusis and diplacusis. Tinnitus was almost equally distributed between PR and CL PMs; diplacusis was more common in CL than in PR PMs, while prevalence of hyperacusis was higher among PR PMs. Our review showed that PR musicians have a higher risk of developing HL compared to CL PMs; exposure to sounds of high frequency and intensity and absence of ear protection may justify these results. Difference in HL symmetry could be explained by the type of instruments used and consequent single-sided exposure.

Effects of music intervention on inflammatory markers in critically ill and post-operative patients: A systematic review of the literature

BACKGROUND

Music listening has been shown to reduce anxiety, stress, and patient tolerance of procedures. Music may also have beneficial effects on inflammatory biomarkers in intensive care and post-operative patients, but the quality of evidence is not clear.

OBJECTIVES

We conducted a systematic review to evaluate the effects of music on inflammatory biomarkers in intensive care, and post-operative patients.

METHODS

A comprehensive search of the literature was performed. After screening 1570 references, full text review of 26 studies was performed. Fourteen studies were selected for inclusion.

RESULTS

Seven studies showed a significant decrease in cortisol levels, but the level of evidence was low. Three studies had low risk of methodological bias, while 11 studies had high risk of bias.

CONCLUSIONS

Music intervention may decrease cortisol levels, but other biomarkers remain unchanged. Given the low level of evidence, further research on music effects on inflammatory biomarkers is needed.

Music Therapy Reduces Radiotherapy-Induced Fatigue in Patients With Breast or Gynecological Cancer: A Randomized Trial

PURPOSE

To investigate the influence of music therapy on the reduction of fatigue in women with breast or gynecological malignant neoplasia during radiotherapy, since it is one of the most frequent side effects of this type of treatment, and may interfere with self-esteem, social activities, and quality of life.

EXPERIMENTAL DESIGN

Randomized controlled trial (control group [CG] and music therapy group [MTG]) to assess fatigue, quality of life, and symptoms of depression in women undergoing radiotherapy using the Functional Assessment of Cancer Therapy: Fatigue (FACT-F) version 4, Functional Assessment of Cancer Therapy-General (FACT-G) version 4, and Beck Depression Inventory in 3 separate times, namely, during the first week of radiotherapy, on the week of the intermediary phase, and during the last week of radiotherapy. Individual 30- to 40-minute sessions of music therapy with the presence of a trained music therapist were offered to participants.

RESULTS

In this study, 164 women were randomized and 116 (63 CG and 53 MTG) were included in the analyses, with mean age of 52.90 years (CG) and 51.85 years (MTG). Participants in the MTG had an average of 10 music therapy sessions, totaling 509 sessions throughout the study. FACT-F results were significant regarding Trial Outcome Index ( P = .011), FACT-G ( P = .005), and FACT-F ( P = .001) for the MTG compared with the CG.

CONCLUSIONS

Individual music therapy sessions may be effective to reduce fatigue related to cancer and symptoms of depression, as well as to improve quality of life for women with breast or gynecological cancer undergoing radiotherapy. Further well-designed research studies are needed to adequately determine the effects of music therapy on fatigue.

Validation of the German Version of the Music-Empathizing-Music-Systemizing (MEMS) Inventory (Short Version)

Background: Kreutz et al. (2008) developed the Music-Empathizing-Music-Systemizing (ME-MS) Inventory to extend Baron-Cohen's cognitive style theory to the domain of music. We sought to confirm the ME-MS construct in a German sample and to explore these individual differences in relation to music preferences.

Methods: The German adaptation of the MEMS Inventory was achieved by forward and backward translation. A total of 1014 participants (532 male, age: 33.79 ± 11.89 years) completed the 18-item short version of the MEMS Inventory online. Confirmatory factor analysis (CFA) was performed and cut-off values were established to identify individuals who could be classified as ME, Balanced, or MS. Statistical analyses were used to examine differences in music preference based on music-related cognitive styles.

Results: Confirmatory factor analysis (CFA) confirmed two factors, ME and MS, with sufficiently good fit (CFI = 0.87; GFI = 0.93) and adequate internal consistency (Cronbach's Alpha ME: 0.753, MS: 0.783). Analyses of difference scores allowed for a classification as either ME, Balanced, or MS. ME and MS differed in sociodemographic variables, preferred music genres, preferred reasons for music listening, musical expertise, situations in which music is listened to in daily life, and frequency of music-induced chills.

Discussion: The German short version of the MEMS Inventory shows good psychometric properties. Based on the cut-off values, differences in music preference were found. Consequently, ME and MS use music in different ways, and the cognitive style of music listening thus appears to be an important moderator in research on the psychology of music. Future research should identify behavioral and neurophysiological correlates and investigate mechanisms underlying music processing based on these different cognitive styles of music listening.

Psychedelics and music: neuroscience and therapeutic implications

From the beginning of therapeutic research with psychedelics, music listening has been consistently used as a method to guide or support therapeutic experiences during the acute effects of psychedelic drugs. Recent findings point to the potential of music to support meaning-making, emotionality, and mental imagery after the administration of psychedelics, and suggest that music plays an important role in facilitating positive clinical outcomes of psychedelic therapy. This review explores the history of, contemporary research on, and future directions regarding the use of music in psychedelic research and therapy, and argues for more detailed and rigorous investigation of the contribution of music to the treatment of psychiatric disorders within the novel framework of psychedelic therapy.

Music therapy versus treatment as usual for refugees diagnosed with posttraumatic stress disorder (PTSD): study protocol for a randomized controlled trial

BACKGROUND

Meta-analyses of studies on psychological treatment of refugees describe highly varying outcomes, and research on multi-facetted and personalized treatment of refugees with post-traumatic stress disorder (PTSD) is needed. Music therapy has been found to affect arousal regulation and emotional processing, and a pilot study on the music therapy method Trauma-focused Music and Imagery (TMI) with traumatized refugees resulted in significant changes of trauma symptoms, well-being and sleep quality. The aim of the trial is to test the efficacy of TMI compared to verbal psychotherapy.

METHODS

A randomized controlled study with a non-inferiority design is carried out in three locations of a regional outpatient psychiatric clinic for refugees. Seventy Arabic-, English- or Danish-speaking adult refugees (aged 18-67 years) diagnosed with PTSD are randomized to 16 sessions of either music therapy or verbal therapy (standard treatment). All participants are offered medical treatment, psychoeducation by nurses, physiotherapy or body therapy and social counseling as needed. Outcome measures are performed at baseline, post therapy and at 6 months' follow-up. A blind assessor measures outcomes post treatment and at follow-up. Questionnaires measuring trauma symptoms (HTQ), quality of life (WHO-5), dissociative symptoms (SDQ-20, DSS-20) and adult attachment (RAAS) are applied, as well as physiological measures (salivary oxytocin, beta-endorphin and substance P) and participant evaluation of each session.

DISCUSSION

The effect of music therapy can be explained by theories on affect regulation and social engagement, and the impact of music on brain regions affected by PTSD. The study will shed light on the role of therapy for the attainment of a safe attachment style, which recently has been shown to be impaired in traumatized refugees. The inclusion of music and imagery in the treatment of traumatized refugees hopefully will inform the choice of treatment method and expand the possibilities for improving refugee health and integration.

TRIAL REGISTRATION

ClinicalTrials.gov ID number NCT03574228, registered retrospectively on 28 June 2016.

Music and the Meeting of Human Minds

Over tens of thousands of years of human genetic and cultural evolution, many types and varieties of music and language have emerged; however, the fundamental components of each of these modes of communication seem to be common to all human cultures and social groups. In this brief review, rather than focusing on the development of different musical techniques and practices over time, the main issues addressed here concern: (i) when, and speculations as to why, modern Homo sapiens evolved musical behaviors, (ii) the evolutionary relationship between music and language, and (iii) why humans, perhaps unique among all living species, universally continue to possess two complementary but distinct communication streams. Did music exist before language, or vice versa, or was there a common precursor that in some way separated into two distinct yet still overlapping systems when cognitively modern H. sapiens evolved? A number of theories put forward to explain the origin and persistent universality of music are considered, but emphasis is given, supported by recent neuroimaging, physiological, and psychological findings, to the role that music can play in promoting trust, altruistic behavior, social bonding, and cooperation within groups of culturally compatible but not necessarily genetically related humans. It is argued that, early in our history, the unique socializing and harmonizing power of music acted as an essential counterweight to the new and evolving sense of self, to an emerging sense of individuality and mortality that was linked to the development of an advanced cognitive capacity and articulate language capability.

Music intervention to prevent delirium among older patients admitted to a trauma intensive care unit and a trauma orthopaedic unit

PURPOSE

Evaluate music listening for delirium prevention among patients admitted to a Trauma Intensive Care and Trauma Orthopaedic Unit. The Roy Adaptation Model provided the theoretical framework focusing on modifying contextual stimuli.

METHODS

Randomised controlled trial, 40 patients aged 55 and older.

INTERVENTION

Participants randomly assigned to receive music listening or usual care for 60 minutes, twice a day, over three days. Pre-recorded self-selected music using an iPod and headsets, with slow tempo, low pitch and simple repetitive rhythms to alter physiologic responses.

OUTCOMES

Heart rate, respiratory rate, systolic and diastolic blood pressure, confusion assessment method.

RESULTS

Repeated measures ANOVA, F(4, 134) = 4.75, p = .001, suggested statistically significant differences in heart rate pre/post music listening, and F(1, 37) = 10.44, p = .003 in systolic blood pressure pre/post music listening. Post-hoc analysis reported changes at three time periods of statistical significance; (p = .010), (p = .005) and (p = .039) and a change in systolic blood pressure pre/post music listening; (p = .001) of statistical significance. All participants screened negative for delirium.

CONCLUSION

Music addresses pathophysiologic mechanisms that contribute to delirium; neurotransmitter imbalance, inflammation and acute physiologic stressors. Music to prevent delirium is one of few that provide support in a critical care setting.

Pilot randomized controlled trial of Tuning Relationships with Music: Intervention for parents with a trauma history and their adolescent

For parents who have experienced childhood interpersonal trauma, the challenges of parenting an adolescent may trigger memories of abuse, intensifying conflict, resulting in negative cycles of relating and poorer responsiveness to emotions when parenting. This study examined whether Tuning Relationships with Music, a dyadic therapy for parents and adolescents, increased responsive parent-adolescent interactions and parent emotion coaching whilst reducing conflict and adolescent mental health difficulties. Twenty-six parent-adolescent dyads were recruited if parents had a trauma history and the dyad were currently having high levels of conflict. Dyads were randomly allocated into intervention or wait-list control and completed questionnaires and observation assessments at baseline and 4-month post-baseline follow-up. Those allocated to the intervention condition participated in 8 sessions of Tuning Relationships with Music.

TRIAL REGISTRATION

ANZCTR: 12615000814572. Parents and adolescents reported significant reductions in conflict. Parents in the intervention condition were observed to significantly improve their nonverbal communication, emotional responsiveness and non-reactivity toward their adolescent. Although parents reported they were less dismissive and punitive, and more encouraging of their adolescent's emotions, and both parents and adolescents reported improvements in the adolescent's mental health, these were not statistically significant. Findings suggest Tuning Relationships with Music may assist parents with a history of childhood interpersonal trauma and their adolescent to reduce conflict and increase responsive ways of relating that may positively impact the young person's mental health. Future trials with a larger sample are warranted.

The biological impact of listening to music in clinical and nonclinical settings: A systematic review

This systematic review explored the evidence base on the impact of listening to music on biological response in both clinical and nonclinical settings. Human studies exploring the effects of listening to recorded music on biological markers were included. Studies had to involve a non-music control condition. Keyword searches were carried out of five major databases (Cochrane/Wiley, PsycINFO, PubMed, Sage, and Science Direct) and bias was assessed using the Cochrane Risk of Bias Tool for Randomized Studies (RoB 2.0). Forty-four studies assessing the biological impact of music listening were identified: 27 in clinical settings and 17 in nonclinical settings. Eighty-two percent had examined the effects of short-term listening interventions, while the remainder had looked at longitudinal interventions. Thirteen of 33 biomarkers tested were reported to change in response to listening to music. The most commonly analyzed biomarker was the stress hormone cortisol, with half of clinical studies demonstrating a stress-reducing effect of music listening. Blood glucose was also found repeatedly to reduce in response to music listening. Many of the other biomarkers analyzed are also part of biological stress pathways, which suggests that the primary way by which music listening affects us biologically is via modulations of stress response. Effects were shown irrespective of genre, self-selection of the music, or duration of listening, although a majority did use classical music. The evidence base for understanding biological responses to music is still developing, but there is support for the application of listening to music, especially within clinical settings for stress reduction.

Mobile Software as a Medical Device (SaMD) for the Treatment of Epilepsy: Development of Digital Therapeutics Comprising Behavioral and Music-Based Interventions for Neurological Disorders

Digital health technologies for people with epilepsy (PWE) include internet-based resources and mobile apps for seizure management. Since non-pharmacological interventions, such as listening to specific Mozart's compositions, cognitive therapy, psychosocial and educational interventions were shown to reduce epileptic seizures, these modalities can be integrated into mobile software and delivered by mobile medical apps as digital therapeutics. Herein, we describe: (1) a survey study among PWE about preferences to use mobile software for seizure control, (2) a rationale for developing digital therapies for epilepsy, (3) creation of proof-of-concept mobile software intended for use as an adjunct digital therapeutic to reduce seizures, and (4) broader applications of digital therapeutics for the treatment of epilepsy and other chronic disorders. A questionnaire was used to survey PWE with respect to preferred features in a mobile app for seizure control. Results from the survey suggested that over 90% of responders would be interested in using a mobile app to manage their seizures, while 75% were interested in listening to specific music that can reduce seizures. To define digital therapeutic for the treatment of epilepsy, we designed and created a proof-of-concept mobile software providing digital content intended to reduce seizures. The rationale for all components of such digital therapeutic is described. The resulting web-based app delivered a combination of epilepsy self-care, behavioral interventions, medication reminders and the antiseizure music, such as the Mozart's sonata K.448. To improve long-term patient engagement, integration of mobile medical app with music and multimedia streaming via smartphones, tablets and computers is also discussed. This work aims toward development and regulatory clearance of software as medical device (SaMD) for seizure control, yielding the adjunct digital therapeutic for epilepsy, and subsequently a drug-device combination product together with specific antiseizure medications. Mobile medical apps, music, therapeutic video games and their combinations with prescription medications present new opportunities to integrate pharmacological and non-pharmacological interventions for PWE, as well as those living with other chronic disorders, including depression and pain.

Increased Engagement With Life: Differences in the Cognitive, Physical, Social, and Spiritual Activities of Older Adult Music Listeners

Purpose of the Study

Clinical studies have demonstrated the health benefits of music listening, especially among older adults; however, this connection has not yet been examined in a nationally representative population based sample. The purpose of this study was to measure the connections between health, listening to music, and engagement with life activities among older Americans.

Design and Methods

We used data on 5,797 participants in both the 2012 Health and Retirement Study and 2013 Consumption and Activities Mail Survey. Participants reported their lifetime prevalence of health conditions, number of hours spent per week listening to music, as well as various cognitive, physical, social, and spiritual activities. We categorized participants as non-listeners (those reporting zero hours of music listening), average listeners (between >0 and 28.5 hr), and high listeners (>28.6 hr) and assessed associations between these music listening categories and life activities and the prevalence of health conditions.

Results

Approximately 20% of the older Americans were non-listeners, a majority (75%) reported average amounts, and 5% reported high levels of music listening. Older Americans who were average or high music listeners reported a greater number of hours engaged in several cognitive, physical, social, and spiritual activities each week. Music listeners additionally reported fewer problematic health conditions than non-listeners.

Implications

Listening to music relates to increased life engagement and better health among older Americans. Given the wide-spread availability of music-based interventions for diverse populations, future studies may investigate the beneficial use of music as a public health initiative for older adults.

Infants born preterm, stress, and neurodevelopment in the neonatal intensive care unit: might music have an impact?

AIM

The neonatal intensive care unit (NICU) provides life-saving medical care for an increasing number of newborn infants each year. NICU care, while lifesaving, does have attendant consequences which can include repeated activation of the stress response and reduced maternal interaction, with possible negative long-term impacts on brain development. Here we present a neuroscientific framework for considering the impact of music on neurodevelopment in the NICU of infants born preterm and evaluate current literature on the use of music with this population to determine what is most reliably known of the physiological effects of music interventions.

METHOD

Using online academic databases we collected relevant, experimental studies aimed at determining effects of music listening in infants in the NICU. These articles were evaluated for methodological rigor, ranking the 10 most experimentally stringent as a representative sample.

RESULTS

The selected literature seems to indicate that effects are present on the cardio-pulmonary system and behavior of neonates, although the relative effect size remains unclear.

INTERPRETATION

These findings indicate a need for more standardized longitudinal studies aimed at determining not only whether NICU music exposure has beneficial effects on the cardio-pulmonary system, but also on the hypothalamic-pituitary-adrenal axis, brain structures, and cognitive behavioral status of these children as well.

WHAT THIS PAPER ADDS

Provides a neuroscience framework for considering how music might attenuate stress in neonatal intensive care unit (NICU) infants. Considers how repeated stress may cause negative neurodevelopmental impacts in infants born preterm. Posits epigenetics can serve as a mechanistic pathway for music moderating the stress response.

Does Music Matter? A Look at the Issues and the Evidence

Does music matter? Judging from the ever-diminishing support for music education in public funding, the message is that it is just a frill to be cast aside for more pressing needs. The pleasure of listening to music is worthy in itself and reason enough for support, but what happens when people are more deeply engaged, such as when they learn to read music and play an instrument? Can more material rewards follow for cognition, language, and emotion, and for social and physical well-being? This essay presents an overview of issues and evidence from a broad range of disciplines and age groups.

Assessing a cognitive music training for older participants: a randomised controlled trial

OBJECTIVES

In a randomised controlled trial, we investigated whether a cognitive training based on rhythm-music and music improvisation exercises had positive effects on executive functions in older participants.

METHODS

Thirty-five residents in a guest home with mild-moderate cognitive impairment and healthy ageing were randomly assigned to an experimental group (n = 18) featuring cognitive music training composed of 12 bi-weekly 70-min sessions, and a control group (n = 17) attended 12 bi-weekly 45-min sessions of gymnastic activities offered by the institute. A neuropsychological test battery was administered at baseline and at the end of treatment, including the Mini-Mental State Examination, verbal fluency test, Trail Making Test A, attentional matrices test and clock-drawing test.

RESULTS

Pre-test and post-test comparison showed a significant improvement for the experimental group reflected in the Mini-Mental State Examination (F(1,33) = 13.906; p < 0.001; pη²  = 0.296), verbal fluency test (VFL) (F(1,33) = 6.816; p < 0.013; pη²  = 0.171), and clock-drawing test (F(1,29) = 16.744; p < 0.001; pη²  = 0.366), while the control group did not show any significant improvements. In addition, there was a tendency towards significance for the Trail Making Test A (F(1,20) = 3.268; p < 0.086; pη²  = 0.140). Regarding the attentional matrices test, no significant differences were found for the experimental group (F(1,29) = 2.833; p < 0.103; pη²  = 0.089), while the control group had a significant performance reduction (F(1,29) = 3.947; p < 0.050; pη²  = 0.120).

CONCLUSION

The use of a cognitive protocol based on music-rhythmic exercises and music improvisation exercises is associated with improved cognitive functions in older people with mild-moderate cognitive impairment regardless of the individual's degree of cognitive reserve. Copyright © 2017 John Wiley & Sons, Ltd.

Potential Cognitive Benefits From Playing Music Among Cognitively Intact Older Adults: A Scoping Review

The aging population is growing rapidly, raising rates of cognitive impairment, which makes strategies for protection against cognitive impairment increasingly important. There is little evidence indicating highly effective interventions preventing or slowing onset of cognitive impairment. Music playing influences brain and cognitive function, activating multiple brain areas and using cognitive and motor functions as well as multiple sensory systems, simultaneously. The purpose of this study was to review the current evidence related to playing a musical instrument being a potentially protective mechanism against cognitive decline among older adults. Using scoping review procedures, four databases were searched. Paired reviewers analyzed articles for content, design, and bias. Eleven studies met study criteria and were included in the review. All studies showed that music playing was correlated with positive outcomes on cognitive ability; more high-quality research is needed in this area to understand mechanisms behind potential cognitive protection of music.