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Trimble MR, Hesdorffer D, Hećimović H, Osborne N. Personalised music as a treatment for epilepsy. Epilepsy Behav 2024; 156:109829. [PMID: 38761451 DOI: 10.1016/j.yebeh.2024.109829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Revised: 04/29/2024] [Accepted: 05/06/2024] [Indexed: 05/20/2024]
Abstract
In this paper we look at non-pharmaceutical treatments for intractable epilepsy based on neurophysiological methods especially with EEG analysis. In summary, there are a number of limbic and thalamo-cortical related structures involved in the processing of musical emotion (exposure), including the amygdala (arousal, expression of mood, fear), hippocampus (memory, regulation of HPA axis, stress), parahippocampal gyrus (recognition, memory retrieval), insula (valence), temporal poles (connectivity), ventral striatum (expectation and experience of reward), orbitofrontal cortex (valence) and cingulate cortex (autonomic regulation). One method is to audify (a form of sonification) EEG activity to find music by feedback to entrain abnormal EEG activity. We discuss various methods and our use of X-System (https://www.x-system.co.uk/) which is a computational model of the musical brain capable of predicting the neurophysiological effects of music. It models structures and pathways related to responses to music, including the cochlea, brain stem, auditory and motor cortex, as well as basal ganglia, cerebellum and limbic structures. It can predict autonomic and endocrine activity as well as the substrates of electrical activity to select music which can regularise EEG abnormalities to decrease epileptic activity and seizures, especially in those unresponsive to antiepileptic medication or invasive treatments.
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Affiliation(s)
- M R Trimble
- University College London, Institute for Neurology, London, UK.
| | - D Hesdorffer
- GH Sergievsky Center and Department of Epidemiology, Columbia University, New York, NY 10032, USA
| | - H Hećimović
- University North, Varaždin, Croatia; Neurocenter, Zagreb, Croatia
| | - N Osborne
- Reid School of Music, University of Edinburgh, Edinburgh, Scotland, UK
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Ding R, Tang H, Liu Y, Yin Y, Yan B, Jiang Y, Toussaint PJ, Xia Y, Evans AC, Zhou D, Hao X, Lu J, Yao D. Therapeutic effect of tempo in Mozart's "Sonata for two pianos" (K. 448) in patients with epilepsy: An electroencephalographic study. Epilepsy Behav 2023; 145:109323. [PMID: 37356223 DOI: 10.1016/j.yebeh.2023.109323] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 06/08/2023] [Accepted: 06/09/2023] [Indexed: 06/27/2023]
Abstract
BACKGROUND Mozart's "Sonata for two pianos" (Köchel listing 448) has proven effective as music therapy for patients with epilepsy, but little is understood about the mechanism of which feature in it impacted therapeutic effect. This study explored whether tempo in that piece is important for its therapeutic effect. METHODS We measured the effects of tempo in Mozart's sonata on clinical and electroencephalographic parameters of 147 patients with epilepsy who listened to the music at slow, original, or accelerated speed. As a control, patients listened to Haydn's Symphony no. 94 at original speed. RESULTS Listening to Mozart's piece at original speed significantly reduced the number of interictal epileptic discharges. It decreased beta power in the frontal, parietal, and occipital regions, suggesting increased auditory attention and reduced visual attention. It also decreased functional connectivity among frontal, parietal, temporal, and occipital brain regions, also suggesting increased auditory attention and reduced visual attention. No such effects were observed after patients listened to the slow or fast version of Mozart's piece, or to Haydn's symphony at normal speed. CONCLUSIONS These results suggest that Mozart's "Sonata for two pianos" may exert therapeutic effects by regulating attention when played at its original tempo, but not slower or faster. These findings may help guide the design and optimization of music therapy against epilepsy.
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Affiliation(s)
- Rui Ding
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, University of Electronic Science and Technology of China, Chengdu 611731, Sichuan, China; Center for Information in Medicine, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu 611731, Sichuan, China; Montreal Neurological Institute, McGill University, Montreal, QC, Canada, H3A 2B4.
| | - Huajuan Tang
- Department of Neurology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, China; Department of Neurology, 363 Hospital, Chengdu 610041, Sichuan, China.
| | - Ying Liu
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, University of Electronic Science and Technology of China, Chengdu 611731, Sichuan, China; Center for Information in Medicine, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu 611731, Sichuan, China.
| | - Yitian Yin
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, University of Electronic Science and Technology of China, Chengdu 611731, Sichuan, China; Center for Information in Medicine, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu 611731, Sichuan, China.
| | - Bo Yan
- Department of Neurology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, China.
| | - Yingqi Jiang
- Department of Neurology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, China.
| | - Paule-J Toussaint
- Montreal Neurological Institute, McGill University, Montreal, QC, Canada, H3A 2B4.
| | - Yang Xia
- Center for Information in Medicine, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu 611731, Sichuan, China.
| | - Alan C Evans
- Montreal Neurological Institute, McGill University, Montreal, QC, Canada, H3A 2B4.
| | - Dong Zhou
- Department of Neurology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, China.
| | - Xiaoting Hao
- Department of Neurology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, China.
| | - Jing Lu
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, University of Electronic Science and Technology of China, Chengdu 611731, Sichuan, China; Center for Information in Medicine, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu 611731, Sichuan, China.
| | - Dezhong Yao
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, University of Electronic Science and Technology of China, Chengdu 611731, Sichuan, China; Center for Information in Medicine, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu 611731, Sichuan, China.
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Wired for sound: The effect of sound on the epileptic brain. Seizure 2022; 102:22-31. [PMID: 36179456 DOI: 10.1016/j.seizure.2022.09.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 09/08/2022] [Accepted: 09/23/2022] [Indexed: 11/22/2022] Open
Abstract
Sound waves are all around us resonating at audible and inaudible frequencies. Our ability to hear is crucial in providing information and enabling interaction with our environment. The human brain generates neural oscillations or brainwaves through synchronised electrical impulses. In epilepsy these brainwaves can change and form rhythmic bursts of abnormal activity outwardly appearing as seizures. When two waveforms meet, they can superimpose onto one another forming constructive, destructive or mixed interference. The effects of audible soundwaves on epileptic brainwaves has been largely explored with music. The Mozart Sonata for Two Pianos in D major, K. 448 has been examined in a number of studies where significant clinical and methodological heterogeneity exists. These studies report variable reductions in seizures and interictal epileptiform discharges. Treatment effects of Mozart Piano Sonata in C Major, K.545 and other composer interventions have been examined with some musical exposures, for example Hayden's Symphony No. 94 appearing pro-epileptic. The underlying anti-epileptic mechanism of Mozart music is currently unknown, but interesting research is moving away from dopamine reward system theories to computational analysis of specific auditory parameters. In the last decade several studies have examined inaudible low intensity focused ultrasound as a neuro-modulatory intervention in focal epilepsy. Whilst acute and chronic epilepsy rodent model studies have consistently demonstrated an anti-epileptic treatment effect this is yet to be reported within large scale human trials. Inaudible infrasound is of concern since at present there are no reported studies on the effects of exposure to infrasound on epilepsy. Understanding the impact of infrasound on epilepsy is critical in an era where sustainable energies are likely to increase exposure.
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The Effect of Acute Aerobic Exercise with Music on Executive Function: The Major Role of Tempo Matching. PHYSICAL ACTIVITY AND HEALTH 2021. [DOI: 10.5334/paah.75] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Music processing deficits in Landau-Kleffner syndrome: Four case studies in adulthood. Cortex 2020; 129:99-111. [PMID: 32442777 DOI: 10.1016/j.cortex.2020.03.025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Revised: 12/23/2019] [Accepted: 03/05/2020] [Indexed: 11/20/2022]
Abstract
Verbal-auditory agnosia and aphasia are the most prominent symptoms in Landau-Kleffner syndrome (LKS), a childhood epilepsy that can have sustained long-term effects on language processing. The present study provides the first objective investigation of music perception skills in four adult patients with a diagnosis of LKS during childhood, covering the spectrum of severity of the syndrome from mild to severe. Pitch discrimination, short-term memory for melodic, rhythmic and verbal information, as well as emotion recognition in music and speech prosody were assessed with listening tests, and subjective attitude to music with a questionnaire. We observed amusia in 3 out of 4 patients, with elevated pitch discrimination thresholds and poor short-term memory for melody and rhythm. The two patients with the most severe LKS had impairments in music and prosody emotion recognition, but normal perception of emotional intensity of music. Overall, performance in music processing tasks was proportional to the severity of the syndrome. Nonetheless, the four patients reported that they enjoyed music, felt musical emotions, and used music in their daily life. These new data support the hypothesis that, beyond verbal impairments, cerebral networks involved in sound processing and encoding are deeply altered by the epileptic activity in LKS, well after electrophysiological normalization.
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Sesso G, Sicca F. Safe and sound: Meta-analyzing the Mozart effect on epilepsy. Clin Neurophysiol 2020; 131:1610-1620. [PMID: 32449680 DOI: 10.1016/j.clinph.2020.03.039] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Revised: 03/11/2020] [Accepted: 03/28/2020] [Indexed: 12/22/2022]
Abstract
OBJECTIVE The use of music-based neuro-stimulation for treating seizures and interictal epileptiform discharges (IED) (the so-called "Mozart effect") remains a controversial issue. We have conducted an updated meta-analysis in order to systematically review literature evidence and provide further insights about the role of the Mozart effect in epilepsy. METHODS Following the "Preferred Reporting Items for Systematic Reviews and Meta-Analyses" (PRISMA) guidelines, we searched three bibliographic databases from their date of inception to January 2020. Nine meta-analyses were performed according to both music stimulation protocols and outcome measures. We applied the Cochrane Q-test and the I2-index for heterogeneity evaluation, and either fixed-effect or random-effect models to compute mean differences and pool data. RESULTS Of 147 abstracts, 12 studies were included and grouped according to stimulation protocols and outcome measures. The nine meta-analyses showed significant reductions in seizures and IED frequencies after long-term music treatment, and in IED frequency during and after a single music stimulus. CONCLUSIONS Music-based neurostimulation may improve the clinical outcome of individuals with epilepsy, by reducing the frequency of seizures and IED. Further and stronger evidence will allow defining its potential in the different forms of epilepsy, and the most effective stimulation protocols. SIGNIFICANCE Music therapy should be considered as a complementary, non-invasive approach for treating epilepsy and epileptiform discharges.
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Affiliation(s)
- Gianluca Sesso
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Federico Sicca
- EPILAB - Epilepsy and Clinical Neurophysiology Laboratory, Department of Developmental Neuroscience, IRCCS Stella Maris Foundation, Pisa, Italy.
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Stegemann T, Geretsegger M, Phan Quoc E, Riedl H, Smetana M. Music Therapy and Other Music-Based Interventions in Pediatric Health Care: An Overview. MEDICINES 2019; 6:medicines6010025. [PMID: 30769834 PMCID: PMC6473587 DOI: 10.3390/medicines6010025] [Citation(s) in RCA: 63] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/30/2018] [Revised: 02/01/2019] [Accepted: 02/11/2019] [Indexed: 01/08/2023]
Abstract
Background: In pediatric health care, non-pharmacological interventions such as music therapy have promising potential to complement traditional medical treatment options in order to facilitate recovery and well-being. Music therapy and other music-based interventions are increasingly applied in the clinical treatment of children and adolescents in many countries world-wide. The purpose of this overview is to examine the evidence regarding the effectiveness of music therapy and other music-based interventions as applied in pediatric health care. Methods: Surveying recent literature and summarizing findings from systematic reviews, this overview covers selected fields of application in pediatric health care (autism spectrum disorder; disability; epilepsy; mental health; neonatal care; neurorehabilitation; pain, anxiety and stress in medical procedures; pediatric oncology and palliative care) and discusses the effectiveness of music interventions in these areas. Results: Findings show that there is a growing body of evidence regarding the beneficial effects of music therapy, music medicine, and other music-based interventions for children and adolescents, although more rigorous research is still needed. The highest quality of evidence for the positive effects of music therapy is available in the fields of autism spectrum disorder and neonatal care. Conclusions: Music therapy can be considered a safe and generally well-accepted intervention in pediatric health care to alleviate symptoms and improve quality of life. As an individualized intervention that is typically provided in a person-centered way, music therapy is usually easy to implement into clinical practices. However, it is important to note that to exploit the potential of music therapy in an optimal way, specialized academic and clinical training and careful selection of intervention techniques to fit the needs of the client are essential.
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Affiliation(s)
- Thomas Stegemann
- Department of Music Therapy, University of Music and Performing Arts Vienna, 1030 Vienna, Austria.
- WZMF-Music Therapy Research Centre Vienna, University of Music and Performing Arts Vienna, 1010 Vienna, Austria.
| | - Monika Geretsegger
- GAMUT-The Grieg Academy Music Therapy Research Centre, NORCE, 5008 Bergen, Norway.
| | - Eva Phan Quoc
- WZMF-Music Therapy Research Centre Vienna, University of Music and Performing Arts Vienna, 1010 Vienna, Austria.
| | - Hannah Riedl
- WZMF-Music Therapy Research Centre Vienna, University of Music and Performing Arts Vienna, 1010 Vienna, Austria.
| | - Monika Smetana
- Department of Music Therapy, University of Music and Performing Arts Vienna, 1030 Vienna, Austria.
- WZMF-Music Therapy Research Centre Vienna, University of Music and Performing Arts Vienna, 1010 Vienna, Austria.
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BOŞNAK MEHMET, KURT AKİFHAKAN, YAMAN SELMA. BEYNİMİZİN MÜZİK FİZYOLOJİSİ. KAHRAMANMARAŞ SÜTÇÜ İMAM ÜNIVERSITESI TIP FAKÜLTESI DERGISI 2017. [DOI: 10.17517/ksutfd.296621] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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Hegde S, Bharath RD, Rao MB, Shiva K, Arimappamagan A, Sinha S, Rajeswaran J, Satishchandra P. Preservation of cognitive and musical abilities of a musician following surgery for chronic drug-resistant temporal lobe epilepsy: a case report. Neurocase 2016; 22:512-517. [PMID: 27367173 DOI: 10.1080/13554794.2016.1198815] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Mesial temporal lobe epilepsy (TLE) affects a range of cognitive functions and musical abilities. We report a 16-year-old boy diagnosed with drug-resistant right-medial TLE. He is a professional musician, trained in Carnatic classical music. Clinical, electrophysiological, magnetic resonance imaging (MRI) and positron emission tomography evaluation localized the seizure focus to the right medial temporal lobe. Patient underwent detailed neuropsychological evaluation and functional MRI (fMRI) for musical abilities prior to surgery. He underwent an awake craniotomy and tailored resection of lateral neocortex as well as amygdalohippocampectomy under guidance of cortical stimulation and clinical monitoring. The superior temporal gyrus where activation was revealed on task-based fMRI was preserved. At 16-month follow-up, there was no seizure recurrence and his cognitive functions including musical abilities did not deteriorate with surgery. The task-based fMRI while listening to music revealed bilateral frontotemporal activation. There was evidence of increased left frontotemporal connectivity during the postsurgical period in the resting state fMRI. It is hypothesized that the intact neuropsychological and musical abilities might be as a result of intense musical training from an early age despite the illness leading to functional and neural adaptation of the brain might have contributed to his preserved cognitive functions and musical skills. Intense musical training at a young age perhaps not only honed a range of cognitive functions but also resulted in functionally more efficient cognitive networks despite the surgical resection.
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Affiliation(s)
- Shantala Hegde
- a Neuropsychology Unit, Department of Clinical Psychology , NIMHANS , Bangalore , India
| | - Rose Dawn Bharath
- b Department of Neuroimaging and Interventional Radiology , NIMHANS , Bangalore , India
| | | | - Karthik Shiva
- b Department of Neuroimaging and Interventional Radiology , NIMHANS , Bangalore , India
| | | | - Sanjib Sinha
- d Department of Neurology , NIMHANS , Bangalore , India
| | - Jamuna Rajeswaran
- a Neuropsychology Unit, Department of Clinical Psychology , NIMHANS , Bangalore , India
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Särkämö T, Altenmüller E, Rodríguez-Fornells A, Peretz I. Editorial: Music, Brain, and Rehabilitation: Emerging Therapeutic Applications and Potential Neural Mechanisms. Front Hum Neurosci 2016; 10:103. [PMID: 27014034 PMCID: PMC4783433 DOI: 10.3389/fnhum.2016.00103] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2015] [Accepted: 02/25/2016] [Indexed: 11/13/2022] Open
Affiliation(s)
- Teppo Särkämö
- Cognitive Brain Research Unit, Institute of Behavioural Sciences, University of Helsinki Helsinki, Finland
| | - Eckart Altenmüller
- Institute of Music Physiology and Musicians' Medicine, University of Music, Drama and Media Hanover Hanover, Germany
| | - Antoni Rodríguez-Fornells
- Cognition and Brain Plasticity Unit, Bellvitge Research Biomedical InstituteBarcelona, Spain; Department of Basic Psychology, University of BarcelonaBarcelona, Spain; Institució Catalana de Recerca i Estudis AvançatsBarcelona, Spain
| | - Isabelle Peretz
- International Laboratory for Brain, Music, and Sound Research and Centre for Research on Brain, Language and MusicMontréal, QC, Canada; Department of Psychology, Université de MontréalMontréal, QC, Canada
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