A musical way to rewire the brain

Increasing evidence supports the idea that active or passive engagement with music and related interventions offers valuable insights into the brain’s plasticity as music proves effective in reorganising the brain across various medical conditions, writes Dr Praveen Kumar Kaudlay

After suffering a catastrophic brain injury in a fall, an 18-year-old needed a thorough neuropsychological test because of persistent cognitive and linguistic abnormalities. Assessments conducted after 20 music and rhythm-based cognitive retraining sessions using Neurologic Music Therapy (NMT), a standardised research-based training method, showed a significant improvement in quality of life as well as cognitive and emotional functioning.

The ability of the human brain to self-reorganise and rewire in response to both internal and external stimuli is astounding. Innovative scientific research and cutting-edge brain imaging technology have solidified this idea. Neuronal connections are complex structures that are dynamically altered by life events, learning, healing from injuries, and degenerative diseases. Neuroplasticity is the name given to this extraordinary capacity for adaptability.

Donald Hebb postulated the “What fires together wires together” theory in 1949, implying that concurrent rewiring amplifies brain development. There is growing evidence to support the theory that listening to music actively or passively and utilising related interventions can provide important insights into the plasticity of the brain. Using music treatments to reorganise the brain has been shown to be useful for a variety of medical disorders. Through research on the extraordinary plasticity of the brain, music has been found to be a powerful tool for unlocking the potential of neuroplasticity.

Research on the brains of musicians shows that music training modifies the basal ganglia, cerebellar connections, and outer structure of the cortex. Long-term potentiation (LTP) is induced by sound and music stimulation, which fortifies neural networks. This strengthens already-existing connections to previously disconnected areas and creates new brain pathways. Youngsters receiving music instruction have better verbal memory, fine motor control, and sophisticated auditory processing, all of which affect how sound is perceived.

The Music Cognition Lab is headed by Dr Shantala Hegde, an Additional Professor of Neuropsychology at the National Institute of Mental Health and Neurosciences (NIMHANS). Individuals suffering from brain injuries or diseases typically exhibit deficiencies in many neurocognitive domains, including attention, memory, learning, and motor control. The brain indeed has the innate ability to rewire itself. “Our research has focused on enhancing neurocognition through the use of rhythm and music,” adds Dr Hegde.

Research suggests that patients receiving NMT had a considerable increase in motor activity. It helps to improve everyday psychosocial functioning in addition to boosting cognitive and motor abilities. Following a stroke, traumatic brain injury, or degenerative disease, depression and anxiety are common. A variety of interventions, including singing, instrumentation, and guided listening, are used in music rehabilitation. The quality of life is reduced by traumatic brain damage, which affects social, psychological, and physical elements of functioning. Cognitive functions get impaired. Improvements in the linguistic, sensorimotor, and cognitive domains are methodically addressed by neurologic music therapy. Music’s rhythmic stimulation of the auditory system, known as Rhythmic Auditory Stimulation (RAS), enhances gait and balance after a stroke. National stroke guidelines in the USA and Canada endorse RAS as a recommended treatment for stroke-affected patients undergoing gait training. RAS is among the 20 clinical techniques within NMT. Prof Michael Thaut, a dual faculty member at the University of Toronto in Music and Medicine, specialising in Neuroscience and Rehabilitation Sciences, is a pioneering figure in NMT. His studies have shown measurably improved gait in stroke and Parkinson’s disease patients, as well as the neurological mechanisms underpinning these important clinical advantages, especially when employing RAS. Prof Thaut emphasises the universal applicability of music in rehabilitation, transcending cultural boundaries.

At NIMHANS, Dr Hegde is customising NMT for the Indian setting and creating a neuropsychological rehabilitation programme with Indian music and rhythm at its core. The programme aligns with neuroplasticity principles and NMT techniques. Prof Thaut posits that the engagement of auditory centres with cortical and subcortical regions of the brain, along with activation in the Cerebellum during music, forms a crucial network for connectivity. This network activation is instrumental in understanding the role of music in neurorehabilitation.

For patients with neuromotor speech and communication impairments, Dr Preetie Shetty of the Department of Audiology and Speech-Language Pathology at Kasturba Medical College Mangalore, MAHE Manipal, employs NMT techniques like integrating rhythm, pitch, tempo, and stress patterns of prosody to tackle communication challenges and foster neural network reorganisation. Dr Shetty advocates for applying these techniques in speech motor disorders such as Parkinson’s, as well as neurodevelopmental disorders like autism, stuttering, dyslexia, and attention deficit hyperactivity disorder, leveraging auditory processing and speech perception strategies.

(The author is a consultant haemato-oncologist with a special interest in stem cell transplantation at Royal Wolverhampton NHS Trust, UK. He can be reached at [e-mail])