The Marriage of Music and Medicine

Music is unavoidable. Like Daniel J. Levitin stated in his book, “This is Your Brain on Music”, music is unusual among all human activities for both its ubiquity and its antiquity (Levitin, 2006). Music is deeply rooted. The oldest artifacts found in human excavation sites are musical instruments. Music is also all encompassing. It can be found unique to cultures, diverse as an art, evident in economics and politics, rife in our natural environment, and now, even powerful in medicine.

Music and medicine? Why medicine?

For individuals, the diagnosis of any medical disease is one of the most feared and serious life events. It disrupts social, physical, and mental well-being in the individual and their respective families. Although many scientifically sound techniques exist as treatment options, the development of modern medical care has brought openness to new trends of holistic thinking and rationale.

One such trend is the impact of sound and music in medicine. Although often overlooked, music in medicine is much more viable than typically recognized. Consider this: how often do you turn to a song for strengthening your immune system? What if you could dispose of those vitamin supplements and just pick up an instrument instead? Have you heard that sound waves can possibly stagnate cancer cells? The idea that patients may benefit from musical experiences has been supported by a sufficient amount of music therapy and music in medicine research. It’s undeniable that music is able to act as a supplement to our recoveries. However, can music entirely replace medicine in certain situations?

The growth and emergence of music in medicine provokes many questions: what is music’s evolutionary role and why do we respond to it? How does sound’s mechanics influence cell communications and biological systems? Finally, in what ways can we use musical applications to benefit, direct, or recover the human body and its various processes?

Music in an evolutionary perspective

Levitin’s book on music and the brain discusses evolutionary musicology in two perspectives. One perspective proposed by Steven pinker, a cognitive psychologist and scientist, is renown for issuing the challenge that states, “music is a by-product, an evolutionary accident piggybacking on language.” In his proposal, he notes that music is a pleasure seeking behavior that exploits one or more existing behaviors, presumably linguistic communication. Music can affect humans because it pushes buttons in the auditory cortex system that responds to the emotional signals in sounds such as a human voice crying or cooing, and the motor control system that injects rhythm into the muscles when walking or dancing. But biologically, music is useless and exists simply for the pleasure that it produces (Levitin, 2006).

However, Levitin’s debunks the view that music is biologically useless. He believes that music has evolutionary survival value because musicianship is a sign of sexual fitness (Levitin, 2006). The ability to sing advertises overall good health and resource wealth. Music making is an overt display of good health because it involves an array of physical and mental skills. It is theorized that evolution has also selected creativity as a marker of sexual fitness. Improvisation and novelty in a music performance would indicate the cognitive flexibility, signaling an individual’s potential for strategizing. Music expertise, which takes dedication and time, is also a demonstration of wealth. It suggests that an individual is well off enough to be able to afford to spend valuable time on developing an entirely unnecessary skill. Further evidence also shows that interest in music peaks during adolescence when men are most sexually potent. A parallel can be also be drawn between interest in music and ownership of cars and jewelry, suggesting that music is related to these high status materials that display the owner’s sexual fitness. Together, human specific behaviors such as music production and artistic ability may have evolved principally to advertise intelligence and opulence during courtship, handing musicianship an evolutionary advantage.

Although different, both viewpoints advocate that the presence and endurance of music can be attributed to its link to survival value. In Pinker’s perspective, music is not itself an evolutionary advantage, but instead, a companion or additive to ones such as pleasurable activities. Such activities, such as eating and sex, have clear links to survival because they stimulate brain mechanisms specifically evolved to reward and encourage adaptive behaviors. Music itself may not enhance human survival, but it exploits one or more existing pleasure channels that evolved to reinforce some other adaptive behavior(s) (Levitin, 2006). Likewise, Levitin alleges music as a marker for sexual fitness. Music’s advantage in increasing the survival of an individual’s genes enabled its existence. Both perspectives offer critical points on why we respond to music and why it has been kept alive.

The mechanics of biology and music

The ability of sound frequencies and rhythm to affect physiological processes and to treat physical ailments is also a relatively new domain. A wealth of new studies is publicizing the benefits and impact of music and sound on health.

In his ted talk, Tim Ringgold, a renowned music therapist, introduces the idea that music and sound are intersected. The reason is because like music, our whole bodies are composed of rhythm from the cellular level to the systems. “We are rhythmic beings,” Ringgold explains, “Consider our heartbeat, breath, and sleep cycle. We are built on rhythm.”

To understand the mechanical influence of music on biological systems, we must explore how physical stimuli provoked by music is assimilated in living organisms.

Firstly, the basis of music is sound and sound is a vibration. It is possible for sound to manipulate biological systems because sound is a repeated pressure wave that travels through matter. In living organisms, there are many mechanical interactions and oscillations in cellular systems, such as cell communications and cell divisions, which can be plausibly modified by sound waves (Butler 2012).

One such sound frequency is ultrasound, which is prevailing in medical applications. Many prior studies have suggested ultrasound’s ability to affect pathways and cellular development through the mechanical effect of waves pushing cells together or through local heating (Butler 2012). This ultrasonic trapping allows the moving and gathering of cells in vitro. These mechanical similarities in sound waves and biological pathways gives sound its ability to influence.

Screen Shot 2015-11-17 at 12.09.43 PMFigure 1: this image shows cells forced together in an ultrasound trap (Butler, 2012)

In 2012, three researchers at the University of Auckland conducted a study on the effect of different sonic wave frequencies on yeast cell’s basal metabolism and growth. The choice of a unicellular organism helped eliminate the influence of nervous and auditory systems and allowed more focus on the physical aspects of sound on biological cells. Using metabolomics and shake-flask cultivations under ideal growth conditions, the physiology of yeast cells was measured under the presence of music, high frequency, low frequency sound waves, and silence. It was found that certain frequencies affected different metabolites such as ATP formation and rotation. It was confirmed in the study that all sound stimuli increased the growth rate of yeast cells and affected cell metabolism (Aggio, 2012).

Another application of sound in medicine is through vibroacoustic therapy. This intervention involves using low frequency sound to produce vibrations applied directly to the body. In a study led by Lauren K. King of Wilfrid Laurier University, researchers found that short-term use of vibroacoustic therapy with Parkinson’s disease patients led to improvement in symptoms (Novotney, 2013). Additionally, this group of researchers is also examining thalmocortical dysrhythmia, which is a disorientation of rhythmic brain activity that plays a role in several conditions like Parkinson’s and fibromyalgia. Low-frequency sound is currently being used to restore normal communication among brain regions and there have already been signs of improvement in symptoms.

These studies show that through mechanical interactions, sound frequencies alone have a direct impact on cellular systems and physical processes. The ability for sound to physically move cells, increase metabolite processes, and alter cell communications and signaling shows that sound can play an important role in treatment methods. However, the mechanical influence of sound waves is just one direct way music can affect biological systems. In other cases, music’s ability to influence health is based on its impact on cognitive pathways and production of emotion.

Cognitive effects of music and its impact on health

Music therapy interventions are often utilized to affect emotions and moods. These alterations can be designed to promote wellness, govern emotions, manage stress, reduce pain, and promote physical rehabilitation. This is because music and sound can regulate structures involved in cognitive, sensorimotor, and emotional processing.

Neuroimaging and lesion studies have shown that emotions evoked by music are involved in core structures of emotional processing. Because the activities of the autonomic, endocrine, and immune systems are under modulatory control of emotional processes, the emotional effects produced by music are important for possible music interventions in illnesses related to these systems.

Supported by the German Research Foundation, a study conducted research on the emotional impact of music. Data obtained from Profile of Mood States (POMS) indicated that during the experiment, music group participants felt more pleasant, more aroused, happier, less angry, less sad, and less anxious compared to the control group (Table 2). Chiefly, the largest difference in emotion ratings was observed for happiness (Koelsch, 2010).

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Emotional processing can produce physiological effects on the human body. In 2002, Dawn Kuhn from Willamette University conducted a study that measures SIgA levels in saliva samples after active and passive participation in music. SIgA is an enzyme found in saliva and other body secretions that is one of the first line of defense against upper respiratory tract pathogens. The study not only found that SIgA levels increased in participants who engaged in musical activities compared to those who weren’t but it also elicited a difference in increased SIgA levels between passive and active music participation. The findings showed that active musical engagement enhanced an individual’s immunocompetence more than passive participation, but overall, participation in music enhanced immunocompetence. The study proposed several crucial conclusions. First, it showed that a minimal intrusive environment is important to allow subjects to play an active role in choosing, which promotes a stronger positive emotional influence. Second, the result of allowing personal choice produces a sense of control that is responsible for the increase immune response. Activities that are met with greater personal significance produce a more intense emotional experience, and thus, increase the release of immune hormones.

A 2012 pilot study conducted on older adults with Alzheimer’s disease and related dementias, individuals who showed signs of restlessness and agitation became calmer and more involved in-group activities after active engagement in singing. Singing served a regulative function with the capacity to soothe individuals who were disorganized or anxious at abnormal levels. Extensive inquiry researched whether pre-meal singing could also combat malnutrition in ADRD individuals. Furthermore, ADRD diseases affect a person’s ability to complete critical daily activities such as eating (McHugh).

In an interview with music expert Daniel Levitin, Levitin exposes studies that have shown that music can not only alter brain chemistry but also influence the production of cytokines, immunoglobulin A, and other components of healthy immune system. The span of research goes even further, uncovering the involvement of music in advancing wound regeneration, improving nutritional intake, reducing pain perception, inducing cancer cell apoptosis, and aiding nocturnal restlessness (Levitin).

Because emotions are closely linked to peripheral physiological effects, they can always have an impact on health through influence of the autonomic nervous system, the endocrine system, and the immune system. Supposing sound is found to be particularly important in cells, what does this say about cellular origins and the position of sound in evolution?

The consensus that acoustic effects are important in cellular development and processes seems to be building. Understanding that music has been preserved due to its evolutionary advantage has unveiled its foundation and purpose in human life. Furthermore, the ability of music to physically and emotionally influence our bodies exhibits its capacity and scope of function. The goal of all these studies is to help develop “prescribable” music therapy and “music medicine” protocols that can attend to deficits resulting from disease and health conditions. From analyzing the beginnings of music through the evolutionary perspective to modern implications of music in medicine, these studies collectively support the execution of music in health and medicine. Besides viewing music only as a cultural phenomenon, the art should be seen as a vibratory stimulus and a cognitive influencer that has many medical applications and biological dimensions (Novotney, 2013). When we look at music in this perspective, we start to see the interface to how the brain and body work together.

Bibliography

Aggio, R.B.M, and Victor Obolonkin, and Silas Granato Villas-Boas. 2012. “Sonic Vibration Affects the Metabolism of Yeast Cells Growing in Liquid Culture: a Metabolomic Study.” Metabolomics 8 (4): 670–678.

Blood, Anne J, and Robert J. Zatorre. 2001. “Intensely Pleasurable Responses to Music Correlate with Activity in Brain Regions Implicated in Reward and Emotion.” Proceedings of the National Academy of Sciences of the United States of America 98 (20): 11818-11823.

Butler, Michael. “Cells and Sound: An Introduction.” Academia.edu. 2012. Accessed October 12, 2015.

Huron, David. 2001. “Is music an evolutionary adaptation?” Annals of the New York Academy of Sciences 930: 43-61.

Koelsch, Stefan, Kristin Offermanns, and Peter Franzke. 2010. “Music in the Treatment of Affective Disorders: An Exploratory Investigation of a New Method for Music-Therapeutic Research.” Music Perception 27 (4): 307–316.

Kuhn, Dawn. 2002. “The Effects of Active and Passive Participation in Musical Activity on the Immune System as Measured by Salivary Immunoglobulin A (SigA).” Journal of Music Therapy 39 (1): 30-39.

Levitin, Daniel J. 2006. This is Your Brain on Music: The Science of a Human Obsession. New York: Dutton Penguin.

McHugh, Larisa, Susan Gardstrom, James Hiller, Megan Brewer, and Wiebke S. Diestelkamp. 2012. “The Effect of Pre-Meal, Vocal Re-Creative Music Therapy on Nutritional Intake of Residents with Alzheimer’s Disease and Related Dementias: A Pilot Study.” Music Therapy Perspectives 30 (1): 32-42.

Novotney, Amy. 2013. “Music as Medicine.” Monitor on Psychology, November 10. 

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