But what does personalised music actually do in the brain?
Researchers at the University of Utah explored this question and for the first time provided objective evidence with brain imaging diagnostics: biographically meaningful music could be an alternative way to communicate with advanced Alzheimer’s patients .
For this purpose, the research team searched for meaningful songs from the patients’ respective biographies and each participant received a customised music collection with their favourite songs. What was striking was the fact that dementia patients really perked up as soon as headphones were put on them and familiar music was played. This phenomenon is so impressive and moving that the TV station ARTE picked it up in the documentary “Alive Inside – Die Musik meines Lebens” (Alive Inside – The Music of My Life), which accompanied and filmed the interventions of the “Music & Memory” initiative.
You can find the video in full length until 31th May 2021 in the download area of ARTE: https://www.arte.tv/de/videos/070804-000-A/die-musik-meines-lebens/
Using an imaging method called functional magnetic resonance (fMRI) the researchers examined the active brain regions of patients while they listened to personalised music (also played backwards) and compared the images with those recorded during quiet moments. They found that the personalised soundtracks not only activated many regions of the brain, including the salience network, but also the visual network, the executive network and parts of the cerebellum (with its connections to the cerebral cortex), but also made them communicate with each other and thus produced significantly higher functional connectivity of these regions overall.
In the study, special attention was paid to the so-called salience network (see info box): This brain area is responsible, for example, for the goose bumps one gets when listening to a particularly moving piece of music. The reason for this is that the brain’s salience network is closely connected to the reward circuits (in the ventral striatum). This neural connection plays a key role in both the processing of music perception and music enjoyment and can therefore produce the emotional shivers when listening to music.
The memory loss associated with Alzheimer’s disease is typically accompanied by a progressive loss of neural connections, which also explains the apathetic and demotivated states typical in dementia. Surprisingly, the salience region is an island of memory that is spared from this destruction for a long time. In this respect, this brain region is particularly interesting for late-stage therapy, even when linguistic and visual memory pathways have already been destroyed: it could be the key to efficient music-based treatments. The observed symptomatic relief as well as the patients’ “waking up” when listening to favourite music could be attributed to the specific ability of this music to activate salience circuits and to form further functional networks, i.e. to cause a so-called increase in connectivity.
This study, however, is only the beginning: The number of participants, 17, was rather small for reliable conclusions. Also, there was only one imaging session for each patient in the study. So, it remains unclear whether the observed effects actually last and whether other areas of memory are involved.
All in all, the study results of the last few years are more than promising:
- Personalised music programmes have been shown to be able to reactivate the brain and form new connections even in the case of far advanced dementia. This would be particularly important for patients who have lost contact with their environment: music could reconnect the patient with their identity, environment and biography.
- When listening to familiar music, attention is increased via the salience centre. This can also have a positive effect on the reward centre in the brain and thus on motivation. This leads to emotional stresses being more easily managed by Alzheimer’s patients.
- Thus, music therapy offers a new way to address anxiety, depression, aggression and agitation in dementia patients and potentially alleviate severe symptoms such as dysphagia.
- Potentially, activating neighbouring brain regions via the long-maintained salience network could perhaps be one approach to improving quality of life in the long term, and thus delaying further deterioration caused by disease.
With the increasing dementia diagnoses in our society, which stretch financial and human resources to the limit, every opportunity should be taken to improve Alzheimer’s symptoms or at least make them more manageable, so that the patient’s quality of life can be improved!
In this context, we would also like to refer to our partner initiative of the Singing Hospitals. This project has set itself the task of using the healing power of singing for people and making it possible for them to experience it. Hereyou will find contact details and further information about this valuable project.
About the “Music and Memory” initiative:
“Music & Memory” is a US non-profit organisation founded in 2010 that equips nursing homes with iPods and trains staff to therapeutically implement music tailored to the patient’s individual biography and preferences. Unlike in the USA, Australia and the Netherlands, where many facilities already use personalised music therapy in dementia care, the initiative is largely unknown in Germany so far: only the Ferdinand-Heye-Haus of the Diakonie Düsseldorf participates in the programme.