The Mozart Effect – Music and health

Music is a fundamental attribute of the human species. Virtually all cultures, from the most primitive to the most advanced, make music. It’s been true through history, and it’s true throughout an individual’s lifespan. In tune or not, we humans sing and hum; in time or not, we clap and sway; in step or not, we dance and bounce. The human brain and nervous system are hard-wired to distinguish music from noise and to respond to rhythm and repetition, tones and tunes. Is this a biologic accident, or does it serve a purpose? It’s not possible to say. Still, a varied group of studies suggests that music may enhance human health and performance.

Music and the mind

The most highly publicized mental influence of music is the “Mozart effect.” Struck by the observation that many musicians have unusual mathematical ability, researchers at the University of California, Irvine, investigated how listening to music affects cognitive function in general, and spatial-temporal reasoning in particular. In their first study, they administered standard IQ test questions to three groups of college students, comparing those who had spent 10 minutes listening to a Mozart piano sonata with a group that had been listening to a relaxation tape and one that had been waiting in silence. Mozart was the winner, consistently boosting test scores. Next, the investigators checked to see if the effect was specific to classical music or if any form of music would enhance mental performance. They compared Mozart’s music with repetitive music by Philip Glass; again, Mozart seemed to help, improving spatial reasoning as measured by complex paper cutting and folding tasks and short-term memory as measured by a 16-item test.

How might music enhance cognitive performance? It’s not clear, but the researchers speculated that listening to music helps organize the firing of nerve cells in the right half of the cerebral cortex, the part of the brain responsible for higher functions. According to this construct, music — or at least some forms of music — acts as an “exercise” that warms up selected brain cells, allowing them to process information more efficiently.

Music and stress

In every era of human history and in every society around the globe, music has allowed people to express their feelings and communicate with others. More than simply expressing emotions, music can alter them; as British dramatist William Congreve put it in 1697, “Music has charms to soothe a savage breast.”  Few things are more stressful than illness and surgery. Can music reduce stress in these difficult circumstances? Several trials show it can.

A study from New York examined how music affects surgical patients. Forty cataract patients with an average age of 74 volunteered for the trial. Half were randomly assigned to receive ordinary care; the others got the same care but also listened to music of their choice through headphones before, during, and immediately after the operations. Before surgery, the patients in both groups had similar blood pressures; a week before the operations, the average was 129/82 millimeters of mercury (mm Hg). The average blood pressure in both groups rose to 159/92 just before surgery, and in both groups, the average heart rate jumped by 17 beats per minute. But the patients surrounded by silence remained hypertensive throughout the operation, while the pressures of those who listened to music came down rapidly and stayed down into the recovery room, where the average reduction was an impressive 35 mm Hg systolic (the top number) and 24 mm Hg diastolic (the bottom number). The listeners also reported that they felt calmer and better during the operation.

A study of 80 patients undergoing urologic surgery under spinal anesthesia found that music can decrease the need for supplementary intravenous sedation. In this trial, patients were able to control the amount of sedative they received during their operation. Patients who were randomly assigned to listen to music needed less calming medication than those assigned to listen to white noise or to the chatter and clatter of the operating room itself.

In the cataract and urologic surgery studies, the patients were awake during their operations. But a study of 10 critically ill postoperative patients reported that music can reduce the stress response even when patients are not conscious. All the patients were receiving the powerful intravenous sedative propofol, so they could be maintained on breathing machines in the intensive care unit (ICU). Half the patients were randomly assigned to wear headphones that played slow movements from Mozart piano sonatas, while the other half wore headphones that did not play music. Nurses who didn’t know which patients were hearing music reported that those who heard music required significantly less propofol to maintain deep sedation than those patients wearing silent headphones. The music recipients also had lower blood pressures and heart rates as well as lower blood levels of the stress hormone adrenaline and the inflammation-promoting cytokine interleukin-6.

Music and mood

Soothing jangled nerves is one thing; raising sagging spirits, another. Bright, cheerful music can make people of all ages feel happy, energetic, and alert, and music even has a role in lifting the mood of people with depressive illnesses. An authoritative review of research performed between 1994 and 1999 reported that in four trials, music therapy reduced symptoms of depression, while a fifth study found no benefit. A 2006 study of 60 adults with chronic pain found that music was able to reduce pain, depression, and disability. And a 2009 meta-analysis found that music-assisted relaxation can improve the quality of sleep in patients with sleep disorders.

Bach may never replace Prozac, but when it comes to depression, even a little help strikes a welcome chord.

Music and movement

Falling is a serious medical problem, particularly for people over 65; in fact, one of every three senior citizens suffers at least one fall during the course of a year. Can music help? A 2011 study says it can. The subjects were 134 men and women 65 and older who were at risk of falling but who were free of major neurologic and orthopedic problems that would limit walking. Half the volunteers were randomly assigned to a program that trained them to walk and perform various movements in time to music, while the other people continued their usual activities. At the end of six months, the “dancers” exhibited better gait and balance than their peers — and they also experienced 54% fewer falls. Similar programs of movement to music appear to improve the mobility of patients with Parkinson’s disease.

Heart beats

You don’t have to be a neurophysiologist to understand that music can affect the brain and at least a few of its many functions. And even if you’re not a cardiologist, you may be interested to learn that music can also help the heart and circulation.

One way is by reducing stress. A study from Wisconsin evaluated 45 patients who had suffered heart attacks within the previous 72 hours. All the patients were still in an intensive care unit but were clinically stable. The subjects were randomly assigned to listen to classical music or simply continue with routine care. All were closely monitored during the 20-minute trial. Almost as soon as the music began, the patients who were listening showed a drop in their heart rates, breathing rates, and their hearts’ oxygen demands. Music had no effect on their blood pressure; however, nearly all heart attack patients are given beta blockers and ACE inhibitors, both of which lower blood pressure on their own. The cardiovascular improvements linked to music lasted for at least an hour after the music stopped, and psychological testing also demonstrated lower levels of anxiety.

Without offering final proof, these studies suggest that music may help the heart and circulation as well as the brain and mind. But how? Slowing the heart rate, lowering blood pressure, and reducing levels of stress hormones are likely explanations, and research presents another possibility. Scientists studied arterial function and blood flow in 10 healthy volunteers before, during, and after the subjects listened to various types of music, watched humorous videos, or listened to relaxation tapes. Joyful music produced a 26% increase in blood flow, a benefit similar to aerobic exercise or statin therapy and well ahead of laughter (19% increase) and relaxation (11%). But the power of music can work both ways; selections that triggered anxiety in the listeners produced a 6% decrease in blood flow. Men with teenaged children, take note.

Concerts, too?

Most of the studies on music and health rely on individual listening, typically through headphones. That fits right in with the iPod generation’s approach — but what about old-fashioned concertgoing?

To find out, scientists in Sweden evaluated the habits of 12,982 people, recording their previous health, social networks, attendance at concerts and plays, education and income levels, and smoking and exercise patterns. As expected, smoking and previous illness predicted early death; exercise, higher education, and financial security predicted long life.

But there was also an unexpected finding: attendance at cultural events had a surprisingly powerful effect on mortality. In all, people who attended concerts and plays rarely or never were 1.57 times more likely to die during the study period than people who attended frequently. Occasional concertgoers were in between. The apparent protection conferred by cultural events was not explained by differences in income, social networks, or education. The investigators speculate that music may stimulate specific regions of the brain, causing favorable changes in hormone levels or immune function. Or perhaps concertgoers have their own version of a religious experience as they take in what Shakespeare called “music from the spheres.”

It’s only one study, and it should be confirmed before concert tickets take their place in the medicine cabinet. Even now, however, people who like to go to cultural events may get a little extra pleasure from the hope that something enjoyable may actually be healthful.

The science of art

The ancient Greeks put one god, Apollo, in charge of both medicine and music. Today’s doctors tell us that music can enhance the function of neural networks, slow the heart rate, lower blood pressure, reduce levels of stress hormones and inflammatory cytokines, and provide some relief to patients undergoing surgery, as well as heart attack and stroke victims. But these biological explanations and clinical observations may not do full justice to the effect music has on man and his world. Fortunately, poets and philosophers can fill in the gaps.

Doctors tell us that social isolation is a cardiac risk factor, and Robert Browning wrote that “He who hears music feels his solitude peopled all at once.” Psychologists tell us that expressing emotions is healthful, and Tolstoy explained that “Music is the shorthand of emotion.” Clinicians teach that human warmth can blunt many woes, and Shakespeare proclaimed, “If music be the food of love, play on.” And in the days when Apollo reigned, Plato explained that “Music is a moral law. It gives soul to the universe, wings to the imagination, and charm and gaiety to life and to everything else.”

First Published: July, 2011 by Harvard Medical School – read the full article here

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