Therapeutic use of music in neurological disorders: A concise narrative review

Abstract

Background: Music elicits multifactorial benefits in emotional, social, cognitive, and academic aspects of human life. Music is clinically proven to reduce stress and anxiety, and improve mood and self-expression, particularly after traumatic events. Studies have also demonstrated that music promotes parasympathetic autonomic systems, suppresses hyperactivation of stress responses, and boosts immune functions. However, its ability to promote brain plasticity and signalling are only beginning to be realized. Moreover, its employment as a therapy for the treatment of specific aspects of other neurological disorders, including neurodevelopmental and neurodegenerative conditions and their comorbidities, is fast becoming an interesting field of research.

Objective: The aim of this review is to summarize some of the recent studies focused on evaluating the applications of music therapy. For this purpose, we have focused on disorders encompassing both temporal extremities of brain developmental stages, from developmental conditions of autism and attention deficit hyperactivity disorder (ADHD), to ageing-related pathologies of Parkinson's disease and dementias.

Results: The findings of the reviewed studies indicate potent utilities of music-based interventions in beneficially affecting multiple spheres of brain functions, such as sensorimotor, auditory, communication/language, psychological/emotional, behavioural, sleep and memory and cognitive attributes of patients diagnosed with diverse neuropathologies. Nevertheless, lack of standardized protocols for music provision as well as absence of information regarding key aspects, such as cultural and musical orientations of subjects and therapists'/caregivers' attitudes, have hindered the complete realization of music's therapeutic potential for neurological conditions. Further, while some studies have undertaken assessments of core neurophysiological mechanisms underlying music therapy, this information is largely lacking for most clinical studies.

Conclusion: While this is not an exhaustive review of literature, we do hope that it serves as a platform to promote future research for establishing music therapy as a relevant neurotherapeutic strategy.

Keywords: ADHD; Circadian rhythm; Cognition; Dementia; Parkinson's disease; Schizophrenia.

Fig. 1

Clement's model of responses to musical stimuli. Clement's model is depicted as a four step scheme, arranged in decreasing levels of complexity. The first level is learned cognitive response and primal and isomorphic learned responses. The second level is circuit based approach. The third and fourth levels comprise of mechanisms at sensory, and cellular and genetic levels, respectively.

Fig. 2

Summarization of the brain region-specific effects of exposure to music. The diagram depicts region-specificity of therapeutic aspects of music as an animation of the human brain. The different parts of cortices contribute to therapeutic effects at different levels; viz. Somatosensory, visual, auditory, motor and mood. Hippocampus is involved in memory-related aspects, while cerebellum contributes to motor responses. Nucleus accumbens and amygdala participate in emotional and behavioural aspects of music therapy.

Fig. 3

Proposed neurobiological mechanisms underlying music therapy. The figure shows a flowchart of mechanisms underlying neurotherapeutic aspects of music. Limbic system and prefrontal cortices relay the information to sub-regions of basal ganglia, nucleus accumbens, hippocampus, hypothalamus and VTA. This information is converted to molecular responses in form of enhanced dopamine and oxytocin signalling, resulted in stimulation of neurotrophic factors (BNDF and NGF), which finally cause enhancement in neuronal connections and their strengths.