The bidirectional role of music effect in epilepsy: Friend or foe?

Abstract

Epilepsy is a prevalent neurological disease that impacts around 70 million individuals globally. Anti-seizure medications (ASMs) are the first choice for clinicians to control unprovoked epileptic seizures. Although more than 30 ASMs are available in the market, patients with epilepsy (PWEs) still show poor responses to adequate drug treatment. Meanwhile, long-term medications not only bring heavy financial burdens but also lead to undesirable side effects. Music, a ubiquitous art form throughout human history, has been confirmed as therapeutically effective in various neurological conditions, including epilepsy. This alternative therapy offers convenience and a relatively safe approach to alleviating epileptic symptoms. Paradoxically, besides anti-convulsant effect, some particular music would cause seizures inversely, indicating the pro-convulsant effect of it. Considering that investigating the impact of music on epilepsy emerges as a compelling subject. In this review, we tried to present the following sections of content on this topic. Initially, we overviewed the impact of music on the brain and the significant progress of music therapy in central neurological disorders. Afterward, we classified the anti-convulsant and pro-convulsant effects of music in epilepsy, relying on both clinical and laboratory evidences. Finally, possible mechanisms and neural basis of the music effect were concluded, and the translational potentials and some future outlooks about the music effect in epilepsy were proposed. PLAIN LANGUAGE SUMMARY: Epilepsy is an extremely severe neurological disorder. Although anti-seizure medications are preferred choice to control seizures, the efficacy is not satisfied due to the tolerance. Anecdotal music effect had been deemed functional diversity but not clarified on epilepsy, pro-convulsive, or anti-convulsive. Here, we reviewed this interesting but puzzling topic, as well as illustrating the potential mechanisms and its translational potential.

Keywords: anti‐convulsant; epilepsy; music effect; pro‐convulsant.

FIGURE 1

The auditory pathway transmits audio signals from the ear to the brain. Once reaching the eardrum, a sound triggers a sequence of mechanical, chemical, and neurological events in several parts of the auditory system, including the cochlea, cochlear nucleus, inferior colliculus, superior olivary nuclei, medial geniculate nucleus, and the auditory cortex.

FIGURE 2

The anti‐convulsant music effect. Particular musical stimuli exhibit specific clinical adjunctive anti‐convulsant benefits. Mozart's sonatas K.448 and K.545 have a beneficial impact on decreasing the frequency of epileptic seizures. Furthermore, they have been found to improve cognitive function in both humans and rats. In rats, these sonatas have also been observed to boost the effectiveness of low‐dose anti‐seizure medications.