The human brain is the one of the most magnificent, highly structured, and advanced systems ever found in nature. I imagine the brain wearing a top hat and monocle, drinking tea on a Sunday afternoon because of its sophistication (#BrainSwag). To put it quite plainly: we have some pretty big and fancy brains. We are good at thinking, remembering, calculating, imagining, and speaking— but, how? As you read this sentence, the neurons in your brain are frenetically whispering to one another. This results in our conscious awareness by how we are aware of something external within ourselves. Otherwise defined as our ability to experience wakefulness and having a sense of self within the control system of the mind (“this is your Captain speaking”).
Sometimes after suffering from a severe brain injury or after the progression of a serious neurologic disease, consciousness can be inhibited. We have discussed in our blogs how NMT changes lives in helping many populations regain functioning. NMT can also be utilized to treat and assess this population diagnosed with severe traumatic brain injury, also known as Disorders of Consciousness (DOC). This grouping of diagnoses include: coma, vegetative state (VS), and minimally conscious state (MCS)
Diagnosis of DOC depends on how much brain damage occurs in the brain and on what level of conscious responsiveness a patient exhibits. Let’s talk about VS and MCS. A VS brain doesn’t have awareness but has periods of arousal. An MCS brain has limited awareness, certain motor responses, and responds inconsistently to verbal commands (Boly et al., 2005).
So how exactly does music work for this population? Grab your dapper top hat, monocle, and tea. Ok brainiac, let’s look at some research! Boly et al. took a look at how blood flows in the brains of people in different states of consciousness when they heard auditory stimuli (clicks). MCS brains lit up in areas similar to healthy brains that process normal perception of sounds (like temporal and frontal brain areas). This shows that they can still respond to higher auditory processing, which is necessary for consciousness. Higher processing areas weren’t activated by the sound in VS brains, but DID light up some bilateral areas. This evidence suggests that VS brains are actually still able to encode basic sound attributes!
Let’s make this a little more personal. Think about the feeling you get when you hear someone say your name or when you tune into a song that pulls your heart strings. Boly et al. took this a step further and checked in on brains when they heard the sound of their own name compared to the sound of meaningless noise. Brains spoke volumes when the sound of their name sparked more areas to light up when compared to listening to meaningless noise… like it’s saying HEY THAT’S ME! Kelly et al. (2013) threw preferred songs into the mix. EEGs showed that live music yielded global activation in normal brains, significant eye-blinking data in VS brains, and frontal lobe power peaked for MCS brains.
NMT puts this research into practice with Music Sensory Orientation Training (MSOT). MSOT focuses on live music to stimulate senses, arousal, and help maintain awareness for DOC patients. Music is the secret passageway to access the areas we can’t reach. It’s a sustaining stimulus that arouses the brain by encoding sounds and facilitates meaningful responses. On top of all this, live music has the emotional significance that allows the intervention to capitalize on additional centers that contribute to consciousness. MSOT goals include localization (orienting a patient to where the sound is coming from), tracking (facilitating the patient to attend and visually follow the sound), and vocalization. We can even assess and diagnose a patient’s level of awareness with the Music Therapy Assessment Tool for DOC (MATADOC), which is a valid and reliable measure compared to other diagnostic tools (Magee, et al., 2013).
Science is the push behind NMT. Evidence-based music interventions can ultimately, and permanently, change lives. NMT is the tool to literally change the human brain. Yes, there’s still much to uncover, but the conscious investigation and success in using music to change our brains is one of the most impressive qualities that make us human. #NMT #MusicItsScience
By: Steph Mathioudakis, MedRhythms Blogger
Boly, M., Faymonville, M.E., Peigneux, P., Lambermont, B., Damas, F., Luxen, A.,…Laureys, S. (2013). Cerebral processing of auditory and noxious stimuli in severely brain injured patients: Differences between VS and MCS. Neuropsychological Rehabilitation, 15(3-4),283-289.
O’Kelly, J., James, L., Palaiappan, R., Taborin, J., Fachner, J., & Magee, W.L. (2013). Neurophysiological and behavioral responses to music therapy in vegetative and minimally conscious states. Frontier in Human Neuroscience, 7, 1-13.
Magee, W.L., Siegert, R.J., Daveson, B.A., Lenton-Smith, G., & Taylor, S.M. (2013). Music therapy assessment tool for awareness in disorders of consciousness (MATADOC): Standardisation of the prinicipal subscale to assess awareness in patients with disorders of consciousness. Neuropsychological Rehabilitation, 10, 1-30.