by Marisa Aveling

Before it happened, it seemed like just another day. As usual, Sean headed to the gym. Partway through his workout, though, the 22-year-old came up from a squat and felt what he thought was a burst of water in his head. As blood began seeping into his brain, Sean wobbled over to the bench and struggled to keep himself upright. He was rushed into emergency surgery and spent 36 hours lying in a coma before waking up to discover that, following his stroke, he couldn’t move the left side of his body.

After a few harrowing weeks last spring, Sean slowly began to regain mobility and started sessions with Brian Harris, an innovative music therapist at the Spaulding Rehabilitation Hospital in Boston. Their biggest focus was getting Sean to walk again. The pair slowly padded up and down the hospital hallways, Sean tentatively moving forward as he retaught his body what had once been second nature. Harris walked backwards in front of him, playing the guitar to help Sean’s legs find their rhythm.

Sean progressed quickly, and at the urging of Harris, he eventually took off his leg brace, discarded his hulking quad cane, and took proper, unassisted steps again for the first time. “It’s been so incredible for me,” Sean says about incorporating music into his rehabilitation therapy. Six months after that fateful day at the gym, he’s able to move relatively freely, as he did before. “It was huge in getting me to walk again.”

While new findings coming out of labs continue to help us learn more about the health-related effects of music, the notion in itself is not new. Rhythm and melody have been part of ritualistic healing practices as far back as ancient times—in his book De Anima, Aristotle suggested that flute music could purify the soul. Music therapy as an organized clinical profession was conceived more fully after World War II, in response to the demand to treat returning veterans. And subsequent research has shown that most of us intuitively regulate our moods with music, from listening to a playlist that motivates us to run faster, to playing songs to help us relax before sleep.

As the field moves forward, a number of tech companies are starting to make their way into the space where music and medicine meet. Their approaches are as diverse as the many ways that music can be applied to health and wellness, but their higher purpose is largely unified: to combine science and technology to empower people to self-medicate with music on an unprecedented scale.

Sean’s therapist, Brian Harris, is part of this vanguard. Last August, he co-founded MedRhythms, a Boston startup that specializes in neurologic music therapy (NMT), a new field that officially emerged in 1999. The practice is centered around developing treatments based on research into the effect music has on nonmusical parts of the brain, like language, cognition, memory, or movement.

Harris’ dedication to the field was acquired firsthand as an undergrad at the University of Maine, assisting the only private practicing music therapist in the state at the time. His first session was with a developmentally delayed boy in his late-teens who was functioning at the level of a toddler. Harris says that only 10 minutes into the music therapy, everyone witnessed higher levels of behavior than the patient’s everyday carers had ever seen.

“At that moment I realized my calling in life was to do this work,” Harris remembers. “It wasn’t a magical response—we could figure out why this boy was having this response and we could really harness that power and replicate it for a lot of people.”

NMT as practiced today is based on two main principles. The first is music’s ability to stimulate a whole range of different parts of the brain. “There’s no other stimulus on earth that provides such a global activation of our brains as music,” Harris says. The second is that music helps with neuroplasticity, that is, the way our brains constantly create new connections and strengthen old connections throughout our lives. Harris says research has even proven that music helps the brain heal itself by creating these new connections.

Right now MedRhythms provides in-home NMT services, as well as in- and out-patient treatment out of Spaulding Rehabilitation Hospital, where Sean was treated. The company’s team of therapists works with people recovering from brain injuries, diseases such as Parkinson’s and Huntington’s, and stroke. A series of videos on MedRhythms’ website show stories with what appear to be profound results—a man who couldn’t speak rediscovers his voice; after one session, another who could only muster up stilted steps with a cane takes strides without it.

With a system in place to treat patients one-on-one, Harris is now focusing on using technology to take this treatment further than is currently humanly possible. The aim is to give people access to highly specialized therapy almost everywhere using a platform that’s as easy to play with as an everyday app. “We’re actually building software and hardware products that can do what our therapists are doing and think like our therapists think, but without the need of a therapist,” he says.

The goal is to create an entire digital medicine platform, but to start, MedRhythms’ first prototype involves gait training similar to the therapy Harris conducted with Sean, helping people relearn how to walk. Paired with a small, customized tablet that MedRhythms will send out, patients will wear off-the-shelf sensors that feed data about the way they’re walking into the platform, which will then be able to interpret that data. For example, it will look at the speed at which they’re moving and change the music in real time based on exactly what they need to help them improve. According to Harris, the product will be up for FDA approval and clinical trials in the coming months.

The ability to scale treatment like this while keeping it relatively cheap presents promise in a system where expenses consistently barrel much deeper than the pockets of the average American. “What we’re finding is that 30 percent of people who have had strokes still have deficits after their insurance benefits have run out,” Harris says. “We’re really empowering people in a low cost way to be able to continue their rehab.”

The Sync Project is another music and health startup based in Boston that CEO and co-founder Marko Ahtisaari describes most simply as “a biometric music recommendation engine.” They believe that music can be listened to for purpose as well as pleasure. For the past year Sync has been gathering data from multiple sources, like Spotify and voice-activated virtual assistants including Amazon’s Alexa, to make music recommendations based on a range of everyday health needs. This could mean generating playlists to help you focus and be productive, destress and relax, or gear you up for exercise and activity. Going deeper than a regular Spotify “sleep” playlist, these songs will be personalized while also having the right acoustic properties to do the job properly, as proved by biometric data.

Sync’s team is propelled by considerable heavy-hitting power, led by Ahtisaari, the former head of product design at Nokia. And they’ve partnered with a smattering of category-defining researchers from top universities to ensure their work is steeped in hard science. On the music side, artists who use technology creatively, including St. Vincent, Peter Gabriel, and Jon Hopkins, sit on the board as advisors on product strategy, or how to package the music recommendations to people.

“The Sync Project taps into two longstanding fascinations of mine,” Hopkins explains, “the ability of music to positively influence mood and consciousness, and using the mind-body connection to improve health and wellbeing. We as a species have long had an intuitive understanding that music has physical benefits, but now the science exists to back this up. The Sync Project is at the forefront of putting these findings into some kind of practical, usable form.”

The platform can only make recommendations as good as the data they’re based on, so Sync has taken a very serious approach to collecting it. On the biggest end of the spectrum, this means analyzing tens of millions of public playlists that have names offering up health cues—such as “sleep” and “relaxation”—as well as inviting people to make music recommendations through their website. At the smallest end, Sync is looking at very specific and targeted studies in partnership with various researchers about how music can make a high intensity interval workout more effective, or how it can help to reduce physical pain. “There’s strong directional evidence that having music intervention after an operation leads to people self-administering less opioids,” Ahtisaari explains.

Meaningful relationships with the scientific community are important to Sync, because when the chemistry is just right, it can be beneficial for everybody. Last summer they gathered 30 key players together for a convention around tech, music, health, and neuroscience. “We said to them, ‘What can we do to accelerate your research, and what are you missing in order to make breakthroughs?’” Ahtisaari recounts. The answer was a way to collect data at scale, in a natural setting that stands in contrast to a stark lab environment. Sync’s platform does just that.

Dr. Jessica Grahn is an associate professor and cognitive neuroscientist studying music at Western University in London, Ontario, who’s developed a working relationship with Sync punctuated by mutual admiration. “They’re PhDs and they don’t want to sell crap,” she laughs. Grahn has devoted long hours to researching how the brain perceives rhythm, and how it helps people with neurological disorders like Parkinson’s to initiate movement. Together, Grahn and Sync are developing algorithms to accurately monitor the way people walk using information from their phones.

Instead of trying to get participants to come to the lab, Grahn and her team can come to them—virtually. This essentially opens up a huge new way to collect information from people at home on a scale Grahn has never been able to achieve. “This will help us help individuals, because we’ll just have so much more information about different varieties of patterns that people have in their responses to music,” she explains.

Sync’s platform is meant to be something you use every day; it’s designed to seamlessly fit into your life as you know it, and make it a little better. But as much as the platform is a product, it’s an ongoing experiment too. As more people begin using the recommendation service, the Sync team and their partnering scientists will receive more and more data to learn from—both from people giving feedback about how effective they found particular sets of music to be for a certain purpose, as well as over time with biometric sensors offering listener data during more targeted experiments. Equipped with this information, they’ll be able to strengthen their research and the effectiveness of the very platform itself while it’s being used.

“The whole distinction between what’s an experiment versus a product kind of fades,” Ahtisaari says. “We’ll be continuing to gather data, but people will be able to use this and benefit from it at the same time.”

BioBeats, a company that uses artificial intelligence to support wellbeing, essentially started when CEO and co-founder David Plans’ life nearly ended. A few years ago, the one time AI researcher arrived at an airport in Brussels running on very little except high stress—he hadn’t slept for 36 hours. He went into cardiac arrest then and there. As he was rushed to the hospital, paperwork pertaining to his death began to be prepared; after he was revived, a nurse gave him those same documents as a mortal reminder and told him it was time to make some changes.

Plans started thinking about how he could have prevented the entire episode from happening. With his background in AI, he began exploring how algorithms could be written to monitor people’s bodies and minds to become an alarm system that would tell them when they were getting close to a breaking point before it happened.

BioBeats’ focus is “adaptive media,” a term they’ve coined to describe technology that adapts and responds to a person’s physiologic data in real time. This new vernacular excited big-name interest early on, with Justin Bieber's manager Scooter Braun and Will Smith both signing on as investors. New York City-based Cantora, which started as a record label, putting out MGMT’s first EP, and has since grown its interests to include a smart tech portfolio, is also an investor and advisor.

Pulse, BioBeats’ first release in 2013, was an experimental app that let you literally listen to your heart by creating music unique to your heartbeat. Their second, more established product is Hear and Now, a mindfulness and stress-reducing app released as a public beta earlier this year. By putting your finger on the camera flash of your phone, the app reads your heart rate. It then uses this data to guide you through breathing exercises, with generative music to help you relax, and graphics that sharpen the more accurately you’re able to follow along.

Clinical trials that BioBeats recently completed with 600 bank employees in the UK emerged with promising findings. “Now we have data that shows that doing breathing exercises with that sort of biofeedback, both at the music and graphics level, definitely curbs stress by around 23 percent,” Plans says.

Based on this recent study, the BioBeats team is working on developments for the next version of Hear and Now, such as several more music systems to expand the library of the existing app. A future iteration will also start targeting people who display particular emotional profiles with specific types of music, which will change depending on how they’re feeling.

Another way to think about adaptive media is simply as preventative healthcare. With applications across almost everything that we interact with, from smart wearables and cars to products we use at home, the area feels big and promising. And as one of the most effective tools to help people understand what their own data is saying about them—and to tell them what to do next—music plays a key role. “Music actually helps at a biofeedback level where almost nothing else can,” Plans says, “including medical attention.”

While there is a lot of research pointing to music’s effectiveness as a mood and emotion regulator, it’s also being adapted to target very specific illnesses. Tinnitracks is a prescription app currently available in Germany, the Netherlands, and Austria to treat tinnitus with a patient’s own music from their smartphone. Led by Joerg Land, the co-founder and CEO of app development company Sonormed, the Hamburg-based team has maneuvered through the stringent rules and regulations of the country’s government-controlled health insurance system to become the first app reimbursed by a health insurer.

Similarly to the other companies, Tinnitracks is built on research. The clinically proven therapy was originally created by the University of Muenster in Hamburg, but the task for Land and his team was to build technology to bring this treatment to people beyond the lab.

The university’s studies, which have emerged over the past 10 years, posit that ringing in the ears is actually “ringing” inside the brain. The findings suggest that symptoms of tinnitus are due to hyperactivity of nerves within the structures of the brain that process sound. Thanks to neuroplasticity, this means the damage can be partially (or, in some cases reported by users, completely) reversed by using certain frequencies to precisely stimulate affected areas.

So for around $20 a month, you can upload your own music to be analyzed by Tinnitracks to see if it’s suitable for treatment. And if it is, it will be filtered so that you can play the tracks on your phone as a form of treatment.

Land says that the main challenge lay not in developing the technology, which took a year, but in getting German healthcare players onside, which took double that time. “In many cases, our product was the first digital product within the health system, so we needed to answer many questions,” he explains. Both the privilege and obstacle of being first meant interpreting regulations for physical medical devices and applying them to software and apps. There was also a large element of education for doctors, the gatekeepers recommending Tinnitracks to patients, who typically hadn’t seen apps being used in this way before.

Land wouldn’t reveal Tinnitracks’ user numbers in full, instead saying that it’s currently “in the thousands.” Germans are used to getting their money back on most medical devices, and now with country-wide reimbursement from the largest health insurer, Tinnitracks anticipates interest and users to increase quite rapidly. “We have this big discussion in Germany around the quality of medical apps,” Land says. “Americans always talk about chance; Germans always talk about risk.”

Tinnitracks has been eyeing the U.S. market for some time, and with the blessing of the German government in the form of funding, is preparing to bring the app Stateside.“The U.S. market is very interesting to us, but it’s also a very challenging market, because we basically need to start from the beginning,” Land says. It’s hard for him to pinpoint exactly when Tinnitracks will be available as the timelines shift and change, but he hopes to treat American tinnitus patients some time next year.

As varied as these startups are, all of them take a very careful approach to dispensing music as medicine, creating products steeped in science. Together they’re working to make music part of our health and wellbeing at a cost that everyone can afford, for everyone to enjoy.

But as interest in this area expands, and more companies join in, not all of them will have the same noble intentions. A scientific voice of reason, Dr. Grahn also points out that as much as it presents possibility, we always have to be smarter than the technology we’re using—especially when it comes to our health. “It also opens up a lot of garbage unfortunately,” she says with a laugh. “So much of what is out there is not based on any sort of evidence whatsoever. The trick will be for people to be able to tell the difference.”