One of the most poignant early images of the coronavirus pandemic was of Italians playing music and singing from their balconies even as the virus ravaged their cities. Others soon followed suit, including pop stars streaming live performances from their homes and choirs sharing concerts via Zoom—all trying to provide connection during a frightening and uncertain time.
Of course, music has been bringing people together for millennia, and not just during crises. And in the last few decades, investigators have been training their attention on the so-called universal language of music—how it affects our brains and how it might be used to facilitate health and healing. That interest is now being fueled by new research attention and funding: In June, the Global Council on Brain Health, an independent science and policy collaborative devoted to understanding brain health, released a report concluding that music has “significant potential to enhance brain health and well-being for individuals of different ages and different levels of health” and making recommendations for future study. And last year, Sound Health, a program launched by the National Institutes of Health (NIH) and the Kennedy Center, in association with the National Endowment for the Arts (NEA), awarded $20 million over five years to support its first 15 research projects on the topic, including several headed by psychologists.
“Why is music so captivating for us?” asks Thomas Cheever, PhD, staff assistant to NIH Director Francis Collins, MD, PhD, for Sound Health and a program director at the National Institute of Neurological Disorders and Stroke. “The more we understand about that, the more fascinating it’s going to be, and the more we are going to learn about how the brain works in general.” Psychologists and neuroscientists are particularly interested to find out which neural pathways are affected by music, how music influences children’s development, and how music interventions may help people with a range of physical and mental health conditions, including Alzheimer’s disease, schizophrenia, delirium and Parkinson’s disease.
And they are adding COVID-19 to the conditions they are trying to ease. Babar A. Khan, MD, assistant professor of medicine at the Indiana University School of Medicine in Indianapolis, for example, is using a Sound Health grant to test a music intervention with patients who have delirium, including those with COVID-19. Delirium—an acute, short-term condition marked by confusion and emotional disruption—afflicts as many as 80% of patients who are in the intensive care unit for respiratory failure, including those with COVID.
If the intervention proves helpful, says Khan, “it will be used immediately during the course of the current pandemic.”
One ongoing research interest is how music may affect youth in terms of language development, attention, perception, executive function, cognition and social-emotional development. Psychologist Assal Habibi, PhD, an assistant research professor at the University of Southern California Dornsife’s Brain and Creativity Institute, has been investigating these topics for the past seven years in collaboration with the Los Angeles Philharmonic Youth Orchestra, known as YOLA, an after-school program that brings low-income youngsters together to learn, play and perform music. Now in its final year, the study has been tracking brain and learning outcomes of 75 children who are either participating in YOLA, a community sports program or no after-school program.
Data published from the first few years of the intervention show that YOLA participants gradually develop auditory and cognitive advantages over youth who aren’t involved in music. After the second year of the study, the YOLA participants showed greater ability to perceive pitch, rhythm and frequency of sounds, as well as enhanced development in the auditory pathway, the neurological route that connects the inner ear to auditory association areas in the brain (Developmental Cognitive Neuroscience, Vol. 21, 2016). After the third and fourth years in the program, they also began to perform better on tasks unrelated to music, including on executive function tasks involving working memory and delayed gratification—likely because of the discipline required to patiently learn pieces of music, Habibi says. In addition, youth involved in YOLA showed greater development in brain areas related to language and auditory processing, and greater neuronal connectivity in the corpus callosum, the nerve bundle that connects the brain’s right and left hemispheres (Cerebral Cortex, Vol. 28, No. 12, 2018).
“We obviously expected their musical skills to get better,” she says, “but it seems a broad range of other skills are also impacted by music.”
Habibi now has a grant from the NEA to follow these same children into adolescence to see whether the brain benefits they derived early on translate into real-life behaviors and decisions as teens—choice of peers, for example, or whether they show up to class. She also has an NIH Sound Health grant to compare differences in executive functioning among bilingual youth who are learning music and those who are learning music but only speak one language.
“As a developmental psychologist, I don’t think there’s just one pathway to better executive function in children,” she explains. “So, it will be interesting for us to identify different mechanisms and understand how each one works.”
Researchers are also exploring whether music may prove to be a helpful therapy for people experiencing depression, anxiety and more serious mental health conditions. A study of 99 Chinese heart bypass surgery patients, for example, found that those who received half an hour of music therapy after the operation—generally light, relaxing music of their own choice—had significantly lower self-reports of depression and anxiety than those who rested or received conventional medical check-ins in the same time frame (Journal of Cardiothoracic Surgery, Vol. 15, No. 1, 2020). Meanwhile, in conjunction with the Global Council on Brain Health’s strong endorsement of more research on music and brain health, an AARP survey of 3,185 adults found that music has a small but statistically significant impact on people’s self-reported mental well-being, depression and anxiety.
Others are examining whether music interventions could benefit those with serious mental illness. Yale experimental psychologist and cognitive neuroscientist Philip Corlett, PhD, for example, will use a Sound Health grant to test an intervention in which people with schizophrenia come together to write and perform music for one another. The work builds on Corlett’s developing model of schizophrenia, which maintains that people with the disorder have difficulty revising and updating their views of self and reality based on newly emerging events, considered a central feature of the healthy human brain. Making music with others—which involves both positive social interactions and a type of expression with predictable outcomes—could allow participants to experience more realistic predictions and hence foster their sense of predictability and security, he hypothesizes.
“If we can show that music-making changes the mechanisms that we think underwrite these symptoms [of schizophrenia],” Corlett says, “then we can figure out its active ingredients and ultimately come up with ways to deliver this to people who need it.”
The impact of music on older adults’ well-being is likewise of keen interest to researchers, who are looking at how music therapy may help verbal fluency and memory in people with Alzheimer’s disease (Journal of Alzheimer’s Disease, Vol. 64, No. 4, 2018) and how singing in a choir may reduce loneliness and increase interest in life among diverse older adults (The Journals of Gerontology: Series B, Vol. 75, No. 3, 2020). Music even shows promise in preventing injury: A study by Annapolis, Maryland–based neurologic music therapist Kerry Devlin and colleagues showed that music therapy can help older adults with Parkinson’s disease and other movement disorders improve their gait and reduce falls (Current Neurology and Neuroscience Reports, Vol. 19, No. 11, 2019).
Still others are investigating how music can help people recover from serious illnesses and conditions, including, now, COVID-19. In a pilot study, Khan of Indiana University showed that patients with delirium on mechanical ventilators who listened to slow-tempo music for seven days spent one less day in delirium and a medically induced coma than those listening to their favorite music or to an audio book (American Journal of Critical Care, Vol. 29, No. 2, 2020). Now, with his Sound Health grant, he is comparing the effects of slow-tempo music or silence on 160 participants with delirium, including COVID-19 patients on ventilators in hospitals in Indianapolis.
Studies like these underscore music’s potential as a safe and effective medical intervention, as well as the importance of conducting more research on which kinds of music interventions work for whom, when and how, including during this difficult time, adds Cheever.
“How do we get [music therapy] into the same realm as other interventions that are the standard of care for any given indication?” he says. “The answer to that, I think, is a solid evidence base.”
NIH/Kennedy Center Workshop on Music and the Brain: Finding Harmony
Cheever, T., et al., Neuron, 2018
