Music As Medicine (english)

Music medicine is typically used by medical personnel as an adjunct to various medical treatments and it often represents an attempt to provide a non-pharmacological intervention for stress, anxiety and pain for the medical patient. Examples of music medicine interventions include background music in waiting rooms or other areas of the hospital, musical programs available via headphones for the patient in the cardiac intensive care unit or prior to surgery. Music medicine interventions rely primarily upon receptive music experiences (listening to music) involving pre-recorded music selected by either the medical staff or by the patient from available programs. Music stimuli may include a wide range of music in a variety of genres and styles, low frequency sounds, specially composed music or various combinations.

Music therapy also referred as medical music therapy or creative music therapy in its approach to medical patients always involves a therapeutic process, a trained music therapist and a relationship that develops through the music and process. Perception of emotion in music is a skill that appears early in life. Recent data suggests that music plays an important role in emotion communication and regulation between care-givers and infants. There is current evidence to show that premature babies exposed to womb sounds and music, in the form of lullabies sung by their mothers, gain weight faster and they are discharged earlier from neonatal intensive care units compared to babies not listening to music(1).

Very recent research studies have shown that music can partly replace some of the drugs used to introduce anesthesia and sleep during operations and it can also be used to treat pain as a complement to standard pain killer agents(2). A neurochemical approach to music listening has recently suggested that the objectively measured effects of music on hemodynamic parameters like arterial pressure are associated with molecular changes on opiate receptors and cytokine processes.

Greek edition of a book on the healing aspects of music and modern clinical applications of music therapy and music medicine. Inclusive in this book a CD which uses classical music to introduce relaxation and reduce stress (INFO HEALTH 2003).

Recent work from the Dept. of Cognitive Neuroscience, McGill University, Montreal Canada has suggested that musical perception and musical performing abilities can be maintained in the presence of cerebrovascular attacks which have caused impairment of speech so aphasia can occur without amusia and vice versa. Studies using PET scan have shown that although specialized brain pathways associated with musical perception have been destroyed however, the ability of music to introduce emotions (happy-sad) can be maintained in the presence of inability to recognize the melody of very familiar and simple tunes eg happy birthday to you. Up to now research data is suggesting that emotional appreciation of music is subserved by a distinct neural pathway that requires cortical mediation. Cortical mediation appears to involve the right hemispheric structures with a possible contribution of the left frontal lobe regions(3).

Clinical studies have also shown that selected music can be used to relieve stress and offer relaxation in cardiovascular patients during their stay in the coronary care unit. This observed relaxing effect of music is associated with beneficial changes in heart rate and/or arterial pressure. Arterial pressure or heart rate lowering induced via music listening has been associated with a significant reduction in the levels of stress related neurohormones like nor-epinephrine, cortisol and ACTH(4).

Very recent research data from the Department of Cardiology at the Onassis Cardiac Surgery Center, Athens, Greece has shown that in patients with neurocardiogenic syncope listening to relaxing music decreases stress and arousal during head-up tilt table testing and alters the response to the tilt test. This ability of music to change the outcome of tilt testing was associated with a normalization of the neuroendocrine response to head-up tilt in patients with recurrent episodes of vasovagal attacks(5), (6).

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There is strong evidence arising from many research studies that music can be used as a complementary diagnostic and therapeutic tool in many medical conditions. The therapeutic effects of music are currently used in modern medicine as either music therapy or as complementary treatment in the setting of receptive music therapy and music medicine. Important advances are expected in the near future due to further flourishing of brain imaging technologies and motivation for understanding the biological foundations of music is very high in the scientific community

REFERENCES

(1) Dileo C. Introduction to music therapy and medicine: Definitions, theoretical orientations and levels of practice. In Music Therapy & Medicine, Theoretical and Clinical Applications, eds American Music Therapy Association (1999), pp 1-10.

(2) Zhang XW, Manyande A, Tyan YK, Yin P. Effects of music on target-controlled infusion of propofol requirements during combined spinal-epidural anesthesia. Anesthesia 2005;60:990-4.

(3) Peretz I. Listen to the brain: a biological perspective on musical emotions. In Music and emotion, eds Juslin and Sloboda, Oxford University Press, 2001, pp 105-134.

(4) Byers JF. Effects of music intervention on noise annoyance, heart rate and blood pressure in cardiac surgery patients. Am J Crit Care 1997;6:183-191.

(5) Dritsas A, Leftheriotis D, Karabela G et al. The effect of relaxing music on the stress dimension and the response to tilt test in vasovagal patients. Eur Heart J 2004;24 (suppl):574

(6) Kostopoulou A, Dritsas A, Theodorakis GN et al. Effect of music listening during head up tilt in neurocardiogenic syncope. Eur Heart J 2006; 27(suppl):186.