Health · Music

A Neurologist’s View of Music Therapy in Patients With Brain Trauma

Music and the Brain

The processing of sound is a complex process in the brain. Sounds vibrate the ear drum and activate the cochlear nerve. This nerve brings data to the cochlear nucleus, which sits in the lowest part of the brain (the brain stem) and passes information up into bilateral superior olivary complexes, which sit in the pons. These structures pass information higher into the thalamus, which acts as a relay of sensory information to the cortex and as a regulator of consciousness. Finally, in the cortex, sound is processed into more consciously recognized patterns, such as speech, music, etc. In this way, sounds have an effect on the most primitive and most advanced parts of the brain.


More recently, scientists have found that music and speech are processed by overlapping but different areas of the brain, showing how music is likely a fundamentally different product in the brain than speech.


Source: Merrill et al. Perception of words and pitch patterns in song and speech. Frontiers in Psychology (2012)  (in graphs, speech is mostly processed on the left side of the brain, while song is mostly processed on the right).

While the data presented in the above figure show some of the cortical areas that process speech and music, there are many other areas that will be activated by speech, song, or both.

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Music Therapy and Brain Injuries

Over the last several years, music therapy has been shown to be effective in aiding recovery of brain injured patients. Multiple studies have demonstrated that music therapy is beneficial in patients recovering from strokes.

In retraining speech in patients suffering from aphasia (inability to speak), Cortese et al used a technique called melodic intonation training to improve communication. Not only did it improve the rhythm (or prosody) of speech, but also helped patients improve their abilities to name objects, to comprehend speech, and to communicate overall. Schlaug et al have shown that melodic intonation training engages areas of the brain used for processing music (mostly in the right hemisphere) and changes brain connections allowing these areas to be used in speech as well.

In helping patients recover motor deficits after stroke, Ripollés et al used music supported therapy to restore connections between auditory and motor areas, leading to functional improvement in weakened hands.

Even in comatose patients recovering from severe traumatic brain injury, Park et al showed that stimulation with familiar sounds (e.g. family members’ voices and favorite types of music) were more effective in arousal than non-familiar sounds (e.g. general music and TV sound).

In more chronic diseases, like Parkinson’s disease, music therapy can improve daily functioning in multiple domains. Music therapy can specifically improve motor function, cognitive function, functional gait, balance, tremor and bradykinesia (i.e. slowness of movement).

The Future

There has been an exponential increase in the utilization of music therapy in brain injured patients over the last several years due to the low risk and generally low costs of these interventions. There is still significant work to be done, to best delineate how these therapies are effective, to see to what degree they are effective, and to determine which interventions in particular are most useful. Thanks to the pioneering work and tireless promotion of practitioners like Drs. Sachs and Tomaino, that future is possible.

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  • Andrea July 12, 2016 at 8:10 am

    Thank you Dr Allen for this insightful information- music is indeed a healer!