Music is a creative force that has long been harnessed by the medical world for its positive effects on our health. Parkinson’s disease (PD) is debilitating both physically and mentally, and music therapy has a way of helping treat many of its most difficult symptoms. Behind universally accepted phrases such as “music lifts our moods” and “walking to a beat will steady your gait”, there lies a complexity of physiological and cognitive processes that show how art and science intersect to treat motor and non-motor symptoms in PD patients.
Parkinson’s disease arises from the degeneration of the dopaminergic system, which leads to movement dysfunction such as gait (walking) instability, slower movement, tremors, rigidity, and impaired balance (Parkinson Canada, n.d). A music therapy session is simple: PD patients convene in a group with a music therapist and together, are encouraged to sing songs, tap their feet to the rhythm, play an instrument to the beat of the music, and even dance. In doing so, patients are participating in a total brain workout that is ultimately improving their internal rhythm and working to facilitate movement behaviour. Movement dysfunction originates from the patient’s inability to coordinate their internal timing of movements, and this can be somewhat difficult to treat pharmacologically (Nombela et al., 2013). Instead, music therapy can be used as an avenue to improve degenerating movement behaviours. Structured rhythmic stimuli provide a template for motion in which muscle activation becomes synchronous to the pattern of beat that the patient is listening to. The auditory and motor systems in the body are neurologically connected (Nombela et al., 2013), as it has been observed that the auditory and premotor cortex couple their activity while processing rhythm. Through these neural networks, rhythmic stimuli also activate structures of the brain such as the basal ganglia and the cerebellum, which are both heavily involved in movement and are compromised in many PD patients (Nombela et al., 2013). The perception of rhythm is thus at the crux of mitigating PD motor symptoms with music therapy, as it re-wires connections in the brain and strengthens important neurological motor structures to help regulate movement.
Non-motor symptoms in PD patients are also commonly treated using music therapy. These symptoms may include depression, anxiety, and dementia (Parkinson Canada, n.d), and they can be incredibly adverse towards maintaining quality of life. Pacchetti et al. (1998) conducted a study to assess the impact of music therapy on emotional states in PD patients and found that group music therapy reduced anxiety levels and stress hormone levels, and promoted novelty-seeking behaviour. Furthermore, music is helpful in managing depression, which is a symptom experienced by 35% of PD patients (Raglio, 2015). Music has been shown to activate areas such as the nucleus accumbens and ventral striatum in the brain, which are involved in motivation-reward stimulation (Morris et al., 2019), and are associated with pleasure. Music therapy sessions also promote socialization and self-expression, as they involve gathering with fellow patients and accomplishing a task together. This can provide positive stimulation for the mind and be very rewarding for the patient’s mental health.
It is clear that music affects PD patients through physiological and cognitive pathways, and the outcomes are seen in improved motor control and emotional states. The remarkable aspect of music therapy is that its effects are not only felt after a structured session—music can improve health during unstructured, everyday activities too. Some PD patients describe the therapeutic effects of singing or humming to themselves as they go about their day and report feeling encouraged when they can suddenly recall long-lost song lyrics (Deporter, 2021). Carol Rosenstein, whose husband has PD, saw how alert and energetic he became after playing the piano, describing it as a “resurrection”. In light of this, she decided to organize a band for her husband and other PD patients. They called themselves the 5th Dementia, and have since grown into Music Mends Minds, a non-profit organization that strives to involve PD patients in music by joining bands and attending weekly rehearsals (Dolhun, 2015). Music therapy knows no limits in improving the lives of PD patients, and the science behind why it works complies across all forms, from seeing a music therapist to having a jam session with your friends.
Every PD patient has a unique experience with this disease, and the accessibility and flexibility of music therapy makes it a viable option for most to partake in. Music is the universal language– something that everyone can understand, feel, and benefit from physically, psychologically, and cognitively. Music is medicine, and it hits all the right notes in helping those who live with Parkinson’s Disease.
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References
Deporter, L. (2021). Singing, laughing, and humming can bring little victories. Parkinson’s News Today. https://parkinsonsnewstoday.com/2021/02/18/singing-laughing-humming-music-little-victories/
Dolhun, R. (2015). Ask the MD: Music as medicine for the mind. Michael J. Fox Foundation. https://www.michaeljfox.org/news/ask-md-music-medicine-mind
Morris, I. B., Vasudevan, E., Schedel, M., Weymouth, D., Loomis, J., Pinkhasov, T., Muratori, L. M. (2019). Music to one’s ears: Familiarity and music engagement in people with Parkinson’s disease. Frontiers in Neuroscience, 13.
Nombela, C., Hughes, L. E., Owen, A. M., Grahn, J. A. (2013). Into the groove: Can rhythm influence Parkinson’s disease? Neuroscience and Biobehavioral Reviews, 37, 2564-70.
Parkinson Canada. (n.d). Symptoms. https://www.parkinson.ca/about-parkinsons/symptoms/
Pacchetti, C., Mancini, F., Aglieri, R., Fundaro, C., Martignoni, E., & Nappi, G. (1998). Active music therapy in Parkinson’s disease: An integrative method for moto and emotional rehabilitation. Psychosomatic Medicine, 62(3), 386-393.
Raglio, A. (2015). Music therapy interventions in Parkinson’s disease: The state-of-the-art. Frontiers in Neurology, 6.
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