Golden oldies and silver brains: Deficits, preservation, learning, and rehabilitation effects of music in ageing-related neurological disorders

Abstract

During the last decades, there has been major advances in mapping the brain regions that underlie our ability to perceive, experience, and produce music and how musical training can shape the structure and function of the brain. This progress has fueled and renewed clinical interest towards uncovering the neural basis for the impaired or preserved processing of music in different neurological disorders and how music-based interventions can be used in their rehabilitation and care. This article reviews our contribution to and the state-of-the-art of this field. We will provide a short overview outlining the key brain networks that participate in the processing of music and singing in the healthy brain and then present recent findings on the following key music-related research topics in neurological disorders: (i) the neural architecture underlying deficient processing of music (amusia), (ii) the preservation of singing in aphasia and music-evoked emotions and memories in Alzheimer's disease, (iii) the mnemonic impact of songs as a verbal learning tool, and (iv) the cognitive, emotional, and neural efficacy of music-based interventions and activities in the rehabilitation and care of major ageing-related neurological illnesses (stroke, Alzheimer's disease, and Parkinson's disease)."Music evokes emotion and emotion can bring its memory". This famous quote from Dr. Oliver Sacks elegantly summarizes one of the key facets of music, namely its unique ability to convey and elicit emotions and their close linkage to episodic and autobiographical memories. While this holds true for all of us, the emotional, communicative, and mnemonic impact of music is particularly evident in persons suffering from neurological illnesses affecting verbal expression (aphasia) and memory (dementia). Overall, music is an important source of enjoyment, learning, and well-being in life as well as a rich, powerful, and versatile stimulus for the brain. With the advance of modern neuroimaging techniques during the past decades, we are now beginning to understand better what goes on in the healthy brain when we perceive, experience, and produce music and how the structure and function of the brain can change as a result of musical training and expertise.The progress in uncovering the neural basis of music has greatly fueled and renewed clinical interest towards music as a neurorehabilitation tool to facilitate recovery and functioning in severe ageing-related neurological illnesses, including stroke, Alzheimer's disease (AD) and other dementias, and Parkinson's disease (PD) (for recent reviews, see Magee, Clark, Tamplin, & Bradt, 2017;Sihvonen et al., 2017a;van der Steen et al., 2017). Overall, music has the capacity to enhance mood and arousal, facilitate verbal and non-verbal (emotional) communication and social interaction, engage multiple cognitive and motor functions, and provide reward and motivation to learn and train. This makes music a highly versatile and potentially very effective means of rehabilitation, setting it apart from other ...

Links Between the Neurobiology of Oxytocin and Human Musicality

“…Music can induce activity in all these regions, while music that is perceived as arousing and is appreciated also drives dopaminergic activity in nucleus accumbens in the ventral striatum, an anticipatory and reward center (Blood and Zatorre, 2001 ; Menon and Levitin, 2005 ; Boso et al, 2006 ; Salimpoor et al, 2011 ; Zatorre and Salimpoor, 2013 ; Mueller et al, 2015 ; Ferreri et al, 2019 ; Gold et al, 2019 ; Shany et al, 2019 ). Music that evokes strong emotional valence is associated with altered activity not only in the superior temporal gyrus but also in the caudate nucleus, insula, thalamus, cingulate cortex, orbitofrontal, dorsomedial, dorsolateral and ventromedial prefrontal cortex, inferior frontal cortex and supplementary motor area (e.g., Blood and Zatorre, 2001 ; Koelsch et al, 2006 ; Mitterschiffthaler et al, 2007 ; Chapin et al, 2010 ; Brattico et al, 2011 ; Pereira et al, 2011 ; Khant et al, 2012 ; Altenmüller et al, 2014 ; Koelsch, 2018 ; Särkämö and Sihvonen, 2018 ; Sachs et al, 2019 ). Of course, music involves more than just listening, and imaging of people—alone or with others—creating and improvising jazz, rap or rock music has also revealed increased neural activity in the medial frontal lobe and altered, usually decreased, activity in the dorsolateral prefrontal cortex when compared to the same subjects playing or singing “formulaic sequences” (Limb and Braun, 2008 ; Liu et al, 2012 ; Donnay et al, 2014 ; Tachibana et al, 2019 ).…”

“…From an evolutionary perspective, it may clarify the extent to which evolving musical capabilities in modern humans took advantage of the ancient oxytocinergic network to facilitate prosocial interactions, promote trust and reciprocal affiliative behaviors, and help reduce levels of anxiety and individual insecurity throughout life. It will also contribute to a better understanding of the mechanisms that underlie the mental and general health benefits of music, its remarkable emotional and mnemonic power, it’s capacity to alter brain architecture, and its ability to revitalize episodic memories (Zhang et al, 2017 ; Särkämö and Sihvonen, 2018 ), especially vulnerable in early stages of Alzheimer’s disease (Groussard et al, 2019 ; Slattery et al, 2019 ).…”

“…Music, via its impact on various regions within the limbic system, is also rewarding, motivating, and facilitates aspects of learning and memory (Zatorre and Salimpoor, 2013 ; Koelsch, 2018 ). Lastly, and no less important, it is increasingly appreciated that musical activities are useful therapeutic tools, aiding in the treatment of some developmental disorders (Quintin, 2019 ), and capable of ameliorating behavioral and psychological symptoms in several neurodegenerative conditions (e.g., Abraha et al, 2017 ; Zhang et al, 2017 ; Särkämö and Sihvonen, 2018 ; Groussard et al, 2019 ; Pereira et al, 2019 ).…”

Reorganization of the neurobiology of language after sentence overlearning

“…For example, given the preservation of formulaic language and corresponding sensorimotor regions in some individuals with aphasia and Alzheimer's disease, it makes sense to focus on those expressions and regions as they might be used as a scaffold for language recovery. Indeed, use of formulaic song and language shows promise in therapy [185][186][187][188][189][190] . In contrast, the relative preservation of some other aspect of language and associated distributed set of network nodes might benefit from a different intervention.…”

Could Self-Consciousness Be Enhanced in Alzheimer’s Disease? An Approach from Emotional Sensorial Stimulation

“…These emotionally charged sensory stimulations could help to implement better intervention strategies to improve the well-being of AD patients and their families; hence, the importance of studying potential SC enhancers in AD, using the Emotional sensorial stimulation with odor, musical, or taste cues. The powerful senso-perceptive cues have a beneficial impact on the involuntary retrieval of autobiographical memories in AD, principally by diminishing the time taken to retrieve these memories [113][114][115][116][117]. The involuntary retrieval may promote a direct link between the cue and the memory trace, thus avoiding the complex recovery process involved in voluntary autobiographical remembering.…”