Prescribing Music

Physicians and patients get into the groove of ‘neuromusic’

Cleveland Clinic neurologist Kamal Chémali, MD, a conservatory-trained pianist, specializes in neuromuscular diseases and the autonomic nervous system. He says the study of “neuromusic” is an active field of research made possible by modern imaging technologies such as functional MRI (magnetic resonance imaging), PET (positron emission tomography) scan and MEG (magnetoencephalography). Now researchers can observe the parts of the brain responsible for body movements, sensory perception, coordination, cognition, mood and anxiety. And they can see which parts are working during a particular activity. They also can reveal differences between a normal brain and one with underlying problems.

Oliver Sacks, MD, neurologist and Columbia University professor, explores the importance of the union of music and the brain in his book Musicophilia: Tales of Music and the Brain (Knopf, 2007). “Music therapists have known for decades that music works therapeutically – it works for people with Parkinson’s, Alzheimer’s, autism and many, many other conditions. But it is only in the last few decades, with the new techniques of brain imaging, that we have been able to study exactly how this happens on a neural level,” Dr. Sacks wrote in an email.

“I expect and hope that music therapy will become a therapeutic option at every hospital over the next few years,” he continued. “It is not only efficacious for many, many patients – it is extremely cost-effective, and it contributes to the quality of life for all of us.”

The most immediate clinical application of neuromusic, Dr. Chémali says, is music therapy. “And yes, we do prescribe music therapy in neurological and palliative medicine,” he says. The goal of palliative medicine is to relieve suffering and improve quality of life for people facing serious illness. He prescribes Mozart twice a day for 20 minutes – with headphones – for patients with chronic pain or with disorders that have not responded well to other treatments. Dr. Chémali says Mozart’s music is pleasant, well balanced and easy to like, though he sometimes chooses other composers.

Music therapy is not limited to a certain type of music. “We are not at the stage where we can say that rock and roll works on one part of the brain and classical music works on the other,” Dr. Chémali says. “We are still learning.”

This story was excerpted from “Healing Notes,” originally published in the Summer 2009 issue of Cleveland Clinic Magazine.

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