Daniel Levitin

Daniel Levitin: One of the things about musical memory is that, in some respects songs stick in our head, and maybe that’s because they’re supposed to. It’s difficult to talk about these things without talking about evolution. When you can remember a song so well, maybe it suggests that evolution wants us to. Maybe songs played an important role in our evolutionary history. A lover out on a hunt for a long period of time wants to be remembered while he’s away, she wants him to remember her, they have their song that they sang to each other, and, you know, that sticks in the head, and it keeps them faithful, and, you know, there’s some evolutionary advantages in that, in terms of raising the kids and, and so on. I’m interested in what attributes of music stay stuck in the head. Is it rhythm, it is pitch, what is it? It turns out to be all of it.  The average person has an extraordinary memory for the components of music. Even when there’s no theoretical reason why they should.  So, take the song “Happy Birthday”. Every time you sing it, you sing it in a different key. It’s still the same song. Whoever it is that’s in the room that starts, they just start any way they feel like, they may not even think ahead. And then you all join in, and some of you are synchronized in the right pitch, and some of you aren’t, and it doesn’t really matter. It’s still the same song.

In fact, it was the Gestalt psychologists, who noticed in the 1890s, Christian Von Ehrenfels and Max Wertheimer and others, that there’s this funny property to songs. You can sing them with any group of notes, and they’re still recognizable as the same song. Even when you change every single note, it’s still the same song.

It’s because songs are defined by the relationship between pitches, not the absolute pitches. Nevertheless, if you ask the average person in the street to just sing their favorite song, they tend to sing it with the right pitches. Their memory has encoded this information that isn’t necessary for maintaining the identity of the song, but it’s there.  Why would evolution create a brain mechanism that holds onto the stuff that it doesn’t need? It must’ve been important, throughout evolutionary time, or it must be that memory is more efficient, if it can hold onto all this detail. People don’t just remember the absolute pitches, but they tend to remember the actual tempo, and a lot of the little nuances of the singer’s voice. When Michael Jackson goes, “Eeh, eeh!” or Madonna has a particular growl in her voice, people remember all of that, and they replicate it when they sing.

So describe how you do this experiment to study this.

One of the ways that, that we study this is we just bring people into the laboratory, or stop them on the street. We ask them to sing their favorite song. And then we analyze their production, and compare it to the CD. Now, in order for this to work, they can’t be singing a song like “Happy Birthday”, or the National Anthem, or “Deck The Halls”, where there is no right key. But if they sing a pop song, a song by U2 or by Backstreet Boys, that song exists in the world in only one version, and it’s the version that people have heard thousands and thousands of times. There is a correct answer to the question, “What is the tempo of that song?” or, “What is the, the right pitch, starting pitch?” You just record them, you compare it to the CD, and you, you look at the pitch and the tempo and you see how close they got.

So, coming back to emotion in music- what are the possible theories about why music affects us emotionally?

There are a lot of different factors that go into our emotional appreciation of music.  Some of it is the memories we have of a particular song, which we heard at a particular time in our lives, or it reminds us of a song that had those qualities. Some of it has to do with just the beat, the pulse. Music like James Brown or March music, for that matter, can be invigorating. It makes you want to move your body. Other music can make you, uh, just sort of melt and relax.  It’s, it’s either composed to have that affect, or it’s performed to have that affect.

We do know that listening to music releases certain neurochemicals. If you listen to music that you enjoy, it releases dopamine, a so-called “feel-good hormone”. It can also release prolactin, the comforting hormone that’s associated with mothers lactating and feeding their infants.

There’s another hormone called oxytocin that’s the so-called “trust hormone.” This is the hormone that’s released when two people- well, if a person has an orgasm, oxytocin is released, and it makes them bond to the person that they’re with. If two people have an orgasm at the same time, they bond to each other. There’s an obvious evolutionary advantage for this. Oxytocin causes feelings of trust with the person. For reasons that we don’t fully understand, when people sing together, oxytocin is released. People trust more, people that they’ve sung and played music with.  So there’s all this neurochemical change that occurs, in response to playing and listening to music.  And we’re just at the beginnings of trying to sort it all out.

Do you think in a very broad sense, that it’s more because we associate music with something that creates an emotion, or because there’s something structural about the nature of music itself?

I think music contains an enormous amount of information. And I mean information in the technical sense of information theory, the amount of unique content.  That there’s more information than speech.  It’s more complex a signal. And so I think that although music doesn’t convey information like, “Hey, would you open the window over there?”, it conveys emotional information that’s very nuanced, and we’re sensitive to that. I think that music was probably an early form of emotional communication between humans, and the reason it lasted even after the introduction of language, is that it’s much better at some forms of communications, in some feelings that you want to communicate, than language is. It’s much better at communicating the dynamics of human emotion.

Oliver Sacks, MD, FRCP: We are wired for speech, we are wired for spoken language, for expressing and understanding spoken language. That’s to say any human being who is exposed to language at a critical stage of development in their second or third year will acquire language without any explicit form of teaching. Comsky above others has spoken wonderfully about this, but basically exposure to language activates language parts of the brain. However we are not wired for written language in the same way. Written language only goes back five or seven thousand years. There is no built-in circuitry in the brain for written language. But a circuitry is developed through learning to write. A circuitry which may be somewhat different in different people. In other words what is already in the brain is recruited and pressed into a new use when one learns to write. So in this way is music like speech? Or is it like writing? I’m inclined to think, but here only one can speculate, that both of these are involved. I think there are certain aspects of music which do not have any equivalent in speech, in particular the pulse of music, the steady rhythm, and its synchronization with movement.  I think there is good reason for supposing for that is built in, and there are anatomical connections, which are strongly and almost exclusively developed in human beings.

Concetta Tomaino, D.A., MT-BC, LCAT: One of the reasons, and one of the exciting reasons, why music therapy has so much promise for people with neurological conditions is that music accesses the networks in the brain in a complementary faction (fashion) or differently than the function that a person has lost. And what I mean by that is we can stimulate the timing mechanisms, we can stimulate word finding ability, we can stimulate recognition memory, even short-term memory function through using music in a specific way that makes available to these patients function in the brain that’s still there but maybe they can’t get at independently because of the inhibition that has taken place due to their brain injury.

So music is an enriched sensory stimulus that allows for, I believe, the disinhibition of some of the inhibited function that has been lost in these individuals. And by stimulating these complementary or parallel networks, we see this type of ability come back.

Oliver Sacks: Although personally music has been very important to me from before I can remember. As a physician it only hit me really in the 1960s, and that was when I found myself at a hospital in the Bronx seeing the frozen post-encephalitic patients whom I later wrote about in Awakenings. These were people with very profound Parkinsonism, so profound that sometimes they would stay absolutely motionless for hours on end and could not initiate any movement or speech or indeed thought, although one learned that later, but so much so, “What’s going on with these people?” “Are they there?” “Is there anyone at home?” And it was originally the nurses and people who knew of these patients well who said they could be transformed by music. If there’s music, these people could dance, they could sing, they could talk, they can do things, they can think, they can become almost normal while music is there.

And then I saw this for myself, and I was stupefied. I don’t know what term to use. And 40 years later I find it astounding and it needs to be seen as someone for whom music—someone for whom movement is unimaginable suddenly able to move. But it strictly goes with the music, and when the music stop, they stop. So music therapy for these Parkinsonian patients was my first experience as a physician, and I wondered what sort of music was involved or any music could do so. It didn’t have to be familiar music or loved music. It doesn’t sometimes have to be a conscious attention to the music. But obviously the rhythm and the beat and pulse of music was very important. And this would spontaneously and almost automatically I think allow people to move. So the good music had a strong rhythm, not overwhelming but a strong rhythm. But obviously I think if people like the music, so much the better.

Interviewer: And what have you found out about or what do you believe is going on in the brain that creates this effect?

Oliver Sacks: Well, this reminds me of the way in which all of us want to keep time and tap time, and how children spontaneously start to dance or keep time to music they hear or imagine. And that seems to be a very strong human attribute to have motor responses, movements synchronized with the pulse of music, the sounds.  And uniquely in the human brain, at least uniquely among mammals, one finds connections between the auditory parts of the brain and what’s called the dorsal pre-motor cortex, some of the motor parts. And it seems to be this conjunction of auditory and motor, which is so crucial for all of us in responding to music, but especially if you have something like Parkinson’s. So I think that’s one of the very important thing whether the shape of the melody and the life of the music. Kant the philosopher called the music the quickening art. And music seems inherently alive and to give a feeling of life and emotion and ongoing, and of a journey, a sort of trajectory. And I suspect important all of these could be important as well. It’s just not the rhythm.  Everything in music carries one along.

Also read Concetta Tomain’s article, “How Music Can Reach the Silent Brain.”

Oliver Sacks: And you’ll find that even a few minutes of five finger exercises will make functional changes in the brain, so the brain’s response to music in physiological terms is almost immediate although obviously it would take months or whatever to have anatomical changes. But a year of Suzuki training will produce physical changes in the brain, and there have been studies looking at the brains before and after a year of training. And so whatever gifts a  person has or doesn’t have, musical training seems to be very important, the more so if it’s early.

If music can so alter the brain, at least the musical parts of the brain, when people are young, one would wonder the role of music in education, and whether this enlargement and benefit can spread to other parts of the brain, whether it will facilitate reading, memory, concentration, focus, and there’s quite a lot of evidence that this is the case, and therefore strong arguments for including music in education. But I stress this is something beyond the so-called Mozart effect. A little Mozart under the pillow, a teaspoon of Mozart, while it’s very pleasant and it may introduce people to Mozart, in itself, that’s not enough. There needs to be real engagements with music and a lot of it.

Oliver Sacks: I said earlier that there’s no one music center. And one of the things which is now apparent from brain imaging is that music can involve many different parts of the brain, special parts for the response to pitch, and to frequency, and to timbre, and to rhythm, and to melodic contour, and to harmonic and everything else. In fact you may find that much more of the brain is involved in the perception and the response to music than to language or anything else. One aspect of this is that if one does brain imaging, you can often distinguish the brains of musicians from the brains of non musicians because certain parts of the brain may become so enlarged in response to music that you can see the changes with the naked eye. You can’t say that’s the brain of a mathematician or a visual artist. You may be able to say I think that’s the brain of a musician.

Oliver Sacks: Now there’s no one musical center, there are 15 or 20 different systems in the brain. But in general many of the musical parts of the brain, if I could put it this way, are close to the memory parts and close to the emotional parts. And so music tends to embed itself in memory and to evoke emotions with an immediacy beyond, I think, of any other stimulus with the possible exceptions of smells. But in particular when people really have chills and thrills and sort of their hair stands on end with music enraptured, then you can find the particular systems of the brain rewards systems are activated, the same systems which are activated when one falls in love, or is overwhelmed with beauty generally. But that being said, that leaves the problem “So what’s beauty?” It’s just not sort of pleasure, it’s the whole nature of aesthetic and beauty and the sublime, which is so overwhelming in music or can be.

My awakening came in a small nursing home in East New York more than 20 years ago.

Strange sounds and the cadences of repetitive speech filled the dementia day unit. In the noisy chaos, some residents slowly limped around the room or along the halls; others sat, heads down, silent, seemingly unaware of their surroundings. Here were all the human losses that we associate with dementia, stroke, and late stages of neurologic diseases. Visitors to nursing homes know them well, and most assume, as I did, that the lost functions are gone forever. Indeed, I asked myself that day, what could music possibly do for men and women so afflicted? Still, I had come to begin my work as a music therapist, so I sat down at the piano and started to play “Let Me Call You Sweetheart.”

At first, I could barely hear myself play. But after a few minutes, the sound of singing began to rise above the noise, then dominate it. As I watched, even the silent patients turned their gaze to me. It was too remarkable a change to assign only to the allure of an old familiar song. People who had seemed unable to focus became attentive. Residents whom I knew to have limited cognitive skills had recognized the melody; their voices found the right words. Some with seemingly uncontrollable repetitive movements now kept steady time with their hands and feet.

I wondered: Could our processing of music be so different, or so basic, that abilities relating to it remained accessible in people so limited in function? In 1978, little was known about music and brain function. Today, as a result of exponentially increasing research, particularly over the past five years, we can venture some initial answers to my question.

Music’s Forgotten Secrets

Music predates recorded history, but its roots may lie in early human communication and rituals for healing. In traditional African cultures and rain forest cultures in other parts of the world, for example, music is connected with many of life’s vital patterns and occasions. In Western culture, however, as music became increasingly accepted as an art form, its therapeutic properties were mostly forgotten—rediscovered only when music therapy became an organized field in the early 1950s. Since then, a torrent of peer-reviewed clinical and scientific studies have focused on music’s therapeutic value in areas from reducing pain, to improving memory and cognition, to helping motor function. But even though we know how effective music therapy can be, the investigation of its effects on recovery of function in people with neurologic impairment is new and exceedingly challenging.

Music is a complex stimulus, involving everything from pitch to rhythm, melody to volume. Consequently, it is not processed in a single area of the brain. We can see this in what is called “amusia,” in which a single musical skill is lost when a specific area of the brain is damaged—for example, loss of pitch perception resulting from lesions to the right temporal lobe. But while a component of music, such as pitch, may be processed in a specific region of the brain, the overall experience of music is a gestalt of perceptual and psychological processes occurring in synchrony and involving a spectrum of neurologic activity and brain regions.

We now know from clinical case studies that music can affect—in very specific ways—human neurological, psychological, and physical functioning in areas such as learning, processing language, expressing emotion, memory, and physiological and motor responses. How your brain perceives and processes music also differs depending on whether or not you are a musician. The effects of music raise intriguing questions about both early brain development and brain plasticity later in life.

Sam: Getting The Beat

Sam, a man in his late 60s, was recovering from a stroke. His physical therapist rated him a “guarded walker”—able to shuffle along with a quad cane, but not steady enough to walk outdoors, where he might have difficulty negotiating the uneven pavement. Because his left side was weak, his left foot dragged along the floor, causing him to take faltering steps. Each step was slow and hesitant, as Sam focused intensely on the process of walking. After he had been in traditional physical therapy for two months, and was showing little further improvement, he was referred to music therapy in the hope that he could improve his sense of his body’s position and his balance.

The physical therapist tested Sam’s gait, and I found music with a tempo that matched the pace of his stride. He knew the music and was comfortable walking to it. In fact, he told me how, as a teenager, he used to go dancing every week at the gym. As he walked, he became more confident of his movements. Amazingly, he began to add dance steps, sliding his feet or clicking his heels. He said he couldn’t help it; it just happened. He wasn’t “thinking about walking,” he said, he was “thinking about dancing.”

Could there be a separate motor template for these dance movements, so different from walking? Or was it lack of conscious motor planning on Sam’s part that freed up his motor cortex to send the necessary signals to his legs? As the sessions went on, he became more inventive in his movements. After several weeks of twice-weekly meetings, he began lifting his left foot off the floor. Now his steps were in perfect time to the rhythm of the music. He was not consciously aware of this, but he said that he could feel the tempo in his leg and thought that he was able to feel the floor with his left foot. This suggested that he was regaining sensation and control in that side of his body. But when the music stopped, Sam would again shuffle and drag the affected leg. We worked together for two months, twice a week, and his physical therapist also had Sam sing the song to himself as he walked in the rehabilitation gym. The music’s rhythm was an external cue that organized Sam’s walking without conscious effort.

Rhythm is, in fact, the primary property of music and is critical to human life in other ways. Plato defined rhythm as “the order in movement,” and the temporal structure of music (its movement) has suggestive parallels in human motor development. At five months of age, when a fetus’s neural circuits and auditory memory are forming, it experiences rhythm through the mother’s heartbeat and respiration. Immediately after birth, basic motor patterns begin to develop. While eating, crawling, and walking, each child finds a cadence, particular motor rhythms that will remain fairly consistent throughout life. Our natural and spontaneous body movements may be outward representations of inner timing mechanisms. Leon Glass, Ph.D., at McGill University, and other scientists are investigating the complex mathematics of physiological rhythms and how they interact to maintain our health. We know that an alteration in internal rhythm—cardiac arrhythmia, for example— can be the harbinger of ill health or death.

Some internal rhythms can come to match external rhythms. In effect, a rhythm in the external world is heard and internalized, evoking an answering rhythm within us. When we understand how and when external auditory rhythms, or cues, influence various internal timing mechanisms, rhythm can become a powerful therapeutic tool.

The effect of external rhythmic cues on motor function, as we saw with Sam, is a prime example of how this influence occurs. Brain-imaging studies show that an area in the prefrontal motor cortex will start to become active at precise intervals in anticipation of a sequence of motor activity, such as finger tapping at one-second intervals. The resiliency of this motor-timing mechanism is strikingly apparent in people whose motor control, or motor initiation, has been lost as a result of a stroke or Parkinson’s disease, but whose brains still respond to a rhythmic stimulus.

In neuromuscular diseases affecting the ability to initiate and control movement, external rhythm seems to supply the timing information that makes movement possible. For Sam, even singing the song to himself provided the required neurologic benefit, the external cue. Writer and neurologist Oliver Sacks, M.D., author of The Man Who Mistook His Wife for a Hat, eloquently describes a similar response to music in one of his post-encephalitic patients, who had great difficulty walking alone but walked perfectly if someone walked with her—or could time her steps to music. She said: “Whether it is others, in their own natural movement, or the movement of music itself, the feeling of movement, of living movement, is communicated to me. And not just movement, but existence itself.” Sacks studied this phenomenon in the EEGs of some of these patients when they merely imagined a specific piece of music. Although their regular EEGs were very abnormal—the brain was slow on one side while convulsive on the other, for example— when they played the piano or simply imagined a piece of music, their EEGs became more normal.

Why Movement Responds To Rhythm

Michael Thaut, Ph.D., and his colleagues at Colorado State University suggest that the sensitivity of our motor systems to influences from sounds may have developed during human evolution so we could use the way we process what we hear to enhance our ability to organize and control our movements. Our basic auditory-arousal mechanisms (for example, our movements in reaction to a sudden loud noise) operate primarily through the amygdala in the brain’s limbic system and may have originated in adaptive evolutionary processes, namely, the fight-or-flight response. In any case, the auditory system has connections to the brain stem, midbrain, and higher cortical structures, and normal motor function requires that these subcortical and cortical regions work in concert with each other.

The basal ganglia, a brain region affected in Parkinson’s disease, provides a link to still other areas of the brain that connect mental processes and the initiation of movement. While the thought or wish to move depends on higher cortical processing, the actual ability to move depends on lower brain regions. If the higher cognitive processes that can initiate movement are damaged in traumatic brain injury or stroke, the requisite will to move may nevertheless get a “jump-start” by stimulating motor nerves that are still functional. Does the patterned auditory cue supplied by musical rhythms excite the more primitive motor areas first, and only then recruit or drive higher cortical circuits into action?

New evidence from studies by Wen Jun Gao, Ph.D., and Sarah L. Pallas, Ph.D., at Georgia State University suggests that learning, or at least the organization and development of cortical circuits in the brain, is influenced by patterned sensory activity, such as listening to sound clicks presented at specific time intervals. If such sensory signals turn out to enhance neural development, what role does rhythm—patterned auditory stimulation—play in the restimulation of these networks once they have been laid down? In patients like Sam, regaining physical function began on a spontaneous, unconscious level, indicating that the subcortical areas of his brain were being activated before the restoring of the higher cortical areas involved with the thought and the intent to initiate movement.

Mary: Rhythm And Melody Find A Voice

Rhythm also has a therapeutic effect for people with dysarthria, a motor/speech problem that occurs when functioning of the vocal organs is impaired. Dysarthria results in poor articulation of words; speech is slurred and, in the most severe cases, unintelligible.

Mary, a 56-year-old music therapy patient, had been in a coma for three months. It left her with severe dysarthria— a lack of vocal tone and severely distorted articulation. Spasmodic tremors contributed to the severity of her symptoms, and she had an open tracheotomy that made vocal sound production even more difficult.

Because weak muscles made her breath control poor, she also had difficulty sustaining any sounds she did make. Mary’s overall comprehension of language, however, was intact. She was getting speech therapy to help her produce adequate yes or no responses, develop techniques for functional communication, and maximize existing “mouthing” skills, including motor gestures like chewing and yawning.

We knew that Mary had sung in her church choir and was familiar with many old hymns. In fact, even with her inability to sustain any intelligible sounds, she participated in weekly music therapy sessions on her hospital unit, silently smiling at the old tunes. With encouragement, she would attempt to sing along. I could see that her problem resulted in part from lack of coordination between her breathing and her attempts to form a sound, so I asked her to tap her finger as she tried to make a sound. Just that rhythm imparted enough coordination to gain some success, and soon she could sustain the tone for longer.

Once Mary became aware of her increasing ability to alternate breathing and making sounds, in a pattern cued by her tapping finger, she carried this ability over to pacing syllables and short phrases in speech. Before she started music therapy, she could articulate three-syllable phrases with the help of some cueing to breathe at the initiation of the phrase. She also knew the skills she needed to succeed: breathe, speak slowly, exaggerate articulation, and make a syllable-by-syllable attack. She could repeat single words and phrases, albeit with many attempts at self-correction.

In her music therapy sessions, we asked Mary to sing short phrases—five to six words—with the melodic line matching the natural contour of the spoken phrase. The rhythm provided a natural timing mechanism for her breathing, and the melody enabled her to lend a more natural sound to the phrase. In a relatively short time, Mary was applying these techniques outside of therapy and speaking longer, clearer phrases and even sentences.

Words Spoken And Sung

There are several cases in which a patient has recovered speech through the systematic use of rhythmic patterning, leading first to recovery of familiar lyrics and words embedded in songs, then to self-initiation of normal, fluent speech.Image courtesy of Concetta M. Tomaino

Because music has parallels to spoken language, much research on music and the brain has zeroed in on the similarities and differences between them. The similarities could be clues to more successful methods of using musical cueing to stimulate similar language responses in people with brain injuries. One remarkable example of the functional difference between music and language, however, occurs in people who have suffered a left-side stroke, resulting in a type of aphasia where verbal comprehension still exists but the ability to speak or find the right words is lost. In these cases, the brain lesion is often located in what is called Broca’s area; speech is slow, not fluent, and hesitant, with great difficulties in articulation.  Yet, despite the loss of speech, many people with this type of aphasia can sing complete lyrics to familiar songs. This has usually been attributed to the separation of function of the left and right hemispheres of the brain, speech being dominant on the left and singing on the right.

Because many clinicians assume a complete separation of function between singing and speaking, they give little attention to the potential for using music to aid speech. But there are several cases in which a patient has recovered speech through the systematic use of rhythmic patterning, leading first to recovery of familiar lyrics and words embedded in songs, then to self-initiation of normal, fluent speech. In each case, however, this remarkable change had been attributed not to the music but to spontaneous recovery during the early months after the stroke.

A similarity shared by music and speech is what we call “prosody,” which includes the elements of stress, pitch direction, pitch height, and intonation contour, or inflection. People with nonfluent aphasia can perform a type of prosodic speech that includes the inflection and contour of previously known phrases. This speech differs, however, from propositional speech (which includes verbal expression of new thoughts and ideas) in its rate, discrete pitch, and increased predictability. Aniruddh D. Patel, Ph.D., a scientist at the Neurosciences Institute in California, theorizes that rhythm and song, which are inherently predictable, may create a “supra-linguistic” structure that helps cue what is coming next in an utterance.

Brain-imaging studies by Dr. Pascal Berlin, of the Service Hospitalier Frederic Joliot in France, and more recently by Dr. Burkhard Maess at the Max Planck Institute of Cognitive Neuroscience, used PET and MEG scans to determine that areas peripheral to the left language regions of the brain are involved in processing the singing of single words. Additional imaging studies suggest that some aspects of music and language are processed in both the right and left sides of the brain. In many patients who are able to carry over speech techniques from music, success seems to come from their increased ability to attend to sounds and to initiate them, perhaps because parallel mechanisms for these functions have been called into play by music and singing.

Sally: Out Of Silence, A Remembered Song

Just as rhythm can affect motor function and the initiation of movement, a familiar tune or melody can reawaken in persons with dementia, or with traumatic brain injury, seemingly lost memories and feelings. We are so much the sum of our experiences and memories that we cannot help associating each new experience with something that came before it. Imagine how the world must seem to someone with no memory link from past to present. But sometimes music can provide a bridge.

Sally had been diagnosed with leucoencephalopathy. She was mute; apart from crying, she made no vocal sounds. She spent her days pacing the long nursing home corridor and crying. Although she seemed to have lost the ability to recognize objects, she navigated well. If she walked into something, including a person, she would touch it and immediately seem to identify its purpose. One day, as I played some tunes to other residents, I was surprised to hear a beautiful voice singing the complete lyrics to the song I was playing. I turned to the door to see Sally dancing and singing her way into the room.

Later, I telephoned her sister and learned that Sally had played the piano; she had loved to entertain at parties, singing many of the songs I had been playing for the residents. Nevertheless, Sally’s sister was astonished at what I reported, because Sally had fallen mute long before her illness was fully diagnosed. The nursing home staff began singing to Sally every day; she sang back in a kind of chanting tone. Her crying stopped, as did her restless wandering of the halls. Soon she began speaking and became more integrated into the world of the nursing home.

We do not know specifically how music affects memory, but most of us experience that effect every time we hear a favorite song. Indeed, music is capable of arousing in us deep and significant emotions. Memories of music can be so well preserved that the merest fragment of a melody stimulates recall of the song’s title or lyrics. Emotionally charged responses to familiar music are probably the result of connections from the auditory nerve to key limbic structures in the brain. The limbic area, which is associated with emotion, includes the olfactory cortex, amygdala, and hippocampus. The amygdala gets its input from our senses and directly affects our autonomic responses; it is also involved with our moods through interconnections with the frontal cortex and thalamus. The hippocampus plays a significant role in storage of factual information, including conscious (declarative) memory.

For people with neurologic impairments or diseases, music therapy can be an essential first step in recovering functions such as speech or the ability to experience emotion. Scientists are beginning to discover how the elements of music may aid in this process. It is rare for someone to lose all capacity to experience rhythm, harmony, pitch, melody, or other aspects of music.Image courtesy of Concetta M. Tomaino

Because memories persist when they have personal significance, the emotional content of music seems to be processed immediately, even by people with severe dementia. Is this a possible pathway we can use to reach their sense of self? Ernest G. Schachtel said in 1947 that memory, as a function of the living personality, can be understood only as the capacity to organize and reconstruct past experiences and impressions in the service of present needs, fears, and interests. Just as there is no such thing as impersonal perception and impersonal experience, there is no impersonal memory. Thus, familiar songs may serve as cues to recall memories. People with dementia, who may have lost the capacity to process many types of information, including the ability to identify a song, may still respond to that song spontaneously and emotionally. In “Music and the Brain,” Oliver Sacks writes that “it is the inner life of music which can still make contact with their inner lives which can awaken the hidden, seemingly extinguished soul; and evoke a wholly personal response of memory, associations, feelings, images, a return of thought and sensibility, an answering identity.”

Observing how people with dementia respond to music gives us an inkling of how remarkable and instantaneous some of these subcortical processes are. But if, as pointed out earlier, the brain’s processing of music is complex, involving many areas, what specific component of music does a person perceive and process to allow for these immediate responses?

In some instances, factual memories return. New research is shedding light on how this may happen. Ann Blood, Ph.D., Robert Zatorre, Ph.D., and their colleagues at the Montreal Neurological Institute investigated the brain mechanisms involved in emotional responses to music. They found that regions previously identified with pleasant or unpleasant emotional states (with the exception of fear) were activated in the para-limbic brain regions, rather than areas normally associated with music perception. Studies like this reinforce the concept of musical processing as a “whole brain” phenomenon. With the proper musical cue, we may gain access to another system, with enough overlap to jump-start similar areas that are now dysfunctional. That is, when higher cortical processing is compromised, there may be another way into the brain.

Harnessing Music’s Power

Perhaps if we understood more about the relationship between the auditory system and other aspects of human cognitive function, we could reach more people like Sam, Mary, and Sally. For those with neurologic impairments and diseases like Parkinson’s or multiple sclerosis, music therapy is only beginning to be recognized as a promising treatment. In its “Primer on Reimbursement,” the American Music Therapy Association notes that music therapy is recognized as a viable treatment option, including in federal law and by accrediting agencies. It is included in the Older Americans Act Amendments of 1992 and the Individuals with Disabilities Education Act, and recognized by the Rehabilitation Accreditation Commission and the Joint Commission on the Accreditation of Health Care Organizations. Even so, the availability of music therapy for the whole range of situations where it could help is gravely limited.

Although much is being discovered about music’s effects on the brain’s functioning, we have no cohesive, detailed theory of how this takes place. For example, what specific element of music aids in the recovery of language in a person with aphasia? Is it the articulation and rhythmic cueing of familiar speech patterns? Or does singing the lyrics stimulate and improve word retrieval for normal speech? How, specifically, does music affect retrieval of memories? When stimulated by music, what role do lower brain areas (the cerebellum, reticular formation, and others) have in the upward activation of higher cortical mechanisms?

The great Russian neuropsychologist Alexander Luria observed that what we know of brain function is based on what has been lost and what remains following a traumatic brain injury. Music therapists who do neurologic rehabilitation know that it is almost impossible to lose all aspects of music perception. Knowing how the brain processes the elements of music—rhythm, pitch, harmony, timbre, tempo, contour, loudness, spatial location, and melody— as well as associations and memories, and where overlapping or parallel regions share this processing, could support increased use of these components of music early in treatment, the better to take advantage of brain functions that have been preserved.

With the advent of new imaging techniques, we know that the brain is a dynamic, ever-changing system of interconnecting neurons that work in concert to produce our complex, dynamic responses to the world around us. The discovery that new networks and connections may be formed in the brain every time we learn a new skill has implications not only for early childhood development, but also for potential recovery of function after injury.

I will never forget one patient, admitted for short-term rehabilitation when he was in the early stages of dementia. He no longer could dress himself. He seemed not to have the fine motor skills to button his shirt, yet he could play the opening of the “Hungarian Rhapsody” on the violin. Both skills obviously had been used almost every day throughout this man’s life, yet he had lost one and not the other. How can rehabilitation take advantage of such similar but subtly different functions?

It is highly unlikely, for example, that a symphony conductor and a tennis player would have the same motor skills and memories for movement in the left and right hands and arms, yet standard physical and occupational rehabilitation practices would treat them as identical. Conductors, at least the good ones, must be able to give two simultaneous signals that may convey completely different messages—for example, cueing the violins while setting the timing patterns for the percussion section. They will tell you that they can separate the functioning of their left and right sides. In musicians with these overlearned motor skills, certain motor neural networks and overlaying motor areas in the brain may remain intact even after a stroke, and could aid in earlier recovery of function or even development of compensatory mechanisms. But to help, we simply have to know more.

Both basic research and clinical investigations on the underlying brain mechanisms stimulated by different elements of music will continue. It is fairly safe to predict that we will discover that certain elements of music are processed in “primitive” brain regions, including some that are highly resistant to the ravages of traumatic injury and disease. Then we must ask: How do these deeper regions of the silenced brain, reached by rhythms or melodies of music, in turn stimulate the brain’s higher regions (or bypass them) so as to switch on motor, cognitive, or emotion-related functions that had appeared lost forever? The answers will come, though no one can predict how rapidly, and then we may see more often— even routinely—what now seems (and is) a miracle: the man struggling to walk will dance; the haunted, weeping woman who walks the halls will rejoin us, singing; and the mind drained of its memories will know the comfort of a familiar old tune.

Originally published by The Dana Foundation.

Daniel Levitin

Daniel Levitin: In my book, The World In Six Songs: How the Music Brain Created Human Nature, what I’m arguing is that certain changes in the prefrontal cortex, evolutionarily speaking, created structures in the brain that allowed for art, and allowed for reflexive thinking, and allowed for music and science, all as part of the same structural changes in the brain.  The musical brain is also the scientific brain, the metaphorical brain, and the brain that was able to create societies, systems of courts and justice and systems of democratic principles, such as welfare, taking care of people who can’t take care of themselves. All this came from an ability to see ourselves objectively, to see ourselves as members of a society, to build societies in which people looked out after each other and took care of one another.

There is no other species that does this. I mean, we look at ant society, and bee society, which is highly structured, but it’s very different. They don’t have systems of courts, they don’t create art, they don’t try to reflect on their own existence.  I think all of these came from a single set of changes in prefrontal cortex that gave us music at the same time.

So what’s the big question driving music research now?  Is it, “What is the purpose of music?”

I’m not sure there’s a single big question driving music cognition research. I think most of us in the field came at it not from the standpoint of wanting to do music cognition, per se, but wanting to do cognition. How does the brain work? How does attention work?  How does memory work? How do we form new concepts, how do we put things into categories? And we use music as a way to get at those questions because it’s a converging approach, it’s another window into these operations.

It’s also a nice way to spend your time, in the laboratory. I think some of us also have bonafide questions about music, and its role in human culture and in human development.  I happen to think that music was necessary for the formation of human societies.

If you look at primates, they tend not to have living groups with more than eighteen males, because there’s too much competition, they can’t sustain themselves. But for at least five or six thousand years, human beings have lived in assemblies of hundreds of thousands, half a million people. Ancient Athens, ancient Rome were big, big cities. Why is it we can do it and primates can’t? One argument is that collective music making soothes some of the social tensions that would’ve created, splinter societies.

What about the Steven Pinker’s argument?  Tell me what it is, and your response to it.

Steven Pinker’s argument is that music was a spandrel or a co-opted adaptation. These are technical ways of talking about evolutionary biology, but the upshot is that language is what evolution selected for, and music sort of came along for the ride, later.

Once we had language, we figured out ways to trick the brain into making music. And he calls it “Auditory Cheesecake,” which is a well-known argument in evolutionary theory.

People say, “Well, why do we like cheesecake? That’s not adaptive, too much cheesecake causes obesity, and can lead to diabetes and things like that. Cheesecake is not healthy.” But the fact is, over evolutionary time scales, you can’t talk about the age of manufactured foods, you know, with the last fifty years, a hundred years- evolutionary time scales are much longer than that. Tens of thousands of years ago our hunter gatherer ancestors had very few sources of fats and sweets, and it was an adaptive strategy, when they found them, to load up on them, to take some pleasure in storing them in their bodies.

Now, where can you just open the pantry, and there are obscene amounts of fats and sweets available, and you don’t have to work for it?  They’re everywhere, and it turns out they can lead to health problems that we didn’t anticipate. Our liking for cheesecake, Pinker and others argue, is a by product of this old evolutionary system that no longer works. He says the same thing is true of music — our liking for music is a by product of an old evolutionary system that’s selected for language.

I think Pinker’s argument is that there isn’t a gene, or set of genes, that sub-serve music.  We’ve somehow tricked the language system into giving us music. He may be right. There may not be a gene for music. There may be genes that serve components of music. And if they’re there, we have to wonder why they’re there- the genome is crowded. In fact, it’s getting more and more crowded each year. Five years ago we thought humans had thirty thousand genes, now we think there are only twenty-three thousand. I pick up journals every month and they’ve, they’ve lowered the number.  That’s not a lot of genes.

Even though most of the story is how genes interact with one another and whether they’re turned on or not, whether they’re expressed or not at a particular point in time. Gene expression is really the frontier of genetics research today. Still, twenty-three thousand genes- it isn’t a whole lot to go around, when you consider all the different ways that human differ from one another. And when you consider that we’ve got ninety-eight percent of our DNA in common with the chimpanzee, there just isn’t a whole lot left over for things like music, and painting, and language, politics, and art. You know, all the things that make us human.

And what do you think of that?

Well, it’s a reasonable argument.  I think the evidence, has to be considered and weighed by each person for themselves. My personal view, not just because I like music, but my personal view of the science of it, is that there’s more evidence on the side that music was first.

Such as?

Some of the evidence is the way in which music activates primitive structures in the brain, that language doesn’t. The fact that music seems to trigger certain neurochemical reactions- they can be taken evidence, either way. You know, heroin is maladaptive, in the long run, and yet people seem to like it once they try it. It’s tricking the pleasure center into thinking it’s got something good. So, the fact that we get this neurochemical happy juice, or burst, when we listen to music, you can say that, well, it’s, “It’s more like heroin, it’s an accident that music triggers these things.” Or, you can say, “It’s more like nutrition. It’s supposed to trigger those things.” That’s hard to weigh.

But when I look at the animal literature, and you look at birds and primates who have calls that are more musical than they are speech-like — that is they tend to have properties that more resemble human music than they do human speech — to me, anyway, that suggests that music was something that early hominids, Neanderthals and Homo sapiens, probably had, and language came out of that. You can imagine, as Stephen Mithen does — and this is kind of a cartoon version of his argument — that you can imagine a conversation between Neanderthals that had music, but no speech. You’ve got these musical elements, and sort of speech-like elements. You’ve got prosody, rhythm, tempo, pitch changes-all this without words, right? All of this is being conveyed by what we conventionally think of as the elements of music.

Daniel Levitin

Daniel Levitin: I’m not sure if I would say the purpose of music was to build community, but it may have been a function of music. We may have discovered that music can help ease and defuse social tensions, and create social bonds. My idea is that in fact music functioned in six distinct ways, throughout the development of our species. That’s the world, that’s the six songs, in The World In Six Songs. Social bonding was just one of them. Another was to communicate knowledge.

Knowledge becomes embedded in music, and it’s more easily remembered. We can remember things set to song more easily, whether it’s how to build a canoe, or, you know, how to prepare a plant so that it won’t be poisonous.  Another one is comfort.  Mother’s soothing their infants, letting them know that they’re here, even when the infant can’t feel the touch of the mother, because she’s out cooking or gathering. From the auditory signal, the infant is comforted by the recurring sound of the mother’s voice. Or lovers comforting one another, or hunters just letting each other know that they’re out there, when they can’t see each other, under the cover of night, or the cover of trees.

Another one would be joy. Just waking up in the morning and feeling really great, and wanting to move your body and sing, and you just, you know, make nonsense syllables as you move around, and I think, you know, there would have been some evolutionary reward for moving your body, for staying limber and flexing it, and music helps us to synchronize our body movements. It’s important to realize that you can’t make music without moving some part of your body. You either have to hit something or scrape something, or at least vibrate your vocal chords. Or you blow into something.

Love is another one. I think that people use music to express love to one another, as the Native American Indians did, as Pete Seeger told me, there would be a special song that a young man would compose for a young Native American woman, and that would be their song. And it would be what would bind them together. And he couldn’t sing it to anybody else, and she wouldn’t sing it to anybody else. That was their song, and we still talk about “our song”, in our culture. It has an interesting origin.

So there’s love, comfort, joy, friendship or social bonding knowledge, and the final one is religion. I think it’s a separate category of how people used music to think beyond themselves, beyond their own existence, to create a notion that there was something larger than themselves. Now, whether we believe in God today or not is beside the point.  We’re talking about tens of thousands of years of evolution, where people either believed in God, or Gods, or, or some higher power, or, some entity, that was larger than they were, larger than their own concerns, and larger than their own family group. Something they would appeal to, to rescue them in times of trouble.  And music has always been there for that.

But, all those uses of music, or purposes of music, are certainly part of daily life; are  an integral part of our existence, which is somewhat different from the way we may think of music today, going to a concert hall and sitting there and listening.

There has been this interesting evolutionary trend or cultural trend, anyway, in the last five hundred years, that, at least in Western society, we’ve set up a situation where most of us don’t make music everyday, and we don’t participate when other people are making music. We pay money, and then the experts entertain us. In fact, we’re told in school, sometimes, “Oh, don’t sing, leave the singing to the other kids. You just stand there and mouth the words and pretend that you’re singing with us, because you don’t sing well enough.”

Now, this is a relatively recent phenomenon. The first concert halls weren’t built until five hundred years ago, in Europe.  The idea that you would go and pay a class of experts to play for you, and that you would sit quietly with your hands folded in your lap, that’s actually foreign to us, evolutionarily speaking. I’m not saying that it’s a bad thing. — I love a good concert as much as anyone, and I admire great musicians and love hearing them do what they do.  But, if we’re talking purely historically, anthropologically, this is something that’s foreign to our species.

How does music, its power to change the brain, have implications in the field of medicine, and also in education?

There’s been, in parallel to the more basic science side of things, there’s been a kind of practical side of music research: trying to figure out if music can make you smarter, or if learning an instrument has ancillary cognitive benefits. And there have been some rough starts in this arena, over the last fifteen years. But the emerging evidence, from carefully controlled studies, is that learning to play an instrument — not just passively listening, but learning to play an instrument early on — can actually confer some cognitive advantages.

It seems from early evidence thatif you learn to play an instrument early, you learn to read at an earlier age, you learn to read more quickly, you’re better at math, you’re better at a variety of scholastic topics, and we’re not exactly sure why this is, but it seems as though learning to play an instrument trains attentional networks in the interior Cingulate gyrus, in a way that maybe other things would do, too. Learning a second language learning to multitask, maybe crossword puzzles. I mean, nobody’s saying that music does it uniquely. But we’re saying that music does seem to do it.

And music uses many different parts of the brain, right?

Yeah.  Music uses many different parts of the brain, so that might be part of the story, too.

And this way that music can affect the brain also has implications for medicine?

There are a number of medical implications for this kind of work in the large picture of things we just don’t understand that much about the normal healthy brain, and how it functions, and how things are wired up. So any information we can get, either using music as a window or athletics, or playing chess- any of that’s helpful. But one of our goals is, that through understanding how music activates different areas of the brain, we’ll be able to map the brain, and be better equipped to come up with programs to help people that are victims of stroke, tumor, lesions, Alzheimer’s Disease, things of that nature.

The other thing that’s interesting is that when you go into old age homes, you find that one of the last things to go is music. Somebody may no longer remember the names of their spouse or family members, and yet, still be able to remember lyrics to songs they knew when they were fourteen.  Music insinuates itself into memory in a special way. This can be a way to reach out to somebody who is otherwise cut off, emotionally or cognitively, from the people around them.