EFTA00304437.pdf

ACADEMIC INNOVATIONS Institute Probes Music's Therapeutic Potential M.J. Friedrich Medical School and an executive board to Dion and the Belmonts and the member of the institute. Young Rascals, he played guitar in a T HE HEALING QUALITIES OF MUSIC Accordingly, the institute is ex- rock band while in grade school, per- have been appreciated since an- pected to draw from the large commu- forming at the New York World's Fair cient times. Today, music con- nity of research scientists, clinicians, in 1965. In high school he began com- tinues to occupy a therapeutic niche in and other experts in the Boston area posing songs, including a rock musi- a range of settings and is gaining rec- who are involved in auditory-related cal, "Apotheosis of the King Who Lost ognition as a valuable complement to His Kingdom," which he recorded for conventional medical treatment in a Columbia Records. number of areas, such as relieving pain Tramo's musical pursuits eventu- during childbirth (Pain Manag Nun. ally took a back seat to his research in 2003;4:54-61). neuroscience, but not without strongly Rigorous evaluation of such effects is influencing his research path. He now needed to ensure that music is used most studies how the auditory cortex pro- effectively in patient care. Such an ef- cesses pitch, harmony, melody, and fort is one of the aims of neurologist other aspects of music, and works with Mark Jude Tramo, MD, PhD, founder patients with epilepsy, stroke, and other and director of the Institute for Music conditions to understand how brain and Brain Science at Harvard Medical damage affects music perception. In- School, in Boston. Throughout his ca- tuition from his musical background reer, Tramo has used music as a lens to "helps me be creative with experi- examine brain function. He envisions the ments, thinking about how the brain nascent institute as an entity that will functions," he said. bring a multidisciplinary perspective to The institute's mission is ambi- research on how the auditory cortex tiously broad, ranging from advancing functions—not only to gain insight into knowledge of the neurobiological foun- fundamental auditory processes, but also dations of music, to rigorously evaluat- to apply that insight to such problems ing and quantifying the healing effects as hearing loss and brain damage. studies, from the very technical to more of music on various disease states. In ad- cognitive and therapeutic areas. A dition, Tramo foresees that insights from LAYING GROUNDWORK center such as this, said Zervas, a former the work could lead to new technolo- Tramo has spent the last 2 years lay- president of the Boston Symphony Or- gies to promote health and treat dis- ing the groundwork for the institute's chestra, can encourage collaboration ease, or improve established technolo- activities. The group currently in- among these experts. gies, such as cochlear implants. cludes a number of investigators affili- ated with Harvard Medical School. But ROCK 'W ROLL HEART NAME THAT TUNE a host of researchers with different areas A musician and composer as well as a Christine Koh, PhD, a postdoctoral fel- of expertise will be required to fulfill physician-scientist, Tramo, a neurolo- low at Harvard Medical School, is col- the institute's goal of finding out "how gist at Massachusetts General Hospi- laborating with Tramo to study music music is understood by the brain, from tal and an assistant professor of neu- perception in patients with brain le- the single cell on up to global process- rology at Harvard Medical School, sions caused by stroke or epilepsy. like ing" and applying that knowledge represents the convergence of music Tramo and many others who study the clinically, said Nicholas Zervas, MD, and science. Growing up in the 1960s neurobiology of music, Koh (who stud- professor of neurosurgery at Harvard in an area of the Bronx that was home ied violin for 12 years) is a musician as 7559 1AM.A, Apnl 7, 2004—Vol 291. No 13 (Reprinted) 02004 American Medical Association. All rights reserved. EFTA00304437  ACADEMIC INNOVATIONS well as a scientist. She is combing a large sents sounds, from music to speech. A mask background noise—and per- database of stroke patients at Massa- key problem concerns understanding haps even speed the healing process, chusetts General Hospital, looking for how information is encoded by neuro- said Tramo. Some studies have shown individuals with specific types of le- nal spike patterns. that enriching the acoustic environ- sions in the auditory cortices. These pa- Cariani likens this problem to the co- ment of neonatal units with music can tients are undergoing a variety of tests nundrum biologists faced before the dis- increase the speed at which preterm in- designed to provide a broad picture of covery of DNA. "Classical geneticists fants gain weight and reduce their the nature of their deficits in music knew that information was encoded length of stay in the unit, he noted (bit perception. somehow, they knew there was a mecha- J Arts Med. 1997;5:4). Koh and Tramo are also studying pa- nism of inheritance, that it was precise Future research plans include iden- tients with epilepsy who plan to un- and reliable," he said. But they did not tifying the types of music and envi- dergo a therapeutic temporal lobec- know whether the information was en- ronmental sounds that have positive tomy or excision of a piece of their coded by proteins or DNA, or how the health effects on mood, blood pres- auditory cortex—dramatic procedures code worked. sure, or immunologic measures, for used to alleviate seizures that severely Neuroscientists face an analogous example. Bernie Krause, PhD, a bio- compromise quality of life. Unlike in- dilemma in trying to understand the acoustic researcher and member of dividuals who have experienced a stroke, nervous system without knowing the the institute's advisory board, noted this group of patients will allow the re- "neural code," he said. "We don't un- that although he and others have searchers to compare musical capabili- derstand the neural codes, we don't un- gathered anecdotal information on the ties before and after the procedure. derstand the nature of the coding of the beneficial effects of natural sounds— Simple tests—such as asking pa- information in the central nervous sys- such as reducing the amount of pain tients to decide if one tone is higher or tem," Cariani explained. "It's hard to medication patients require in some lower, longer or shorter, or louder or understand informational processes if situations—more objective data are softer, than a second tone—accecc pitch you don't understand this." needed. discrimination. Other tests probe such A better understanding of neural cod- To this end, Tramo and Krause (presi- abilities as being able to determine ing has practical applications, said Cari- dent of Wild Sanctuary Inc, a California- whether two melodies are the same or ani. For example, cochlear implants based company that produces natural different. have been developed by trial and er- sound recordings for soundscape de- "The remarkable thing—and one of ror, to a large extent, without a very ex- sign, and a former member of the folk the reasons that music research is so fas- plicit notion of neural coding in the au- group, The Weavers) hope to evaluate cinating—is that you can do a lot of this ditory nerve. But if scientists succeed the effects of such sounds on individu- testing with people who don't have any in cracking the neural code, the ad- als with such conditions as anxiety, musical training," noted Koh. Due to vance could lead to improvements in depression, and pain. early exposure or intuitive sense, hu- the devices. As the research proceeds, efforts are man beings seem to have an inherent also under way to secure a funding base musical sense, she said. SOUNDSCAPING from public and private sources to take One of the goals of Koh's research is While basic neuroscience research is an the institute to the next phase, from a to determine whether low-level func- integral aim of the institute, it is im- loose collection of like-minded collabo- tions such as pitch discrimination are portant not to lose sight of the fact that rators to an entity with a full-time related to higher-level cognitive func- music and other components of the complement of researchers and oth- tions such as melody processing. acoustic environment can help pa- ers, said Douglas Brightbart,JD, the in- "While some of this work is very ba- tients feel better, said Tramo. stitute's chief operating officer. sic, it will provide us with the founda- With that in mind, part of the insti- Tramo predicts that exploring the tion to get a better understanding of tute's mission is to raise awareness neurobiological foundations of music how the auditory system is laid out," about the importance of improving the is likely to provide insights into the she said. "That will help direct us to "acoustic ecology," or soundscaping, of neurobiology of perception, perfor- practical therapeutic applications." hospitals and clinics. Tramo believes mance, development, plasticity, emo- that just as attention is paid to the tion, and learning. But it's important BREAKING THE CODE art that adorns the walls of hospital cor- to keep the focus on trying to help Another member of the institute, Pe- ridors and patient rooms, the sound- people, he said. "That's a major goal of ter Cariani, PhD, assistant professor of scaping of these areas should also be the institute, to carry out studies well, neurocomputation and neurophysiol- addressed. and if they really do show positive ogy at Harvard Medical School, wrestles A pleasing acoustic environment with effects [on health), to deliver these with the issue of how the brain repre- music and natural sounds can help to benefits to patients." O2004 American Medical Association. All rights reserved. (Reprinted) JAMA, April 7, 2004—Vol 291, No 13 1555 EFTA00304438