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The healing power of music: How it works in the brain

Professor Wolfgang Mastnak specialises in neurosciences, music therapy, cardiac rehabilitation or sports medicine. As a professor in University of Music and Performing Arts Munich and in Peking University, as well as a full member of the New York Academy of Sciences and the European Academy of Sciences and Arts, he holds academic lectures and conducts research around the world. On the occasion of the European Music Therapy Day, which falls on November 15, he delivered a lecture on neurophysiological effects of music therapy at a symposium which was held at the Physical medicine and rehabilitation clinic of the First Faculty of Medicine and General Hospital. He explained to us that music therapy also has a positive effect on patients with neurodegenerative diseases such as Alzheimer’s disease and Parkinson’s disease.


Music therapy has been shown to affect the brain at a neurophysiological level. What is the mechanism behind this?

In general, underlying mechanisms concern regions with multiple functions, for example ventral medial prefrontal cortex for individual identity, the self, and musical significance. There are lots of specific studies on such topics. Music therapy affects principles such as neuroplasticity or improve functional connectivity. And it also affects specific networking, for example music has an impact on the default mode network – creativity and re-organising of cognitive structures. We assume, on the basis of functional magnetic resonance imaging, that music therapy is efficient in reduction of psychotic symptoms – for example auditory hallucinations. This is well known in psychiatry due to interactive involvement of the anterior cingulate cortex, the angular gyrus, the insular cortex and the inferior frontal gyrus.

At the moment we try to find out why particularly aesthetic qualities, because it must sound well, and singing classes for patients are highly effective and play an important role.

Could you tell us more about the “Mastnak’s hypothesis” that you mentioned in your lecture? How does music therapy affect cognitive function in Alzheimer’s patients?

Musical structures are extremely widespread in the brain and central nervous structures. For example, interaction with the speech system, the biographical system or social systems. Particularly in early stages, music can most probably activate non-affected networks that may compensate for specific cortical losses – which can lead in regaining speech competencies through association with well-known lyrics.

How does dancing affect amplitude of low frequency fluctuations and what does it mean for brain functions in patients with Parkinson disease – what motorics are improved by music therapy and how big is the benefit?

Concerning amplitude of low frequency, a Chinese study summarises: “Compared to the novices, ballroom dancers showed increased amplitude of low frequency in the left middle temporal gyrus, bilateral precentral gyrus, bilateral inferior frontal gyrus, left postcentral gyrus, left inferior temporal gyrus, right middle occipital gyrus, right superior temporal gyrus, and left middle frontal gyrus. The ballroom dancers also demonstrated lower amplitude of low frequency in the left lingual gyrus and altered functional connectivity between the inferior frontal gyrus and temporal, parietal regions”.

Concerning music-dance therapy in Parkinson we found that precise internal timing, for example supplementary motor cortex, is crucial for the internal management of movement, which can partly compensate for dysfunctions of basal ganglia due to dopamine loss. In general, we try from the perspective of medical epistemology to not only discover data-connections – for example fMRI and symptom reduction – but explore the quality of the mechanisms, which is – as we all know in medicine – a huge challenge.