Journal of Health Care and Research
ISSN: 2582-8967
Article Type: Commentary
DOI: 10.36502/2024/hcr.6236
J Health Care and Research. 2024 Sept 28;5(2):53-56
Recent Topics for Music Therapy and Related Development
Akiyo Yoshioka1, Hiroshi Bando1,2iD*, Yu Nishikiori1
1Shikoku Division of Integrative Medicine Japan (IMJ), Tokushima, Japan
2Medical Research/Tokushima University, Tokushima, Japan
Corresponding Author: Hiroshi Bando ORCID iD
Address: Tokushima University /Medical Research, Nakashowa 1-61, Tokushima 770-0943, Japan.
Received date: 04 September 2024; Accepted date: 21 September 2024; Published date: 28 September 2024
Citation: Yoshioka A, Bando H, Nishikiori Y. Recent Topics for Music Therapy and Related Development. J Health Care and Research. 2024 Sept 28;5(2):53-56.
Copyright © 2024 Yoshioka A, Bando H, Nishikiori Y. This is an open-access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium provided the original work is properly cited.
Keywords: Music and Art Therapy, Integrative Medicine Japan, Playing a Musical Instrument, Mild Cognitive Impairment, Musical Experience Questionnaire
Abbreviations: IMJ: Integrative Medicine Japan; MCI: Mild Cognitive Impairment; MEQ: Musical Experience Questionnaire
Abstract
In the context of aging and neuropathology, recent topics in music therapy and related advancements are introduced. The authors have managed the Shikoku division of Integrative Medicine Japan (IMJ). Lifelong engagement in music activities can help maintain cognitive reserve, thus promoting brain health. Musical instrument training has been shown to improve executive function, processing speed, and verbal memory. Playing a musical instrument was associated with a significantly decreased risk of dementia, with a hazard ratio (HR) of 0.64 among the elderly. A comparison between playing an instrument and karaoke showed dementia risk HRs of 0.70 and 0.90, respectively, for elderly males. Musicians were 64% less likely to develop mild cognitive impairment (MCI) or dementia.
Commentary
From actual medical practice, various activities in music and art can contribute to the treatment of patients [1]. The authors have been physicians, music therapists, pianists, calligraphers, and artists, and have managed the Shikoku division of Integrative Medicine Japan (IMJ) for years [2]. Thus, patient-oriented medicine has been the focus within the broader field of Integrative Medicine (IM). Recent useful topics for these areas are introduced in this article.
In the UK, a large cohort study was conducted on musicality and cognitive states [3]. Participants over 40 years old (n=1570) were assessed using the Edinburgh Lifetime Musical Experience Questionnaire (ELMEQ) and analyzed by computer. As a result, 1392 participants (89%) had experience playing an instrument, and 690 (44%) were currently playing an instrument. Those who played musical instruments showed significantly better performance in executive function and working memory. A significant relationship was observed between executive function and singing, as well as between working memory and musical ability. Thus, the value of engaging in music activities throughout life can be evaluated as a cognitive reserve measure for protective brain health.
In terms of neuroanatomical and phenotypic grounds, musical exposure may influence the clinical manifestation of behavioral variant frontotemporal dementia (bvFTD). A study was conducted on 14 cases of bvFTD using standardized functional scales and a semi-quantitative musical survey [4]. The cases with greater musical experience earlier in life showed significantly lower Cambridge Behavioural Inventory scores (p=0.01) and higher Modified Interpersonal Reactivity Index (MIRI) scores (p=0.03), after adjusting for general cognitive ability. Listening hours were also related to total MIRI scores (p=0.014) and elevated MIRI perspective-taking scores (p=0.015). Consequently, having more musical experience and listening to music regularly may improve emotional and social abilities in bvFTD cases. Further work is needed to substantiate the robustness of this relationship.
Previous studies in music therapy have shown that musical instrument training improves several abilities, including executive function (trail making test), processing speed (digit symbol coding test), and verbal memory (logical memory test, delayed recall). However, it is unclear whether short-term instrument training can provide similar benefits. A recent study included elderly participants (mean age: 73.3 years, n=30), divided into two groups: trained intervention (n=30) and untrained control (n=30), with 10 sessions per week [5]. Neuropsychological exams were provided to assess the efficacy of the intervention and its association with musical training. Two additional exams for rhythm entrainment (timing task) and verbal working memory (Sternberg task) were also included. The results showed that a short protocol of one week did not yield significant changes, unlike the previous findings after 16 weeks.
Regarding cognition and music domains, the interaction of gene-environment production is likely involved [6]. Genetic predispositions are influenced by various experiences, which lead to subsequent phenotypic expression. In particular, the timing of early exposure seems crucial for music training. It likely produces long-term beneficial impacts on the adult brain and behavior. Previous reports suggest that starting music training before the age of 7–9 strengthens musical performance and modifies brain function and structure. Such research can be expanded to clarify how genetic factors, experience, and brain development interact in the future.
A systematic review and meta-analysis of prospective cohort studies on musical instrument playing and dementia risk were performed [7]. Three papers were found (1 Japanese, 2 US). The meta-analysis showed a significant association between playing a musical instrument and a decreased risk of dementia (HR=0.64) in the elderly. In terms of music therapy, the relationship between engaging in musical activities such as karaoke and the risk of dementia was also investigated [8]. Subjects (n=52,601, ≥65 years) were studied for the content and frequency of musical activities over 5.8 years. The hazard ratio (HR) was calculated, comparing those who engaged in musical activities with those who did not. HR was 0.94 vs. 0.59 in men, and 0.79 vs. 0.89 in women, for single vs. multiple musical activities. For playing musical instruments vs. karaoke, there was a lower risk of dementia, with HRs of 0.70 vs. 0.90 in men and 0.75 vs. 0.77 in women. In conclusion, engaging in musical activities can reduce the risk of dementia.
There have been no evident medical approaches with strong evidence to address health problems associated with aging and neuropathology. In this context, exercise habits and musical activities are examples of ways to enrich lifestyles with satisfaction [9]. In recent years, these activities have been shown to increase cognitive reserve throughout life and maintain neurocognitive function in the elderly. As society ages rapidly, the effects of musical activities are expected to serve as a possible and convenient measure.
When a person engages in intellectually stimulating activities throughout life, their cognitive reserve seems to increase, helping to prevent mild cognitive impairment (MCI). Playing a musical instrument during leisure time can be a viable form of stimulation. A systematic review and meta-analysis on musical instrument playing and the risk of dementia/MCI were conducted [10]. Out of 1211 reports, one twin study and two cohort studies were found. These studies had satisfactory methodological quality, showing a protective effect of musical instrument playing. The twin study found that musicians had a 64% lower risk of developing MCI/dementia after adjusting for education, sex, and physical activity. The cohort studies showed a 59% decreased risk of developing dementia over the follow-up period. These studies demonstrate the relationship between continued musical instrument playing and the incidence of MCI/dementia.
Impressive results have been observed in both young and elderly musicians [11]. Young musicians show greater gray matter volume (GMV) in the auditory-motor region and cerebellum compared to non-musicians. Elderly musicians were studied for GMV, brain activity, behavioral performance, and functional connectivity (FC) during melodic working memory (MWM) tasks. Bilaterally larger GMVs in the cerebellum were found, with stability into very old age. FC analysis revealed that musicians had greater cerebellar-hippocampal FC, correlating with tapping speed.
In summary, this article introduces recent topics in music therapy, art therapy, brain function, and related areas. From the perspective of holistic medicine and integrative medicine, a broader scope of medical practice has been gradually included. Further developments in this field are anticipated.
Conflict of Interest
The authors have read and approved the final version of the manuscript. The authors have no conflicts of interest to declare.
Funding
There was no funding received for this paper.
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