Rande Davis Gedaliah's 2003 diagnosis of Parkinson's was followed by leg spasms, balance problems, difficulty walking, and ultimately a serious fall in the shower. But something remarkable happened when the 60-year-old public speaking coach turned to an oldies station on her shower radio: She could move her leg with ease, her balance improved, and, she couldn't stop dancing. Now, she puts on her iPod and pumps in Springsteen's "Born in the U.S.A." when she wants to walk quickly; for a slower pace, Queen's "We Are the Champions" does the trick.
Music therapy has been practiced for decades as a way to treat neurological conditions from Parkinson's to Alzheimer's to anxiety and depression. Now, advances in neuroscience and brain imaging are revealing what's actually happening in the brain as patients listen to music or play instruments and why the therapy works. "It's been substantiated only in the last year or two that music therapy can help restore the loss of expressive language in patients with aphasia" following brain injury from stroke, says Oliver Sacks, the noted neurologist and professor at Columbia University, who explored the link between music and the brain in his recent book Musicophilia. Beyond improving movement and speech, he says, music can trigger the release of mood-altering brain chemicals and once-lost memories and emotions.
Parkinson's and stroke patients benefit, neurologists believe, because the human brain is innately attuned to respond to highly rhythmic music; in fact, says Sacks, our nervous system is unique among mammals in its automatic tendency to go into foot-tapping mode. In Parkinson's patients with bradykinesia, or difficulty initiating movement, it's thought that the music triggers networks of neurons to translate the cadence into organized movement. "We see patients develop something like an auditory timing mechanism," says Concetta Tomaino, cofounder of the Institute for Music and Neurologic Function in New York City. "Someone who is frozen can immediately release and begin walking. Or if they have balance problems, they can coordinate their steps to synchronize with the music," improving their gait and stride. Slow rhythms can ease the muscle bursts and jerky motions of Parkinson's patients with involuntary tremors.
Actually playing music, which requires coordinating muscle movements and developing an ear for timing, can also bring dramatic results, says Rick Bausman, a musician and the founder and director of the Martha's Vineyard-based Drum Workshop. The workshop uses traditional drum ensembles, in which groups of participants play percussion pieces, as one form of therapy for patients with a variety of cognitive and physical disabilities, including Parkinson's disease. Bausman teaches participants to play along with traditional Afro-Caribbean beats like the Haitian kongo and Cuban bembe using congas, bongos, and djun-djun drums. "Participants report that their control of physical movement improves after playing the drums, their motion becomes more fluid, they don't shake quite as much, and their tremors seem to calm down," says Bausman.
Indeed, research on the effects of music therapy in Parkinson's patients has found motor control to be better in those who participated in group music sessions—improvisation with pianos, drums, cymbals, and xylophones—than in people who underwent traditional physical therapy. But gains were no longer evident two months after the sessions ended, so the best results require continued therapy. To stay motivated, Tomaino recommends seeking out both therapeutic drumming groups like Bausman's and social dance classes. Patients can also create music libraries for CDs or MP3 players that can be used to facilitate walking.
Because the area of the brain that processes music overlaps with speech networks, neurologists have found that a technique called melodic intonation therapy is effective at retraining patients to speak by transferring existing neuronal pathways or creating new ones. "Even after a stroke that damages the left side of the brain—the center of speech—some patients can still sing complete lyrics to songs," says Tomaino. With repetition, the therapist can begin removing the music, allowing the patient to speak the song lyrics and eventually substitute regular phrases in their place. "As they try to recall words that have a similar contextual meaning to the lyrics, their word retrieval and speech improves," she says.