The technique appears to activate areas on the right side of the brain, suggesting that these areas pick up the slack for the damaged left side, according to Gottfried Schlaug, a Harvard neurologist whose ongoing research uses functional MRI scans to study language recovery in stroke patients. "It's startling to see these images," says Sacks, "one would not expect to see such plasticity in the human adult brain."
Trevor Gibbons, 51, can vouch for the brain's flexibility. A patient at Beth Abraham Rehabilitation Center in the Bronx, where Tomaino heads the music therapy program and where Sacks first began treating chronically ill patients decades ago, Gibbons has been able to restore his speech after suffering a devastating spinal injury from a four-story fall and a stroke in 2000. The former carpenter says that before he began vocal training and playing piano with music therapists at the clinic, he couldn't speak or move and would lie for days in bed, depressed. Following intensive sessions three times a week over several years, Gibbons not only recovered his speech but also has written more than 400 songs, recorded three CDs, and performed at a benefit fundraiser for Beth Abraham at Lincoln Center. (Pre-stroke, says Gibbons, he sang only in his church choir.) His depression has improved, too. "It gave me motivation and a chance to look forward to live another day," he says.
Like Gibbons, patients often report more positive moods following sessions. This may be because of an increase in the production of neurotransmitters like norepinephrine and melatonin, suggested a 1999 study by researchers from the University of Miami School of Medicine. Several studies have shown that calming music can lower blood pressure rates, and last year a Spanish investigation showed that listening to music prior to surgery decreased anxiety, heart rate, and levels of the stress hormone cortisol as much as the anti-anxiety drug diazepam. Stress and anxiety relief, in fact, may be one reason music can help people with Alzheimer's and dementia uncover memories that seemed irrecoverable, experts say. Researchers reported in 2006 that enhanced memory recall accompanied significant reductions in anxiety when Alzheimer's patients listened to the "Spring Movement" from Vivaldi's Four Seasons.
Set at ease by familiar melodies, they may be more apt to communicate, too. Even people at advanced stages of the disease sometimes see improvements in attention and alertness, sociability, and overall functioning following music therapy. The reason, experts suspect, is that music stimulates areas deep within the amygdala and hippocampus, where emotion and long-term memory are processed. Both are less prone to the degenerative effects of Alzheimer's than the outer cortex, the hub for complex thought. Music played at a wedding, a religious service, favorite songs from childhood, or concerts from the teenage years or young adulthood can serve as cues to recover memories, says Suzanne Hanser, founder of the music therapy department at Berklee College of Music in Boston and a practicing therapist at the Dana-Farber Cancer Institute.
Not everyone will respond, and it may take several sessions to see any effect, says Hanser. She finds that simple stress reduction techniques such as facial massage or muscle release exercises can often enhance the music's magic.