Music as a Superdrug: How Listening and Playing Enhances Cognitive Functioning

Music unites us as a species. It has existed for tens of thousands of years and survived
downfalls of once-powerful civilizations. Mothers sing soft melodies to lull their babies to
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sleep, military officials blast harsh heavy metal music to torture war criminals, and members of
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mosques, synagogues, and churches sing together in communal ceremonies. Because music is so
prominent in a person's life regardless of his or her age, culture, or belief system, it is evident
that music resonates within us biologically.
The human brain is, in fact, structured to respond to music. We process melodies, for
instance, in our Werneicke's area, the same area that controls verbal processing. Comprehending
rhythm activates our left frontal cortex, left parietal cortex, and right cerebellum. These are
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regions involved in higher-level thinking, long-term memory, mathematics, motor control,
attention, and language. Interpreting tonal relationships (such as harmony and counterpoint)
activates our medial prefrontal cortex, cerebellum, superior temporal sulci, and superior temporal
gyri. These regions are responsible for behavior, thought organization, rationalization, social
cognition, spatial perception, language, vocabulary, and perceiving emotions.
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It is important to note that, as listed above, each brain region affected by music is
primarily designed to perform another neurological rolethere is no "music center" in the brain.
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The discovery of prehistoric and ancient musical instruments has allowed archaeologists to conclude that music
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has existed for millennia.
Winford, John N. "Stone Age Flutes Found in Germany Offer Clues to Early Music." The New York Times. N.p., 24
June 2009. Web. 9 Dec. 2013.
Smith, Clive Stafford. "How US Interrogators Use Music as a Tool of Torture." The Guardian. Guardian News and
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Media, 19 June 2008. Web. 11 Dec. 2013.
Jourdain, Robert. "Glossary." Music, the Brain, and Ecstasy: How Music Captures Our Imagination. New York: W.
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Morrow, 1997. N. pag. Print.
Kinser, Patricia A. "Brain Structures and Their Functions." Brain Structures and Their Functions. Bryn Mawr
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College, 2000. Web. 09 Dec. 2013.
Instead, music activates many areas across both brain hemispheres that function to perform non
music-related tasks. We can draw an exciting conclusion from this: since music can activate the
brain, music can actually stimulate multiple brain centers simultaneously. Simultaneous activity
is part of the process of neurological improvement through music. This requires an interplay
between several factors: neuroplasticity, dopamine, and long-term potentiation.
Neuroplasticity is the brain's ability to alter its structures and functions. This fairly recent
branch of neuroscience understands the brain as a malleable, ever-changing entity. Since the late
20th century, scientists such as preeminent neurologist Paul Bach-y-Rita have used
neuroplasticity to rehabilitate neurologically compromised patients. In essence, neuroplasticity
denotes the brain successfully forming new synaptic associations. Neural 'bridges' develop
between synapses that were previously unconnected, yielding new neurological capabilities and
great potential for growth.
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Effectively rewiring a subject's brain, however, requires that the new neurological
connections brought forth by plasticity achieve permanence. A process called long-term
potentiation, or LTP, accomplishes this. LTP is the way through which the brain internalizes
associations. This happens when a repeated action or stimulus continuously ignites a particular
series of synapses. After enough repetition, the neural pathway solidifies and becomes second-
nature to the subject. Therefore, once the plastic brain creates a new pathway, LTP through
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repetition cements it.
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Doidge, Norman. The Brain That Changes Itself. New York: Viking, 2007. Print.
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Myers, David G. Psychology. New York: Worth, 2013. Print.
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A successful implementation of long-term potentiation may require subjects to spend a
relatively large amount of time repeating an action; hence the phrase "long-term." There is a
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solution, however: a subject can receive a stimulant to quicken the solidification process and
further strengthen the connections.
The acquisition of a stimulant in most scenarios would be in the form of an administered
drug, but part of the great healing potential of music is that it functions as its own stimulant.
When subjects listen to music that they find pleasurable, their reward centers secrete dopamine.
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Dopamine is a powerful hormone that contributes to heightened learning, focus, and positive
emotions. In athletes, for example, dopamine production during periods of strenuous physical
activity causes the ecstatic "runner's high" that runners and non-runners alike experience post-
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workout.
From the information about the brain regions activated by music, to the brain's capability
to form and solidify new pathways, to the stimulating hormone that music helps produce, we can
begin to realize the exciting potential that music has in the realm of neurological improvement.
Once music activates a brain structure, plasticity begins to form neural interconnections within
and around the structure. LTP solidifies these connections, and dopamine, while not pertinent,
helps to reinforce them. This process then yields cognitive growth and development.
Through neuroplasticity, dopamine, and LTP, music has the potential to improve verbal
processing, higher level thinking, memory, mathematic and number processing, motor control,
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The actual amount of time required to solidify a neurological pathway has no defined measure. It varies based
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upon both the subjects and the level of the neurological association's complexity they are trying to solidify.
Salimpoor, Valerie. "Why Music Makes Our Brain Sing." The New York Times. N.p., 7 June 2013. Web.
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Aschwanden, Christie. "How Exercise Revs Your Mood, Brainpower." Las Cruces Sun. N.p., 11 Dec. 2013. Web.
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12 Dec. 2013.
attention, language, behavior, thought organization, rationalization, social cognition, spatial
perception, perception of moving objects, language, vocabulary, and empathy. Any one of these
functions can be either rehabilitated if lost or damaged, or even improved upon if not
compromised. An example of this follows:
Three years ago, in November 2010, I underwent neurological damage as a result of a
prolonged 60/30 blood pressure and post-ICU delirium after contracting Lemierre's syndrome (a
blood disease) and going into septic shock. Prolonged low blood pressure resulted in oxygen
deprivation and brain tissue death. Post-ICU delirium, which occurs in 74% of patients who
survive a critical illness, is a type of profound cognitive impairment usually caused by heavy
narcotic pain medication and/or unconsciousness. I received a dopamine IV to raise my blood
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pressure, several antibiotic IVs to combat sepsis, and, for days at a time, I was constantly given a
double dose of Fentanyl, a superdrug 100 times more potent than morphine.
I had been an A student at Colgate University at the time that I fell ill. Following my
discharge from the hospital, Colgate required that I take an eight month long medical leave of
absence, from December 2010 to August 2011. During my time at home, I experienced a
significant amount of difficulty remembering common words and phrases, memorizing short lists
(a three-item chore list, for example), and I had trouble reading and absorbing verbal
information.
In the fall of 2011, I returned to school at a different university and took classes
comparable in difficulty level to those I had taken at Colgate. I found school unusually
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Phend, Crystal. "ICU Delirium Affects Brain After Discharge." ICU Delirium Affects Brain After Discharge.
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Medpage Today, 2 Oct. 2013. Web. 12 Dec. 2013.
challengingI was unable to absorb topics learned in class, and I could not read through a
paragraph without forgetting its central idea, if I could grasp the idea at all.
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My problems were neurological. My memory issues were due to deficiencies in my
hippocampus and left parietal cortex. A lack of synaptic connections in my superior temporal
gyrus was the culprit behind my compromised reading comprehension skills. Inadequacies in my
medial prefrontal cortex resulted in my occasional confusion and reduced ability to rationalize.
I began studying neuroscience in hopes that I would develop an understanding of my
situation, and perhaps, learn to improve it without aid from the Services for Students with
Disabilities office. After a few months, I developed the following hypothesis: that, using music,
I could significantly improve my intelligence.
I designed an experimental therapy plan in which I would practice instruments such as
violin, voice, guitar, and piano for two one-hour sessions each day and do schoolwork before and
after each session. While studying, I would listen to music I found enlightening, enriching, and
enjoyable. I began this process in the late fall of 2011, one year after my illness.
When I would practice, listen to, and process rhythms, I began to reactivate my left
parietal cortexa rhythm center that controls memory. I gradually rebuilt my verbal processing
skills in my superior temporal gyrus when I would learn, play, or listen to melodies. When I
used my medial prefrontal cortex to analyze chord progressions, I also improved the cortex's
primary task of focus and rationalization.
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A study at the University of Bonn in Germany found that "sepsis survivors showed cognitive deficits in verbal
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learning and memory and had a significant reduction of left hippocampal volume compared to healthy controls."
The hippocampus is a site of memory formation and storage in the brain.
Semmler, A. "Persistent Cognitive Impairment, Hippocampal Atrophy and EEG Changes in Sepsis Survivors."
NCBI. U.S. National Library of Medicine, Jan. 2013. Web. 12 Dec. 2013.
I enjoyed playing and listening to music, and I would repeat this routine almost daily.
My routine activated previously compromised neurological regions through neuroplasticity, and
the frequency with which I repeated the routine began to solidify these new pathways through
LTP. My reward center released dopamine daily in response to my enjoyment, thus, every day,
my brain experienced the equivalent of a stimulant injection. This dopamine sped up the
formation of the new connections that I was creating to rehabilitate my brain.
When I began my therapy routine in November 2011, I was failing two classes and could
not comprehend more than three sentences at a time. After six months of self-administered (and
self-organized) music treatment, I reached my first milestone: I had caught up with the average
student, was achieving Bs and Cs, and was able to understand a chapter after reading through it
two or more times. At twelve months, I began getting As and Bs again, could understand a
chapter after one or two readings, and was able to learn new topics with relative ease. At
eighteen months, I could process entire books and began to read for enjoyment again. By the
twenty fourth month of rehabilitation, I was achieving straight As, could remember specific
details from entire books after reading them once, and was performing better academically than I
had done even before my illness occurred.
I had joined several support groups for victims of septic shock and Lemierre's Syndrome
in the months following my hospitalization, and was startled by the number of people who
struggled with cognitive impairment post illness. Survivors of sepsis who had fallen ill years ago
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and had had minimal to no neurological treatment were still struggling. I, however, was able to
regain most of my pre-illness capabilities and rehabilitate myself through music.
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Because music affects and activates so many different brain regions, its potential for
rehabilitation and cognitive improvement in a variety of applications is promising. Many types
of neurological impairments involve brain regions that are also activated by music. A range of
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conditions that compromise these regions include, but are not limited to, stroke, head trauma,
post-ICU delirium, prolonged oxygen deprivation, Alzheimer's disease, Parkinson's disease,
ADD/ADHD, autism, Asperger's Syndrome, borderline personality disorder, vertigo, and
dyslexia.
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How can a therapist effectively implement music in a rehabilitative context? First, the
therapist must effectively diagnose a condition and its corresponding compromised brain region.
For instance, if patient Z is unable to process language after having a stroke, damage has
occurred in Z's superior temporal gyrus, Werneicke's area, and Brodmann Area 47. Second, the
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therapist must then identify which musical element(s) activate those regionsin this example,
melody activates regions in the superior temporal gyri. Third, the therapist will then administer
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I perform better academically now than I did before my illness. However, my success is due in part to the amount
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of effort I presently put into my studies compared to the lack of effort I exhibited at earlier points in my life. I
expend twice as much time and effort to achieve an A now than I did to achieve an A at Colgate. My actual
intelligence quotient before and after sepsis is somewhat quantifiable: I scored a 155 and a 160 on two
professionally administered IQ tests I took before the illness, at age 5 and age 16 respectively. Recently, I took a test
to get into high-IQ society Mensa, and did not make the cutMensa requires an IQ of 132 or higher. Therefore,
although I have significantly altered my cognitive functioning to improve my academic performance, my natural IQ
is still at least one standard deviation lower than it was pre-illness.
These brain regions are listed in paragraph two.
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Doidge, Norman. The Brain That Changes Itself. New York: Viking, 2007. Print.
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Jourdain, Robert. "Glossary." Music, the Brain, and Ecstasy: How Music Captures Our Imagination. New York:
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W. Morrow, 1997. N. pag. Print.
Sancar, Feyza. "Music and the Brain: Processing and Responding (A General Overview)." Bryan Mawr, 07 Jan.
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2002. Web. 14 Nov 2013.
the specific musical element in such a way that LTP is achieved, to internalize the eventual
structural change accomplished by plasticity, and that dopamine is released, to strengthen and
quicken the process. In this example, Patient Z would listen to, learn, sing, and memorize
melodies for a specified amount of time each day to regain and improve his or her verbal
abilities.
On January 8, 2011, a deranged gunman shot congresswoman Gabrielle Giffords in the
head. The blast severely damaged her Broca's area, the part of the brain adjacent to the
Werneicke's area that functions in verbal processing and speech. Although Giffords could not
speak, she could sing, because, as previously discussed, the neural pathways involved in melody
are not specific to a single brain region. Thus, Giffords's therapists began to heal her through
song by instructing her to sing familiar melodies she remembered, such as "Happy Birthday,"
that reactivated neural pathways in her Broca's area. As the neurons in and around her Broca's
area continued to restructure and strengthen, she developed the ability to "speak" phrases in a
singsong voice: she was still unable to verbalize sentences (for example, "I am feeling well
today") with the vocal intonations of normal speech, but she could sing the words "I am feeling
well today." As treatment progressed and LTP solidified her brain's rewired connections,
Giffords actually regained her ability to speak.
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In the early 1990s, the Dana Foundation experimented with the neurology of music as it
relates to motor control. The Foundation worked with stroke and Parkinson's patients who had
lost the ability to walk and move properly. Therapists played a series of rhythmic auditory cues
to the patients and instructed them to walk or make movements based upon those rhythms. The
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Sohn, Emily. "How Music Helped Gabrielle Giffords Heal: Page 2." DNews. Discovery, 8 Jan. 2012. Web. 11
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Dec. 2013.
results were eye-openingthe patients could move faster and with much better control using
musical stimuli than they had done during traditional physical therapy. Rhythm, as mentioned in
paragraph two, activates neurons in the right cerebellum that function in motor control and
movement.
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Music is an ideal rehabilitative superdrug because, while it effectively accomplishes its
designated task (for example, enabling a stroke patient to learn to speak again), it also activates
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other non-targeted brain regions, facilitates mood-enhancing hormone production, and lacks any
detrimental emotional or physical side effects. Missing a dosage of music will not result in a
painful withdrawal period, and it is impossible to suffer from a musical overdose.
In an era in which technological advances are as astounding as they are commonplace, it
is encouraging to think that music, something that was established at the dawn of humanity,
rivals modern rehabilitative medications and practices in terms of its overall effectiveness. The
deliberate application of music has the power to help and potentially heal cognitively
compromised patients. It is with great hope and thankfulness that we can use this construct from
our ancient past to impact, improve, and reshape the future of neurological rehabilitation.#
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Thaut, Michael, Ph.D. "How Music Helps to Heal the Injured Brain." The Dana Foundation. N.p., 4 Mar. 2010.
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Web. 11 Dec. 2013.
In his book Musicophilia, Oliver Sacks describes how a verbally compromised stroke patient regained the ability
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to speak after learning and singing melodies. Sacks did not, however, go into depth about the neurological
processes, specifically plasticity and LTP, that occurred to rehabilitate this man.
Sacks, Oliver W. Musicophilia: Tales of Music and the Brain. New York: Alfred A. Knopf, 2007. Print.
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Sacks, Oliver W. Musicophilia: Tales of Music and the Brain. New York: Alfred A. Knopf, 2007.
Print.

Salimpoor, Valerie. "Why Music Makes Our Brain Sing." The New York Times. N.p., 7 June
2013. Web.

Semmler, A. "Persistent Cognitive Impairment, Hippocampal Atrophy and EEG Changes in
Sepsis Survivors." NCBI. U.S. National Library of Medicine, Jan. 2013. Web. 12 Dec. 2013.

Sohn, Emily. "How Music Helped Gabrielle Giffords Heal: Page 2." DNews. Discovery, 8 Jan.
2012. Web. 11 Dec. 2013.
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Thaut, Michael, Ph.D. "How Music Helps to Heal the Injured Brain." The Dana Foundation.
N.p., 4 Mar. 2010. Web. 11 Dec. 2013.

Winford, John N. "Stone Age Flutes Found in Germany Offer Clues to Early Music." The New
York Times. N.p., 24 June 2009. Web. 9 Dec. 2013.

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Jourdain, Robert. "Glossary." Music, the Brain, and Ecstasy: How Music Captures Our
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Kinser, Patricia A. "Brain Structures and Their Functions." Brain Structures and Their Functions.
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Doidge, Norman. The Brain That Changes Itself. New York: Viking, 2007. Print.

Myers, David G. Psychology. New York: Worth, 2013. Print.


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