Archive for category Music/Music therapy

[Abstract] The SonicHand Protocol for Rehabilitation of Hand Motor Function: a validation and feasibility study


Musical sonification therapy is a new technique that can reinforce conventional rehabilitation treatments by increasing therapy intensity and engagement through challenging and motivating exercises. Aim of this study is to evaluate the feasibility and validity of the SonicHand protocol, a new training and assessment method for the rehabilitation of hand function. The study was conducted in 15 healthy individuals and 15 stroke patients. The feasibility of implementation of the training protocol was tested in stroke patients only, who practiced a series of exercises concurrently to music sequences produced by specific movements. The assessment protocol evaluated hand motor performance during pronation/supination, wrist horizontal flexion/extension and hand grasp without sonification. From hand position data, 15 quantitative parameters were computed evaluating mean velocity, movement smoothness and angular excursions of hand/fingers. We validated this assessment in terms of its ability to discriminate between patients and healthy subjects, test-retest reliability and concurrent validity with the upper limb section of the Fugl-Meyer scale (FM), the Functional Independence Measure (FIM) and the Box & Block Test (BBT). All patients showed good understanding of the assigned tasks and were able to correctly execute the proposed training protocol, confirming its feasibility. A moderate-to-excellent intraclass correlation coefficient was found in 8/15 computed parameters. Moderate-to-strong correlation was found between the measured parameters and the clinical scales. The SonicHand training protocol is feasible and the assessment protocol showed good to excellent between-group discrimination ability, reliability and concurrent validity, thus enabling the implementation of new personalized and motivating training programs employing sonification for the rehabilitation of hand function.

via The SonicHand Protocol for Rehabilitation of Hand Motor Function: a validation and feasibility study – IEEE Journals & Magazine

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[WEB SITE] The Benefits of Playing Music Help Your Brain More Than Any Other Activity

Learning an instrument has showed an increase resilience to any age-related decline in hearing.

The brain-training is big business. For companies like BrainHQ, Luminosity, and Cogmed, it’s actually a multimillion dollar business that is expected to surpass $3 billion by 2020. But, do the actually benefit your brain?


Research doesn’t believe so. In fact, the the University of Illinois determined that there’s little or no evidence that these games improve anything more than the specific tasks being trained. Luminosity was even fined $2 million for false claims.

So, if these brain games don’t work, then what will keep your brain sharp? The answer? Learning to play a musical instrument.

Why Being a Musician Is Good For Your Brain

Science has shown that musical training can change brain structure and function for the better. It can also improve long-term memory and lead to better brain development for those who start at a young age.

Furthermore, musicians tend to be more mentally alert, according to new research from a University of Montreal study.


“The more we know about the impact of music on really basic sensory processes, the more we can apply musical training to individuals who might have slower reaction times,” said lead researcher Simon Landry.


“As people get older, for example, we know their reaction times get slower. So if we know that playing a musical instrument increases reaction times, then maybe playing an instrument will be helpful for them.”


Previously, Landry found that musicians have faster auditory, tactile, and audio-tactile reaction times. Musicians also have an altered statistical use of multi-sensory information. This means that they’re better at integrating the inputs from various senses.


“Music probably does something unique,” explains neuropsychologist Catherine Loveday of the University of Westminster. “It stimulates the brain in a very powerful way, because of our emotional connection with it.”


Unlike brain-games, playing an instrument is a rich and complex experience. This is because it’s integrating information from senses like vision, hearing, and touch, along with fine movements. This can result long-lasting changes in the brain. This can also be applicable in the business world.

Changes in the Brain

Brains scans have been able to identify the difference in brain structure between musicians and non-musicians. Most notably, the corpus callosum, a massive bundle of nerve fibres connecting the two sides of the brain, is larger in musicians. Also, the areas involving movement, hearing, and visuospatial abilities appear to be larger in professional keyboard players.


Initially, these studies couldn’t determine if these differences were caused by musical training of if anatomical differences predispose some to become musicians. Ultimately, longitudinal studies showed that children who do 14 months of musical training displayed more powerful structural and functional brain changes.


These studies prove that learning a musical instrument increases grey matter volume in various brain regions, It also strengthens the long-range connections between them. Additional research shows that musical training can enhance verbal memory, spatial reasoning, and literacy skills.

Long Lasting Benefits For Musicians

Brain scanning studies have found that the anatomical change in musicians’ brains is related to the age when training began. It shouldn’t be surprising, but learning at a younger age causes the most drastic changes.


Interestingly, even brief periods of musical training can have long-lasting benefits. A 2013 study found that even those with moderate musical training preserved sharp processing of speech sounds. It was also able to increase resilience to any age-related decline in hearing.


Researchers also believe that playing music helps speech processing and learning in children with dyslexia. Furthermore, learning to play an instrument as a child can protect the brain against dementia.

“Music reaches parts of the brain that other things can’t,” says Loveday. “It’s a strong cognitive stimulus that grows the brain in a way that nothing else does, and the evidence that musical training enhances things like working memory and language is very robust.”

Other Ways Learning an Instrument Strengthens Your Brain

Guess what? We’re still not done. Here are eight additional ways that learning an instrument strengthens your brain.


1. Strengthens bonds with others. This shouldn’t be surprising. Think about your favorite band. They can only make a record when they have contact, coordination, and cooperation with each other.


2. Strengthens memory and reading skills. The Auditory Neuroscience Laboratory at Northwestern University states that this is because music and reading are related via common neural and cognitive mechanisms.


3. Playing music makes you happy. McMaster University discovered that babies who took interactive music classes displayed better early communication skills. They also smiled more.


4. Musicians can process multiple things at once. As mentioned above, this is because playing music forces you to process multiple senses at once. This can lead superior multisensory skills.


5. Musical increases blood flow in your brain. Studies have found that short bursts of musical training increase the blood flow to the left hemisphere of the brain. That can be helpful when you need a burst of energy. Skip the energy drink and jam for 30 minutes.

6. Music helps the brain recover. Motor control improved in everyday activities with stroke patients.

7. Music reduces stress and depression. A study of cancer patients found that listening and playing music reduced anxiety. Another study revealed that music therapy lowered levels of depression and anxiety.


8. Musical training strengthens the brain’s’ executive function. Executive function covers critical tasks like processing and retaining information, controlling behavior, making, and problem-solving. If strengthened, you can boost your ability to live. Musical training can improve and strengthen executive functioning in both children and adults.


And, wrap-up, check out this awesome short animation from TED-Ed on how playing an instrument benefits your brain.


via The Benefits of Playing Music Help Your Brain More Than Any Other Activity |

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[ARTICLE] The Use of Rhythmic Auditory Stimulation to Optimize Treadmill Training for Stroke Patients: A Randomized Controlled Trial – Full Text


The use of functional music in gait training termed rhythmic auditory stimulation (RAS) and treadmill training (TT) have both been shown to be effective in stroke patients (SP). The combination of RAS and treadmill training (RAS-TT) has not been clinically evaluated to date. The aim of the study was to evaluate the efficacy of RAS-TT on functional gait in SP. The protocol followed the design of an explorative study with a rater-blinded three arm prospective randomized controlled parallel group design. Forty-five independently walking SP with a hemiparesis of the lower limb or an unsafe and asymmetrical walking pattern were recruited. RAS-TT was carried out over 4 weeks with TT and neurodevelopmental treatment based on Bobath approach (NDT) serving as control interventions. For RAS-TT functional music was adjusted individually while walking on the treadmill. Pre and post-assessments consisted of the fast gait speed test (FGS), a gait analysis with the locometre (LOC), 3 min walking time test (3MWT), and an instrumental evaluation of balance (IEB). Raters were blinded to group assignments. An analysis of covariance (ANCOVA) was performed with affiliated measures from pre-assessment and time between stroke and start of study as covariates. Thirty-five participants (mean age 63.6 ± 8.6 years, mean time between stroke and start of study 42.1 ± 23.7 days) completed the study (11 RAS-TT, 13 TT, 11 NDT). Significant group differences occurred in the FGS for adjusted post-measures in gait velocity [F(2, 34) = 3.864, p = 0.032; partial η2 = 0.205] and cadence [F(2, 34)= 7.656, p = 0.002; partial η2 = 0.338]. Group contrasts showed significantly higher values for RAS-TT. Stride length results did not vary between the groups. LOC, 3MWT, and IEB did not indicate group differences. One patient was withdrawn from TT because of pain in one arm. The study provides first evidence for a higher efficacy of RAS-TT in comparison to the standard approaches TT and NDT in restoring functional gait in SP. The results support the implementation of functional music in neurological gait rehabilitation and its use in combination with treadmill training.


About 60% of all stroke patients (SP) have difficulties with walking (). These are often caused by hemiparesis and/or sensory deficits of the lower extremity and/or trunk and are also due to uncoordinated movements. In addition to motor and sensory dysfunctions, symptoms such as spasticity, somato-sensory neglect, and cognitive malfunctioning may further impede walking. Thus, the restoration of gait is often a key focus of rehabilitation efforts, enhancing not only physical activity but also autonomy and participation in everyday life ().

Treadmill training (TT) with and without body weight support has been shown to improve functional gait in stroke patients effectively. A meta-analysis comparing 44 trials (n = 2,658 patients) revealed clear therapeutic effects on gait velocity and walking endurance, the latter only for TT with body weight support (). However, the improvements were identified only for independent walkers while patients who walked with assistance did not show an additional benefit from TT (). Lee’s work () provided evidence that TT with a high walking velocity at the beginning of training is more effective when compared to a stepwise increase in velocity.

Rhythmic-auditory stimulation (RAS) is defined as a therapeutic application of pulsed rhythmic or musical stimulation in order to improve gait or gait related aspects of movement (). It has been demonstrated that SP are able to synchronize their gait pattern to auditory stimulation using music with an embedded metronome (). This led to immediate improvements in stride time and stride length symmetry as well as weight bearing time on the paretic side, while EMG showed a more balanced muscular activation pattern between the paretic and non-paretic sides (). Training effects of RAS for SP were confirmed in a meta-analysis comparing 7 randomized controlled studies (n = 197) that showed improvements in functional gait performance (velocity, cadence, and stride length) (). This work also gave evidence, that a musical stimulation is more effective in improving gait velocity and cadence then the metronome (). Hayden et al. found that RAS became more effective when it is implemented earlier in the rehabilitation program. This provides evidence that the variation in time of the RAS-training during the rehabilitation process may affect the success of the treatment (). The application of RAS on the treadmill (RAS-TT) was evaluated over a 3-week training period by Park et al. In that study metronome stimulation was used for 9 patients with chronic stroke. The results were compared with a group of 10 patients performing over ground RAS walking training (). The RAS-TT group experienced greater improvements in gait velocity ().

While RAS and TT have proven to be effective for gait training in SP, the efficacy of its combination (RAS-TT) in the early course of rehabilitation in SP has not been investigated to date. Therefore, we hypothesized that RAS-TT in the early course of rehabilitation would improve the clinical efficacy of TT for SP. The purpose of the present study was to investigate the functional improvements of gait using a rehabilitation therapy combining RAS and TT in order to assess its clinical efficacy for patients suffering the aftermaths of a stroke.

Materials and methods


The study protocol was approved by the state authorization association for medical issues in Brandenburg, that determined on the 21st of January 2010 that no formal ethics approval was required. Patients gave their informed consent according to the Helsinki declaration.

The study was designed as a prospective, single center three arm clinical study with parallel groups. We enrolled patients who performed either RAS on the treadmill (RAS-TT) or treadmill training alone (TT). A third group that received neurodevelopmental treatment following the Bobath approach (NDT) served as a control group. The patients were randomly assigned to the three training interventions by a person not involved in the study using a block randomization (software randlist). Allocations were placed in sealed sequentially numbered envelopes and were not opened until the actual study inclusion. Thus, the patients, the responsible doctor, the assessing physiotherapist, and study manager were not informed beforehand regarding the group assignment.

We included stroke patients with a hemiparesis of the lower limb (at least 1 muscle group with muscle strength grade <5 as defined by the British Medical Research Council) or with an unsafe and asymmetrical walking pattern (by assessment of a physiotherapist). The patients had to be able to walk independently with assistive devices if necessary for at least 3 min.

Criteria for exclusion were the following: significantly disturbed language perception (marked by either the Aachener Aphasietest or Token Test), cognitive impairment (Mini Mental Status Test <26), major depression or productive psychosis, adjustment disorder with a need for medical treatment, peripheral arterial occlusive disease with walking distance <100 m, and coronary heart disease (instable angina pectoris).

After having passed the diagnostics patients underwent a screening session on the treadmill. There they had to demonstrate a stable and sufficiently ergonomic gait. Candidates with insufficient quality of gait on the treadmill (multimodal neglect or spasticity as assessed by a physiotherapist) were postponed and re-screened every week (Figure (Figure11).

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Figure 1
Patient flow chart of study design. RAS-TT, rhythmic auditory stimulation on treadmill; TT, treadmill training; NDT, neurodevelopmental treatment.


Continue —>  The Use of Rhythmic Auditory Stimulation to Optimize Treadmill Training for Stroke Patients: A Randomized Controlled Trial

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[WEB SITE] Music Therapy Can Rewire a Broken Brain – Videos

Nothing brings out the grinch in some like the early debut of seasonal music when the season hasn’t even started. Reactions can of course go the other way — people weep with joy at memories attached to a song from their past.
Whatever the reaction, music is powerful. Now, a small company in Massachusetts is trying to harness that power to help people with traumatic brain injuries talk again. And scientists say music is actually rewiring patients’ brains.

It is well documented that those with Alzheimer’s disease can benefit from hearing and singing songs they remember from earlier in life — but research into music’s ability to create new pathways in the brain to combat impairment of language abilities (aphasia), hemineglect, and loss of movement is relatively new. Hemineglect is when brain trauma leads patients to lose the ability to pay attention to one side of space. For example, ask them to draw a clock face and they will only draw half of it, ignoring the other side and leaving it completely blank.

The branch of rehabilitation called Neurologic Music Therapy (NMT) helps patients who have suffered terrible brain injuries regain function — through singing and playing percussive instruments.

When brain injuries affect the left side of the brain, patients can struggle with aphasia because the language function is all held on the left side. Music is different. The fine motor skills necessary to appreciate and make music are a mix of the creative skills found on the right hemisphere, and the mathematical and linguistic aspects found on the left. Playing music has also been shown to strengthen the part of the brain that links between both hemispheres, the corpus callosum. NMT can build a new language area in the right hemisphere, as the late Dr. Oliver Sacks said while speaking about one of the most high-profile brain injury success stories — that of former Rep. Gabby Giffords. “Nothing activates the brain so extensively as music, to be possible to create a new language area in the right hemisphere.”

This is the science that NMT triggers — and that NMT companies like Medrhythms are trying to put to use. It is one of only a handful of neurological rehabilitation companies in the country, created to meet the demand witnessed by its CEO and founder Dr. Brian Harris in the early stages of his career.

Like most of the small number of music therapists in the US, Harris started off as an employee of a hospital working at a stroke and brain injury unit. In fact he was the very first music therapist at Spaulding hospital in New England.

“Within just a few weeks of me being there people were getting better faster, with greater results, and very quickly the demand for these services outgrew our ability to supply them,” he told WhoWhatWhy. He saw an opportunity, and started his company as a way of meeting that need. At first it was a lot of hard, lonely, yet rewarding work.

“It was me, working at the hospital eight hours a day. And then I was going to people’s homes in the evenings and weekends doing in-home care. Then we started hiring some other therapists and we quickly grew.”

Despite there being so few practitioners in this new field it seems as though demand for more NMT therapists will rise as news of its benefits spread.

This week’s videos are a demonstration of a patient’s progress thanks to NMT sessions, and a fun cartoon showing just exactly what happens to the brain when playing music.


via Music Therapy Can Rewire a Broken Brain – WhoWhatWhy

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[WEB SITE] MusicGlove: Improve Hand Function in Two Weeks Through Music and Gaming

Designed for users never expected to regain use of their hands

When returning home from a hospital stay, many stroke patients do not comply with the hand rehabilitation exercises prescribed for them.

Clearly, it’s not because they don’t want to regain use of their hand – it’s just that the exercises are mind-numbingly monotonous, and they soon give up.

Nizan Friedman, founder of Flint Rehabilitation Devices, set out to correct this problem. He dreamt up the idea of the MusicGlove while pursuing his PhD in biomedical engineering at the University of California at Irvine.

As a musician, Friedman’s intent was to combine music therapy and robotics. On his team were David Reinkensmeyer, a rehabilitation robotics expert, and Mark Bachman, a sensor expert and fellow musician.

The three soon realized a robotic hand would be too expensive, so they came up with the idea of using a glove instead. MusicGlove was born, and results were astounding.

“People were trying and crying afterwards,” says Friedman. “People who hadn’t used their hands in months or even years were suddenly seeing benefit.”

How does MusicGlove work?

MusicGlove has fingertip sensors, and plugs into the user’s computer or into the Flint tablet. Musical notes are displayed on a touch screen console. The notes are timed to the rhythm of upbeat songs (think Guitar Hero). Then, while wearing the glove, the user completes specific hand and finger movements in time with the notes.

The program tracks accuracy and speed in performing essential motions such as pincer grasp and key pinch grip, and gives the user immediate feedback on their progress.

What makes MusicGlove different?

Several elements set MusicGlove apart from conventional hand rehabilitation therapy.

First and perhaps most importantly, it motivates users to continue with their therapy regimen long enough to see results. Interacting with the computer and listening to music is fun, and provides a purpose for moving the fingers. Patients typically achieve over 2,000 movements in a 45-minute session.

Second, most conventional hand therapy is designed to help open the hand, but does not retrain the brain to use the hand again.

MusicGlove is unique because it’s designed to encourage neuroplasticity – the process the brain uses to rewire itself after injury.

The more a user plays MusicGlove games, the better their brain becomes at hand control.

Lastly, MusicGlove can change the way clinicians approach hand therapy. Since the device is highly effective without much direct therapist intervention, clinics can provide other intensive services without increasing staff. Farther, MusicGlove records accurate data that helps set goals and track patient progress.

Who can benefit from using MusicGlove?

MusicGlove is intended for people recovering from stroke, spinal cord injury, and neurologic or muscular injury. Those with cerebral palsy, traumatic brain injury, and developmental disability can also benefit from using MusicGlove.

Patients using MusicGlove must be able to touch their thumb to at least one of their fingertips, although mirror therapy can be used for some patients who have no hand movement at all.

Will Medicare cover MusicGlove?

Currently, Medicare does not cover the cost of restorative technology. Therefore, MusicGlove offers a 30-day money back guarantee so that patients and therapists can be certain it’s the right therapy for them.

Also, MusicGlove is FDA approved for purchase without a prescription.

How effective is MusicGlove?

Exercise with MusicGlove has been clinically proven to improve hand function within two weeks, leading to functional gains such as opening doors, typing, toileting independently, and more.

MusicGlove is now used in top rehabilitation programs in the United States, including the Rehabilitation Institute of Chicago and Rancho Los Amigos National Rehabilitation Center. It is backed by the National Institute of Health and the National Institute of Disability and Research Rehabilitation.

What MusicGlove customers are saying

“Could not possibly rate this device highly enough! I had a stroke as an infant, and was a precocious kid who got bored of “traditional” occupational therapy very early in life – so for the past 15 or so years (I’m 24), I haven’t done much of anything. After a two week trial of the MusicGlove, I regained independent movement of each finger of my affected hand – which is something I have NEVER had! I find myself using my hand to complete tasks at work, which I’ve never done either. Needless to say, I purchased the device and am looking forward to the months and years to come! I will sing the praises of the MusicGlove and Flint for the rest of my life for CHANGING MY LIFE and opening so many doors! THANK YOU, THANK YOU, THANK YOU!!!” – Musicglove user review

“My brother had five strokes two months ago and lost the use and feeling on the right side of his body. The first day he used it was fairly disastrous, and he could barely even touch his thumb to his index finger. The next morning he was touching his thumb to each of his fingers over and over – and when we started up the MusicGlove, the difference in one day was amazing. Within the first week using this product, he was feeding himself, holding a pen, and relearning how to write. After 2 months of use, he has mastered each finger individually (being able to hit at least 95% of the notes on the hard setting) and has now started using two fingers simultaneously. I feel like we hit the lottery, having found this rehabilitation tool, and I highly recommend it to anyone trying to recover from a stroke or brain injury that has affected the fine motor skills in their hand! It has exceeded all of our expectations, and given us hope for a full recovery ahead.” – Musicglove user review

via MusicGlove: Improve Hand Function in Two Weeks Through Music and Gaming

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[Conference Proceedings] Rhythmic Entrainment for Hand Rehabilitation Using the Leap Motion Controller – Full Text PDF


Millions of individuals around the world suffer from motor impairment or disability, yet effective, engaging, and cost-effective therapeutic solutions are still lacking. In this work, we propose a game for hand rehabilitation that leverages the therapeutic aspects of music for motor rehabilitation, incorporates the power of gamification to improve adherence to medical treatment, and uses the versatility of devices such as the Leap Motion Controller to track users’ movements. The main characteristics of the game as well as future research directions are outlined.

Full Text PDF

via Rhythmic Entrainment for Hand Rehabilitation Using the Leap Motion Controller | Kat Agres

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[Abstract] Mozart’s music and multidrug-resistant epilepsy: a potential EEG index of therapeutic effectiveness.

Multidrug-resistant epilepsy is a pathological condition that affects approximately one-third of patients with epilepsy, especially those with associated intellectual disabilities. Several non-pharmacological interventions have been proposed to improve quality of life of these patients. In particular, Mozart’s sonata for two pianos in D major, K448, has been shown to decrease interictal electroencephalography (EEG) discharges and recurrence of clinical seizures in these patients. In a previous study we observed that in institutionalized subjects with severe/profound intellectual disability and drug-resistant epilepsy, a systematic music listening protocol reduced the frequency of seizures in about 50% of cases. This study aims to assess electroencephalography as a quantitative (qEEG) predictive biomarker of effectiveness of listening to music on the frequency of epileptic discharges and on background rhythm frequency (BRF).

via Mozart’s music and multidrug-resistant epilepsy: a potential EEG index of therapeutic… – Abstract – Europe PMC

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[WEB SITE] Music may help against epilepsy

Музыка может помогать против приступов эпилепсии

Volunteers play music works Coltrane and Mozart.

According to scientists from Ohio state University (USA), the brains of people with epilepsy in a special way responds to music compared to people without this disease. Researchers believe that the music for patients with epilepsy can be used as a method of therapy that complements traditional treatment.

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Scientists explain that in most cases (80%) the development of epilepsy cause the processes occurring in the temporal lobe of the brain. This part of the brain determines the sensitivity to the music.

Specialists carried out the experiments, which involved 21 patients with epilepsy. Volunteers play music works Coltrane and Mozart, and in those moments, for the activity of their brains was monitored by a sensitive scanning technique. In the control group listened to music participants without the disease.

These trials demonstrated that in patients with epilepsy brain waves are synchronized with the musical frequencies much more often than those who do not have this diagnosis. In General, according to scientists, the brain of epileptics are much more receptive to musical harmony and its activity in the form of response in them was more intense.

The authors of the project expressed that music therapy can be very promising method in the treatment of epilepsy. A preliminary study by researchers from the medical school of the University of the state of Maryland in the USA have shown that listening to music has a tremendously positive effect on the cardiovascular system and improves circulation.


via Music may help against epilepsy | The Bobr Times

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[Systematic Review] Neural Correlates of Familiarity in Music Listening: A Systematic Review and a Neuroimaging Meta-Analysis – Full Text

Familiarity in music has been reported as an important factor modulating emotional and hedonic responses in the brain. Familiarity and repetition may increase the liking of a piece of music, thus inducing positive emotions. Neuroimaging studies have focused on identifying the brain regions involved in the processing of familiar and unfamiliar musical stimuli. However, the use of different modalities and experimental designs has led to discrepant results and it is not clear which areas of the brain are most reliably engaged when listening to familiar and unfamiliar musical excerpts. In the present study, we conducted a systematic review from three databases (Medline, PsychoINFO, and Embase) using the keywords (recognition OR familiar OR familiarity OR exposure effect OR repetition) AND (music OR song) AND (brain OR brains OR neuroimaging OR functional Magnetic Resonance Imaging OR Position Emission Tomography OR Electroencephalography OR Event Related Potential OR Magnetoencephalography). Of the 704 titles identified, 23 neuroimaging studies met our inclusion criteria for the systematic review. After removing studies providing insufficient information or contrasts, 11 studies (involving 212 participants) qualified for the meta-analysis using the activation likelihood estimation (ALE) approach. Our results did not find significant peak activations consistently across included studies. Using a less conservative approach (p < 0.001, uncorrected for multiple comparisons) we found that the left superior frontal gyrus, the ventral lateral (VL) nucleus of the left thalamus, and the left medial surface of the superior frontal gyrus had the highest likelihood of being activated by familiar music. On the other hand, the left insula, and the right anterior cingulate cortex had the highest likelihood of being activated by unfamiliar music. We had expected limbic structures as top clusters when listening to familiar music. But, instead, music familiarity had a motor pattern of activation. This could reflect an audio-motor synchronization to the rhythm which is more engaging for familiar tunes, and/or a sing-along response in one’s mind, anticipating melodic, harmonic progressions, rhythms, timbres, and lyric events in the familiar songs. These data provide evidence for the need for larger neuroimaging studies to understand the neural correlates of music familiarity.


Music is ubiquitous in human culture and has been present since prehistorical times (Conard et al., 2009). Music does not appear to have a survival value, yet most of the current literature has pinpointed it as a fundamental aspect of human life, describing it as a “universal reward” (Trehub et al., 2005). People often value music for the emotions it generates (Juslin and Laukka, 2004Brattico and Pearce, 2013), and listening to music can help to regulate mood and increase well-being (Hills and Argyle, 1998Kawakami et al., 2014). This might explain the use of music in people’s everyday lives (Schäfer and Sedlmeier, 2010).

Familiarity or repeated exposure in music has been reported as an important factor modulating emotional and hedonic responses in the brain (Pereira et al., 2011). The familiarity principle, also known as the “mere exposure effect,” was first described by Zajonc (1968). It is a psychological phenomenon which suggests that the more exposed we are to someone or something, the more we like it. Repetition in music can be of different types: within a piece, across pieces, or across multiple hearings (Margulis, 2013). Both familiarity and repetition may increase the liking of a piece of music, thus inducing positive emotions (Witviliet and Vrana, 2007Omar Ali and Peynircioglu, 2010).

Long before its description in 1968, the phenomenon of familiarity had been known by social psychologists and applied to the music field (King and Prior, 2013). The first person who documented it was Meyer in 1903. He presented his subjects with a dozen repetitions of unfamiliar music that he had composed. After listening to the last repetition, most subjects asserted that “the aesthetic effect was improved by hearing the music repeatedly” (Meyer, 1903). Moreover, Meyer showed that melodies which ended on the frequency ratio symbol 2 (the Lipps-Meyer Law) was preferred to all other melodies. However, this law was later on disputed by Paul Farnsworth, his student, who argued that interval ending preferences could be altered by training. Therefore, repetition and familiarity with a specific ratio ending could increase preference for that specific ending. This effect, explaining the perception of music closure, was called the “habit principle” (Farnsworth, 1926). Overall, it seems familiarity deepens the understanding of music and engagement with music listening (King and Prior, 2013).

However, according to numerous studies, the relationship between exposure and enjoyment is non-linear, following an inverted-U shape preference response. Repeated exposure to music can increase pleasure (“hedonic value”) for a certain period, but ultimately gives rise to increasing displeasure (Jakobovits, 1966Berlyne, 1971Szpunar et al., 2004Schellenberg, 2008).

There are different explanations for the inverted U-shape preference response. One is the perceptual fluency model (Bornstein and D’Agostino, 1994) which explains that people incorrectly assume that the facilitated processing of a familiar stimulus is associated to some positive attribute of the stimulus itself. However, as the conscious recognition of fluency processing increases, they stop misattributing this effect to the stimulus but to repeated exposure, and therefore pleasure decreases. Another explanation proposed by Berlyne (1971) states that the inverted U reflects the “interaction of two opposing impulses:” the ascending part arises from an evolutionary conditioned preference for the familiar (positive learned safety effect), and the subsequent decline of the U favors for novelty seeking (aversion to boredom). Moreover, the complexity of the stimulus also influences the timescale of satiation effect. According to Szpunar et al. (2004), despite initial increases in liking, after the stimulus complexity has been absorbed, boredom intercedes, and satiation reduces likability.

Peretz et al. reported that familiarity is best conceptualized as an “implicit memory phenomenon,” in which previous experience aids the performance of a task without conscious awareness of these previous episodes (Peretz et al., 1998). The ability to recognize familiar melodies appeared to be dependent on the integrity of pitch and rhythm perception. Of these two factors, pitch is thought to play a more important role (Hébert and Peretz, 1997). The authors noted that “although the mere exposure effect is simple to define and to reproduce experimentally, it is more complicated to explain.”

Familiarity is a complex subject and the neural mechanisms underlying this memory phenomenon toward music listening are still not very clear or consistent. Some authors define familiarity as a semantic memory process, which is a declarative knowledge (e.g., words, colors, faces, or music) acquired over a lifetime. Musical semantic memory is defined as the long-term storage of songs or musical excerpts, which enables us to have a strong feeling of familiarity when we listen to music (Groussard et al., 2010a). Brain lesion studies showed that music semantic memory appears to involve both hemispheres; however, the integrity of the left hemisphere is critical, suggesting functional asymmetry favoring the left hemisphere for semantic memory (Platel et al., 2003). Neuroimaging studies featuring musical semantic memory have reported the involvement of the anterior part of the temporal lobes, either in the left hemisphere or bilaterally, and the activation of the left inferior frontal gyrus (Brodmann area (BA) 47) (Plailly et al., 2007). Groussard and her co-workers also found activation of the superior temporal gyri (BA 22). The right superior temporal gyrus is mostly involved in the retrieval of perceptual memory traces (information about rhythm and pitch), which are useful for deciding whether or not a melody is familiar. The left superior temporal gyrus seems to be involved in distinguishing between familiar and unfamiliar melodies (Groussard et al., 2010a).

Plailly et al. (2007) also addressed the neural correlates of familiarity and its multimodal nature by studying odors and musical excerpts stimuli. These were used to investigate the feeling of familiarity and unfamiliarity. Results for the feeling of familiarity indicated a bimodal activation pattern in the left hemisphere, specifically the superior and inferior frontal gyri, the precuneus, the angular gyrus, the parahippocampal gyrus, and the hippocampus. On the other hand, the feeling of unfamiliarity (impression of novelty) of odors and music was related to the activation of the right anterior insula (Plailly et al., 2007). Janata (2009) studied the neural correlates of music-evoked autobiographical memories in healthy individuals and those with Alzheimer disease. His findings showed that familiar songs from our own past can trigger emotionally salient episodic memories and that this process is mediated by the medial prefrontal cortex (MPFC). In the same study, hearing familiar songs also activated the pre-supplementary motor area (SMA), left inferior frontal gyrus, bilateral thalamus, and the right cerebellar hemisphere (Janata, 2009).

Brain imaging studies in the neurobiology of reward during music listening demonstrated the involvement of mesolimbic striatal areas, especially the nucleus accumbens (NAcc) in the ventral striatum. This structure is connected with subcortical limbic areas such as the amygdala and hippocampus, insula and anterior cingulate cortex, and also integrated with cortical areas including the orbital cortex and ventromedial prefrontal cortex. These limbic and paralimbic structures are considered the core structures of emotional and reward processing (Koelsch, 2010Salimpoor et al., 2013Zatorre and Salimpoor, 2013). Recently, Pereira et al. (2011) investigated familiarity and music preference effects in determining the emotional involvement of the listeners and showed that familiarity with the music contributed more to the recruitment of the limbic and reward centers of the brain.

Electroencephalography (EEG) is another neuroimaging technique that enabled us to address the brain’s response to stimuli. It provides a real-time picture of neural activity, recording how it varies millisecond by millisecond. Time-locked EEG activity or event-related potential (ERP) are small voltages generated in the brain structures in response to specific sensory, cognitive or motor event (Luck, 2005). With regards to auditory stimuli—and, more specifically, to music listening and recognition—the N1, P200, P300, and N400 waves have been found to be particularly important. N1, a negative component found 80–110 ms after stimulus onset, is thought to represent the detection of a sound and its features, as well as detection of change of any kind (pitch, loudness, source location etc.) (Näätänen and Picton, 1987Seppänen et al., 2012). It originates in the temporal lobe, predominantly in or near the primary auditory cortex, suggesting that it is involved in early phases of information processing (Hyde, 1997). Secondly, P2 is a positive component that arises 160–200 ms after the onset of the stimulus (Seppänen et al., 2012) and is localized in the parieto-occipital region (Rozynski and Chen, 2015). It is involved in evaluation and classification of the stimulus (Seppänen et al., 2012) as well as other related cognitive processes, such as working memory and semantic processing (Freunberger et al., 2007). P3, instead, is considered to be more related to selective attention and information processing, such as recognition and memory processes. It is traditionally divided into P3a, arising in the frontal region, and P3b, arising in the temporal and parietal regions; it appears 300–400 ms after the stimulus and lasts 300–600 ms (Patel and Azzam, 2005). However, its timing can vary widely, so it is often described as the late positive complex (LPC), a definition which also includes later deflections, such as P500 and P600 (Finnigan et al., 2002). Finally, N400 arises 200–600 ms after the stimulus, but its anatomical localization has not been well defined since it does not seem to be related to a specific mental operation only. Indeed, it seems to be connected to the processing of meaning at all levels, since it is influenced by factors acting both at lower and at higher levels of these cognitive processes (Kutas and Federmeier, 2011).

Advances in brain imaging techniques have facilitated the examination of music familiarity processing in the human brain. Nevertheless, the use of different modalities and experimental designs has led to differing results. Over the years, studies have used varying music stimuli such as melodies, songs with and without lyrics, with diverse acoustic complexity. Due to this heterogeneity, it is not clear which areas are most reliably engaged when listening to familiar and unfamiliar songs and melodies.

To our knowledge, no systematic review or meta-analysis has been conducted to resolve the inconsistencies in the literature. The present study systematically reviews the existing literature to establish the neural correlates of music familiarity, in healthy population using different neuroimaging methods, including fMRI, PET, EEG, ERP, and MEG. Finally, we used the activation likelihood estimation (ALE) method (Eickhoff et al., 2009) to conduct a series of coordinate-based meta-analyses for fMRI and PET studies. We expected to find brain areas related to emotion or reward as the most active regions when listening to familiar music, as familiarity is positively correlated with likeability and pleasure, at least to a certain number of exposures.[…]


Continue —> Frontiers | Neural Correlates of Familiarity in Music Listening: A Systematic Review and a Neuroimaging Meta-Analysis | Neuroscience

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[BLOG POST] Art and music therapy after TBI offer a creative outlet – and bring joy, too!

Discovering How Art and Music Therapy Can Bring Healing After TBI

I’m always careful to keep in mind that there are TBI Survivors who will never fall into certain categories – this is one of those times. Although there can be creative outlets for a large percentage of Survivors, there will always be limitations for some. Since every brain injury presents its own challenges, I wanted to acknowledge that first and foremost. Let’s explore how art and music therapy after tbi can make a difference!

Creative music and art therapy provide help for recovery, recuperation and cognition through listening to music, learning to play an instrument, or through creative art and writing. Music is powerful in the way it can conjure memories of a certain time or place in a person’s life. It also can stir emotions through the song’s structure and words. Learning to play music can create a free flow that comes to a person effortlessly (it seems, at least), or it can be tedious and frustrating to others. Either way, it builds memory in different ways – either by repetition and learning, by building retention and memory capabilities…or by listening to music. This can bring a feeling of “knowing” that is like no other – knowing the song, or knowing it sounds familiar, knowing the words, and also having memories flood back that may relate to another time in a survivor’s life. All of these things can be helpful, but all may not bring positive memories. Nonetheless, remembering things can bring a certainty that “all is not lost”, and can provide a foundation on which a new life can be built, and new memories can be made and added in the days ahead.

The Department of Defense website offers information from the Centers for Disease Control and Prevention saying that about 1.5 million people in the United States have a TBI each year and that 85,000 people have long-term disabilities. That’s a lot of people, and in turn, a lot of rebuilding of lives.

Music is a Healer

Here is an excerpt of an article about TBI recovery that illustrates how music and art therapy are being used in a military setting (Here’s the link to the story  Brain Injury Sufferers Find Benefits in Music Therapy Program )

“The Creative Forces music therapy program assists with the needs of military patients and veterans who have been diagnosed with TBI, as well as their families and caregivers,” said Danielle Kalseth, 673rd Medical Operations Squadron creative arts therapist/music therapist. “Not only do we provide clinical services, we want to provide patients and their families access to the arts in the community.”

The music therapy program currently helps 30 patients rehabilitate from TBI, with new referrals every week. Patients who receive music therapy can participate in group or individual sessions, or a combination of both.

The program enables TBI sufferers to engage in a meaningful activity with others who are experiencing the same issues.

“Music therapy helps with more than just my memory; it helps with my mood too,” Young said. “On days when I’m in a bad mood, playing the guitar is a great way to change that.”

Art therapy is one of many treatment modalities used daily with brain injury patients throughout Brooks’ continuum of care. Art aids in the recovery process by allowing survivors to do something they enjoy. When utilizing art therapy as a treatment intervention, Brooks clinicians are working on various functional skills such as fine motor skills, gross motor skills, standing tolerance, endurance, communication, expression of feelings, relaxation, socialization, memory and problem-solving skills. (*end of excerpt)

You Gotta Have Art

Using art as therapy is also a great way to treat the effects of TBI and helps fuel recovery. When used as a therapeutic approach, it…

  • helps eye-to-hand coordination (motor skills),
  • strengthens a person through standing or sitting up,
  • improves communication through personal interaction with others,
  • helps memory and expression of thoughts/feelings.

Creating artwork also can be rewarding – bringing a feeling of accomplishment, and even relaxation. In short, it’s just a great outlet for sharing thoughts AND feelings in a creative way that builds coordination, self-awareness, and confidence.

Music Strikes A Common Chord For People

When it comes to music, it turns out that you don’t have to play an instrument to reap the benefits of cognitive improvement. Listening to music as therapy creates positivity, an improved mood, better focus, and better behavior.

Here’s a great excerpt from an article by Shantala Hegde on the Frontiers in Neurology website. Music-Based Cognitive Remediation Therapy for Patients with Traumatic Brain Injury.  It’s an in-depth, clinically-based story about Music-Based Cognitive Remediation Therapy for Patients with Traumatic Brain Injury.

Here’s the excerpt:

From a neuroscientific perspective, indulging in music is considered one of the best cognitive exercises. With “plasticity” as its veritable nature, the brain engages in producing music indulging an array of cognitive functions and the product, the music, in turn, permits restoration and alters brain functions. With scientific findings as its basis, “neurologic music therapy” (NMT) has been developed as a systematic treatment method to improve sensorimotor, language, and cognitive domains of functioning via music. A preliminary study examining the effect of NMT in cognitive rehabilitation has reported promising results in improving executive functions along with improvement in emotional adjustment and decreasing depression and anxiety following TBI. (end of excerpt)

Don’t Write Things Off – Write Them Down!


In the world of a TBI Survivor, one of the most personal and reflective ways to share thoughts, feelings, desires, goals, progress, concerns, hopes, dreams (and more) is through writing and journaling. By sharing their thoughts through writing, a TBI Survivor can make huge strides toward healing (physically, mentally and emotionally). It brings self-awareness, self-expression, and can help rebuild after “loss of self” through reinvention and creativity. Journaling can be done individually, in a group or with assistance from caregivers or family. (Here is an excerpt from Journaling After Brain Injury, Written by Barbara Stahura, CJF)

Some good ways to start off writing a journal can start with these basic prompts:

  • Today I feel…
  • I feel stronger when…
  • I’m proud of myself because…
  • If I could change…
  • Even though now I can’t (fill in the blank),

I can still…

  • I am grateful for…
  • I feel powerful when…
  • I want my life to include…
  • One year from today…
  • When I was 10 (or some younger age), I…
  • When I am 60 (or some age older than you are now),


Remember, don’t worry about the “rules” of writing.

Just let your pen move across the page and let the words

flow. Be kind and don’t judge yourself or what you write.


Journaling is a very helpful practice after a brain

injury, both for the person with the injury and family

caregivers and members. Writing down your thoughts

and feelings about what is happening in your life can help

you develop safe ways to cope with change and create a

healthy new life.

(Excerpt from Journaling After Brain Injury, Written by

Barbara Stahura, CJF, and Susan B. Schuster, 2009, ©, All rights reserved – used with permission of authors)

Working To Find Therapeutic Healing Through Art and Music

Visual/Fine arts can be quite rewarding and can bring out the best in a person’s creative expression. It can help a TBI Survivor in many different ways, including the development of creativity, dexterity, motor skills and coordination, technique, and self-expression. In the book “Reinventing Oneself After Loss,” by Hilary Zayed, the author explores her meaning of loss, her search for a new identity, and the reinvention of her “new self” with her new self-awareness. Art became her vehicle for self-exploration as she struggled to build a new identity and move forward.

Hilary is a great example of a person who was quite different after her TBI, and her motivation and determination to take her life in a new direction resulted in finding a new passion for writing and art. Working primarily as a painter and mosaic artist, Hilary found that her new direction was a natural fit and that it was rewarding in many ways…although it was completely different from her previous life as a teacher, horseback rider, and accomplished flute player. She had lost a lot of memories of her life before TBI. She struggled with loss-of-self but decided to forge ahead and pursue what she felt were the gifts that had replaced her former abilities. Her journey took her to a new place, with a better sense of self – and a new identity. One that brought her joy and a sense of accomplishment. Although this is a best-case scenario, many Survivors can take Hilary’s lead, and find things that help complete their lives – even small things that make them happy, such as journaling, poetry, socializing, board games, crossword puzzles or word searches, etc. It all depends on what appeals to them! If they find that art is an interest, adult coloring books are fun and relaxing. If they want to draw, a sketchbook and pencils (or colored pencils) is an inexpensive and easy way to see if that’s their strong suit. The point is to help them search for the thing(s) that suit their desires, talents, and abilities. Creating art, writing and music can propel people to new heights of healing and cognition.

Maybe this will inspire you (as a Survivor) or as someone who loves and assists a TBI Survivor…find inspiration, and in turn, find your new self, or inspire someone to aspire higher!


via Art and music therapy after TBI offer a creative outlet – and bring joy, too!

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