A Fundamental Method for Unlocking Memories
Music Therapy Opens up a Route to the Past for Alzheimer's Patients; Producing an Individualized Playlist

Among the knocks upon iPods is that users tend to close themselves off from others and pull away into their own secret domain.

But with stroke and dementia patients, iPods and additional MP3 players are causing just the reverse effect.

Listening to rap music and reggae on a borrowed iPod each day has helped Everett Dixon, a 28-year-old stroke victim at Beth Abraham Health Services in Bronx, New York., learn to walk and employ his hands once more.

Trevor Gibbons, 52, who fell out of a fourth-floor construction site and sustained a crushed larynx, has become so enamored with music that he's composed four hundred songs and cut 4 CDs.

Ann Povodator, an 85-year-old Alzheimer's patient in Boynton Beach, Fla., listens to her beloved opera and Yiddish songs daily on an iPod with her home wellness aide or her daughter when she arrives to visit. "We listen for at least a half-hour, and we talk after," states her daughter, Marilyn Povodator. "It appears to impact something deep inside her."

Caregivers have noticed for decades that Alzheimer's patients can still recollect and sing songs long after they have stopped distinguishing names and looks. Numerous hospitals and nursing homes employ music as diversion, because it brings patients joy. But beyond the amusement rate, there's developing evidence that listening to music can likewise help excite apparently missing memories and even help regenerate some cognitive function.

"What I think is going on is that by pursuing very primary mechanisms of emotions and listening, music is arousing inactive regions of the brain that have not been available due to degenerative disease," states Concetta Tomaino, executive manager of the Institute for Music and Neurologic Function, a nonprofit establishment set up at Beth Abraham in 1995.

Dr. Tomaino, who's analyzed the healing results of music for more than thirty years, is spearheading a new platform to offer iPods loaded up with tailor-made playlists to help disseminate the benefits of music therapy to Alzheimer's patients even at home. "If someone enjoyed opera or classical or jazz or church music, or if they sang and danced when the kinfolk assembled, we can revive that music and help them live over those experiences," she states.

Dr. Tomaino says she often sees dementia patients attain gains in cognitive function after music therapy. In one unpublished report she moderated several years ago, with financial support from the New York State Department of Health, 45 patients with middle- to late-stage dementia had one hour of individualised music therapy, 3 times a calendar week, for ten months, and bettered their scores on a cognitive-function test by 50% on the average. One patient in the study discerned his wife for the first time in months.

David Ramsey, a music therapist and psychologist, gives twice weekly sittings at Beth Abraham, where small groups of patients can sing and dance to long-familiar songs like "Under the Boardwalk" and "Swing Low, Sweet Chariot." Mr. Ramsey will occasionally quit singing and let occupants fill in the blanks on their own. When they do that, he says, "they're working their cognitive function—just like they're working out in physical therapy." And unfamiliar strains promptly become familiar, another sign that even advanced Alzheimer's patients are shaping new memories. "One of our therapists played, 'Who Let the Dogs Out?' I know they had never heard that one, but it became an anthem," he states.

In addition to benefiting Alzheimer's patients, decades of reports have showed that music can assist premature infants gain weight, autistic children communicate, stroke patients recover speech and mobility, dental, surgical and orthopaedic patients moderate degenerative pain and psychiatric patients handle anxiety and clinical depression. Now, neuroscientists are beginning to distinguish the fundamental brain mechanisms that explain how music links up with the brain and body, and they're beginning to work hand in hand with music therapists to produce new healing programs.

There's no unique core for music in the brain—the mind seems to be connected end-to-end for music, since it employs an all-inclusive assortment of procedures, including hearing, linguistic communication and motion. But Petr Janata, a cognitive neuroscientist at the University of Calif., Davis's Center for Mind and Brain, recently located a region of the brain—the medial prefrontal cortex, just behind the brow—that appears to function as a hub for music, retention and emotions.

In a report released online in the journal Cerebral Cortex in February, doctor. Janata had thirteen UC Davis students listen to extracts of thirty songs selected at random from "top 100" charts from years when they were 8 to 18 years old, while he registered their brain activity utilizing functional magnetic resonance imaging, or fMRI. Strains that were unknown elicited responses in the auditive processing components of the students' brains; those that aroused emotional responses induced additional brain regions. When songs evoked a particular episodic memory, there was especially potent activity in the median prefrontal cerebral cortex. That's where what Dr. Janata calls "a mental film" appears to run in the mind's eye, with music functioning as its soundtrack.

And, it turns out, this equivalent medial prefrontal cortex had been discovered in earlier research as among the last components of the brain to atrophy as Alzheimers advances.

Dr. Janata hopes to analyse whether the identical phenomenon happens, in the equivalent portion of the brain, with older test cases and finally with Alzheimer's patients. He states that triggering memories with music can't repeal or remedy neurological diseases like dementia. But playing well-known music oftentimes can significantly improve a patient's humor, alertness and caliber of life.

Music therapy Is not employed more widely with Alzheimer's and dementia patients mostly because of a want of manpower and money, experts allege. There are only around 5,000 registered music therapists in the United States., and less than twenty% work with geriatric patients. That's why the Institute for Music and Neurologic Function is seeking to bring music therapy into patients' homes.

Caregivers or household members can utilize records or tapes at home, or program their own iPods. The institute furnishes proposed songs by era and musical genre on its Web site, www.imnf.org. But those who do not have the time or specialized skills can mail an iPod to the institute after filling out a questionnaire about the patient's musical preferences, and the institute will program a made-to-order iPod for them. (View the Web site for costs and package info.) The institute is likewise looking for contributions of iPods that are no longer used to load with music and ship to Alzheimer's patients who can not afford their own.

Dr. Tomaino suggests caregivers to listen as long as the patient appears involved. A patient might prefer to listen alone through earphones or through loudspeakers so that an acquaintance or family member can listen along. "Then they can reminisce collectively about what the music reminds them of or just hold hands to be more attached," she states. She likewise advises involving the entire family in interacting with the music. "The children can drum along while grandad listens to Big Band sounds," she states.

One conceivable downside: doctor. Tomaino says occasionally a song can provoke dejected memories, such as the demise of a loved one or a relationship gone bad. She recollects a Holocaust survivor at Beth Abraham who got very distressed upon hearing a Richard Wagner opera.

"If family members do not know what music would be pertinent, think in generalities," she says. "If a parent loved to go dancing in their teens, culling the most common songs from that era tends to be pretty dependable." Music from a person's adolescent days seems to be particularly remindful of memories, for reasons not well apprehended.




“Under the care of Leo J. Borrell, M.D. since December 2001, I have seen a remarkable improvement in my mother’s condition. She is responding dramatically to the new regiment Dr. Borrell has prescribed”

- Beth Rose


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by Dr. Leo J. Borrell, featured in Assisted Living Consult for November/December 2006. A HealthCom Media Publication