Oooops. Sorry 'bout that.
For those interested, the attached just appeared JAMA (Journal of the
American Medical Association) on a current study being done at
Harvard. Subject: testing the viability of certain kinds of sound to
wean folks from drug thearpy (pain associated with terminal illness,
non-terminal illnesses, asthema, and other dibilitating diseases) and
stress. The double-blind study will include the introduction of
certain types of music (created for the project using certain
criteria) and natural soundscapes as potential analgesics and
replacement therapies depending on which emerge as viable (if any).
Bernie
Wild Sanctuary, Inc.
P. O. Box 536
Glen Ellen, California 95442-0536
Tel: (707) 996-6677
Fax: (707) 996-0280
http://www.wildsanctuary.com
Institute Probes Music's Therapeutic Potential
M.J. Friedrich
THE HEALING QUALITIES OF MUSIC
have been appreciated since ancient
times. Today, music continues
to occupy a therapeutic niche in
a range of settings and is gaining recognition
as a valuable complement to
conventional medical treatment in a
number of areas, such as relieving pain
during childbirth (Pain Manag Nurs.
2003;4:54-61).
Rigorous evaluation of such effects is
needed to ensure that music is used most
effectively in patient care. Such an effort
is one of the aims of neurologist
Mark Jude Tramo, MD, PhD, founder
and director of the Institute for Music
and Brain Science at Harvard Medical
School, in Boston. Throughout his career,
Tramo has used music as a lens to
examine brain function.Heenvisions the
nascent institute as an entity that will
bring a multidisciplinary perspective to
research on how the auditory cortex
functions-not only to gain insight into
fundamental auditory processes, but also
to apply that insight to such problems
as hearing loss and brain damage.
LAYING GROUNDWORK
Tramo has spent the last 2 years laying
the groundwork for the institute's
activities. The group currently includes
a number of investigators affiliated
with Harvard Medical School. But
a host of researchers with different areas
of expertise will be required to fulfill
the institute's goal of finding out "how
music is understood by the brain, from
the single cell on up to global processing"
and applying that knowledge
clinically, said Nicholas Zervas, MD,
professor of neurosurgery at Harvard
Medical School and an executive board
member of the institute.
Accordingly, the institute is expected
to draw from the large community
of research scientists, clinicians,
and other experts in the Boston area
who are involved in auditory-related
studies, from the very technical to more
cognitive and therapeutic areas. A
center such as this, said Zervas, a former
president of the Boston Symphony Orchestra,
can encourage collaboration
among these experts.
ROCK 'N' ROLL HEART
A musician and composer as well as a
physician-scientist, Tramo, a neurologist
at Massachusetts General Hospital
and an assistant professor of neurology
at Harvard Medical School,
represents the convergence of music
and science. Growing up in the 1960s
in an area of the Bronx that was home
to Dion and the Belmonts and the
Young Rascals, he played guitar in a
rock band while in grade school, performing
at the New York World's Fair
in 1965. In high school he began composing
songs, including a rock musical,
"Apotheosis of the King Who Lost
His Kingdom," which he recorded for
Columbia Records.
Tramo's musical pursuits eventually
took a back seat to his research in
neuroscience, but not without strongly
influencing his research path. He now
studies how the auditory cortex processes
pitch, harmony, melody, and
other aspects of music, and works with
patients with epilepsy, stroke, and other
conditions to understand how brain
damage affects music perception. Intuition
from his musical background
"helps me be creative with experiments,
thinking about how the brain
functions," he said.
The institute's mission is ambitiously
broad, ranging from advancing
knowledge of the neurobiological foundations
of music, to rigorously evaluating
and quantifying the healing effects
of music on various disease states. In addition,
Tramo foresees that insights from
the work could lead to new technologies
to promote health and treat disease,
or improve established technologies,
such as cochlear implants.
NAME THAT TUNE
Christine Koh, PhD, a postdoctoral fellow
at Harvard Medical School, is collaborating
with Tramo to study music
perception in patients with brain lesions
caused by stroke or epilepsy. Like
Tramo and many others who study the
neurobiology of music, Koh (who studied
violin for 12 years) is a musician as
ACADEMIC INNOVATIONS
1554 JAMA, April 7, 2004-Vol 291, No. 13 (Reprinted) =A92004 American
Medical Association. All rights reserved.
well as a scientist. She is combing a large
database of stroke patients at Massachusetts
General Hospital, looking for
individuals with specific types of lesions
in the auditory cortices. These patients
are undergoing a variety of tests
designed to provide a broad picture of
the nature of their deficits in music
perception.
Koh and Tramo are also studying patients
with epilepsy who plan to undergo
a therapeutic temporal lobectomy
or excision of a piece of their
auditory cortex-dramatic procedures
used to alleviate seizures that severely
compromise quality of life. Unlike individualswhohave
experienced a stroke,
this group of patients will allow the researchers
to compare musical capabilities
before and after the procedure.
Simple tests-such as asking patients
to decide if one tone is higher or
lower, longer or shorter, or louder or
softer, than a second tone-assess pitch
discrimination. Other tests probe such
abilities as being able to determine
whether two melodies are the same or
different.
"The remarkable thing-and one of
the reasons that music research is so fascinating
-is that you can do a lot of this
testing with people who don't have any
musical training," noted Koh. Due to
early exposure or intuitive sense, human
beings seem to have an inherent
musical sense, she said.
One of the goals of Koh's research is
to determine whether low-level functions
such as pitch discrimination are
related to higher-level cognitive functions
such as melody processing.
"While some of this work is very basic,
it will provide us with the foundation
to get a better understanding of
how the auditory system is laid out,"
she said. "That will help direct us to
practical therapeutic applications."
BREAKING THE CODE
Another member of the institute, Peter
Cariani, PhD, assistant professor of
neurocomputation and neurophysiology
at Harvard Medical School, wrestles
with the issue of how the brain represents
sounds, from music to speech. A
key problem concerns understanding
how information is encoded by neuronal
spike patterns.
Cariani likens this problem to the conundrum
biologists faced before the discovery
of DNA. "Classical geneticists
knew that information was encoded
somehow, they knew therewas amechanism
of inheritance, that it was precise
and reliable," he said. But they did not
know whether the information was encoded
by proteins or DNA, or how the
code worked.
Neuroscientists face an analogous
dilemma in trying to understand the
nervous system without knowing the
"neural code," he said. "We don't understand
the neural codes, we don't understand
the nature of the coding of the
information in the central nervous system,"
Cariani explained. "It's hard to
understand informational processes if
you don't understand this."
A better understanding of neural coding
has practical applications, said Cariani.
For example, cochlear implants
have been developed by trial and error,
to a large extent, without a very explicit
notion of neural coding in the auditory
nerve. But if scientists succeed
in cracking the neural code, the advance
could lead to improvements in
the devices.
SOUNDSCAPING
While basic neuroscience research is an
integral aim of the institute, it is important
not to lose sight of the fact that
music and other components of the
acoustic environment can help patients
feel better, said Tramo.
With that in mind, part of the institute's
mission is to raise awareness
about the importance of improving the
"acoustic ecology," or soundscaping, of
hospitals and clinics. Tramo believes
that just as attention is paid to the
art that adorns the walls of hospital corridors
and patient rooms, the soundscaping
of these areas should also be
addressed.
Apleasing acoustic environment with
music and natural sounds can help to
mask background noise-and perhaps
even speed the healing process,
said Tramo. Some studies have shown
that enriching the acoustic environment
of neonatal units with music can
increase the speed at which preterm infants
gain weight and reduce their
length of stay in the unit, he noted (Int
J Arts Med. 1997;5:4).
Future research plans include identifying
the types of music and environmental
sounds that have positive
health effects on mood, blood pressure,
or immunologic measures, for
example. Bernie Krause, PhD, a bioacoustic
researcher and member of
the institute's advisory board, noted
that although he and others have
gathered anecdotal information on the
beneficial effects of natural sounds-
such as reducing the amount of pain
medication patients require in some
situations-more objective data are
needed.
To this end, Tramo and Krause (president
of Wild Sanctuary Inc, a Californiabased
company that produces natural
sound recordings for soundscape design,
and a former member of the folk
group, The Weavers) hope to evaluate
the effects of such sounds on individuals
with such conditions as anxiety,
depression, and pain.
As the research proceeds, efforts are
also under way to secure a funding base
from public and private sources to take
the institute to the next phase, from a
loose collection of like-minded collaborators
to an entity with a full-time
complement of researchers and others,
said Douglas Brightbart, JD, the institute's
chief operating officer.
Tramo predicts that exploring the
neurobiological foundations of music
is likely to provide insights into the
neurobiology of perception, performance,
development, plasticity, emotion,
and learning. But it's important
to keep the focus on trying to help
people, he said. "That's a major goal of
the institute, to carry out studies well,
and if they really do show positive
effects [on health], to deliver these
benefits to patients."
ACADEMIC INNOVATIONS
=A92004 American Medical Association. All rights reserved. (Reprinted)
JAMA, April 7, 2004-Vol 291, No. 13 1555
[Non-text portions of this message have been removed]
"Microphones are not ears,
Loudspeakers are not birds,
A listening room is not nature."
Klas Strandberg
Yahoo! Groups Links
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Wild Sanctuary, Inc.
P. O. Box 536
Glen Ellen, California 95442-0536
Tel: (707) 996-6677
Fax: (707) 996-0280
http://www.wildsanctuary.com
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