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Music Medicine: Sound At A Cellular Level
How does music as sound and vibration impact your body and brain? Dr. Lee Bartel explores how sound can stimulate cells in your body and brain to reduce the impact of Fibromyalgia pain, Alzheimer's disease, Parkinson's disease, depression, and even increase blood flow. It shows how a common consumer vibroacoustic device is used to treat these health conditions. This talk was given in October of 2017 at TEDx Collingwood.
Many years ago I grew up on a honey farm in Western Canada, and so every summer and fall I'd be in the honey house extracting honey from the honeycomb, a very sweet job. And without fail, a couple of drops of honey would land on one of the belts of one of the machines and start to go, "squeak, squeak, squeak" to drive me nuts. And just as inevitably, a cricket would walk into the honey house and would go, "chirp, chirp, chirp". What always amazed me was that it didn't take very long before what started as a sort of random chirp would synchronize with the squeak on the belt.
Why this was happening was a question that lingered in my head for very many years, until I discovered the principle of entrainment in physics -- how one rhythmic, vibrating object will synchronize with another. And so I used that idea and started creating music to affect your brainwaves. Music like this. Pleasant music, but that had a very specific rhythmic structure that would allow me to help you go to sleep, help you relax, even help you focus.
Many years after I started doing this, I discovered that I could just use a single pitch, like this. Forty hertz, remember this sound. Very low, it's like low E on the piano. But with this, I found I could help people reduce their pain, and even reduce Alzheimer's symptoms.
These three sounds, the cricket, the music, and the low-frequency pitch, are all potentially music medicine. Each of these sounds features a rhythmic structure that allows it to impact cells in your body. In fact, my research recently has shown that stimulating cells with sound of this sort can reduce the risk and impact of some common health problems. This is where you're suppose to say, "Wait, what?"
How do Sounds Impact Cells in the Body?
So there are two parts to this that I need to unpack for you so you can understand what I'm getting at. The first is how sound impacts cells in the body. Sound, which includes music, but not all sound is music, but all music is sound, is in essence vibration -- molecular compressions in the air that come to your ear or to your skin if you feel it as vibration as you may have done with the 40 hertz. The ear has hair cells in the cochlea that translate this vibration into electric signals so that the auditory nerve carries this to the brain.
So when you encounter a click, like this, what's happening is that compressions of air molecules are coming to your ear and your ear is translating that into an electric impulse and sending it to your brain something like this. So it goes up the nerve and into the neuron. Except it's not just one neuron, it's probably a thousand or millions of neurons that are responding right to that click.
Just a bit of information, here. When we have one click coming to our ear, we call it one hertz, it's a measure per how per second. When it's five per second, we call it five hertz. When it's 40, we call it 40 hertz. And the brainwave is measured in the same way as hertz. So 40 per second, or 40 hertz, sound will be called gamma because it's in the category of gamma brainwaves.
The other part of my assertion is that brainwaves are important to issues of health. So, let's look at that for a minute. What we know about the brain is that, although there are millions of neurons, they're not just randomly firing unconnected. What we know is that neurons that fire together, wire together, and so we have circuits within our brain. So, for example, the motor circuit is multiple parts of the brain that need to connect so that you can initiate a movement, so you can control that movement and stop that movement. The memory circuit, again, connects multiple parts of the brain, so that what you're experiencing now, you may actually be able to remember tomorrow, as the present experience perception turns into short-term memory and into long-term memory.
What else we know about the brain is that healthy circuits that are functioning for you now, require steady brainwaves. In other words, if one part of the brain is going like this and the other part, occasionally like that, they're not gonna connect. The circuit will not work. And what we know is that the frequency at which neurons like to connect and respond most easily is around 40 hertz. There seems to be a pattern developing here.
When circuits do not function correctly, bad things happen. For example, when the parts of the brain that are supposed to initiate and control movement do not connect, you may not be able to initiate a movement as in dyskinesia or you may not be able stop as in a tremor, so you may have Parkinson's. When parts that are supposed to give you a long term memory do not connect, you may have dementia or Alzheimer's.
So let me talk about a case of Alzheimer's that we treated. She had been diagnosed with Alzheimer's about six months before she came to our extra-mental, vibroacoustic, low-frequency 40 hertz treatment. And so, we gave her a prescription of 30 minutes of 40 hertz sound stimulation three times a week for four weeks, and we used this chair, the Next Wave Chair, that had speakers built into it, six speakers, so that that low-frequency, 40 hertz sound you heard, you would actually feel as vibration. At the end of the 12 weeks, we realized that her test score had gone up. She was giving us indication that she could remember grandchildren's names more easily. She seemed more cognitively engaged and clearer. And so the question is, "What is it about 40 hertz stimulation as vibration sound that might make this happen? Why would this happen in the case of Alzheimer's?"
So, one of the things we know about Alzheimer's is that as a person develops this, there seem to be fewer neurons firing together at the 40 hertz level. So there's less power in 40 hertz, that means the circuits are decaying. We also know, of course, that sound stimulation increases 40 hertz firing, and so we can increase the number of neurons firing at 40 hertz and hopefully restore those circuits, "the cricket principle".
So let me tell you about a study we did next then, which is we took 18 patients, this is just a short, little study to see whether we could have some effect, and we spread these across mild to severe. We used watching a DVD as a control, and the prescription was 30 minutes of sound stimulation in this chair at 40 hertz twice a week for only three weeks, so a total of three hours of stimulation and the results surprised us. What we saw was not just an effect at every session, which is what we thought might happen, but this was accumulating session to session. So over three weeks across the sample, we had an increase of 13% in the test score. We were getting results from patients such as people saying in the third week, "Oh, I remember doing this before." And generally, greater engagement with the world around them in conversation.
So it's a very strong evidence that stimulation might, in fact, improve. Notice the DVD had negative effect. They just got bored and got worse watching the DVD. So one of the questions that came out of that study is, "How long does this last? Can we have this effect for three weeks and then it goes away? What if a person continued this for a while?"
Our first case, after the 12 weeks they were quite happy with the results, and they wanted to continue it, although they were going south for the winter. And so, I suggested they use this device, a portable consumer-based device that produces very good vibration at 40 hertz and has on-board sound, or music in fact, the piece of music that you heard after the crickets, that has a lot of low-frequency at 40 hertz in it. So she used it for 30 minutes, she'd have 10 minutes of 40 hertz sound stimulation. I suggested they use it everyday.
I met the couple three years later, and my first reaction was, "I really can't tell that this woman has Alzheimer's." And so I asked whether they would come back into the hospital to be reassessed and we might be able to complete the case. And in fact, the case was published just this past July. And so, what we found when we reviewed the case file and the testing, was that she had the exact same MMSE, the standardized Alzheimer's score, three years later as she had had when she was first diagnosed. And so it gives us great hope that potentially we can reduce the impact of the development of Alzheimer's. We may be able to slow it down, even if we can't cure it.
So we're planning another study now in which we will do a much more intense look at the mechanism here with MEG imaging of the brain. We will also look at amyloid beta, which is the plaques and tangles, because a study at MIT, almost a year ago, showed that 40 hertz light flicker in the room, seven hours of just flickering 40 hertz in the room, reduced amyloid beta by more than 50%. And so, we're gonna compare that with the sound stimulation and probably, we expect that sound stimulation would also reduce amyloid beta, and in that sense, help to reverse the basis for Alzheimer's. Just for the record, here are some publications:
Clements-Cortes, A, Ahonen, H., Evans, M., Tang-Wai., D., Freedman, M. & Bartel, L. (2017) "Can Rhythmic Sensory Stimulation Decrease Cognitive Decline in Alzheimer's Disease?: A Clinical Case Study' Music & Medicine. Vol 9 No. 3; 174-177.
Clements-Cortes, A, Ahonen. H., Freedman, M. & Bartel, L. (2017) The Potential of Rhythmic Sensory Stimulation Treatments for Persons with Alzheimer's Disease" Music & Medicine. Vol 9 No. 3; 167-173.
Clements-Cortes, A., Ahonen, H., Evan, M., Freedman, M. & Bartel, L. (2016). Short term effects of rhythmic sensory stimulation in Alzheimer's disease: An exploratory pilot study. Journal of Alzheimer's Disease. 52(2). DOI 10.3233/JAD-160081.
Let me tell you next about a case that came to us for treatment with Fibromyalgia. She had been diagnosed with Fibromyalgia about six years before, with a severity scale of about 17 out of 20. She had many of the classic symptoms. She had pain all over her body that she used medication. She had real trouble sleeping. She was depressed. She had stiffness in her neck and shoulders. She couldn't sit and stand for very long at any one time. She missed many days at work. So we gave her a prescription of 23 minutes of 40 hertz sound stimulation, two times a week, for five weeks on this device, the Nexneuro lounge that has two transducers in it. And what we found, after five weeks, was that she had stopped using all her medication. She reported that she could sleep much better. She was less depressed. The chiropractor checked her neck and shoulders and she had more mobility. She was missing fewer days of work.
And so the question is, "Why would 40 hertz sound stimulation have this result in Fibromyalgia that many doctors just say 'Oh, it's just all in your head.'" It's often diagnosed as a psychological problem. I believe it's all in your head or at least a good portion of it is in your head in terms of brain connectivity because research shows that Fibromyalgia has connectivity issues between parts of the brain and then the pain circuits. So the theory would be, and our assumption was, the 40 hertz sound stimulation would restore this connectivity and she demonstrated that there were positive results.
So we then did a study with 19 patients completing in an open label study. The prescription was the same as hers, 23 minutes, two times a week for five weeks. Publication:
Naghdli, L., Bartel, L., Ahonen, H., Macario, P. The Effect of Low Frequency Sound Stimulation on Patients with Fibromyalgia: A Clinical Study. Pain Research & Management. January/February 2015 20(1).
And what we found is that before the treatment started the patients tended to cluster toward the negative side of the scale, the far right, and at the end of the study, they clustered toward the positive side of the scale. What we found was that a quarter had stopped all medication, all had reduced medication. We were getting a positive response across the board.
So we then went on to do a much more rigorous, double-blind, randomized, control trial, Mount Sinai. Prescription here was 40 hertz for 30 minutes a day, five times a week for five weeks, 38 patients completing. We used this same Sound Oasis device, but with an MP3 plugging in the treatment track. And what we found at the end of that study was that we, again, saw significant reduction in Fibromyalgia symptoms. In 52% of the patients, symptoms improved on average by 40%. So, some had considerably more improvement, some had somewhat less.
The next study, which is already funded, will again use brain imaging. And in this case, we'll also do a blood-draw to look at the effect on gene expression, proteomics, and on inflammatory markers.
I can't talk about all the exciting applications. One we're just analyzing now is with major depressive disorder, initially seeing some very good results. My colleagues at Laurier University have done some good studies with Parkinson's. My colleague at University of Toronto has even shown that vibration can increase bone cell density. One of them that I am excited about and just starting is with blood flow. Dr. Arkady Uryash in Miami has done some pioneering work on this and has developed a device that you can attach to the wrist or to the chest and so we're using sound that I have created in a study in L.A. to reduce the impact of stroke with sound stimulation. We're just working on our proposal, to reduce the risk of heart failure.
In this next video, I'm gonna show you briefly how quickly this effect happens. So at the start of this video, we've got the cellphone-type device attached, that size, to this person's wrist. The blue indicates normal blood flow level, and once the device gets turned on you will see very quickly that the yellow and the red will increase as blood flow starts to increase in this hand. So this is an area of research that we're just starting to do intensively and I think has real promise for some very serious cardiac and blood flow treatments.
55 years ago, I was working sticky and sweet by listening to crickets in the honey house and I could never have foreseen that the questions I was asking about crickets and belts, might turn into music medicine. I could not have foreseen that the idea that came from this cricket could start to create sound that might impact cells in your body. That stimulating cells with sound can reduce the risk and impact of health problems like Alzheimer's and Parkinson's and Fibromyalgia and depression. But what I do foresee now in the not too distant future, is that when a doctor encounters something like Alzheimer's or Parkinson's or depression, they might take out their prescription pads, and write a prescription for sound stimulation. And that's music medicine at the cellular level. Thank you.
Lee Bartel is Professor Emeritus of Music and Health and Music Education and at the University of Toronto and Member of the Board and Chair of the Research and Education Committee for the Artists' Health Alliance. He served as Faculty of Music Associate Dean of Research, and was the Founding Director of the Music and Health Research Collaboratory (MaHRC) at University of Toronto from 2011-2015. He is a Member of the Collaborative Program in Neuroscience, Cross-appointed to Institute for Life Course and Aging, as well as the Graduate Department of Rehabilitation Science. He taught graduate courses on Music and Brain as well as Social Psychology of Music. With extensive early experience as a music teacher at all levels and as a performing choral conductor, singer, violinist, and guitarist, he has special interest in conditions of learning, pedagogic culture, social psychology, and music in human development.
Dr. Lee Bartel is not affiliated with avivahealth.com. This talk was given at a TEDx event using the TED conference format but independently organized by a local community.