Reflections in Internal Medicine
From music-beat to heart-beat: A journey in the complex interactions between music, brain and heart

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Abstract

Although the potential influence of music in eliciting organic reactions has been appreciated since the ancient Assyrian and Greek cultures, its relationship with body responses has been believed for long to belong to the field of magic. Growing experimental evidence now attests that some kind of music might indeed modulate several cardiac and neurological functions, as well as trigger biochemical measurable stress-reducing effects in certain individuals, mostly depending on their subjective musical education. On this basis, music has been increasingly used as a therapeutic tool in the treatment of different diseases in healthy and ill subjects over recent years (e.g., the so called “Mozart effect”), although the underlying scientific background is still poorly understood. The aim of this article is to review the current scientific evidences about the complex and multifaceted interactions between music and human biology.

Introduction

Humans discovered the effects of the music on their own wellness at the dawn of the pre-historical age, i.e., during the Cro-Magnon and the Neanderthalian cave cultures. Charles Darwin hypothesized that music may have been a protolanguage in ancient times. Under a cultural perspective, the definition of music is subtle and not well established, since it has varied through history, in different regions, and within societies. The fifteenth edition of the Encyclopædia Britannica describes that “while there are no sounds that can be described as inherently unmusical, musicians in each culture have tended to restrict the range of sounds they will admit”. In his 1983 book, Music as Heard: A Study in Applied Phenomenology, Thomas Clifton affirms that “music is the actualization of the possibility of any sound whatever to present to some human being a meaning which he experiences with his body—that is to say, with his mind, his feelings, his senses, his will, and his metabolism” [1]. On the other hand, the French musicologist Jean-Jaques Nattiez has affirmed that “the border between music and noise is always culturally defined — which implies that, even within a single society, this border does not always pass through the same place; in short, there is rarely a consensus.... By all accounts there is no single and intercultural universal concept defining what music might be” [2] (Table 1).

Some authors believe that the first ancient musical rituals, such as wooden-drums beating, vocalizing (either as animal voice imitation, or as an extension of spoken language) and body swaying and shaking, may represent the oldest form of religion and perhaps of medicine, searching and often obtaining a sense of depersonalization and well-being [3], [4]. The power of the music in eliciting physical reactions has been known probably since the ancient Assyrian and Greek cultures, although the relationship between music and body responses was at that times believed to belong to the field of magic. During the Olympic Games in ancient Greece, musicians were paid for playing flute and kithara (a harp-like string instrument) with the aim of improving athlete's performance [3]. In that era, Pythagoreans were the first to disclaim the mathematical relationships of musical notes, and Plato, in “The Republic”, wrote that “Music is most sovereign because rhythm and harmony find their way to the inmost soul and take strongest hold upon it, imparting grace, in one is rightly trained”. Music was mostly based on three distinct “modes” (dorian, lydian, and phrygian) in ancient Greece, each further subdivided in two or three sub-modes, representative of different musical scales. This organization was strongly related to the feeling, each “mode” being characterized by specific properties (e.g., to arouse pity, or fear, or enthusiasm — this last word having itself a mystic connotation: εν τηεοσ (én Theos), meaning, according to the majority of authors, “having a God inside”, or “being in a God-like state”) and sometimes allowing to “heal and purify the soul” (Aristotle) [3]. In ancient Rome, Plinius reported that Cato recalled a melody specific for the treatment of muscular distractions, and Varro another one for the treatment of gout [3]. In the Middle Ages there was an “epidemic of dances”: choreic patients were used to dance continuously for several hours, in the belief that this might heal them. The southern-Italy dance “tarantella” was also thought to cure some tarantula-spider (Lycosa tarantula, Latrodectes tredecimguttatus and other species) bites [5], [6]. Robert Burton wrote in his “Melancholy's Anatomy” in 1632: “music is the more grateful and effective remedy for sadness, fear and mood disorders”. Peter Lichtenthal, an Austro-Hungarian scientist and musician, wrote in his “Dissertation About the Influence of Music on the Human Body” (1811): “Worthy of the experiment of a physician is, in my opinion, research into the impact of music on man and, led by philosophical reasoning, use it in the treatment of illnesses”. The great German surgeon C.A.T. Billroth (also a good violin and cello player), in his “Wer ist musikalish?” published in 1894, attempted first to correlate musical abilities with the anatomy and physiology of the brain [6]. It was only in 1899, however, that “The Lancet” published an article by J.T.R. Davison, entitled “Music in Medicine”, leading to the now growing field of scientific investigation in music and health [7]. In 1914 E. O'Neil Kane published in JAMA the first experiment describing the effects of music in medical procedures, demonstrating that the use of a phonograph within operating and recovery room was able to decrease the need for pharmacological analgesia and reduce anxiety of patients undergoing “horrors of surgery” [8]. In 1918 Hyde and Scalapino reported, in the first technology-based experiment in this field (e.g., EKG recording), that minor tones increased pulse rate and lowered blood pressure, whereas stirring music increased both blood pressure and heart rate [9]. In recent years, music has been increasingly used as a therapeutic tool in the treatment of different diseases, although the physiological basis in healthy and ill subjects is still poorly understood.

This article is mainly focused on Western music, since the vast majority of available literature regards this fundamental chapter of Western culture.

Section snippets

The neurophysiologic bases of music perception

According to a neurophysiologic perspective, music is elaborated in a primary acoustic projection center localized in areas 41 and 42 of the temporal lobes, whereas the adjacent area 22 is the secondary auditory projection center [10], [11]. A tonotopical organization, beginning from the cochlea and maintained in the acoustic nerve, has been described within these areas, resembling the somatotopical organization of other cortical regions [12]. It is well known, moreover, that there is some

Scientific evidences on the effects of music on human biology

The vast majority of clinical studies dealing with the effects of music on different diseases has been carried out in the neurological field, and the positive effects of music on the motor parameters in patients affected by Parkinson's disease, Alzheimer's disease, multiple sclerosis, ataxia or spasticity, have been clearly demonstrated [5], [24], [25], [26], [27]. In elderly people with gait impairment, music-based multitask training prolonged for six months was able to improve gait and

Learning points

  • The potential influence of music in eliciting organic reactions has been appreciated since the ancient Assyrian and Greek cultures.

  • Growing experimental evidence attests that some kind of music might modulate cardiac and neurological functions and elicit biochemical stress-reducing effects in individuals according to their musical education.

  • Music is also increasingly used as a therapeutic tool in the treatment of different diseases in healthy and ill subjects.

  • The scientific background underlying

Conflict of interest

The authors have no actual or potential conflict of interest including any financial, personal or other relationships with other people or organizations within three years of beginning the submitted work that could inappropriately influence, or be perceived to influence, this work.

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