What is Music?

Music has existed for tens of thousands of years and is far more than sound. It is composed of elements that work together to create a piece of art [1]. These elements include rhythm, which describes when and for how long sounds are played. Rhythm makes you want to tap your foot or dance to a piece of music. Pitch denotes the high and low quality of a sound, while timber indicates the sound of a musical instrument. Tempo describes the speed at which music is performed. These basic elements give rise to music through melody and harmony. Melody is a sequence of notes that creates a recognizable tune. Harmony is what makes music sound full, adding depth to a melody and even changing the mood of a song [1].

Music and the Brain

The brain is divided into four main parts, called lobes: the frontal, temporal, parietal, and occipital lobes, along with the cerebellum (Figure 1). Each lobe performs specific functions. For example, the frontal lobe is crucial for planning movements. The temporal lobe handles hearing and memory, the parietal lobe manages motor movements and spatial skills, and the occipital lobe processes visual information. Lastly, the cerebellum is responsible for emotional experiences and the planning of movements [1].

To create a complete experience of music that captures all its aspects including rhythm, melody, and lyrics, various brain regions must work together [1]. The cerebellum’s timing circuits, which help the brain keep track of beats and pace, regulate rhythmic movements, such as tapping along with music. Performing music—either by playing an instrument or singing—involves the frontal lobe for behavior planning, the motor cortex in the frontal lobe for movement control, and the sensory cortex in the parietal lobe for tactile feedback, meaning the sense of touch and pressure you feel when your fingers press piano keys or guitar strings [1]. Reading music is managed by the visual cortex in the occipital lobe. Interestingly, when listening to familiar music, the hippocampus—a structure deep in the brain that aids in storing memories and recognizing music—becomes active, while the amygdala processes emotional reactions to music (Figure 2).

What is Music Therapy?

Music therapy is a medical practice that uses music to address the physical, mental, emotional, and social needs of patients. It is done by trained music therapists who work in hospitals, schools, and mental health centers. Music therapy falls into two main categories: active and receptive. In active music therapy, the patient gets to play an instrument, learn how to play one, or sing songs. This kind of therapy helps with self-expression, builds confidence, and teaches new skills. In receptive music therapy, the patient listens to music chosen by the therapist and then talks about it. Sometimes, the patient might look at lyrics and explore the feelings the music brings up [2]. Before starting, the music therapist gets to know the patient’s physical and mental abilities, music preferences, and any trauma triggers. After taking the patient’s history and identifying their needs, the therapist will set the session’s goals, design an appropriate therapy plan, and select active, receptive, or a combination of both forms of music therapy.

Music Therapy for Alzheimer’s in Adults

Alzheimer’s disease is a brain disorder that causes a continuous decline in memory, thinking, and organizing skills. The first sign of Alzheimer’s is memory loss, which becomes worse as the disease progresses. Individuals with Alzheimer’s may not recognize who they are when they look in the mirror, and they may not recognize their loved ones. Some Alzheimer’s patients can recall songs from their teenage years, between the ages of 14 and 18. Why that specific age? During this developmental period, the medial prefrontal cortex, responsible for linking emotions to personal identity, is highly active, making music from that time meaningful. Additionally, the first memories encoded are often the last to fade. So, if we play a piece of music from an Alzheimer’s patient’s youth, it allows them to profoundly reconnect with a part of themselves they had lost [3]. While this does not cure or slow Alzheimer’s symptoms, it can help revive certain memories [1, 3].

Music therapy not only helps preserve memories but also lessens the symptoms of Alzheimer’s by reducing agitation and improving mood [2]. Interestingly, there is a type of memory, called motor memory, which is responsible for physical movements. A combination of auditory (sound-based) and motor memory can help a person with Alzheimer’s who has lost the ability to make certain movements in the advanced stages of the disease [3]. Music therapy with a strong rhythmic base can trigger spontaneous movement and keep the limbs and joints flexible and active [3].

Music Therapy for Alzheimer’s in Kids

Imagine Alzheimer’s disease in children. That is basically what every family with children who have Sanfilippo syndrome faces. Often called “childhood Alzheimer’s”, Sanfilippo syndrome is a rare genetic disease that causes children to lose all the skills they have gained [4]. Children with Sanfilippo syndrome appear healthy at birth. Although research on Sanfilippo syndrome is limited, music therapy has shown healing effects on affected children, helping them calm down, stimulating verbal and nonverbal communication, and promoting memory [4]. Music therapy also encourages the expression of positive emotions, such as smiling, and it helps these children to pay attention [4]. Click this link to watch an interview with Ms. Ashley Haywood, as she shares the impact of music on her 9-year-old daughter with Sanfilippo syndrome, Ms. Sadie Haywood.

As noted in the interview, music plays an important role in Ms. Sadie Haywood’s life, helping her family to connect and communicate with her. While Sadie has not received formal music therapy, her story highlights the potential of music as a powerful tool. The support that music therapists provide for children with Sanfilippo syndrome can make a profound difference, by bringing smiles and creating special moments in the face of significant challenges.

Music Therapy and Post-Traumatic Stress Disorder in Adults

When a traumatic event happens to adults, they may not recover from that stress for a long time. For example, some war veterans might feel scared or jumpy when they hear unexpected loud noises, like fireworks or explosions, because these can remind them of battle. This is called post-traumatic stress disorder (PTSD). The symptoms of PTSD include reliving painful memories, avoiding certain places or sounds, and emotional disturbances like fear or anger [5]. For example, veterans with PTSD may suddenly have flashbacks of combat if they hear noises that sound like gunfire, making them feel like they are back in a dangerous situation. Avoidance might involve staying away from loud environments that remind them of their bad experiences. Emotional disturbances can include intense anger that affects their relationships. Music therapy can have a positive influence on all these symptoms [3, 5].

When veterans experience flashbacks, listening to calming music can help them stay focused on the present instead of reliving trauma. However, music therapy might also bring buried memories to the surface. Music therapists can reduce this risk by watching patients closely for emotional reactions and ensuring their safety. Veterans in drumming therapy said it eased their anger and helped them feel more comfortable reconnecting with others [5].

Interestingly, songwriting helps alleviate veterans’ PTSD symptoms of avoidance [3]. For example, writing a personal theme song can help create feelings of safety and empowerment, while working with others to write a song supports emotional expression and trauma processing.

Refugees who endure extremely traumatic experiences in their home countries and during perilous escapes are another example. Leaving their homes behind means losing their culture and family, which is very emotionally disturbing. Music can be a powerful link to their past, and it is the one possession they can take with them [3].

Music Therapy and PTSD in Kids

PTSD is not limited to adults—children can also experience it. There are many kinds of hurtful childhood experiences, including traumas that affect children’s physical, mental, or emotional wellbeing [6]. These experiences can have lasting health consequences, including PTSD. Therapeutic songwriting has been used with teenagers to help them process and bounce back from childhood trauma [6]. Songwriting can help people connect with others. If someone has gone through a personal trauma, it is recommended that their music therapy is one-on-one. However, in cases where people have gone through a similar traumatic event, like war veterans, refugees, and victims of childhood trauma, group music therapy work is extremely powerful, as it allows people to connect socially and can eventually help them to change.

What we Now Know and How it Can Help

Music therapy is a type of treatment that uses rhythm, pitch, tempo, and melody to support emotional and physical healing. Music therapy must be done by a trained professional and can take place in the therapist’s office or, once the patient is taught how to do so, in the patient’s home. If you are passionate about music, consider becoming a music therapist. This job would allow you to help children and adults with movement and psychological needs regain their abilities and find joy. You could also become a researcher exploring the effects of music therapy on the brain and on patients’ overall wellbeing. As our knowledge grows, so does its potential as a rehabilitative tool to enhance quality of life, making music therapy a field full of exciting opportunities for progress.

Glossary

Music Therapy: ↑ A medical practice that uses elements of music, such as melody, rhythm, and harmony, to improve emotional, cognitive, and physical wellbeing. It can include listening, singing, or playing instruments.

Music Therapist: ↑ A qualified healthcare professional who uses music to improve people’s health. They design personalized sessions to treat various conditions and work in hospitals, schools, and rehabilitation centers.

Alzheimer’s Disease: ↑ A brain disorder that is usually associated with long-term memory loss.

Sanfilippo Syndrome: ↑ A rare genetic disease that affects how a child’s body breaks down certain sugars. Over time, these sugars build up and can cause problems with thinking, movement, and overall health.

Post-Traumatic Stress Disorder (PTSD): ↑ A mental health condition that can occur after experiencing or witnessing a traumatic event, and which results in a range of symptoms that impact an individual’s life.

Conflict of Interest

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Acknowledgments

We gratefully acknowledge the mother who gave us permission to present her child’s experience, including the accompanying video.

AI Tool Statement

The author(s) declare that no Gen AI was used in the creation of this manuscript.

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