Neurophysiological and behavioral responses to music therapy in vegetative and minimally conscious states

(O’Kelly J1,2, James L1, Palaniappan R3, Taborin J4, Fachner J5, Magee WL6)

1 Research Department, Royal Hospital for Neuro-disability, London, UK; 2 Dept. of Communication and Psychology, Aalborg University, Aalborg, Denmark; 3 Faculty of Science and Engineering, Wolverhampton University, Wolverhampton, UK; 4 Dept. of Neuroscience, King’s College London, London, UK; 5 Depat. of Music and Performing Arts, Anglia Ruskin University, Cambridge, UK; 6 Boyer College of Music and Dance, Temple University Philadelphia, Philadelphia, PA, USA

Assessment of awareness for those with disorders of consciousness is a challenging undertaking, due to the complex presentation of the population. Debate surrounds whether behavioral assessments provide greatest accuracy in diagnosis compared to neuro-imaging methods, and despite developments in both, misdiagnosis rates remain high. Music therapy may be effective in the assessment and rehabilitation with this population due to effects of musical stimuli on arousal, attention, and emotion, irrespective of verbal or motor deficits. However, an evidence base is lacking as to which procedures are most effective. To address this, a neurophysiological and behavioral study was undertaken comparing electroencephalogram (EEG), heart rate variability, respiration, and behavioral responses of 20 healthy subjects with 21 individuals in vegetative or minimally conscious states (VS or MCS). Subjects were presented with live preferred music and improvised music entrained to respiration (procedures typically used in music therapy), recordings of disliked music, white noise, and silence. ANOVA tests indicated a range of significant responses (p = 0.05) across healthy subjects corresponding to arousal and attention in response to preferred music including concurrent increases in respiration rate with globally enhanced EEG power spectra responses (p = 0.05-0.0001) across frequency bandwidths. Whilst physiological responses were heterogeneous across patient cohorts, significant post hoc EEG amplitude increases for stimuli associated with preferred music were found for frontal midline theta in six VS and four MCS subjects, and frontal alpha in three VS and four MCS subjects (p = 0.05-0.0001). Furthermore, behavioral data showed a significantly increased blink rate for preferred music (p = 0.029) within the VS cohort. Two VS cases are presented with concurrent changes (p = 0.05) across measures indicative of discriminatory responses to both music therapy procedures. A third MCS case study is presented highlighting how more sensitive selective attention may distinguish MCS from VS. The findings suggest that further investigation is warranted to explore the use of music therapy for prognostic indicators, and its potential to support neuroplasticity in rehabilitation programs.

For our Italian friends:

La determinazione dello stato di consapevolezza nei pazienti che soffrono di riduzione della coscienza è un compito estremamente difficile, dovuta all’eterogeneità dei casi. Esiste un dibattito rispetto a quale indagine fornisca la maggiore accuratezza della diagnosi: indagine comportamentale rispetto ai metodi di neuroimmagine. Nonostante i notevoli passi avanti fatti in entrambi i campi, gli errori di diagnosi restano piuttosto alti. La musicoterapia può essere efficace nell’indagine e nella riabilitazione di queste persone grazie all’effetto della musica su stato di vigilanza, attenzione ed emozioni, indipendentemente dai deficit motori e verbali del paziente. In ogni caso, non esistono studi basati sull’evidenza che indichino quale dei due metodi sia più efficace. Per questo gli Autori propongono uno studio neurofisiologico e comportamentale che compara l’EEG, la variabilità del battito cardiaco, la respirazione e le risposte comportamentali di 20 individui sani con 21 pazienti in stato vegetativo o di minima coscienza (VS o MCS). Ai soggetti è stata presentata una selezione della musica preferita e di musica improvvisata adeguata al ritmo respiratorio (una proceduta tipica della musicoterapia), registrazioni di musica sgradita, rumore bianco e silenzio. L’analisi ANOVA indica un range di risposte rilevanti (p=0.05) tra i volontari sani corrispondente a un incremento dell’attenzione in risposta alla musica preferita, che include l’aumento concomitante del ritmo respiratorio e della potenza dello spettro EEG (p=0.05-0.0001) in tutte le bande di frequenza. Mentre le risposte fisiologiche erano eterogenee nella coorte dei pazienti, si notava un miglioramento significativo post hoc nell’ampiezza dell’EEG in risposta alla musica preferita, evidente nel theta della linea frontale mediana in sei VS, e quattro MCS e della banda alfa frontale in tre VS e quattro MCS (p=0.05-0.0001). Inoltre, i dati comportamentali mostravano un significativo incremento nel ritmo di battito delle ciglia in presenza della musica preferita (p=0.029) nei pazienti VS. Due casi in VS hanno evidenziato cambiamenti correlati fra le due misure che dimostrano una reattività a entrambi i tipi di musicoterapia (p=0.05). Un terzo caso MCS è stato illustrato per sottolineare come l’attenzione selettiva possa distinguere gli MCS dai VS. Questi dati suggeriscono che sia auspicabile un approfondimento degli studi per esplorare l’uso della musicoterapia come indicatore prognostico, e valutarne l’uso come supporto per la neuroplasticità in riabilitazione.

(Open access article, creative commons, December 2013).  

Music, Mind, Meaning Conference 2014 at the Peabody Institute of Music

peabody library (January 30-31, Baltimore, MD) The Music, Mind and Meaning Conference will bring together scientists from the field of music cognition  and renowned musicians for a two-day event to explore the relationships between music and science at the Peabody Institute of Music. The events will include presentations from leading scientists and a special musical performance by the Grammy-nominated jazz pianist Vijay Iyer and tenor saxophonist Gary Thomas, Chair of Jazz Studies at Peabody. Keynote speakers will be Drs. David Huron, Aniruddh Patel, and Isabelle Peretz, three remarkable scientists who have led groundbreaking studies of how and why people have engaged in musical behaviors throughout human history. Conference participants will include scientists, clinicians, musicians, students and interested members of the public. Presentations will explore the idea of musical meaning by examining issues of expectation, creativity, evolution, culture, language, emotion and memory from the viewpoint of cognitive psychology, musicology and auditory neuroscience. The conference is generously supported by a conference grant from the Brain Sciences Institute at the Johns Hopkins University School of Medicine. For more information visit http://www.mmmbaltimore2014.org/.

I will be attending and covering this conference, so please feel free to follow me on Twitter @pathwaysinmusic and look for coverage here directly following. A special thanks to Mr. Cooper McClain for making this trip possible.

Valproic Acid for Perfect Pitch? Steady, Now…

FDA_seizure_drug_DepakoteFor the past few days, the internet has been abuzz with the announcement of the “perfect pitch miracle drug.” Let’s back up a bit, shall we?

Valproic acid has been used alone or in addition to other medications for nearly fifty years to treat epilepsy, and is the active ingredient in drugs such as Valproate and Depakon. It is also used in the prevention of migraines, mania in bipolar disorder and for the treatment of aggression exhibited in children with ADHD. It is in the class of anticonvulsants. To talk a little bit about how it works, our brain is made up of thousands of nerve cells that communicate back and forth via electrical signal, a very intricate and delicate process that need maintain a steady and stable balance for normative functioning. When repetitive and abnormally rapid electrical signals are released, this process becomes disturbed and over stimulated. Anticonvulsants such as Valproate function as a stabilizer by increasing the amount of the natural nerve-calming chemical GABA, (gamma-Aminobutyric acid), as an HDAC (histone deacetlyase) inhibitor (Monti et al., 2009). GABA is one of the brain’s chief inhibitory neurotransmitters, which many researchers believe to regulate anxiety. When the amount of GABA in the brain falls too low, Valproate prevents the breakdown of the chemical and works to stabilize the amount of electrical activity, which explains why the drug has been found effective as a treatment for periods of mania and epileptic seizures.

Unfortunately, valproic acid is far from the ideal end-all. Valproate has been known to potentially cause serious or life threatening damage to the liver, pancreas, and blood cells, and holds an alarmingly high statistic for weight gain. It is not approved for use during pregnancy and breastfeeding, and has recently been the target of a lawsuit due to unforeseen birth defects. It is also known to cause ataxia, thrombocytopenia and leucopenia, so before we all go rushing off to “increase our brain function,” it might be wise to spend a moment thinking critically.

This morning, Tom Ashbrook of On Point, NPR stated “Imagine a pill that could rewire your brain. Would make your brain young again. Able to learn and absorb like a five-year old. Music. Languages. Would you take it?”  Neuroplasticity has risen to near-celebrity status over the past few months, and recent study by Frontiers of Systems Neuroscience is certainly fanning the flame. Carried out by researchers from France, Canada, Maryland, Australia, Massachusetts and England, the study set out to discover whether such periods when enzymes “impose ‘brakes’ on neuroplasticity, might be able to “reopen critical periods of neuroplasticity” via a drug that blocks productions of those enzymes. Absolute pitch was thought to be a solid assessment of this possibility because there are “no known cases of an adult acquiring absolute pitch.”

Absolute pitch (AP) is the ability to identify or produce the pitch of a musical sound without any reference point. Individuals who possess AP, constituting about 0.01% of the general population, are able to identify the pitch class, i.e., one of the 12 notes of the Western musical system, e.g., C, D, G#, of a sound with great accuracy (varying between 70–99%, depending on the task, as compared to 10–40% for non-AP individuals, Takeuchi and Hulse, 1993). The study explains:

“Importantly, acquiring AP has a critical period (Levitin and Zatorre, 2003; Russo et al., 2003). A critical period is a fixed window of time, usually early in an organism’s lifespan, during which experience has lasting effects on the development of brain function and behavior. The principles of critical period phenomena and neural plasticity are increasingly well understood both at the behavioral/experiential (Kleim and Jones, 2008) and at the molecular/cellular level (Hensch, 2005). Specifically, behaviorally induced plasticity in the healthy brain, typically after the end of the relevant critical period, can lead to improvement beyond normal or average performance levels. However, for many tasks, this requires targeted training—simple routine use is often insufficient. The factors known to influence the efficiency of such targeted training include the number of repetitions involved, the intensity of the training as well as the relevance or saliency of the stimuli or task trained. Importantly, such training-induced learning is quite specific to the trained task and to the underlying brain networks, although some transfer to other, related domains of knowledge or skills is sometimes possible. At the cellular level, critical periods close when maturational processes and experiential events converge to cause neuoro-physiological and molecular changes that dampen or eliminate the potential for further change (Hensch, 2005Bavelier et al., 2010), thus imposing “brakes” on neuroplasticity. One of the epigenetic changes leading to decreased plasticity after the critical period involves the action of HDAC, an enzyme that acts as an epigenetic “brake” on critical-period learning (Morishita and Hensch, 2008Qing et al., 2008). Research has shown that inhibition of HDAC can reopen critical-period neuroplasticity in adult mice to enable recovery from amblyopia (Putignano et al., 2007Silingardi et al., 2010), and to facilitate new forms of auditory learning (Yang et al., 2012).” (http://www.frontiersin.org/Journal/10.3389/fnsys.2013.00102/full ).

The randomized, double blind study was conducted on twenty four men, half of which received Valproate and the other half, a placebo. The men who received Valproate showed advantage in pitch class identification. To come to the conclusion, it is imperative that we acknowledge the fact that these powerful pharmaceuticals were in no way developed for something so “trivial” of the acquisition of perfect pitch – the diagnostic simply was appropriate for a brief and extremely small study and subject pool. The researchers conclude:

If confirmed by future replications, our study will provide a behavioral paradigm for the assessment of the potential of psychiatric drugs to induce plasticity. In particular, the AP task may be useful as a behavioral correlate. If further studies continue to reveal specificity of VPA to the AP task (or to tasks on which training or intervention is provided), critical information will have been garnered concerning when systemic drug treatments may safely be used to reopen neural plasticity in a specific, targeted way.”

It is vital during this time of exponential and rapid advances in the realm of neuroscience that we keep the grounding measures of ethics and morality at the forefront of our minds. There is a reason performance enhancing drugs are strictly forbidden in competitive sports. While it is truly of great interest to deliberate over the implications of a drug altered to target neuroplasticity, with great power (all together now) comes great responsibility. 

Photo credit: http://sheller.com/practice-areas/practice-areas.php?title=Depakote-divalproex_sodium

9th Annual ASCAP “I Create Music” EXPO Set for April 24-26

ascap2014

**SAVE THE DATE**

ASCAP is pleased to announce that the 9th annual ASCAP “I Create Music” EXPO will be held April 24th-26th, 2014 at the Loews Hollywood Hotel in Los Angeles, CA. The three-day event is the premier conference for songwriters, composers and producers in all genres of music. The ASCAP EXPO will feature creative and business-focused panels, workshops, master classes, keynotes, One-on-One sessions, song critiquing, networking events, product displays, state-of-the-art technology demonstrations, performances and more. Video of panels and performances from this past year’s ASCAP EXPO – over 40 panels, totaling nearly 60 hours of content – is available to stream online for the newly discounted price of $75.

Since 2006, the ASCAP EXPO has brought together some of the biggest names in music. Keynote sessions have featured Katy Perry; Diplo & Big Sean; Ne-Yo & Stargate; Justin Timberlake & Bill Withers; Jon Bon Jovi & Richie Sambora; Tom Petty; John Mayer; Quincy Jones interviewed by Ludacris; Carly Simon; The Smeezingtons (Bruno Mars, Philip Lawrence and Ari Levine); Lindsey Buckingham interviewed by Sara Bareilles; Randy Newman; Jackson Browne; Steve Miller; Ann & Nancy Wilson (Heart); and Jeff Lynne. Writer-composer Master Sessions, performances, panels and the signature “We Create Music” panelshave included an impressive list of music creators, such as Pharrell Williams, Peter Frampton, Natasha Bedingfield, Marcus Miller, Desmond Child, Rodney Crowell, Dr. Luke, Jermaine Dupri, James Newton Howard, Fergie, Steve Lillywhite, Paul Williams, Jimmy Jam & Terry Lewis, Wyclef Jean, John Rich, Stephen Schwartz, Nico Muhly, Jill Scott, Ricky Skaggs, James Levine, Jimmy Webb, Mike Posner, Jared Leto, Rufus Wainwright, John Rzeznik, Ryan Tedder, Seth MacFarlane, Jason Mraz, Don Was, Judy Collins and Chaka Khan to name a few.

All music creators, publishers and executives will benefit from this unique creative event, which is designed around personal interaction, education and networking. The ASCAP EXPO is open to anyone, not just ASCAP members. Registration for the event is now open.

To learn more and to stay up-to-date on the latest ASCAP “I Create Music” EXPO news, visit www.ascap.com/expo, and connect with ASCAP on Facebook and Twitter.

For 2013 coverage by Diana Hereld for Hypebot, please redirect here.

About ASCAP
The American Society of Composers, Authors and Publishers (ASCAP) is a professional membership organization of songwriters, composers and music publishers of every kind of music. ASCAP’s mission is to license and promote the music of its members and foreign affiliates, obtain fair compensation for the public performance of their works and to distribute the royalties that it collects based upon those performances. ASCAP members write the world’s best-loved music and ASCAP has pioneered the efficient licensing of that music to hundreds of thousands of enterprises who use it to add value to their business – from bars, restaurants and retail, to radio, TV and cable, to Internet, mobile services and more. The ASCAP license offers an efficient solution for businesses to legally perform ASCAP music while respecting the right of songwriters and composers to be paid fairly. With over 460,000 members representing more than 8.5 million copyrighted works, ASCAP is the worldwide leader in performance royalties, service and advocacy for songwriters and composers, and the only American performing rights organization (PRO) owned and governed by its writer and publisher members. www.ascap.com

Declaring Our Independence: “I Am A Music Therapist”

Welcome to 2014: Declaring Our Independence

Guest post by Dena Register, PhD, MT-BC

Regulatory Affairs Advisor, Certification Board for Music Therapists

The end of the year always brings with it a great deal of reflection. It feels good to look at the accomplishments of the year at its close, set new intentions and imagine new heights for the year ahead. My own professional reflections for this year brought the realization that over the last eighteen years I have enjoyed a rather diverse career in music therapy with roles as a clinician, educator, consultant and professional advocate. One of the most interesting components of wearing so many different “hats” is trying to imagine how those you are working with perceive music therapy.

There is a constant effort to try and imagine how I can best help others understand what music therapy is and the many benefits for our clients. I feel the need to have an analogy for every situation, description, and population. I can’t imagine that I’m alone in this challenge. I know many music therapists that adapt in this chameleon-like fashion when it comes to how we describe our life’s work. We build rapport with our various audiences by searching for some common ground or understanding to use as a point of departure in hopes that they will have that magical “A-ha!” about the many benefits of music therapy. While these experiences help us develop remarkable skills in story sharing and empathy, we are constantly altering the description of our professional identity in order to help others understand us. This task is a complex one for professionals and is one of the challenges that both students and new professionals find difficult to navigate early on in their careers.

I get to teach a class in philosophy and theory of music therapy. Over the last several offerings of this course the students and I have spent hours exploring what music therapy has in common with other therapeutic and creative arts professions. Each semester produces fascinating discussions, diagrams and reflections on the shared aspects of our professions and, more importantly, how music therapy is notably distinct from any other profession or practice. Successful participation in our profession is reliant upon years of skilled musicianship, and a balance of both scientific and artistic knowledge and understanding. It is highly unlikely that an individual who does not have any prior musical training can make their way through varied and rigorous coursework of a music therapy degree and successfully complete the academic, clinical and musical requirements needed.

In the sixty-plus year development of our profession we have learned to be both flexible and savvy in our descriptions of music therapy. These well-honed skills have built a foundation for our profession to grow and expand in ways we didn’t think possible.  And, in most recent years, our advocacy efforts have brought us to a place of greater acknowledgement and public awareness than we have ever experienced before. What comes next? It is the era of INDEPENDENCE.

With an increased focus on research about the numerous impacts of music as a therapeutic medium, greater access to quality services by licensed professionals and continuously growing clinical offerings music therapy is positioned for continued, exponential growth. Now is the time for continued clarification to others regarding who we are as a profession as well as our unique qualifications.  In 2014, it is imperative that we declareI am a music therapist  and understand how to articulate our unique qualifications and distinctions from our other therapeutic partners.  How will YOU celebrate your ‘independence’ this year?

About the Author: Dr. Dena Register is the Regulatory Affairs Advisor for the Certification Board for Music Therapists (http://www.cbmt.org) and an Associate Professor of Music Therapy at the University of Kansas. She can be reached at dregister@cbmt.org

This January is Music Therapy Advocacy month. For more information on the practice and professionals who make up the field, follow @pathwaysinmusic and #mtadvocacy on Twitter, and check back for updates, interviews and op-eds. For more information on advocacy for recognition and access to services, please visit Music Therapy State Recognition home.

Rest In Peace, Benjamin Curtis.

IMG_1586A couple years ago, a friend took me to see one of my all time favorite bands, Silversun Pickups. Living in LA, I had seen the band around, but never seen them play live. I was making music with my friend at the time, and he joked that any bandmate of his should get to see SSPU live at least once. That show was musical magic for me, but for more than just meeting the band after. 

That night, School of Seven Bells opened. I’d never seen them, or even heard any of their music. I was simply patiently waiting to hear Future Foe Scenarios or the like later on. However, School of Seven Bells began, and I was immediately mesmerized. I left my friends, and went awkwardly closer. As I watched them perform, I had one of those feelings I experience only every couple of years or so- the feeling of being completely intoxicated by musical and visual movement. I later learned the song I had seen and heard was called “Scavenger.”

If you know me or have been around me in the past couple of years, you know this song, whether you realize it or not. You know it, because you have heard it in my car, on a mix I made you, or in my apartment at a party. You know it because I have listened to it at least a thousand times, in a literal sense. My favorite song in 2013 was Where Do My Bluebird Fly by The Tallest Man On Earth. My favorite of 2012 was Scavenger, and I can’t stop listening to it. I have never tired of this beautiful, driving rhythm. I need not say anything of these dark, brutally honest lyrics, because they speak for themselves. They have jaggedly carried me in solidarity through more frustration and turmoil than I can convey. And I am a better person for it.

A mutual friend who also attended the SSPU concert alerted me earlier this year that they were on hiatus because Benjamin had fallen ill. LA Weekly explains that in February, School of Seven Bells announced Curtis’ cancer diagnosis, and artists including Devendra Banhart, and members of the Strokes and Interpol participated in fundraising efforts for his treatment. In October, bands including Silversun Pickups, M83, Cocteau Twins and Blonde Redhead wrote messages of support for Benjamin during his treatment.

I never met Benjamin. Even though I grew up in the Fort Worth/Dallas music scene, and was also an avid fan of Secret Machines, I knew nothing about him. What I do know is what it feels like to lose someone to cancer. He was far too young, and I humbly share that my heart breaks for so many others in learning this shattering news.

I know I am not alone when I say that it seems that every time I turn around this year, there is a death of a loved one. A devastation and losing of something that cannot be replaced. As we ring in another year, God help us take nothing for granted. May we love one another, support one another, and be there for one another. There’s no time not to.

I gave you the tide You didn’t stay You didn’t want it You let the day slide Into a drain Until you lost it You took me like a drug To make you feel loved To make you feel wanted To make you feel fire To make you feel like I made you feel something ‘Cause you can feel nothing I know what you are And you’re a fake You’re a scavenger Too scared to take part You only take ‘Cause you’re a coward On your own, You have no love On your own, You’re not enough You took me like a drug To make you feel loved To make you feel wanted To make you feel fire To make you feel like I made you feel something

Music and Memory 2014 Columbia Music Scholarship Conference

CMSCThe tenth annual Columbia Music Scholarship Conference (CMSC) will be held on March 8, 2014 at Columbia University in the City of New York. The theme of the 2014 meeting is Music and Memory. The conference is organized by graduate students from the Department of Music at Columbia University with financial support from the Department of Music and the Graduate Student Advisory Council.

The conference welcomes Prof. Jonathan Sterne from the Department of Art History and Communication Studies, McGill University as the 2014 keynote speaker. Prof. Sterne teaches in the Department of Art History and Communication Studies and the History and Philosophy of Science Program at McGill University. He is author of MP3: The Meaning of a Format (Duke 2012), The Audible Past: Cultural Origins of Sound Reproduction (Duke, 2003); and numerous articles on media, technologies and the politics of culture. He is also editor of The Sound Studies Reader (Routledge, 2012). His new projects consider instruments and instrumentalities; histories of signal processing; and the intersections of disability, technology and perception.

Burgeoning interdisciplinary inquiry on memory is enabling scholars to develop new perspectives in a diverse array of fields ranging from history, anthropology, sociology, literary studies, art history, archeology, cultural studies, and media studies, to philosophy, political science, theology, education, psychology, and the cognitive sciences. This conference will add to this growing interdisciplinary conversation about memory in the sciences, arts, and humanities, stimulating a dialogue both on the role of memory in music studies and on the place of music in studies of memory.

The conference seeks to consider the complexity of memory’s embeddedness in music’s practices, subjects, objects, ideologies, sites, and technologies. Interests lie in memory as lived, constructed, represented, performed, transmitted, inscribed, incorporated, and stored, as persisting, travelling and circulating, as material and immaterial, human and non-human, as a capacity and a resource that impacts and shapes everyday lives. In what ways can memory influence musical practice, and in what ways can musical practice influence memory? How might memories be theorized musically? What can music scholars offer to memory studies, and memory scholars to music studies?

Information provided by the CMSC website.

 

Ground-breaking study shows music capable of evoking memories in patients with acquired brain injuries

Music has long been shown to aid in the recollection of autobiographical memories in the general population. In recent years, it’s also been proven beneficial to those with Alzheimer’s, or those who have suffered a stroke. However, a recent study proves this process valuable for patients with acquired brain injuries (ABIs). This study is the very first of its kind to examine the possibility of triggering music-evoked autobiographical memories (MEAMs) in patients of this nature.

In the recent issue of Neuropsychological Rehabilitation, Amee Baird and Séverine Samson explain how they have used popular music to help patients with severe brain injuries recall personal memories. The study began with playing extracts from “Billboard Hot 100” number-one songs in random order to five patients taken from the entirety of the patient’s lifespan (commencing age five). These songs were also played to five control participants with no brain injuries. Following the procedure, all subjects were ask to record their familiarity with the given songs, whether or not they was pleasing to hear, and what memories they evoked. The following findings were provided by the Taylor & Francis group:

Doctors Baird and Samson found that the frequency of recorded MEAMs was similar for patients (38%–71%) and controls (48%–71%). Only one of the four ABI patients recorded no MEAMs. In fact, the highest number of MEAMs in the whole group was recorded by one of the ABI patients. In all those studied, the majority of MEAMs were of a person, people or a life period and were typically positive. Songs that evoked a memory were noted as more familiar and more liked than those that did not.

As a potential tool for helping patients regain their memories, Baird and Samson conclude that: “Music was more efficient at evoking autobiographical memories than verbal prompts of the Autobiographical Memory Interview (AMI) across each life period, with a higher percentage of MEAMs for each life period compared with AMI scores.”

The full study may be found here.

The implications of these findings, in terms of neurological rehabilitation through music, memory, and emotion, are simply enormous. I look very forward to learning more of what the inimitable effects of music may have for those whose hope relies in neurological and psychological resilience.

What Dreams May Come : Neural Substrates in Resilience

To be, or not to be, that is the question:
Whether ’tis Nobler in the mind to suffer
The Slings and Arrows of outrageous Fortune,
Or to take Arms against a Sea of troubles,

-Shakespeare, Hamlet

On December 5, 2013, Neuron published case study “The Will to Persevere Induced by Electrical Stimulation of the Human Cingulate Gyrus.” Although researchers at Stanford University came across these intriguing results by accident, the implications may prove in the future to be of some consequence. In order to gain knowledge in the neurological source of seizures, study co-author Vinitha Rangarajan explains they were in the process of delivering an electrical charge to the anterior midcingulate cortex region (involved in emotion, pain and cognitive processing) of two persons with epilepsy when the finding occurred. When the charge was delivered, both individuals experienced increase in heart rate, and various sensations in their chest and neck. These physiological sensations were accompanied by a psychological expectation of challenge, and the desire to surmount it.

When, in following, the patients only thought their brains were being stimulated (but were not), they did not experience any of the prior symptoms. This process of assumed stimulation was repeated 5mm away, with the same result – an absence of any or the previous physical or psychological effects. In a press release, lead author Dr. Parvizi explains “Our study pinpoints the precise anatomical coordinates of neuronal populations, and their associated network, that support complex psychological and behavioral states associated with perseverance.” Dissimilarities in this neuronal structure may be tied to innate differences in our capacity to cope and endure amid trying circumstances.

The study highlights dictate:[i]

  • Electrical stimulation of the anterior cingulate region performed in two subjects
  • A stereotyped set of cognitive and autonomic changes was elicited in both subjects
  • This included feeling of anticipated challenge and strong motivation to overcome it
  • Site of stimulation in both subjects was a core node of the brain’s salience network

Summary

Anterior cingulate cortex (ACC) is known to be involved in functions such as emotion, pain, and cognitive control. While studies in humans and nonhuman mammals have advanced our understanding of ACC function, the subjective correlates of ACC activity have remained largely unexplored. In the current study, we show that electrical charge delivery in the anterior midcingulate cortex (aMCC) elicits autonomic changes and the expectation of an imminent challenge coupled with a determined attitude to overcome it. Seed-based, resting-state connectivity analysis revealed that the site of stimulation in both patients was at the core of a large-scale distributed network linking aMCC to the frontoinsular and frontopolar as well as some subcortical regions. This report provides compelling, first-person accounts of electrical stimulation of this brain network and suggests its possible involvement in psychopathological conditions that are characterized by a reduced capacity to endure psychological or physical distress.

In brief departure, I am reminded of William James’ thoughts on the notion of the “threshhold.”

Recent psychology has found great use for the word ‘threshold’ as a symbolic designation for the point at which one state of mind passes into another. Thus we speak of the threshold of a man’s consciousness in general, to indicate the amount of noise, pressure, or other outer stimulus which it takes to arouse his attention at all. One with a high threshold will doze through an amount of racket by which one with a low threshold would be immediately waked. Similarly, when one is sensitive to small differences in any order of sensation we say he has a low ‘difference-threshold’- his mind easily steps over it into the consciousness of the differences in question. And just so we might speak of a ‘pain-threshold,’ a ‘fear-threshold,’ a ‘misery-threshold,’ and find it quickly overpassed by the consciousness of some individuals, but lying too high in others to be often reached by their consciousness.[ii]

What is it that allows some individuals to fall off the horse fifty times, only to get back up fifty one? To attend one hundred grueling auditions whilst retaining the hope and inertia to continue showing up? To find love and then betrayal, and yet continue to open one’s heart to the vulnerabilities of emotion? Findings such as these in neuroscience are critical to the understanding of pain, fear, and crisis thresholds, and leave many open pathways for discovery in the realm of physical and psychological resilience.

To be, or not to be, that is the question:
Whether ’tis Nobler in the mind to suffer
The Slings and Arrows of outrageous Fortune,
Or to take Arms against a Sea of troubles,
And by opposing end them: to die, to sleep
No more; and by a sleep, to say we end
The Heart-ache, and the thousand Natural shocks
That Flesh is heir to? ‘Tis a consummation
Devoutly to be wished. To die, to sleep,
To sleep, perchance to Dream; Aye, there’s the rub,
For in that sleep of death, what dreams may come,
When we have shuffled off this mortal coil,
Must give us pause.

neurons


[i] Parvizi J, Rangarajan V, Shirer W, et al. The Will to Persevere Induced by Electrical Stimulation of the Human Anterior Cingulate Cortex. Neuron. 2013.

[ii] The Varieties of Religious Experience, New York: Longmans, Green, 1916. Originally published in 1902.

Damasio on The Origins of Creativity (A Philosophy of Art, Part II).

damasio

On Saturday, the Society for Neuroscience presented the Fred Kavli Public Symposium on Creativity. Chaired by Antonio Damasio, presenters included composer Bruce Adolphe, clinical psychologist Kay Redfield Jamison (An Unquiet Mind) and Damasio himself. Each speaker depicted a unique portrait in examples of creations, collaborations and the psyche behind it – Jamison through beautiful insight into the correlation of madness to creativity; Adolphe via imagination in his portrayal of a musical composition in alliance to mental illness.

It was Damasio, however, that really caught my attention in the vein he chose to depict what it is to create. He began, “Creativity is largely human – it is entirely a product of the mind, a product of mind-making brains. It assists life regulation (homeostasis).”[i] Long before there was even the option of achieving a balance of survival, there were simply eukaryotic cells, operating unconsciously. From there came the brain, then the mind, and from there, the self. For Damasio, to construct consciousness, the brain uses the mind (the basic component) and the self (where consciousness comes to light). “Creations are original products of the mind. Creativity is the engendering of such projects – ideas, objects, activities, etc. The self engenders a concern for the life proceedings, and it allows individuals to seek well-being, a state far more complex and difficult to obtain than mere survival. It is only then that the game of life changes radically, and we move from blind biology to the rebellious determination that brings on complex social behavior and eventually culture and civilizations…Art can only emerge then, and it becomes a critical component of that cultural evolution.”[ii]

Before creating a discourse in cultural necessity, let us briefly consider the biological. The cognitive and neural substrates shown between the processes of existing on the creating end, and those on the end of perceiving the created, reveal undeniable similarities. Although the means and neural activations certainly reveal a contrast (for example, portrait painting might activate the fusiform gyrus behind facial recognition, while recognizing expression in the portrait may illuminate the occipital lobe or the amygdala). Much of their motive and affect illustrate many parallels. In creating art, one basic but essential component is being able to utilize skills drawn from learning and memory recall. The creator need use their procedural memory, such as memories storing unconscious learnt skills (such as riding a bike or laying one’s fingers to the piano keys), and declarative memory, in the means of episodic memories (evoked from personal experiences) or semantic (the recall of facts, such as adhering to the accidentals of F minor).

In addition to memories summoned on behalf of the creator, Damasio further explains many of the same tools used in processing and affect are utilized on the opposing end. For the observer, the fluid interplay of remembrance, recalled emotions and feelings oft lead to analysis and reflection (be it superficial or profound). Prior experience with the particular art form (connoisseurship) shapes the observer’s ability to evaluate and enjoy what they have either sought or been presented. Individual preference determines distinctions in imagination and the breakdown/composition of elements in much the same way the creator embarks in posing the question “How novel is it, and how much does it fit the original goal defined?” As Damasio states, “On the mind-brain side of it, you have the importance for imagination, and of memory recall (the ability to display working memory’s faces and realize what it imagined). All of this needs to be modulated by affective experience. The moment you think about this in pure, non-affective cognitive terms, you very simply throw away the baby with the bathwater. It is the guidance that comes from the affective process from the emotional drive and the feeling that is going to make it work, or not.”[iii]

In circling back to the evolutionary underpinnings and origins of art in the physical, musical or visual realms, we retain that both the creator and receiver’s pursuit of art responding to their conscious (or unconscious) recognition of problems and needs. Humanity requires a method of processing, reasoning and making decisions, which the object theoretically should fulfill in its obligation of response. One could easily draw the conclusion that there existed a need (and therefore objective) to communicate with others. Damasio describes threats and opportunities, varying social behaviors, or conveying one’s own sorrow or joy as the probable key intents of communiqué. When these conversations were successful, and were found to be of positive effect, there came to being a compensatory balance. He arrives at a notable point in the seemingly obvious: How would the arts have prevailed otherwise?

Art responds to a need. Art fulfills the wont for intellectual enrichment, satisfies an otherwise empty void for many social contexts and institutions, lends much to the progress of science and technology, and realizes the desire for a more purposeful life existentially. The epic poems of Homer or Ovid are a significant example of a transaction for interaction of information. Prior to the enormous maturity and proliferation of science, literature was a vital method of imparting knowledge and fundamental means of exploration. We observed this heavily is the rise of psychoanalysis at the turn of the century, later by film, and now by neuroscience.

In addition to the evolutionary value of being able to communicate general information, Damasio posits the second largest catalyst for creativity was not only a mechanism of bonding and attachment (i.e. parent to offspring or in reproduction, male to female) but a means to induce nourishing emotions and feelings of varied kinds and importance, such as fear, anger, joy, sadness, indignation, revenge, pride, contempt, shame, loyalty and love. Damasio submits that music does this most of all-most importantly and most universally. The discovery of pleasure in reaction to varying timbres, pitches, rhythms and their relationship to each other surely contributed to the indispensable invention and persistence of this art form – relationships which were discovered in a setting of play, and of repetition.

The foundations of creativity and constructions of art were crucial to the formation of society and to the evolution of humanity in not only the aesthetic sense, but also one of ethics. They promoted a sense of communal organization, and directly provided a mode of exercising moral judgment and moral action. The arts had a candid survival value in forming communication for calls of alarm or opportunity, and they contributed to the notion of well-being. The arts fortified social groups, and social groups in turn fortified creativity. The impulse to create and as a result embrace new and adaptive behaviors possibly even helped humans transcend the Paleolithic era.[iv] They contributed to an exchange of ideas and compensated for emotional imbalances caused by fear, anger, desire, sadness and loss, and catalyzed the sustained process of establishing social and cultural institutions. Because art is so heavily founded in biology, thus homeostasis, and can take us to the highest realms of thought and of feeling, art is an authentic means into the refinement humanity most desires.

 Three years later, much has changed in my life. Three years ago, my father, a singer and profound example of an artist’s command of control and heavenly motive, was still alive. So was a dear friend, who gave me my first book on Jackson Pollock to “stretch my artistic enjoyment.” Much has changed. Much has been found, and lost. Through all the things I have learned and gained, what propels me the most in intellectual, academic and moral pursuits remain: the search for beauty, knowledge, hope, and resilience. I have more than one jealous muse – neuroscience, poetry, dance, psychology, affection, seeking the coveted childlike wonder of the sky’s blanket before dawn – and music most of all. These things are all meaningless, all futile, however, devoid of passion for the refinement and rediscovery of buoyancy, integrity, compassion and love. There are a great many things in art and life that I do not understand, and will never understand. It is the greatest comedy, the most schizophrenic irony of all to be human, in a constant pursuit of perfection that will never be obtained. The alternative is contentment, dormant satisfaction, apathy. This, I reject. If time will not pause while I find my way, it stands to reason that by inertia I will keep going, keep attempting, regardless. If I am to undergo this fallen, fleeting existence of tragic loss and immeasurable joy in the means most true to my human nature, I will do so with art.

After all, in the words of Damasio, when we undergo art, we change for the better.

cupid and psyche


[i] Damasio, Antonio. (November 9, 2013). Fred Kavli Public Symposium on Creativity. Neuroscience 2013. Society for Neuroscience, San Diego.

[ii] Damasio, Antonio. (June 11, 2009).Evolutionary Origins of Art and Aesthetics: Art and Emotions. CARTA (Center for Academic Research and Training in Anthropogeny). Salk Institute, La Jolla.

[iii] Damasio, Antonio. (November 9, 2013). Fred Kavli Public Symposium on Creativity. Neuroscience 2013. Society for Neuroscience, San Diego.

[iv] ibid