2. Current Clinical Use
• Since the mid-20th century, music has been used as a
therapeutic intervention for various types of patients:
– Those undergoing surgery (administered before, during,
or after)
– Cancer
– Terminally ill/hospice
• A major commonality is that
such patients are
experiencing acute or
chronic pain that needs
to be alleviated
3. Examples in Trial Data
• Meta-analysis of 30 trials with 1891 cancer patients
found moderate pain reduction: standard mean
difference (SMD) = -0.59, P = 0.00031
• Among burn victims, significant decreases in pain
before, during, and after dressing changes2
• Among elderly patients with chronic osteoarthritis,
less pain in those listening to music compared to
those simply sitting quietly3
4. Questions Raised
The lead author of the meta-analysis stated:
“Music is something we use every day, and its
powers can be used in a very targeted way . . .”
The big question is: What are the biological
mechanisms by which music reduces [and/or
increases the threshold for] pain?
What precisely are the messages sent and receptors
targeted that lead to the desired therapeutic
outcome?
5. Sounds are perceived within a range of frequencies
and a range of loudness (decibels) transmitted
through solids as mechanical waves.
Music is composed of
sounds highly organized
and structured by
musicians using specific
elements such as pitch,
rhythm, and timbre.
7. Conformons in
Outer Hair Cells
As in skeletal muscle fibers,
outer hair cells in the ear
contain myosin (although a
different type), thus acting as
a molecular motor after ATP
hydrolysis; conformons
provide the free energy and
genetic information that allow
for the function of mechanical
amplification in the cochlea.
9. Conformons in
Inner Hair Cells
“Biopolymers harboring
conformons can generate
mechanical forces (due to free
energy) oriented in a specific
direction (due to genetic
information) in order to cause
goal-directed motions on their
environment, including [ . . . ]
ions.”
11. PET Scans and CNS Effects
A recent study revealed increased
dopamine release/binding when a
person listens to music he or she enjoys.
PET scans, using a radionuclide specific
for dopamine detection, in particular
show increased neurochemical activity.
fMRI scans measure blood flow to areas
of increased neuronal activity (includes
neurons releasing dopamine).
12. Information Transmission
Form of Communication
Human language Cell language Music
Organization Word definitions & Laws of chemistry & Harmony, rhythm,
rules of grammar physics timbre, etc.
Messengers Spoken words & Exogenous & Instrumental or
sentences emitted endogenous computerized
from vocal chords molecules sounds
Outcome Conversations, Maintain Musical
social interactions, physiological compositions
distinctions among equilibrium or performed or
languages cause changes recorded
Examples English, Spanish, Analgesic sedation, Genres: classical,
Chinese reward system rock, electronic
13. Cell Language Theory Applied to Music
1) music’s vibrational waves inner hair cells
opening K+ channels depolarization due to Ca2+
entry pre-synaptic glutamate release post-
synaptic excitation of auditory nerve cells
vestibular nerve cells cranial nerve VIII cells
2) temporal lobe cells of cerebral cortex
dopamine release from ventral tegmental area
(VTA) cells of midbrain dopamine binding in
nucleus accumbens cells of striatum increased
pleasure, reduction in pain perception
14. Mechanical and chemical changes mentioned
previously are determined by dissipative
structures reliant on music as an energy source.
Listening to music—like taking a
drug—must administered to an
individual to have effects; if you
don’t listen to music or take a
drug in the first place, they
obviously can’t cause any
biological changes within you.
15. Taking Drugs : Receiving Phonons
pho·non (fōnän)
n.
quantum (wave-like and particule-like) of acoustic or vibrational energy
17. Additional Analgesic Pathways
In addition to the mesolimbic reward pathway,
pain reduction may also result from the
nigrostriatal motor pathway (see caudate PET).
18. Happiness and Endorphins
If a song is especially enjoyable for a patient, endogenous
morphine may be released, working on pre-synaptic μ-
opioid receptors, just like exogenous morphine.
Editor's Notes
Currently, many hospitals have music therapy programs in which musicians perform bedside for a variety of patients. The focus of this short talk is on the mechanisms by which music in general—performed or recorded—is able to attenuate pain. Whether a person is in a hospice or a hospital or at home, he or she can use a musical instead of [or in addition to] a pharmaceutical method to feel both mentally and physically more at ease.
Such music therapy is conducted by live performers. Undoubtedly recorded music listened on a stereo or through headphones would produce the same effects, depending on patients’ preferences. In fact, greater control of a CD or MP3 player in terms of song choices and volume and other sound levels in addition to its reduced costs may indicate more practical usage.
[1] Music interventions for improving psychological and physical outcomes in cancer patients.[2] The efficacy of music therapy protocols for decreasing pain, anxiety, and muscle tension levels during burn dressing changes: a prospective randomized crossover trial.[3] Effect of music on chronic osteoarthritis pain in older people.
The PET scan using FDG radionuclide shows the differences in brain activity of a person who experiences different types of auditory stimulation: 1) silence, 2) spoken words, 3) spoken words and music, and 4) music. Although spoken words and music are both comprised of sounds, the nuances produce varied outcomes. PET scans specific for people listening to music are shown in later slides.
Music, emotions, and pleasure: evidence for dopamine release in the brain.
The same way that the humans’ spoken words consist of different fundamental components (adjectives, nouns, verbs), cell language signals initiated by music consist of different components (actions, cells, ions/neurotransmitters) that—when put together in an organized way—elicit a response from the listener.
Role of central dopamine in pain and analgesia.
Mu-opioid receptors, like dopamine receptors, are metabotropic and located in the CNS.
