Music and the Brain

As COVID-19 spread insidiously around the globe this spring, people sought solace in music. They sang from their balconies, performed virtual fundraising concerts, and created both silly and serious tunes about hand washing, physical distancing, and other aspects of pandemic life.

That so many people have used music as a way to connect, console, and lift spirits during these unsettling times comes as no surprise to David Silbersweig, MD, chair of the Department of Psychiatry at Brigham and Women’s Hospital (BWH) and the Stanley Cobb Professor of Psychiatry at Harvard Medical School, and Nikki Haddad, an incoming BWH psychiatry resident who earned her MD this May from Brown University’s Warren Alpert Medical School.

“We’re all dealing with this very stressful and traumatizing situation, and music is universally accepted as something helpful during these periods,” says Haddad.

Silbersweig and Haddad are both musicians (he plays trombone, drums, and guitar, and she sings and plays guitar) with longstanding interests in how music excites the brain—and how it can be used to improve health. Among other projects, they are collaborating with faculty at Boston’s Berklee Music and Health Institute to study the role of music in supporting critical care providers on the front lines of COVID-19.

In his BWH lab, Silbersweig, a neurologist and psychiatrist who co-directs the Neurosciences Center at BWH, uses imaging technology to peer (noninvasively) inside individuals’ brains and observe how their neural circuits fire in real time. His patients include stroke and tumor survivors who have developed music-related conditions from damage to their brain tissue. For example, patients with sensory amusia lose the ability to perceive or respond to music, and those with musical hallucinosis perceive music even when there is none playing. This work offers insights into how our brains process music and rhythms.

Activating the Brain

The process by which we’re able to perceive a series of sounds as music is incredibly complex, Silbersweig and BWH psychiatry colleague Samata Sharma, MD, explained in a 2018 paper on the neurobiological effects of music on the brain. It starts with sound waves entering the ear, striking the eardrum, and causing vibrations that are converted into electric signals. These signals travel by sensory nerves to the brainstem, the brain’s message relay station for auditory information. Then they disperse to activate auditory (hearing) cortices and many other parts of the brain. It is noteworthy that different parts of the brain are activated, depending on the type of music—for example, melodic versus dissonant—and whether we are listening, playing, learning, or composing music (see related box).

Music can alter brain structure and function, both after immediate and repeated exposure, according to Silbersweig. For example, musical training over time has been shown to increase the connectivity of certain brain regions. “If you play an instrument like the violin,” he said in a recent Zoom interview, “the areas in your brain that are associated with the frequencies of the violin are more stimulated and the synaptic connections are richer.”

Healing Power of Music

These changes in brain circuitry and connectivity suggest opportunities to activate certain regions to promote healing, Silbersweig says. He and Haddad look forward to using cutting-edge brain research to build on what’s already known about the therapeutic power of music for patients with dementia, depression, and other neurological conditions. The pair note, for instance, that playing a march or other rhythmic piece for people with Parkinson’s disease stimulates the brain circuits that get them physically moving. Similarly, people with short-term memory loss from Alzheimer’s disease often recognize familiar songs like “Happy Birthday” because “that memory’s encoded into their brain’s long-term memory,” Haddad notes.

Haddad witnessed this response during high school and college while performing for patients in hospitals and assisted living facilities. “You have these patients who are essentially sedated, lying down, eyes closed, not able to communicate,” she recalls. “And when you play a song that they recognize from their youth, their eyes light up. They’re sitting up, and they’re smiling. It’s just incredible.”

Brain Areas: Working in Concert

We may not realize it when listening to a favorite tune, but music activates many different parts of the brain, according to Harvard Medical School neurologist and psychiatrist David Silbersweig, MD. These include:

• The temporal lobe, including specific temporal gyri (bulges on the side of the brain’s wrinkled surface) that help process tone and pitch.
• The cerebellum, which helps process and regulate rhythm, timing, and physical movement.
• The amygdala and hippocampus, which play a role in emotions and memories.
• Various parts of the brain’s reward system.

“All of these areas,” Silbersweig noted in a 2018 paper, “must work in concert to integrate the various layers of sound across space and time for us to perceive a series of sounds as a musical composition.”

Debra Bradley Ruder is a freelance medical writer based in Greater Boston.

The Harvard Mahoney Neuroscience Institute hosts a public lecture series to continue its efforts to educate the public on the latest scientific discoveries in neuroscience and translate how these discoveries are relevant in our daily lives.

Since its founding in 1990, the Harvard Mahoney Neuroscience Institute has helped advance neuroscience at Harvard Medical School by promoting public awareness of the importance of brain research and by helping to fund research at the School's Department of Neurobiology.