Neuroanatomy of music therapy and hematopoietic stem-cell transplantation

Abstract

In Turkey, after a long gap from 1800s to 2000s, music therapy has developed rapidly in recent years. Most of the healthcare providers are suspicious of the effects of music in therapy and try to understand the mechanism of ac­tion. Music is now starting to be seen as a therapeutic intervention. In this study, we tried to explain neuroana­tomical substrate of music and its possible mechanism of action in patients undergoing hematopoietic stem-cell transplantation (HCT). Music is a multi-faceted entity that involves complex brain functions such as auditory processing, auditory mem­ory, musical syntax and semantics. Furthermore, music perception may influence the autonomic nervous system together with the endocrine physiology. Music has important qualities such as tempo, rhythm, melody, harmo­ny and timbre. Melody and harmony are tonal dimensions, whereas meter and rhythm are temporal dimensions, which represent organization of sounds in time. Neuroimaging studies, using PET and fMRI, have shown that su­perior temporal gyrus is not the only substrate for music. Frontal lobes are also important. For example, viola­tion of tonal context activates Brodmann Area 44 (also known as pars opercularis of the inferior frontal gyrus) together with ventrolateral prefrontal cortex (VLPFC). Perception of consonant versus dissonant musical compo­sitions also engages VLPFC. In order to stress the power of music therapy in various patient groups, we selected patients undergoing HCT and performed a database search to allocate music therapy studies in this particular patient group. Almost 60,000 HCTs are performed annually worldwide at more than 400 centers. Although, HCT is associated with severe dis­tress and mortality, few studies have investigated the effects of music therapy in these patients. Most of these stud­ies reported that music therapy improved mood disturbances and shortened time for engraftment in these pa­tients. These effects may be attributed to autonomic innervation of bone marrow. Collectively, understanding the neuroanatomy of music may provide new insights and indications for music therapy.