Therapeutic tunes: How music can transform our brains

With the help of new tech and innovative approaches, scientists are learning that we listen to may have the power to heal what ails us.

Nat King Cole’s voice is instantly recognizable as it floats through the headphones. Sonorous and wholesome with a touch of melancholy, it’s the postwar era in musical form. As Cole croons, my mind flits to a time, long before I was born, when the moon landing was still pie in the sky and homemade cookies were perpetually baking in the oven.

On the table in front of me at Toronto Metropolitan University (TMU), a tablet is trying to discern whether Cole is to my taste. Using the device’s camera, an artificial intelligence system is looking for clues in my eye movements and shifting facial expressions. The machine is trying to gauge if I’m into this music and whether I find it soothing. For what it’s worth, I don’t have strong opinions of any kind about Cole. Next, the system selects something a little more upbeat and Elvis Presley is suddenly resonating in my ears.

As the AI-curated artist options might suggest, tech-curious writers in their 40s are not the device’s intended audience. This system was dreamed up by Toronto startup Lucid to deliver music as a therapeutic tool for older adults experiencing agitation and anxiety, which can be caused by cognitive decline or dementia. The idea is to provide a personalized playlist of familiar tunes that can tackle these symptoms and improve the quality of life for individuals experiencing these conditions and their care providers.

The device is being tested by Frank Russo, a psychology professor at TMU who is also Lucid’s chief science officer. “There’s lots of evidence that listening to music can alleviate anxiety,” he says. Exposure to music has been shown to slow the pulse, increase heartbeat variability and reduce skin conductance, which are all signs of reduced stress. But simply playing a bunch of random chilled-out tunes may not do much to help someone who is agitated. It’s the musical equivalent of telling your angry uncle to calm down.

“If someone is really anxious, it makes more sense to meet them close to where they are and progress through a playlist that takes them toward a calmer state,” says Russo. That’s where the system gets smart. Drawing from a catalogue of thousands of songs, the AI DJ can curate a mix on the fly that accounts for the user’s mood, musical preferences and responses to songs that have already been played.

The system has another trick up its sleeve: Using some snazzy sound engineering, the folks at Lucid have found an aesthetically pleasing way to smuggle tones into every song that are a shade away from the main key. What this means is that a listener’s left ear hears notes at an incrementally different frequency than their right ear, which creates something called a binaural beat in the music. And here’s where things get weird: Although the slight difference between the frequencies is almost imperceptible, the brain still subconsciously clocks it. After a while, the listener’s brainwaves start to pulse in time with the binaural beat.

While there are a lot of theories about the capabilities of binaural beats, Russo says many of those claims are bogus — or rather, “there’s not sufficient evidence for them right now.” But when it comes to relaxation, he adds, there is solid evidence that binaural beats can be effective.

Those rhythmic brainwave patterns — created by a process called neural entrainment, where our brains sync up with external stimuli — have been shown to elicit a sense of calm. As for how it works, “that’s beyond our current understanding,” he says. “But there’s a link there that appears to be real.”

The fact that a slightly off-key Elvis can alter brainwaves is, well, kind of mind-blowing. But when it comes to how music can affect our minds, that’s barely the tip of the iceberg.

Rhythm is a dancer

Over at the University of Toronto, a few blocks west of TMU, Michael Thaut has been exploring how the brain processes music for more than two decades.

Thaut is a professor who straddles the worlds of music, rehabilitation medicine and neuroscience. He and his colleagues have published more than one hundred studies demonstrating the effects of music on brain rehabilitation; they have an extensive library of videos that illustrate the findings of their work. In one, a man recovering from a stroke tries to walk. At first, he limps badly as he avoids using his weakened leg. But in the next scene, filmed just six weeks later, his movements are almost fluid. He exhibits a confidence and purpose in motion that he previously lacked. Off camera, a researcher is playing a simple beat at walking pace — or adagio, if you’re musically inclined — that is helping to bring about this startling improvement.

“We were hoping for some effect, but we didn’t expect it to be this dramatic,” says Thaut. By every metric — speed of movement, step rate, stride length, step symmetry — this approach outperformed standard gait training, a form of physical therapy often used in stroke rehabilitation.

In another video, a woman left unable to run by a car accident a decade earlier takes her first steps jogging after training to a musical beat. And in a particularly touching scene, a Japanese man whose brain injury has robbed him of the ability to speak is able to form the word konnichiwa using a technique called melodic intonation — essentially, singing words rather than saying them.

Scientists don’t fully understand how music can bring about these changes, but they are beginning to peel back the layers of mystery. One of the key factors seems to be that music is inherently complex. Even a simple nursery rhyme contains language and meaning in the lyrics; there’s also the melody and harmony, different rhythms and an underlying beat. It may not feel like it, but your brain is compelled to work overtime to make sense of all those elements. On scans, the minds of people listening to music light up like the pyrotechnics at a Taylor Swift concert.

“The cerebellum,” a section toward the back of the organ that operates as “an optimization system for the whole brain, is part of the large network activated in a precise, synchronized way by music,” says Thaut.

Scientists hypothesize that firing up the brain like this could prime it to find new ways to perform previously learned tasks, such as walking and speaking, that have been affected by injury. It diverts the signals away from damaged areas of the brain and through parts that are still functioning, not unlike how traffic can be re-routed through city streets when a highway is closed for construction.

“Undamaged neurons that were not part of the original networks now become part of new networks, restoring function,” says Thaut.

Similarly dramatic effects have been observed in seniors with dementia. Dan Cohen, a social worker who appeared in Alive Inside, a groundbreaking 2014 documentary about music and memory, says songs can summon periods of clarity in people experiencing cognitive decline. He recalls putting on music for an elderly man who was typically only able to communicate in indistinct mumbles. “I came back half an hour later and he said, ‘Thank you very much, that was great.’ I couldn’t understand him before, and then he was clearly telling me what he thought.”

You’ve got the music in you

Given the potential of music to improve patients’ lives, you might expect that these approaches would be extensively implemented in clinics and care homes. But there is still work to do on that front.

“We need to move beyond this concert hall idea that music just makes people feel good and explain how it’s actually a brain language that can be used in rehab,” says Thaut.

It is increasingly common to use music in rehabilitation centres. Thaut has developed a system called neurological music therapy that includes 20 standardized treatment techniques and has been used to train staff at hospitals, private clinics and nursing homes in 68 different countries. The Heart and Stroke Foundation has also disseminated best-practice guidelines that suggest music could help restore verbal memory functions for stroke patients.

But things get trickier when it comes to senior care, where there is already an acute shortage of workers and a great deal of variability in the approach to care depending on the facility. “It’s a matter of walking the walk when it comes to improving quality of life,” says Cohen, who created an organization called Right to Music to advocate for universal access to music-based interventions. There are multiple ways to enrich lives with music in this context, including MP3 players, smart speakers, dementia choirs and staff engagement, he adds. “There is a stigma around cognitive decline that gets in the way of giving people what they need. But people who have dementia are still very much there and deserve to stay connected with their music.”

Organizations like the Alzheimer Society of Toronto send out hundreds of MP3 players to seniors every year. But it can be difficult for younger people to determine which songs to load onto those devices in order to create the most effective playlists. Musical taste is eclectic and personal, and seniors with cognitive decline are often unable to explain what they like.

“There is no template for the kind of music someone will enjoy — everybody’s completely different. It’s like a fingerprint,” says Cohen, who notes that he is especially partial to tunes from the ’60s (“God Only Knows” and “Stairway to Heaven” are particular faves). Often, songs that are linked to life experiences like attending a high-school prom or getting married will have the greatest impact. But it’s a fair bet that most people don’t know what was playing during their grandparents’ first dance at their wedding.

That’s the gap Lucid is aiming to fill. Given a rough idea of which eras and genres the user likes, the AI system will home in on specific songs that will be the most soothing. Because it operates automatically, this tech should free up family or paid caregivers from the need to play deejay.

With two clinical trials completed and FDA authorization, Lucid is launching its product with care providers in several states in the U.S., where the device will be reimbursable through Medicare. The company is currently exploring opportunities in Canada, with an aim of making this technology accessible. But regardless of whether or not we all end up with an AI-selected soundtrack to our lives, Cohen has some advice for those approaching their later years: Write down 100 or more songs that you relate to and share that list with your loved ones now. Because ultimately, the only person who knows which songs will get your neurons firing is you.

Illustration by Monica Guan