September 2023

NEUROSCIENCES

IMPROVISATORY MUSIC CALMS EPILEPSY PATIENTS

Improvisatory viola music calms agitated epilepsy patients — as seen in their brain waves — when they are hospitalized in the epilepsy monitoring unit, reports a new Northwestern Medicine pilot study.  
 
Patients with epilepsy endure difficult conditions in the hospital to adjust their medication dosing. They must temporarily stop or decrease their medications for days to provoke a seizure. Many feel fidgety and anxious. Some are so uncomfortable that they cannot complete their testing.   
 
But when these patients listened to improvisatory music — a violist playing live music who responded to their state of agitation in real time — the patients’ brain waves (as monitored on an EEG) slowed to a calmer state. Patients also reported feeling less stress and anxiety after their clinical music experience.  
 
“Their brains went into a meditative state,” says lead investigator Borna Bonakdarpour, MD, associate professor of Neurology at Northwestern Medicine. “When they engaged with the real world, such as watching a show on TV or browsing social media on their phone, their brain frequency was an average of 12 or 13 (beta waves) Hertz, but after the music it dropped to an eight or nine, which is the alpha state.” 
 
The study was published September 1 in Frontiers of Neurology.  
 
“There has been a paucity of non-pharmacological interventions for epilepsy patients in the hospital, and we show that the patients benefited significantly from music intervention,” Dr. Bonakdarpour says. “Importantly, patients’ reports correlated with objective EEG changes, which is something that had not been done in an epilepsy monitoring unit.”
 
The study, with five patients, was small, but Dr. Bonakdarpour plans a larger clinical trial with 30 to 50 patients. 
 
The impact of the findings may apply to patients in the hospital for other reasons, Dr. Bonakdarpour says.  “Music as a clinical tool is underutilized in outpatient settings and in hospitals,” he explains. 
 
During the pilot study, 21 patients with epilepsy were identified as suitable for the trial. Five of these individuals were reported by the nursing and social work staff to have significant distress and were included in this study to receive the intervention. Listening to their favorite songs alone seemed not to be effective for these patients.
 
Participants in the study received a personalized 40-minute live music session over FaceTime by a clinically trained violist in consultation with a music therapist. The violist chose music styles the patients liked.
 
The viola was chosen for this research due to its pitch range reflecting the human “safe” vocal range, which is the two middle octaves. Research shows this range, used for lullabies, activates the calming systems of the brain. Clinically designed improvisatory music has simple meandering melodies played at a slow tempo. The improvisation was slow and meter-less, played in -two-minute long statements with an ending that tapers to silence. 
 
The music was offered as part of the Northwestern Medicine Telemusic Intervention Program during in early 2020 to relieve patients’ distress in the Northwestern Memorial Hospital Neurosciences Unit. The results of the broader study included 87 sessions during a three-month period. 
 
Northwestern Medicine co-authors include: Guangyu Zhou, Daniel Huang, Catherine Vidano, Stephan Schuele, Christina Zelano and Clara Takarabe. 
 
The title of the article is "Calming Effect of Clinically Designed Improvisatory Music for Patients Admitted to the Epilepsy Monitoring Unit During the COVID-19 Pandemic: A Pilot Study." 
 
The research is funded by National Institutes of Deafness and other Communication Disorders grant R01-DC-018539 of the National Institutes of Health and Northwestern Medicine Department of Neurology philanthropy.

This article was originally published in Northwestern University News Center on August 31, 2023. 
Borna Bonakdarpour, MD, Associate Professor of Neurology (Behavioral Neurology) at Northwestern Medicine.

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