Music therapy may recruit alternative brain pathways in dementia, study suggests

Researchers from Swinburne University in Melbourne tested six participants with dementia in an eight-week music therapy program that included singing tasks and playing individual tune bells in a group to the melody of Doggie in the Window. Before and after the program, the team used magnetoencephalography (MEG) to map brain activity, looking for changes in connectivity. Lead author Dr Benjamin Slade reported participants improved their test scores after therapy. "Broadly we saw there was a definite change in brain connectivity in each person after therapy," he said. "We found that change was directly linked to compensatory neural networks, where there was increased activity after therapy. We also found areas not associated with these networks were activated. We hypothesised these areas of the brain were recruited to help complete the task."

The study, published in the journal biomedicines, is small, six participants and a control group, and limited by health, recruitment and neuroimaging requirements. But it provides new clues into the mechanisms behind music therapy's impact on cognitive symptoms of dementia. The findings suggest music therapy could awaken a person's cognitive reserve, the brain's accumulated ability to adapt and solve problems when areas become damaged. Active participation was key: participants were given tasks such as singing the lyrics of a known song while skipping words beginning with specific letters. Music therapist Dr Romy Engelbrecht, a co-author, said participants enjoyed the therapy. "These people had real changes of behaviour," she said. "If you go past the room and look in, it looks like everyone is happy and having fun but when you look underneath, what's happening is quite scientific." The program culminated in a handbell performance at an aged care facility. "They learnt a handbell song – they had to remember the information, wait for their turn and then perform," Engelbrecht said. "You could see their happiness and sense of accomplishment. On performance day, they kept performing over and over again, they were so happy."

Slade said pharmaceutical options are usually first-line treatments for dementia. He believes music therapy should be considered as a frontline co-therapy, given it can provide relief, improve quality of life, and may have cognitive benefits at low cost with no immediate side effects. "Music therapy is implemented a lot in aged care but it's variable in how it's delivered," he said. "It needs to be targeted and active to be beneficial." The team is calling for further research to build on their findings and establish a stronger evidence base. Engelbrecht noted there is very little neuroimaging research relating to music or reminiscence therapy.

Cabaret singer Rupert Noffs' mother Mandy was diagnosed with Alzheimer's at 65. Noffs began singing to soothe her when she became anxious and started asking repetitive questions. To his surprise, Mandy, never a singer before, "started singing things note for note, word for word, with harmonies, phrasing and an incredible musical memory." He said, "It was quite astonishing. I realised there was this whole musical ability in Mum that we'd never really seen before."