Esoteric or Exoteric? Music in Medicine

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Music has been an essential part of healing since the beginning of cultural history.[1,2] However, the precise physiological mechanisms by which music might achieve this therapeutic benefit have not been elucidated.[3–6]

We recently completed a study on critically ill, intubated ICU patients to investigate whether a well-defined selection of Mozart music can alleviate stress in critically ill patients, and how this effect might be mediated physiologically. The patients, while off sedation, were exposed to a 1-hour session of slow movements of Mozart's piano sonatas. Before and after the intervention, a defined set of stress hormones, cytokines, and physiologic parameters – such as heart rate and blood pressure – were determined.

We demonstrated that, compared to controls, music significantly reduced the amount of sedative drugs needed to achieve comparable levels of sedation. Simultaneously, among those receiving the music intervention, plasma concentrations of growth hormone rose, whereas those of interleukin-6 and epinephrine fell. The reduction in systemic stress hormone levels was associated with a significantly lower blood pressure and heart rate. Based on these findings, we developed a model of how music might act on neurologic, hormonal, and humoral levels to effect this relaxation.[7,8]

While this study begins to elucidate some of the physiologic mechanisms dictating music's therapeutic benefit, it also raises new questions that warrant further investigation.[9–11] We do not know whether the observed effect is specific to Mozart music, or perhaps related to the underlying severity of the clinical situation studied. We do not know what mediates the effects of music on clinicians. Allen and Blascovich, for example, have demonstrated surgeons perform mental subtraction tasks faster if simultaneously exposed to self-chosen music.[12]

Thus, future studies are necessary to investigate how this beneficial effect of music can be further integrated clinically, both for patient and for physician.[13,14]

That's my opinion. I am Dr. Claudius Conrad, Senior Surgical Resident, Harvard Medical School, Massachusetts General Hospital.