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Brains in sync

Dr Clemens Maidhof and Prof Jörg Fachner in a music therapy room

Music therapy can help to improve the lives of people with conditions such as anxiety, autism and dementia, but at a scientific level, we still do not fully understand what makes it so effective. Research by Jörg Fachner and Clemens Maidhof is starting to show how the brains of patients and therapists ‘connect’ through music.

At our Jerome Booth Music Therapy Centre in Cambridge, a patient listens to L’enfance Du Christ by Berlioz. She is here because she is suffering from anxiety, prompted by complications affecting her granddaughter’s pregnancy. The aim of the session is to ease her stress, and to help her to think more positively, so that she can support her granddaughter through this difficult time.

Specifically, this is a Guided Imagery and Music session, in which the music is used to stimulate images, memories and feelings to help the patient.

As the choral music swells, the therapist gently invites the patient to discuss what it makes her see and feel, reawakening old memories. Suddenly, the patient develops the clear sensation that her own grandmother is sending her a message. 'She’s telling me not to worry,' she says. 'It’s like the music is relief coming into the body… and into the heart.'

The science behind the therapy

This extraordinary moment occurred during a recent therapy session that was being monitored by Professor Jörg Fachner and Dr Clemens Maidhof, from our University’s Cambridge Institute for Music Therapy Research (CIMTR). Music, used therapeutically, can improve wellbeing, and treat conditions including anxiety, depression, stroke, autism and dementia. The institute aims to deepen our understanding of how this can be done.

"Music therapy is very successful, but it's not completely clear why it works."

Jörg and Clemens study the neuroscience behind the therapy itself. 'Music therapy is very successful, but it’s not completely clear why it works,' Jörg explains. 'We want to know what is actually happening in our brains that makes it so effective.'

The pair use a technique called ‘hyperscanning’, which involves recording the brain activity of two or more people simultaneously. In the session described above, the therapist and patient wore caps fitted with sensors, which capture data about electrical signals in the brain. Jörg and Clemens then study and compare how their brains experienced and processed the therapy.

"Usually, therapists rely on the patient’s reaction to judge whether the therapy is working. Our data can show what was actually happening in their brain."

Hyperscanning has never been used in this way before, but it is already helping to pinpoint pivotal moments during therapy sessions. Music therapists work towards ‘moments of change’, at which they make a meaningful connection with the patient. 'Usually, therapists rely on the patient’s response to judge whether this is working,' Clemens says. 'Our data can show what was actually happening in their brain.'

During the above episode where the anxious patient recalled her grandmother, for example, the researchers examined activity in the brain’s right and left frontal lobes, where negative and positive emotions are processed respectively. They analysed this alongside a video and transcript of the session.

As the patient spoke about the message from her grandmother, her brain activity shifted suddenly from displaying deep negative feelings to a positive ‘peak’. Moments later, as the therapist realised the session was working, her scan displayed similar results. In subsequent interviews, both said that was a moment when they felt the therapy was really working. For the first time, the hyperscan shows what this breakthrough looked like within the brain itself.

Meaningful connections

A second study involved a young dementia patient in his 30s, and also appears in the recent BBC documentary, Our Dementia Choir.

The patient was a drummer who, tragically, can no longer play in time because of his condition. During the session, Jodie Bloska, our music therapist, played the drums with him and, remarkably, this helped him to master a tempo. As their beats fell into step, the researchers again saw a peak both in the patient’s and the therapist’s frontal lobe activity. These neural signals show that the patient was making a positive and meaningful connection with the therapist through the music – a hugely important step for anyone with dementia, which so often leaves sufferers feeling detached and confused.

Hyperscanning in this way can help to highlight where therapy sessions have worked best, which could be particularly useful when treating patients for whom verbal communication is challenging.

Over time, Jörg and Clemens want to achieve much more. By recording more sessions with their research collaborators at IMC Krems, in Austria, and in the UK, they hope to spot recurring patterns in the data – neural ‘signatures’ that indicate strong, positive connections between therapist and patient. By cross-referring these with other information about how the brain was working during those same moments, they should gain better insights into the neural mechanisms that make music therapy successful.

'In the end, we don’t just want to confirm breakthroughs; we want to explain what makes them different,' Jörg adds. 'If we can understand that, we should be able to make music therapy even more effective for patients in future.'

Music therapy research at ARU

Our Cambridge Institute for Music Therapy Research is a world-class, interdisciplinary institute dedicated to advancing the understanding of music therapy and its ability to affect positive change on health and human wellbeing.

CIMTR’s research calls on expertise and insight from across sectors and disciplines, with the ultimate aim of influencing national and international initiatives, and advocating for the important role music plays in education, health and community.

Access our expertise

Find out how you can access our research expertise: contact Amy Mitchell, Partnerships Development Manager, on 01223 695139.