Why a Mozart sonata surprised epilepsy researchers at Dartmouth with its therapeutic effect
Dartmouth researchers are exploring why Mozart’s Sonata for Two Pianos in D Major decreases abnormal epileptic activity in the brain.
“There were intermittent reports as well as small studies suggesting that this Mozart sonata has a positive effect on seizures in patients.” says Dr. Barbara Jobst, director of the Epilepsy and Cognition Lab at Dartmouth-Hitchcock Medical Center. “I initially was very skeptical about this. And if you're skeptical about something in medicine, the best thing is to study it.”
Jobst and the other study researchers monitored the brain activity in 16 patients with epilepsy, specifically the abnormal brain activity (or “spikes”) occurring in patients with epilepsy. Those spikes are associated with seizure frequency and impaired cognition.
Researchers found that the frequency of the spikes was reduced when the Mozart sonata played for at least 90 seconds.
Jobst points out that the sonata’s effect is only on the spikes in brain activity, and does not indicate any conclusions about cognition or intelligence.
“We have to be very careful to not make general assumptions such as ‘Mozart is generally good for you,’” says Jobst.
Jobst and Dartmouth music professor Michael Casey say the next step is to study the elements of the sonata that could be reducing the spikes in abnormal brain activity.
“[Music] has different effects on our hearing, on our attention, on different brain circuits,” Casey says. He says researchers are now studying whether musical features like tempo and rhythm are causing the decrease in spikes.
Jobst says that ultimately they want to engineer therapeutic music which could help people with seizures. Now, researchers need to figure out what musical features would be medically helpful.
Dr. Barbara Jobst: So the reason to focus on this sonata is I've done epilepsy work for quite some years, and there were intermittent reports, as well as small studies suggesting that this Mozart sonata has a positive effect on seizures in patients. So I initially was very skeptical about this. And if you're skeptical about something in medicine, the best thing is to study it
Rick Ganley: And we don't want to, you know, spoil the headline here, but you did find that there was some beneficial effect. We do need to point out this is one study, right, with sixteen subjects.
Dr. Barbara Jobst: This is one study that we did. This particular sonata is compared to other music, as well as to music that the patient likes, [and it] seems to stand out in terms of having a positive effect of cutting down abnormal brain activity that patients with seizures have.
Rick Ganley: What are you observing in patients specifically? Was it whether the sonata would prevent or stop seizure?
Dr. Barbara Jobst: So it's not that it clearly prevents or stops seizures. This is very hard to prove because seizures occur very infrequently, and you can't play the sonata all the time for 24 hours. But what we did was we can measure abnormal brain activity actually in the brain of patients that only occur in patients who have seizures, and these abnormal waveforms called spikes, when we played Mozart, significantly reduced in frequency as compared to other pieces of music. And this particular study also shows you have to at least play it for 90 seconds to have an effect on this abnormal epileptic activity in the brain.
Rick Ganley: Michael, you do a lot of research on how sound affects the brain. What other music did you play for patients to test this particular sonata's impact?
Michael Casey: So we looked at music in a range of different styles because we wanted to know, well, if patients usually listen to country music, would they have a greater effect listening to country music than classical music and some rock and roll and some world music? And also one or two other selections of classical music, some Wagner, because that's quite different than the Mozart. But then also some Liszt and some other piano music as well.
Somewhat to my chagrin, and to our surprise, coming into this as being skeptical about the properties of this one piece of Mozart, it is actually the piece that yielded an effect that is measurable and is statistically significant.
Rick Ganley: I remember many years ago, I think this was back in the '90s, talk of the so-called Mozart effect, specifically with helping children to learn. And a lot of that research, I think, eventually was found to be deficient. I'm wondering if this has any relation to that when we talk about something called the Mozart effect.
Dr. Barbara Jobst: So there I want to comment on this, especially from a medical side, we have only shown that this particular piece of music decreases these abnormal potentials in the brain. This is no judgment of cognition, intelligence, learning, etc. So we have not really studied these parts, whether they have an effect or not.
The only thing we have shown [is] that there is a relationship between this Mozart sonata and a positive effect on seizures and epilepsy and those abnormal brain potentials. So we have to be very careful to not make general assumptions like "Mozart is generally good for you." We have to be careful with this judgment and this just applies to this patient population.
Rick Ganley: Obviously, for anyone who deeply enjoys music, you know it has a true effect on you and the way you feel, your mood and your thoughts. I'm wondering, Michael, do you know why you know the specific sonata, this specific type of music would have affected patient's brain activity the way it did and maybe another piece of music that they would normally find enjoyable?
Michael Casey: Well, the short answer to your question, Rick, is no, we don't actually know specifically what is causing the effect that's observed.
However, music has a lot of different properties, right? When we listen we hear that it is going at a certain speed, its tempo. It might make you want to move, dance. It has a groove or not. It may consist of vocals or violins or, in this case, a piano. And they sound quite different. And they have different effects on our hearing, on our attention, on different brain circuits.
And so what we're looking at now is trying to understand if some very simple feature of the music, such as how fast it's going and what the rhythm is, is causing the effect. Or if it's something more at the level of what the composer was doing in the form of the music.
Dr. Barbara Jobst: The ultimate goal with that is really to engineer some music that would have a therapeutic effect on seizures. So that's why we are doing this research to find out what are the features that we would need to engineer music that is medically helpful.