Neuroscientific Insights for Improved Outcomes in Music-based Interventions

Abstract

Music therapy is an evidence-based practice, but the needs and constraints of various stakeholders pose challenges towards providing the highest standards of evidence for each clinical application. First, what is the best path from clinical need to multi-site, widely adopted intervention for a given disease or disorder? Secondly, how can we inform policy makers that what we do matters for public health––what evidence do we have, and what evidence do we need? This article will review the multiple forms of evidence for music-based interventions in the context of neurological disorders, from large-scale randomized controlled trials (RCT) to smaller-scale experimental studies, and make the case that evidence at multiple levels continues to be necessary for informing the selection of active ingredients of interest in effective musical interventions. The current article reviews some of the existing literature on music-based interventions for neurodegenerative disorders, with particular focus on neural structures and networks that are targeted by specific therapies for disorders including Alzheimer’s Disease, Parkinson’s Disease, and aphasia. This is followed by a focused discussion of principles that are gleaned from studies in cognitive and clinical neuroscience, which may inform the active ingredients of music-based interventions. Therapies that are driven by a deeper understanding of the musical elements that target specific disease mechanisms are more likely to succeed, and to increase the chances of widespread adoption. The article closes with some recommendations for future research.