– and now researchers believe they know why.
Investigators conducting new research found that the acoustic characteristics of Mozart’s Sonata for Two Pianos in D Major (K448) suppresses brain activity in patients with epilepsy, while a piece by the 18th century classical composer Franz Joseph Haydn did not have this effect.
Listening to this Mozart sonata and perhaps other musical pieces may eventually become a treatment for preventing epileptic seizures, said study investigator Ivan Rektor, MD, CSc, Epilepsy Centre at the Hospital St. Anne and professor at the Central European Institute of Technology, Masaryk University, Brno, Czech Republic.
“This research into the impact of listening to music could lead to the development of a music-related type of palliative neurostimulation therapy,” said Dr. Rektor.
The findings were presented at the 2021 Congress of the European Academy of Neurology and published online in the European Journal of Neurology.
Clinically controversial?
Epilepsy affects 6 million people in Europe. Furthermore, estimates show that about 15 million Europeans have had at least one seizure at some time in their lives. In addition, about 30% of patients with epilepsy are not adequately treated with antiseizure medications.
Researchers have been studying the impact of Mozart’s music on brain-wave activity since the 1990s. Various studies report a reduction in epileptiform discharges in patients with epileptic seizures, coma, and refractory nonconvulsive status.
A 2012 meta-analysis of 12 publications involving patients with epilepsy showed an overall reduction in the number of interictal epileptic discharges (IEDs) or abnormal electrical brain waves in 84% of participants who listened to Mozart’s music. A more recent meta-analysis also showed a significant reduction in epileptic seizures and IEDs.
American researchers also found Mozart’s music regulated abnormal interictal epileptiform activity (IEA), especially in those with a high baseline rate of interictal spikes.
However, the methodological quality of some of this research “has been limited,” Dr. Rektor noted. He added that use of music therapy in clinical practice is still considered “controversial.”
The new study included 18 treatment-resistant patients with epilepsy (50% men) who ranged in age from 19 to 55 years. Participants had intracerebral electrodes implanted in the brain before undergoing surgery.
Of the total study population, 15 had temporal lobe epilepsy and three had extratemporal epilepsy. Eleven were affected on the left side, six on the right side, and one bi-temporally. Duration of epilepsy ranged from 8 to 40 years.
Patients listened to the Mozart piece intermittently on one day and to Haydn’s “Surprise” Symphony No. 94 the next day. Researchers counted the number of ED discharges before, during, and after the patients listened to the music.
Surprising finding
Results showed that exposure to the Mozart piece was associated with a 32% reduction in IEDs, from 28 EDs pre-exposure to 19 during exposure. However, IEDs rose to 21 post-exposure.
Overall, the Haydn piece was associated with an increase in IEDs, from 23 pre-exposure to 26 during and post-exposure.
“We saw a clear decrease in epileptic spikes while listening and after listening to Mozart, while there was an increase in spikes while listening to Haydn,” Dr. Rektor said.
He added that all 18 patients responded “more or less” to the music and that the results were statistically significant.
Dr. Rektor noted that the investigators were not surprised by the Mozart effect but were somewhat taken aback by the opposite effect from listening to Haydn.
The impact differed between men and women. The Mozart piece had a larger effect on women. In addition, the Haydn piece led to a decrease in spikes in women but led to “a clear” increase in men, Dr. Rektor reported.
In an effort to explore why the two classical pieces had such different effects, the researchers examined the acoustic properties. They worked with acoustic engineers to examine three musical properties that might influence the number of spikes: rhythm (tempo or beats per minute), dynamics (energy), and timbre (how harsh or unpleasant, how noisy, and how many “high-frequency” parts the music has).
“We observed that K448 [Mozart’s piece] has a more harmonic spectrum and its spectral content doesn’t change quickly, which probably has a positive effect on epilepsy patients,” said Dr. Rektor.
Specific features of the music had a slightly different effect on men and women. Men were more sensitive to dissonance and high-frequency parts while women were more sensitive to energy.
