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Ask An Expert: Can Music Therapy Really Help With The Physical And Mental Symptoms Of Multiple Sclerosis (MS)?

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The right song can literally send shivers down your spine, so it’s clear music can trigger physical reactions.[1,2,3] Could it also be good for your health? An initiative called MS in Harmony is harnessing the effect of music therapy to help people impacted by multiple sclerosis achieve mind-body harmony.

The following information was provided to BuzzFeed by Bristol Myers Squibb in partnership with Betsy Hartman, board certified music therapist, and is meant to provide an overview of the potential benefits of music therapy in multiple sclerosis and encourage you to learn more about MS in Harmony.

Betsy Hartman, MT-BC, is a board certified music therapist based in Seattle, where she founded her private practice PNW Music Therapy, LLC and works with Swedish Medical Group’s MS Center and Cancer Institute. She recently sat down with us to discuss the physical and mental impact of multiple sclerosis (MS), how music therapy works and how people living with MS and their care partners can experience it for themselves.

I’ve heard of multiple sclerosis (MS), but I’m not too familiar with it. Can you tell me about how it affects those living with it? What kinds of symptoms does the condition cause?

The National Multiple Sclerosis Society describes MS as 'an unpredictable disease of the central nervous system that disrupts the flow of information within the brain, and between the brain and body.'[4] From working with people with MS, I have seen firsthand how it can affect physical and mental functioning. There are many people living with MS that, from the outside, may look uninhibited by the disease; however, when you take a closer look, you may find that this person is experiencing mind and body symptoms such as fatigue and sluggishness, difficulty walking, or a decline in cognition, difficulty processing information, and memory loss or worsening memory.[5,6] There is a wide spectrum of how MS affects people, and symptoms can vary from severe to barely noticeable to the outside eye.[5] My clients have told me this is one of the hardest parts about MS: It can feel like a “hidden” thing you’re dealing with alone.

Can you explain to readers the benefits of music therapy (MT) in terms of what impacts it has on physical and mental function?

This is truly one of the reasons I love MT — people may receive both physical AND mental benefits. Research suggests that when there is a direct auditory input, we have a direct motor output.[7] So, when we listen to music, specifically the rhythm or beat of music, our bodies respond by moving.[8] Many people with MS have difficulty moving their bodies in the way that they want them to move. I have seen irregular gait patterns, limited mobility in upper extremities, or freezing.[5,6] When music is used to accomplish a nonmusical goal, like walking, we see that the rhythm, tempo, repetition, and melodic phrasing of a song (the auditory input) actually helps a person with the appropriate movement.[9]

As I was saying before, not only might MT support physical outcomes, but it can also help improve mental health as well.[10] Imagine a person is working on improving walking or upper extremity coordination. If they’re listening to music, that gives them goosebumps and elevates their mood, dopamine is being released.[11] Not only are they improving motor skills, but they’re also making themselves happy at the same time through positive reinforcement and reward. This is only the tip of the iceberg on the many ways that MT can potentially improve health. It’s incredibly individualized and patient centered.

Has MT been studied in MS specifically? What impacts have they seen it have?

Yes! There have been a number of studies published suggesting that MT may help promote physical and cognitive changes in people with central nervous system diseases, including MS, such as improved walking speed/stride and upper/lower extremity function, improved balance and strength, improved long-term memory storage and recall, and a sense of self-control and elevated self-esteem.[12,13,14,15] For these reasons, MT has been used as part of comprehensive disease management plans for people living with MS for years. It’s also become a national research priority, as well; in 2019, the National Institutes of Health awarded $20 million over five years to bring together MT and neuroscience.[16] Needless to say, people in and outside the MT field are continuing to collaborate and uncover the possible benefits that can occur when we listen to and use music therapeutically, which is really exciting.

Tell us about the science behind how music affects us. Is there really evidence behind how it gives us energy, makes us happy, gives us goosebumps?

There definitely is! Recent research suggests that when we listen to music we enjoy, dopamine, “the feel-good neurotransmitter,” is released in our brain, causing our bodies to have a physiological response to the song that just came on the radio.[10] This can come out in many forms — goosebumps, an increased heart rate, or feeling a bit happier.[1,2,3] Something I like to point out to people is: imagine yourself in a restaurant. All of a sudden, you notice you’re tapping your foot along to a beat, but you didn’t even realize you were listening to music. Your body is having a physiological response to something you’re hearing, and responding subconsciously. It’s pretty incredible.

Do you need to be musically inclined to benefit? What would you say to someone who was considering trying MT?

I would say there’s no reason to be afraid. Just like you aren’t required to be an athlete to participate in physical therapy, you don’t need to be a musician to participate in MT. It’s important to remember that we aren’t working on musical outcomes — like becoming the next John Denver, Celine Dion or Billie Eilish — we’re working on non-musical goals — like walking, talking, and thinking. Sometimes MT sessions do not even involve the client touching an instrument.

Why is MS in Harmony meaningful for someone living with MS?

MS in Harmony is meaningful for people now more than ever. The recent pandemic showed how it can often be difficult or even risky to attend appointments. Plus, many people are struggling to balance work and care for their families. All of these people still deserve access to good care. MS in Harmony allows people with MS to engage in MT-informed content whenever and wherever they want. Furthermore, it's designed in such a way that is inclusive to people of varying abilities, backgrounds, and needs. Not only that, but this platform is easy-to-use and a great way to involve your family or loved ones in health and wellness to, for example, show your 13-year-old things you’re doing to help yourself move and feel better. If you’re someone who is looking for an efficient, effective, and safe way to learn how MT may help improve your physical and mental health, MS in Harmony, available at MSinHarmony.com, is for you.

You’re clearly passionate about MT. What inspired you to enter the field, and what do you hope people take away from it?

Growing up, I was always playing music, but I knew early on I didn’t get a thrill from performing. I had intended to be a nurse who would somehow manage to play music for her patients in her spare time (shows how little I knew about nursing at that time!), but once I learned about this field, I never looked back. MT is perfect for me because music therapists are passionate about and understand music, but we have added skills in music education, psychology, and neuroscience. My personal mantra is that through music therapy, I can help patients with their bodies, minds, and souls. In the moment, we’re working on physiological goals, but I think we also offer a way to learn skills people can bring back to improve their daily lives, ways to creatively process mood challenges, and an opportunity to find resilience and hope.

What if someone with MS tries your music therapy informed videos on MS in Harmony and wants more — what should they do?

MS in Harmony guides people with MS on how they can achieve mind-body harmony through MT, but it’s not a replacement. To experience MT, look for a music therapist in your county, city, or state! You can do this through the “find a therapist near you” page on the American Music Therapy Association website (musictherapy.org). I would also suggest talking to your medical provider, physical therapist, or friends to ask if they know of a music therapist practicing near you. Many music therapists are offering services via telehealth, so this may be an option to pursue as well. Lastly, if you can’t find a music therapist near you, ADVOCATE for music therapy in your clinic. Obviously, I’m biased, but I really do think MT should be a part of MS care plans everywhere. Let your doctor know that this is a service you and all other people living with MS should have access to, and encourage your clinic to bring MT on to its clinical team!

All images courtesy of Bristol Myers Squibb.

[1] Mori K, Iwanaga M. Two types of peak emotional responses to music: The psychophysiology of chills and tears. Sci Rep. 2017;7:46063. Published 2017 Apr 7. doi:10.1038/srep46063

[2] Blood AJ, Zatorre RJ. Intensely pleasurable responses to music correlate with activity in brain regions implicated in reward and emotion. Proc Natl Acad Sci U S A. 2001;98(20):11818-11823. doi:10.1073/pnas.191355898.

[3] Arjmand H-A, Hohagen J, Paton B and Rickard NS (2017) Emotional Responses to Music: Shifts in Frontal Brain Asymmetry Mark Periods of Musical Change. Front. Psychol. 8:2044. doi: 10.3389/fpsyg.2017.02044.

[4] Stream to End MS. National Multiple Sclerosis Society. https://www.nationalmssociety.org/stream-to-end-ms/about-ms. Accessed February 5, 2021.

[5] MS Symptoms. National Multiple Sclerosis Society. https://www.nationalmssociety.org/Symptoms-Diagnosis/MS-Symptoms. Accessed February 5, 2021.

[6] Gait or Walk Problems: The Basic Facts Multiple Sclerosis. National Multiple Sclerosis Society. https://www.nationalmssociety.org/NationalMSSociety/media/MSNationalFiles/Brochures/Brochure-Gait-or-Walking-Problems.pdf. Accessed February 5, 2021.

[7] Leman, Marc & Desmet, Frank & Styns, Frederik & Van Noorden, Leon & Moelants, Dirk. (2009). Sharing Musical Expression Through Embodied Listening: A Case Study Based on Chinese Guqin Music. Music Perception - MUSIC PERCEPT. 26. 263-278. 10.1525/mp.2009.26.3.263.

[8] Clark, Imogen & Tamplin, Jeanette. (2016). How Music Can Influence the Body: Perspectives From Current Research. Voices: A World Forum for Music Therapy. 16. 10.15845/voices.v16i2.871.

[9] Moumdjian L, Moens B, Maes PJ, et al. Walking to Music and Metronome at Various Tempi in Persons With Multiple Sclerosis: A Basis for Rehabilitation. Neurorehabil Neural Repair. 2019;33(6):464-475. doi:10.1177/1545968319847962

[10] Leubner D and Hinterberger T (2017) Reviewing the Effectiveness of Music Interventions in Treating Depression. Front. Psychol. 8:1109. doi: 10.3389/fpsyg.2017.01109

[11] Salimpoor, Valorie & Benovoy, Mitchel & Larcher, Kevin & Dagher, Alain & Zatorre, Robert. (2011). Anatomically distinct dopamine release during anticipation and experience of peak emotion to music. Nature neuroscience. 14. 257-62. 10.1038/nn.2726

[12] Thaut M, Peterson D, McIntosh G, Hoemberg V. Music mnemonics aid verbal memory and induce learning – _related brain plasticity in multiple sclerosis. Front Hum Neurosci. 2014;8:395. Published 2014 Jun 13.

[13] Gallagher L and Bethoux F. Therapeutic use of the arts for patients with multiple sclerosis. US Neurology. 2017;13(2):82–9. doi:10.17925/USN.2017.13.02.82

[14] Aldridge D, Schmid W, Kaeder M, Schmidt C, Ostermann T. Functionality or aesthetics? A pilot study of music therapy in the treatment of multiple sclerosis patients. Complement Ther Med. 2005;13(1):25-33. doi:10.1016/j.ctim.2005.01.004

[15] Ghai S and Ghai I (2018) Effects of Rhythmic Auditory Cueing in Gait Rehabilitation for Multiple Sclerosis: A Mini Systematic Review and Meta-Analysis. Front. Neurol. 9:386. doi: 10.3389/fneur.2018.00386

[16] NIH awards $20 million over five years to bring together music therapy and neuroscience. National Institutes of Health. https://www.nih.gov/news-events/news-releases/nih-awards-20-million-over-five-years-bring-together-music-therapy-neuroscience#:~:text=The%20National%20Institutes%20of%20Health,from%20neurological%20and%20other%20disorders. Accessed February 5, 2021.