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Music, Spatial Task Performance, and Brain Plasticity in Elderly Adults

2016; Wiley; Volume: 64; Issue: 10 Linguagem: Inglês

10.1111/jgs.14361

1532-5415

Maria Tecla Pecci, Walter Verrusio, A. Radicioni, Antonella Anzuini, Alessia Renzi, Valentina Martinelli, Evaristo Ettorre, Jessica Miele, Sergio Scaccianoce, Mauro Cacciafesta,

Diverse Music Education Insights

To the Editor: The effect of music by Mozart on cognitive performance and brain plasticity in elderly adults was explored. To the knowledge of the authors, this is the first study to provide documentary evidence of an increase in brain-derived neurotropic factor (BDNF) serum levels after exposure to Mozart's music in human beings. The Mozart effect (ME), an enhancement of performance or change in neurophysiological activity associated with listening to Mozart's music, was first described in 1993.1 Other studies did not succeed in repeating the ME, and some have suggested that it is an artifact of arousal or mood.2 Music can increase cerebral synaptic plasticity. BDNF is a growth factor that promotes neurogenesis and structural plasticity in the hippocampus. Knowing the effect of exposure to Mozart's music on the concentration of BDNF in humans could help in better understanding the underlying mechanisms of ME. Twenty elderly adults were enrolled: 10 controls with no known cognitive deficit (average age 68 ± 4.5) and 10 with a diagnosis of mild cognitive impairment (MCI) (average age 69 ± 3.1). Duration of MCI was between 6 months and 10 years and was defined as a Mini-Mental State Examination score between 23 and 27 and a Clinical Dementia Rating Scale score of 0.5. Exclusion criteria were neurological diseases, use of cholinesterase inhibitors or N-methyl-D-aspartate-receptor antagonists, anxiety or depression, and experience as a musician. Informed consent was obtained from all participants. The study was conducted according to the guidelines on biomedical research involving human subjects (Declaration of Helsinki). Each individual underwent two sessions of musical exposure. Participants came to the laboratory 120 minutes after breakfast and sat and relaxed for 15 minutes, after which blood samples were taken. A paper-folding and cutting test (PFC)3 was administered to measure spatial–temporal abilities and the clock-drawing test (CT) to measure ideational–praxis abilities.4 Participants then listened to a Mozart piece (K448) for 30 minutes, immediately after which a second sample was taken, and the two tests (PFC, CT) were then administered again. Seven days after the first session a second session was conducted following the same protocol as in the first session but with exposure to Beethoven's “Für Elise.” Five participants in each group listened first to the Mozart sonata and then to Beethoven's Für Elise after a week; the other five participants listened first to Beethoven's Für Elise and then to the Mozart sonata after a week. Serum cortisol was measured in duplicate using a radioimmunoassay (Immunotech s.r.o., Radiova 1, Prague, Czech Republic) (normal morning value: 260–720 nmol/L). Serum BDNF protein content was measured using an enzyme-linked immunosorbent assay (BDNF Emax Immunoassay System, Promega, Milan, Italy). Repeated-measures analysis of variance was performed with cognitive status and time (before and after music sessions) as independent variables and PFC and CT scores and cortisol and BDNF blood levels as dependent variables. P < .05 was considered significant. One control participant withdrew for personal reasons. A significant reduction in blood cortisol levels was found in the two groups after the Mozart (P = .001) and Beethoven (P = .001) music sessions, confirming a possible positive role of music in stress reduction (Table 1). Some authors have questioned the existence of the ME,2 and it is felt that listening to music can affect the performance of cognitive tasks by modifying arousal (degree of physiological activation) and the mood of the listener, but the current study showed better performance on PFC (P = .01) and CT (P = .03) in both groups only after exposure to Mozart's music, in line with what other studies have reported.5, 6 Data analysis showed a significant effect of the interaction between group and time on BDNF blood levels after listening to Mozart (P = .04). Post hoc analysis showed a significant increase in BDNF blood levels in the MCI group after listening to Mozart (P < .001) and a significant difference between the groups in BDNF blood levels after the Mozart session (P < .001). No increase in BDNF serum levels was found in cognitively intact participants after exposure to Mozart's music. It could be that the neurophysiological mechanisms of cognitively intact individuals are different from those of individuals with MCI. Although Mozart's music may affect the activity of cerebral areas involved in the solution of spatial–temporal tasks in cognitively intact individuals,6-8 the ME in individuals with MCI could emphasize neuroplastic compensatory mechanisms at the initial stage of cognitive deterioration,9 with positive effects in terms of spatial–temporal abilities. A recent study has shown not only improved cognitive performances, but also an increase in BDNF serum in individuals with MCI who underwent physical rehabilitation.10 The current study results indicate that Mozart's music can play a relevant role in cognitive rehabilitation of individuals with MCI using a noninvasive rehabilitation method without collateral effects and at almost no cost. Further studies are necessary to better understand the neurophysiological mechanisms of the ME. We gratefully acknowledge the Fondazione Roma for supporting our studies on the ME. We would like to thank Dr. Giovanni Longo and Dr. Marco Peronti for their technical support. Conflict of Interest: The authors declare that they have no competing financial interests. Author Contributions: Verrusio, Pecci, Scaccianoce, Cacciafesta, Radicioni: study design, participant recruitment, data collection. All authors: data analysis and interpretation, revision of manuscript for important intellectual content, approval of final version. Radicioni, Anzuini: serum cortisol measurement. Scaccianoce, Miele: serum BDNF measurement. Verrusio: drafting the manuscript. Sponsor's Role: None.