Proceedings of the 6th International Conference of the Greek Society for Music Education Music: Trains, Educates, Heals Keynote Presentations Proceedings of the 6th International Conference of the Greek Society for Music Education, “Music: Trains, Educates, Heals”, Athens, 30/10 - 01/11/2009 May Kokkidou & Zoe Dionyssiou (Eds.) Music Medicine Intervention: a complementary therapeutic tool for the cardiovascular patient Athanasios Dritsas Abstract Objectives: Recent studies have suggested that listening to music may reduce stress, alter mood profile and improve hemodynamics via a brain-heart relaxation interaction. The aim of the present study was to examine the effects of music on hemodynamics, neuroendocrine function and also on stress perception and mood derived via psychometric questionnaires. Methods: We studied 50 patients (pts) in the coronary care unit (CCU), 60 pts (30 as active and 30 as control group) during treadmill exercise testing and 26 pts with neurocardiogenic syncope during head up tilt-testing (TT). In addition 24 coronary artery bypass (CABG) pts were studied during the early post-op period prior to extubation. All patients were exposed to relaxing type selected music pieces via high quality headphones according to the study protocol. Subjective assessment of stress, anxiety and mood profile was measured using either a visual analogue scale (VAS) or State-Trait Anxiety Inventory (STAI) and the Profile of Mood States (POMS). Standard monitoring of arterial pressure, heart rate and ECG was carried out before, during and after all interventions. Patients with neurocardiogenic syncope (n=26) and a positive baseline TT repeated a second TT within 24hrs and were divided in a music listening group (n=13) and a non-music control group (n=13) during the 2nd TT. During TT blood samples for epinephrine, nor-epinephrine, prolactin and cortisol were taken. For CABG pts also the amount of opioid pain killers given immediately post-op was recorded. Results: 94% of CCU patients indicated that selected music can offer significant relaxation and 78% CCU patients showed >50 % in perceived stress reduction with music. A negative for ischemia exercise ECG result was more frequently associated with participation in the music listening group compared to controls (p<0.01). According to POMS score music listening favored tension-anxiety (p<0.001), depression-dejection (p<0.05) and anger-hostility (p<0.05). A significant negative correlation was detected between state-anxiety scores and time duration of the exercise test (r=-0.354, p<0.01). Music listening during TT prevented onset of a syncopal episode during TT compared to non-music state (p<0.05) in patients with neurocardiogenic syncope. Cortisol and prolactin showed a 2-fold increase during a positive TT, however this rise did not occur when TT became negative during music listening. In the post CABG music group less Pethidine (1.5±10 mg) was used compared to controls (6.25±11), (p<0.05). Conclusions: Our findings suggest that music listening has a positive effect on stress reduction and mood changes during medical interventions in patients with cardiovascular disease. These subjectively perceived changes are associated with favourable objective changes in hemodynamic indices or the neuroendocrine profile. In addition music may influence the diagnostic outcome of an exercise test or response to tilt-testing. Furthermore music may act as a pleasant distracter in various settings possibly by diverting patient attention from the medical procedure and relieve stress. 22 Proceedings of the 6th International Conference of the Greek Society for Music Education, “Music: Trains, Educates, Heals”, Athens, 30/10 - 01/11/2009 May Kokkidou & Zoe Dionyssiou (Eds.) Music and Human Substance Lenia Serghi Abstract Music is an indispensable part of human’s emotional, cognitive and social life. The last decades there is an increasing interest and extended field of research concerning the role of music, and in consequence music education, in structuring human personality. Researches and scholars of different fields, like philosophy, the sciences of music (music education, musicology, ethnomusicology), social sciences (psychology, sociology), and even neurology and biology, are making joined efforts in order to sketch the longitudinal importance of music on human substance. 23 Proceedings of the 6th International Conference of the Greek Society for Music Education, “Music: Trains, Educates, Heals”, Athens, 30/10 - 01/11/2009 May Kokkidou & Zoe Dionyssiou (Eds.) Neuropsychobiological features of musical behaviour and development Graham F. Welch Abstract The paper reviews recent research literature to suggest that: (a) the structure and functioning of the brain relies on the networked integration of relatively specialised modules; (b) a key property of the brain is its neuroplasticity; that is, it has the ability to form new neural connections in response to experience; (c) there is an integration in function between the human body’s three main systems: nervous, endocrine, immune, which together may be considered to be a human ‘bodymind’ and (d) although there may be some form of hemispheric (left/right) bias in the underlying neural activity for musical perception, nevertheless, common musical behaviours that are valued and practised by social groups are normally multi-sited. Links are made into how these various elements are combined to create behaviour, development and learning, both within and beyond music. Introduction The advent of modern neuroimaging techniques over the past two decades or so has been marked by neuroscientists taking an increasing interest in music. This is because music is seen to relate to many different brain functions, such as perception, action, cognition, emotion, learning and memory (Pantev, 2009). Amongst their discoveries is the suggestion that the brain’s underlying neural architecture is modular - in the sense that different parts of the brain have relatively specialised functions - whilst also providing evidence that musical behaviours (such as in musical performance) customarily involve many different areas (modules) of the brain networked together (Peretz & Coltheart, 2003; Stewart & Williamon, 2008; Callan et al., 2007; Brown et al., 2006). Asymmetries are often evidenced between the left and right brain hemispheres, as are relative biases towards particular neural locations, depending on the type of musical behaviour under consideration. In general, musical behaviours in adulthood appear to depend on specific brain circuitry that is relatively discrete from the processing of other classes of sounds, such as speech or song lyrics, although it has been conjectured that certain features of linguistic and musical syntactic processing may have a common basis, such as in the perception of melody and linguistic intonation contours (Patel, 2009). Other findings support a notion that musical perception normally involves some form of cross-hemispheric processing, although this is likely to be subject to developmental processes. For example, in musically experienced adults, an initial right-hemispheric recognition of melodic contour and metre is followed by an identification of pitch interval and rhythmic patterning via left-hemisphere systems (Schuppert et al., 2000). In contrast, there are reported hemispheric weighting differences between adults and young children - and also between boys and girls - in the perception of musical syntax related to the discrimination of major/minor tonal patterns (Koelsch et al., 2003). Singing behaviours are another example of modular co-operation. Separate systems within the brain are responsible for the analyses and combined production of lyrics, rhythm and pulse, and pitch (Peretz & Coltheart, 2003). These systems relate any incoming song and singing information to existing banks of knowledge and store of emotional experiences. In the reproduction of a heard song, the brain undertakes an initial acoustic analysis. This is then 24 Proceedings of the 6th International Conference of the Greek Society for Music Education, “Music: Trains, Educates, Heals”, Athens, 30/10 - 01/11/2009 May Kokkidou & Zoe Dionyssiou (Eds.) ‘forwarded’ to a set of discrete ‘modules’ that are specifically designed to extract different features, namely pitch content (pitch contour and the tonal functions of successive intervals) and temporal content (metric organisation = temporal regularity; and rhythmic structure = relative durational values). Both pitch and temporal outputs are further ‘forwarded’ to a personal ‘musical lexicon’ that contains a continuously updated representation of all the specific musical phrases experienced by us as individuals over a lifetime. The output from this musical lexicon depends on the task requirements. In relation to singing, if the goal is the reproduction of a song, then the melody from the musical lexicon will be paired with its associated lyrics that are stored in a ‘phonological lexicon’ (Peretz & Coltheart, op.cit.; Welch, 2005). In essence, therefore, sung performance requires simultaneous cooperation between areas within the left and right cerebral hemispheres, respectively (Besson et al., 1998), drawing on auditory-tonal and auditory-verbal working memory. Because song lyrics are processed separately and in parallel with song rhythm and melody, there are often developmental differences evidenced in young children in their performed recall of these elements (e.g. Welch et al., 1997). There is also evidence that