Neurophysiological activity during music therapy with individuals with dementia

Abstract

Music therapy is becoming widely recognised as an effective non-pharmacological therapeutic modality in dementia care, offering psychological, social, and physical benefits. However, little is known about the neurophysiological activity during active and receptive music therapy methods for persons with dementia. This may shed light on client experiences, particularly those with limited external responses. In this pre-experimental pilot study, a group of healthy older adults (n=5) and persons with mild-moderate (n=8) and severe dementia (n=5) received once-off individual music therapy sessions including receptive and active techniques during which heart rate (HR), respiration rate (RR), and electroencephalogram (EEG) responses were recorded.

There was a general increase in HR from baseline resting measures and nonparametric tests showed significant changes during singing a familiar song (p=0.044) and drumming (p=0.019). An increase was also observed during vocal improvisation. RR was highly variable as it was influenced by singing. The largest increase occurred during drumming. The autonomic data suggest that active music therapy techniques may induce greater physiological arousal than receptive techniques but this requires further investigation. Findings were minimal for the prefrontal cortex EEG; however, there were significant limitations in the acquisition and analysis of this data. There was an unexpected decrease in Gamma power for participants with severe dementia during the drumming exercise, which may implicate the Default Mode Network (DMN). Four case examples are presented in the discussion that illustrate significant moments within the sessions and relate these to the real-time neurophysiological data. These case examples highlight the differences in engagement between participants with mild-moderate and severe dementia and explore several instances of the neurophysiological data that bring insight into participant experiences as well as the shortcomings of the neurophysiological data.

Whilst the findings were modest, this research offers insight into the challenges and limitations of experimental research in music therapy and dementia. This dissertation reflects on the limitations of neurophysiological investigations of active music-making and the challenges of the dual researcher-therapist role. It critiques the ecological validity of protocolised music therapy and the use of purely quantitative methodology in music therapy research.