Why a Mozart sonata surprised epilepsy researchers at Dartmouth

Dartmouth Researchers explore why Mozart’s Sonata for two pianos in D major decreases abnormal epileptic activity in the brain.

“There have been intermittent reports as well as small studies suggesting that this Mozart sonata has a positive effect on seizures in patients.” says Dr Barbara Jobst, director of the epilepsy and cognition laboratory at Dartmouth-Hitchcock Medical Center. “At first I was very skeptical about this. And if you are skeptical about anything in medicine, your best bet is to study it.

Jobst and the other researchers in the study monitored brain activity in 16 patients with epilepsy, specifically the abnormal brain activity (or “spikes”) occurring in patients with epilepsy. These peaks are associated with the frequency of seizures and cognitive impairment.

The researchers found that the peak frequency was reduced when Mozart’s sonata was played for at least 90 seconds.

Jobst points out that the sonata effect only relates to peaks of brain activity and does not indicate any conclusions about cognition or intelligence.

“We have to be very careful not to make general assumptions like ‘Mozart is generally good for you,’” Jobst says.

The next step, according to Michael Casey, a music professor at Dartmouth and Jobst, is to study the elements of the sonata that could reduce spikes in abnormal brain activity.

“[Music] has different effects on our hearing, on our attention, on different brain circuits, ”says Casey. He says researchers are now studying whether musical characteristics like tempo and rhythm are causing the peaks to decrease.

Jobst says that at the end of the day, they want to design therapeutic music that could help people with seizures. Now, researchers must determine which musical characteristics would be medically useful.


Dr Barbara Jobst: So the reason I am focusing on this sonata is that I have been working on epilepsy for many years, and there have been intermittent reports, as well as small studies suggesting that this Mozart sonata has a positive effect on seizures in patients. So I was initially very skeptical about this. And if you are skeptical about something in medicine, your best bet is to study it

Rick Ganley: And we don’t want to, you know, spoil the title here, but you found that there was a beneficial effect. We have to stress that this is a study, right, with sixteen subjects.

Dr Barbara Jobst: It is a study that we did. This particular sonata is compared to other music, as well as to the music the patient likes, [and it] appears to stand out in terms of a positive effect on reducing abnormal brain activity in patients with seizures.

Rick Ganley: What do you see specifically in patients? Was it if the sonata would prevent or stop the seizure?

Dr Barbara Jobst: So it’s not that he clearly prevents or stops seizures. This is very difficult to prove because seizures happen very rarely and you cannot play the sonata all the time for 24 hours. But what we’ve done is we can measure the abnormal brain activity actually in the brains of patients that only occur in patients who have seizures, and those abnormal waveforms called spikes, when we were playing Mozart, were considerably reduced in frequency compared to other pieces of music. And this particular study also shows that you need to at least play it for 90 seconds to have any effect on this abnormal seizure activity in the brain.

Rick Ganley: Michael, you do a lot of research on how sound affects the brain. What other music have you played for the patients to test the impact of this particular sonata?

Michael Casey: So we looked at music in a range of different styles because we wanted to know, well if patients usually listen to country music, would they have a greater effect listening to country music than classical music and rock and roll and world music? And also one or two other classical music selections, from Wagner, because it’s quite different from Mozart. But also Liszt and other piano music.

Much to my regret and surprise, given that we are skeptical about the properties of this unique Mozart piece, it was actually the piece that produced a measurable and statistically significant effect.

Rick Ganley: I remember many years ago, I think it was in the 90s, there was talk of the so-called Mozart effect, especially to help children learn. And a lot of that research, I think, ultimately turned out to be flawed. I wonder if that has to do with that when we talk about what is called the Mozart effect.

Dr Barbara Jobst: So there I want to comment on this, especially from a medical side, we’ve only shown that this particular piece of music decreases these abnormal potentials in the brain. It is not a judgment of cognition, intelligence, learning, etc. So we haven’t really looked at these parts, whether they have an effect or not.

The only thing we showed [is] that there is a relationship between this Mozart sonata and a positive effect on seizures and epilepsy and these abnormal brain potentials. We must therefore be very careful not to make general assumptions such as “Mozart is generally good for you”. We have to be careful with this judgment and it only applies to this patient population.

Rick Ganley: Obviously, for anyone who loves music deeply, you know it has a real effect on you and the way you feel, your mood and your thoughts. I wonder, Michael, do you know why you know the specific sonata, this specific type of music would have affected the patient’s brain activity the same way he did and maybe another piece of music that would they normally find enjoyable?

Michael Casey: Well, the short answer to your question, Rick, is no, we don’t know precisely what is causing the observed effect.

However, music has a lot of different properties, doesn’t it? When we listen, we hear that it goes at a certain speed, its tempo. It might make you want to move, to dance. It has a groove or not. These could be voices or violins or, in this case, a piano. And they sound quite different. And they have different effects on our hearing, on our attention, on different brain circuits.

And so what we’re looking at now is trying to figure out if a very simple characteristic of music, like how fast it goes and what the beat is, is causing the effect. Or if it’s something more on the level of what the composer was doing in the form of music.

Dr Barbara Jobst: The ultimate goal with this is really to design music that would have a therapeutic effect on seizures. This is why we are conducting this research to find out what features we would need to design medically useful music.

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