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Exploring the science of song

Work carried out by Dr Mark Tramo in Harvard Medical School suggests that patient care can be greatly improved by using music to relieve their pain.

Most of us are familiar with how a sudden blast of our favourite piece of music can instantly make a person feel better. Music is a proven mood-enhancer. But how much of this good feeling comes down to association with memories of good times and can music have a physical effect as well as a psychological one?

Dr Mark Tramo, Professor of Neurology at Harvard Medical School, believes that simple melodies can be a powerful tool in reducing pain and speeding the recovery of premature babies. He first started thinking about the relationship between medicine and music after his daughter, Cadence, was born three weeks premature and was in intensive care.

“She had a feeding tube but I wanted to try and feed her. So I held her in my hand and I started singing.” Dr Tramo sang the first soothing words and tunes that came to him and his daughter never needed a feeding tube again.

While teaching neurology at Harvard, he conducted an experiment at Massachusetts General Hospital for Children to see whether he could confirm his theory that music is good medicine.

Western lullabies

“We found that traditional Western lullabies could decrease the stress and pain response to procedures,” he said. “Relative to a control group, more than twice as much.” Dr Tramo studied premature babies who routinely have their blood drawn using a painful procedure called a heelstick.

“The procedure itself requires the warming of a heel so that you increase the blood supply. Then a lancet is used to prick a baby’s heel so that blood can be drawn.”
The technique is very painful, especially for infants. Dr Tramo found that the baby’s blood pressure goes up, and the heart rate goes up about ten beats per minute when the heel is punctured. He measures a baby’s level of pain by behavioural responses such as grimacing or crying, as well as physical responses. “The respiratory rate could also change. So you can use the heart as a window into the brain.”

When a speaker is placed in the incubator and a quiet lullaby is played, the baby’s heart rate decreases, a response Dr Tramo has observed in case after case during the course of his study.

Heart rate went down

“The heart rate went down more than twice as much after the heelstick if they got music compared to when if they didn’t,” said Dr Tramo. “In the realm of measurements we make, more than twice as much is a big effect.”

There is also evidence that premature babies exposed to music may actually get out of intensive care sooner. Babies gain weight faster and need less time in intensive care if they are receiving some kind of calibrated structured sound, or music.

But why a lullaby? “The rhythmic structure is simple, and the tempo’s relatively slow,” explained Dr Tramo. “The melody is diatomic or pentatonic, meaning that it’s very simple, so it’s easy to digest for the hearing system.”

Understanding the biology of music could allow people to use it better in medical and other areas where evidence indicates music produces benefits beyond entertainment, he believes.

Following heart bypass surgery, patients often experience erratic changes in blood pressure. Such changes are treated with drugs. Studies show that those in intensive care units where background music is played need lower doses of these drugs compared with patients in units where no music is played.

“The approach is controversial,” Dr Tramo said, “but there’s enough favourable evidence for researchers to continue testing it. Apollo was the god of both music and medicine in the Greek tradition. Music is such an essential part of the human condition; it’s really something that we need to know about.”

Posted in Features, Foreign News on 16 June 2008
Tags: palliative care