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CASE REPORT
Year : 2021  |  Volume : 69  |  Issue : 4  |  Page : 1024--1026

Post Music Session Real-Time EEG Changes in Patients who Underwent Neurosurgical Intervention for Neuronal Dysfunction

B Ushasree1, A Al Anzari2, NS Sampath Kumar3, P Phanisree4, S Indira5, Luis R Moscote-Salazar6, Amit Agrawal2,  
1 Department of ENT and HNS, Narayana Medical College Hospital, Chinthareddypalem, Nellore, Andhra Pradesh, India
2 Department of Neurosurgery, Narayana Medical College Hospital, Chinthareddypalem, Nellore, Andhra Pradesh, India
3 Department of Neurology, Narayana Medical College Hospital, Chinthareddypalem, Nellore, Andhra Pradesh, India
4 Pediatrician, CMOSGS Hospital, Mysore, Karnataka, India
5 Professor and Dean, Narayana Nursing College, Chinthareddypalem, Nellore, Andhra Pradesh, India
6 Neurosurgery-Critical Care, Red Latino, Organizacion Latinoamericana de Trauma y Cuidado Neurointensivo, Bogota, Colombia

Correspondence Address:
Amit Agrawal
Department of Neurosurgery, Narayana Medical College Hospital, Chinthareddypalem, Nellore - 524 003, Andhra Pradesh
India

Abstract

Music is universal and is present in all cultures and capable of conveying emotions irrespective of verbal content. The present study was conducted to understand the impact of music on brain with real-time monitoring of EEG changes in patients with moderate-to-severe neuronal dysfunction. In this prospective study, adult patients who had brain trauma and unconscious were considered for the study. Two different music pieces were selected to give music experience. One is Revathi raga with Upanishads' stands. Another is Ragamalika, an instrumental music piece comprising various Carnatic ragas. For EEG recording, electrode montage was done according to international 10-20 system. After music experience, again EEG recording was done without music. Comparison of EEG activity during different musical pieces was not considered. A total of six adults were studied. During the time of music session, there was no change in the EEG at other channels, but at T6 electrode, EEG did not have the arc like fast theta. That fast theta was disappeared in T6 electrode and it was suppressed like a contralateral sided electrode. After the music session (post music session), the EEG is back to baseline, but the temporal arc like fast theta speed was decreased (2–4 seconds per page). In this case series, we observed that in one case, there was appearance of slow activity in EEG. However, there is a need for larger studies to confirm these findings.



How to cite this article:
Ushasree B, Al Anzari A, Sampath Kumar N S, Phanisree P, Indira S, Moscote-Salazar LR, Agrawal A. Post Music Session Real-Time EEG Changes in Patients who Underwent Neurosurgical Intervention for Neuronal Dysfunction.Neurol India 2021;69:1024-1026


How to cite this URL:
Ushasree B, Al Anzari A, Sampath Kumar N S, Phanisree P, Indira S, Moscote-Salazar LR, Agrawal A. Post Music Session Real-Time EEG Changes in Patients who Underwent Neurosurgical Intervention for Neuronal Dysfunction. Neurol India [serial online] 2021 [cited 2021 Dec 3 ];69:1024-1026
Available from: https://www.neurologyindia.com/text.asp?2021/69/4/1024/323889


Full Text



Music is universal and is present in all cultures and capable of conveying emotions irrespective of verbal content.[1] Auditory stimulation with or without language helps in identifying awareness of individual.[1] Nowadays EEG is used as a diagnostic tool as well as a research tool for finding the function of brain in various disorders. Here, we are using EEG as a research tool to study brain activity in unconscious patients having moderate-to-severe neuronal dysfunction during music listening experience. In the field of music therapy, lot of research is going on to find music effect on brain but effect of Indian music ragas is not yet well studied. This study tried to find out how neuronal system is reacting when music is presented, using EEG. If impact is there, then how that information can be utilized for clinical purpose? The present study was conducted to understand the impact of music on brain with real-time monitoring of EEG changes in patients with moderate-to-severe neuronal dysfunction.

 Methodology



A prospective study was conducted on patients of Department of Neurosurgery. Only adult patients who had brain trauma and unconscious were considered for the study. Patients who were having ear complaints were excluded from study. Two different music pieces were selected to give music experience. One is Revathi raga with Upanishads' stands. Another is Ragamalika, an instrumental music piece comprising various Carnatic ragas. These music pieces were made by professional Carnatic musicians. Both music pieces were given using mp3 player with earphones. Volume of the music was kept lower than the normal conversation level and steady throughout the session. For EEG recording, electrode montage was done according to international 10-20 system. Initially, a baseline EEG was taken without music experience. After that, patients were given music lasting up to 30 min and EEG recording was done during music experience. After music experience, again EEG recording was done without music. Data analysis for EEG reading was done with the help of frequency spectra analysis.

 Results



A total of six adults (1 female and 5 males) were taken for study. Age of the patients ranges from 24 years to 52 years [Table 1]. Among them, three patients underwent decompressive craniotomy, one had undergone surgery for tumor removal, one had undergone surgery for hydrocephalus, and one had acute subdural hematoma. All patients had undergone tracheostomy. Comparison of EEG activity during different musical pieces was not considered. Only overall changes in EEG before, during, and after music listening experience were considered. Usually when patient is unconscious and on ventilator, there will be delta and slow theta activity (i.e. 3–4 Hz). This kind of EEG pattern was seen in all patients except one (CH, 51 years/M). During the time of premusic session, except posterior temporal electrode (T6 Electrode–According to 10-20 international System), rest of all electrodes showed delta activity throughout the premusic session but in the T6 electrode showed 5–7 Hz fast arc like theta intermittently (3–5 seconds/page, 1Page = 10 seconds). During the time of music session, there was no change in the EEG at other channels but at T6 electrode EEG did not have the arc like fast theta. That fast theta was disappeared in T6 electrode and it was suppressed like a contralateral sided electrode. After the music session (post music session), the EEG is back to baseline, but the temporal arc like fast theta speed was decreased (2–4 seconds per page).{Table 1}

 Discussion



Music therapy is increasingly considered in the rehabilitation of various disorders like autism, depression, stroke, traumatic brain injury (TBI), etc., due to its positive effect on individuals/diseased population. Listening to music is enjoyed by many due to certain mental process. Neuroscientific research showed music therapy effect on neuronal plasticity, neuronal transmission, rhythm, and synchronized body movements.[2] Thus, music helps in identifying brain activity. EEG measures provide information of neuronal activity with maximum accuracy. Results of an EEG experiment are mostly shown in a distinct brain wave pattern of waves ranging Delta (δ =1–3 Hz), Theta (θ =4–7 Hz), Alpha (α =8–13 Hz), and Beta (β =14–30 Hz). Among these, Delta waves are associated with deepest levels of relaxation and healing sleep.[3] The bandwidth of various waveforms helps us to know the state of brain like internal attention processing, episodic memory, mental effort, meditative state, anxiety state, positive emotion state, etc.[4] When the music was provided to patient CH (51 years/M), it was effective in inducing the relaxation for neural current at T6 electrode (i.e., reduction in the theta wave frequency and amplitude). Thus, the music stimulation leads to relaxed and deep sleep which can help humans to recover from stress.

The processing mechanisms for musical rhythm are confined to mostly in right or bilateral areas of frontal, cingulate, parietal, prefrontal, temporal, and posterior cerebellar cortices.[4] Music has a strong bonding with attention and memory systems. Studies have revealed that listening to music (combination of sound patterns based on rules) affects bilateral temporal, fontal, and parietal neural network for attention, working memory, semantic and syntactic processing, and imagination.[5] Listening to music improves performance on spatial-temporal abilities in normal population.[5] Attention and meditation levels in EEG are affected by changes in the sound pattern of music ranging from greatest to smallest.[6] Frontal midline theta indicates internal attention processing and meditative and positive emotional states.[1]

 Conclusions



The present study explores our understanding regarding the impact of music on brain with real-time monitoring of EEG changes in patients with moderate-to-severe neuronal dysfunction. In this case series, we observed that in one case, there was appearance slow activity in EEG. However, there is a need for larger studies to confirm these findings. We need larger studies to further explore and standardize the effect of various forms of music and factors affecting the outcomes to understand the impact of music therapy to recover neuronal dysfunction.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

References

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