Schizophrenia is a severe mental illness characterized by behavioural impairments affecting cognition, affective behaviour, and perception. Music can be used as a complementary treatment to alleviate symptoms in patients with schizophrenia, alongside antipsychotic drugs. A clinical study published in the Neural Plasticity journal tried to find out what goes on in the brains of subjects with schizophrenia who undergo music intervention. 

The Effects of Music Intervention on Functional Connectivity Strength of the Brain in Schizophrenia

Background and aims: Existing neuroimaging studies show that the pathophysiology of schizophrenia may be associated with dysfunctional brain networks. Music interventions in subjects with schizophrenia have shown promising results such as improvements in cognitive task performance, personal relations and subjectivity. However, the neural mechanisms of these effects are not well known. 

Resting-state fMRI is a method to study spontaneous brain activity at rest and also to map functional connectivity (FC) between regions,  proving to be a very useful tool for brain disorder research.

Therefore this study aimed to address the following goals:

  1. To assess how music intervention modulates resting-state functional networks in patients with schizophrenia using fMRI.
  2. To explore the relationship between music intervention-induced changes to FC and changes in schizophrenic symptoms.
  3. To study the duration of effects from music intervention by assessing the patients 6 months later.

Methodology: 56 patients with schizophrenia and 19 healthy controls were recruited. Patients were randomly assigned to either music or no-music interventions for 1 month. A music therapist conducted the music interventions while the no-music intervention group was treated with antipsychotics only. Resting-state fMRI was obtained at the baseline, after 1 month and after 6 months. The Positive and Negative Symptom Scale (PANSS) was used to assess psychiatric symptoms and the Benton Visual Retention Test (BVRT), Block Design Test and Spatial Maze test for neuropsychological assessment.

Main findings: Music intervention for 1 month significantly increased BVRT scores (aka improvement in visual memory) and reduced PANSS scores (aka reduction of symptom severity in schizophrenia patients). These effects did not last at the 6-month follow-up. Based on fMRI results on FC, music intervention improves the functional connectivity between the middle temporal gyrus (MTG), insula and sensorimotor gyrus in patients with schizophrenia, regions necessary for emotion and sensorimotor function so possibly related to remission of psychiatric symptoms in schizophrenia.

Take away: Apart from higher-order deficits such as in memory and cognition, basic sensory processing has also been shown to be disturbed in schizophrenia. Music intervention may help to strengthen functional connectivity between visual and sensorimotor networks, which could improve visual processing and related action like social function (e.g. recognition of faces) in patients with schizophrenia. Music intervention may also increase the functional connection between the right MTG and righter anterior insula, potentially useful for emotional processing (e.g. expression and recognition of emotions).

Schizophrenia

Shehani Jayalath

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