Dr. Piedra grew up and lives in a family who has a special love for music. Not only has he loved listening to music but also to play it. Thus, our musical experiments consisted on me playing a particular tune on the piano (like the Peanut Vender) while he followed the rhythm with one of the multiple percussive devices he collects for personal enjoyment.
As we played together I noticed his tremor disappearing as soon as he joined the beat of the music, giving him a sense of “relief”. Interestingly, the relief only lasted as long as he was involved in the process of “making” music. These experiments took place twice a week over a two month period, and although his prescription did not change, the akinesia decreased significantly.
The cells in the brain responsible for motor control and coordination are damaged by Parkinson’s disease, and as those neurons degenerate, the disease leads to progressive deterioration of motor function including “involuntary shaking, slow movement, stiffened muscles, and impaired balance.” Under normal circumstances, those neurons produce a neurotransmitter called dopamine. L-DOPA is an artificial generator of dopamine which provides a relief from Parkinson’s disease. “The only problem with L-DOPA and other similar drugs -says Dr. Lindquist- is that their effectiveness decreases as the disease progresses.” ( 3). As in music, dopamine acts as a “biological metronome” that regulates the rhythms of the brain’s processes. In Parkinsonism these natural automatic rhythms are gone.
Profesor Yoram Baram recently gave origin to a virtual reality device that helps Parkinson’s Disease patients regain their ability to walk at a “near normal stride and speed”. (4) The device operates under the principles of “neuroplastic brain response” (A brain that changes itself, Norman Doldge). This process is described as the capacity of the brain to change itself by remapping and finding alternatives pathways by which rewire itself. The brain does so “using healthy circuits to bypass diseased areas” (4). His studies showed an improvement in walking speed and stride length for 70% to 85% of PD patients after only two weeks of 30 minutes practice sessions. (Baram). This technological afferent stimulus can indeed improve Parkinson’s Disease patients’ life. Nonetheless, this technological device only focuses in the improvement on gait, and not in the impediment of generating movement.
In his most recent book Musicophilia, Dr. Oliver Sacks speaks about Parkinson’s disease as a “movement disorder” (Sacks). Through individual examples of Parkinson patients he reveals how these people “respond beautifully to the rhythm and flow of music” (Sacks).:
“One minute I would see her compressed, clenched, and blocked, or else jerking, ticcing, and jabbering–like a sort of human time bomb. The next minute, if played music for her, all of these explosive-obstructive phenomena would disappear, replaced by a blissful ease and flow of movement, as Mrs. D., suddenly freed of her automatisms, would smilingly conduct the music, or rise and dance to it.” (Sacks)
As powerful as a medical prescription, music was for this woman a “drug” that temporarily allowed her to scape from the symptomatology of the disease, giving her as well with a touch of joy and happiness.
During a scientific experiment conducted by Dr. Christopher Bonvin and Judith Horvath over two Parkinson patients in the context of increased dopamine replacement therapy, an abnormal compulsive singing behavior was evident and became subject to investigation. As Parkinson’s disease worsen the patient conditions, they suffer an “addiction” to dopamine similar to any other drug addiction. Behavior disorders also become part of this symptomatology, including impulsive disorders, and psychotic manifestations. Compulsive singing was a significant symptom in these two patients; and although the characteristics of each individual case differed from each other in quantitive terms and details, the conclusions pointed out to the same direction:
“Even though it (compulsive singing) was disruptive, preventing sleep and social interactions, singing was reported as pleasant and associated with a feeling of calmness and relief. If interrupted, they became irritated.” (5)
In Dr. Piedra’s case, these behavior disorders have not had any manifestation. Nonetheless, the relief and feeling of calmness that he experiences when performing music also “takes him away” from the “locked in” state and puts him into a “rhythmic” pace.
Parkinson disease is a very complex threshold beyond which ideas fade. Hence, to believe that music could change the course of rigorous and tangible result-oriented scientific research is a beautiful idea. However, to undermine the effect that music has on the human brain is a naive point of view; yet, this field of study remain generally unknown to science. Music became recognized as a “therapy” until the middle of the 60s, when post cardiopathology patients presented an improvement in their condition after being exposed to certain music over a fixed amount of time (6). Nonetheless, music has been part of humankind since memorial times. To suggest that certain musical waves could change the construction of the brain –and hence some of its specific functions– is still unknown, and maybe improbable. However, numerous practical results of how Parkinson’s patients successfully respond to music have been clearly demonstrated. Dr. Piedra indeed was a tangible example among many of this statement.