European Journal of Cardiovascular Medicine

Many studies of musical training and cognitive functioning have examined young adults enrolled in the conservatory and tracked the development of children enrolled in music lessons. These studies have found that musical activity impacts the structure of specific brain regions and/or neural networks through emotional response ⁽³⁾ or cognitive abilities ⁽⁴⁾. Specifically, studies have found a relationship between musical training and enhanced reading, vocabulary, and phonological processing in young children ⁽⁵⁾; higher verbal IQ and executive functioning ^(6), and higher scores on verbal memory tests ⁽⁷⁾. One study found that musicians more easily switched between tasks and multitasked (dual-task performance) compared to non-musicians ⁽⁸⁾

Improved neural connections with age reduce the risk of common neurodegenerative disorders like Alzheimer’s. Neurological disorders make the patient dependent on others to perform even their day-to-day routine activities. It also creates tremendous work responsibility for caretakers of such people.  

Hence it was of utmost importance to study the playing of musical instruments as one of the factors that can reduce or slow down the cognitive decline in humans. Music constitutes an integral part of the Indian culture and a study needed to be done on the Indian population about the neurocognitive benefits of music.

The study is observational, cross-sectional, and comparative in nature. The study was conducted over a period of 10 months, from March 2023 to December 2023. The permission of IEC was taken and informed consent was obtained, with a sample size of 30 participants and there was no conflict of interest involved. Group A (Instrumental musicians) and Group B (control group) were included. The Trail Making Tests (TMT) A and B were employed to check for executive functioning and the standardized Mini Mental State Examination (MMSE) was done to assess the memory of the individuals.

Group A: (Instrumental Musicians) Individuals of the age group 25-35 years were taken randomly who have been playing musical instruments (like piano, guitar, ukulele, violin, electric guitar, cello, drums, harmonium, bass guitar, electric keyboard, flute, Cajon, etc.) or are training in various music classes for the same.

Inclusion Criteria-

• Any individual in the age group of 25-35 years
• Individuals enrolled in learning a musical instrument and have already completed a year of regular training or
• Playing an instrument for a minimum of 1-1.5 hours a day for at least 3 times per week for over a year or
• Instrumental musicians performing weekly for over a period of 3 years

Exclusion Criteria-

• Any Individual not fulfilling the above inclusion criteria
• Individuals with less than one year of training or experience in playing a musical instrument
• Presence of any neurological, cardiac, metabolic disorders, or color blindness
• Disorders affecting cognition such as early onset dementia, depression, attention deficit disorder
• Participants taking psychostimulant drugs to improve mental and physical performance (for e. g. Modafinil, donepezil, rivastigmine

Group B: (Control Group)

Inclusion Criteria-

• Any individual in the age group of 25-35 years
• Individuals with no experience in playing a musical instrument

Exclusion criteria-

Same as the exclusion criteria for Group A individuals

Sample size:

Since there were no Indian reference articles related to the study, we conducted a pilot study of 30 participants,15 participants each in both groups.

The Mann-Whitney U test was conducted to assess significant differences in the scores for MMSE, TMT A, and TMT B between musicians and non-musicians. Musicians exhibited higher scores on the MMSE compared to non-musicians. In contrast, non-musicians demonstrated longer completion times for both TMT A and TMT B in comparison to musicians.

The analysis revealed statistically significant differences in MMSE (p < 0.001) between musicians and non-musicians, depicted in Table no.1 & illustrated in Figure no.1.

Table no. 1 Comparison of MMSE between Musicians and Non-musicians

*  - Significant

Fig 1: Graphical representation of MMSE between musicians and non-musicians

The analysis revealed statistically significant differences in TMT A (p < 0.001) between musicians and non-musicians, depicted in Table no.2 & illustrated in Figure no.2.

Table no. 2 Comparison of TMT A between Musicians and Non-musicians

*  - Significant

Fig 2: Graphical representation of TMT A between musicians and non -musicians

The analysis revealed statistically significant differences in TMT B (p = 0.007) between musicians and non-musicians, shown in Table no.3 & illustrated in Figure no.3.

Table no. 3 Comparison of TMT B between Musicians and Non-musicians

*  - Significant

Fig 3: Graphical representation of TMT B between musicians and non-musicians

A previous study ⁽⁹⁾ has found that music enhances memory in the prefrontal cortex, the part of our brain that Alzheimer’s disease affects last.

Music improves both Explicit and Implicit memory. Implicit memory systems are robust and emotional, and not damaged by Alzheimer’s disease ⁽¹⁰⁾. It changes the basic sensitivity of synaptic transmission due to repeated neural activity and forms new facilitated pathways known as memory traces. The memory traces are important because once these are established, they can be selectively activated by the thinking mind to reproduce the memories. ⁽¹¹⁾

It has been studied that most of the memory we associate with intellectual processes is based on memory traces in the cerebral cortex ⁽¹²⁾.

There is a potential increase in synaptic plasticity in the auditory pathways; i.e. they are modified by experience (could be facilitatory or inhibitory) during adolescent years through training in music, which can result in enhanced neural processing and improvement of language skills ⁽¹³⁾.

Also, in the memory system observed in the snail (Aplysia), there are two synaptic terminals ⁽¹⁴⁾. One terminal from a sensory input neuron terminates directly on the surface of the neuron that is to be stimulated and is called the sensory terminal. The other terminal, the presynaptic ending that lies on the surface of the sensory terminal, is called the facilitator terminal. When the sensory terminal is stimulated repeatedly, but without stimulation of the facilitated terminal, signal transmission at first is great, but it becomes less and less intense with repeated stimulation until transmission almost ceases. The phenomenon is called Habituation. Conversely, if a provocating stimulus excites the facilitator terminal, at the same time that the sensory terminal is stimulated, instead of the transmitted signal into the postsynaptic neuron becoming progressively weaker, the ease of transmission becomes stronger and stronger, and it will remain strong for minutes. hours, days, or, with more intense training, up to about three weeks even without further stimulation of the facilitator terminal. Thus, the noxious stimulus causes the memory pathway through the sensory terminal to become facilitated for days and weeks thereafter. It is especially noted that even after habituation has occurred, this pathway can be converted back to a facilitated pathway with only a few provocative stimuli.

Therefore, music integrates and influences widespread regions of the brain, the auditory, motor, and limbic (emotional) regions.

Playing a musical instrument significantly improves the neuro-cognitive abilities of adult individuals helping them to have an improved memory and better executive functioning.

This allows them to have an improved quality of life and an opportunity to be better in different areas of life by being able to perform better.

Not only this, having an improved memory and executive functioning will help to reduce or slow down cognitive decline in humans. It may also prevent the occurrence of many neurocognitive disorders like Alzheimer’s disease or ADHD (attention deficit hyperactivity disorder).

Accordingly, future studies should seek to design and test interventions targeted at improving cognitive functions through musical training in individuals based on these results.

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