How Mozart is Helping People with Epilepsy

Post by Christopher Chen

The health benefits of music

For thousands of years, music has been used to improve health and well-being. As far back as ancient Greece, records indicate that philosophers/physicians like Hippocrates and Pythagoras extolled the ways playing music to their patients improved the mind and body. In modern times, clinical research has shown that playing music to people with Alzheimer’s disease improves performance on cognitive-based tasks and that pairing music therapy with medication reduces schizophrenic symptoms more than medication alone. 

Using music to help reduce epileptic seizures

Music helps reduce seizure activity in patients with epilepsy. Epilepsy, a brain disorder affecting over 50 million people worldwide, is a brain condition characterized by seizures that if left untreated, can sometimes cause permanent brain damage. Seizures are the result of two events in the brain: 1) high-frequency bursts of action potentials (in neurons), and 2) hypersynchronization of a neuronal population. While most patients with epilepsy can live a normal life with the help of anticonvulsants, roughly 30% have a form of drug-resistant epilepsy. While these patients may eventually find a suitable combination of medications to control seizure activity, music therapy has been used as a non-pharmacological strategy for decades.

However, while studies have shown a range of music types can help reduce seizure activity in epileptics, one song has been shown to have the most robust anticonvulsant effect: Mozart’s K.448 sonata. First reported in 1998, this finding sparked a wave of similar studies across a diverse range of epilepsy types and clinical subjects, with the data largely recapitulating this “Mozart Effect.”

However, using music to help patients with epilepsy is not consistently beneficial. Despite the success of interventions involving the “Mozart Effect”, it is still unclear why it specifically helps reduce seizure activity. And while studies have shown K.448 decreases overall seizure activity, the effect is not universal and in at least one study, there was an increase in seizure activity in ~20% of the patients.  

To further complicate things, there is a rare form of epilepsy called musicogenic epilepsy where musical stimuli actually cause seizures. Though the condition is rare (affecting roughly 1 in 10,000,000 people), seizures in patients with musicogenic epilepsy may follow exposure to specific types of music, a specific type of instrument, or even thinking about music. Studies examining patients with this type of epilepsy indicate there is an emotional component to the seizures, suggesting the seizures may not be directly caused by the music itself but rather in combination with the emotional component associated with it.  

Disentangling music’s role in epilepsy

Researchers are slowly learning more about the biological bases of music’s effects on epileptic seizures. Due in large part to the complex interactions between music and the brain, it has been difficult to determine the science behind music’s effects on epileptic seizures. There has been substantial progress, though, in outlining the basic principles as to why music – and Mozart’s music specifically – can help reduce seizure activity.

Some of the most fascinating findings come from studies comparing Mozart’s music to music from other classical composers. In one study comparing Mozart with music from the German composer Richard Wagner, researchers found that Mozart’s music was more harmonic and repetitive than Wagner’s, suggesting that repetitive and organized structures may have anti-epileptic effects. In a study comparing Mozart and Beethoven, researchers found the brain waves generated by listening to Mozart’s music resembled brain waves from a healthy brain state and were starkly different than the waveforms generated by seizures (Beethoven’s music elicited brain waves more like those found in a seizure state). Thus, listening to Mozart may put the brain in a “healthier” state and protect it against seizures.

Perhaps the most actionable insights come from studies involving dopamine, a neurotransmitter (chemical) in the brain well-known for its role in mood enhancement. Studies have found that several forms of epilepsy have been linked to low dopamine levels in a part of the brain called the striatum. Compellingly, studies have found that in healthy subjects, listening to music induces the release of dopamine into the striatum. Thus, when patients with epilepsy listen to music, this flood of dopamine into the striatum may be helping maintain sufficient levels of dopamine to prevent seizures. 

The future of sound-related strategies to reduce seizure activity in epileptics

The interest in music’s ability to reduce symptoms of epilepsy has led researchers to investigate how other sound-related therapies may reduce seizures in epileptics. One such strategy is using targeted, low-intensity ultrasound. Delivered directly to the scalp, ultrasound treatments have been shown to reduce seizure activity in preclinical and several small, clinical populations. Researchers believe the soundwaves may be altering the physical properties of neurons associated with the seizures, resulting in a reorganized neuronal structure more closely resembling that in a healthy brain. Some drawbacks include overheating of the scalp and the costs associated with the treatment, and the treatment’s efficacy in larger clinical studies remains to be determined.

As for Mozart? His work remains very much involved in current research, with a recent article showing K.448 may be reducing seizure activity in patients via the brain’s higher-order association networks. So even with the introduction of modern anticonvulsant techniques such as ultrasound, epileptics may still benefit from a healthy dose of Mozart.  

References +

Brackney et al. Complementary and Alternative Medicine: The Mozart Effect on Childhood Epilepsy—A Systematic Review. The Journal of School Nursing (2017).

Ferreri et al. Dopamine modulates the reward experiences elicited by music. Proceedings of the National Academy of Sciences (2018).

Fischer et al. Long-Known Music Exposure Effects on Brain Imaging and Cognition in Early-Stage Cognitive Decline: A Pilot Study. Journal of Alzheimer’s Disease (2021).

Hughes et al. The ‘Mozart Effect’ on the Epileptiform Activity. Clinical EEG and Neuroscience (1998).

Jia et al. The effectiveness of adjunct music therapy for patients with schizophrenia: A meta-analysis. Psychiatry Research (2020).

Liang et al. Application of Music Therapy in General Surgical Treatment. BioMed Research International (2021).

Lin et al. Non-invasive ultrasonic neuromodulation of neuronal excitability for treatment of epilepsy. Theranostics (2020).

Maguire, M. Music and epilepsy: A critical review. Epilepsia (2012).

Maguire, M. Wired for sound: The effect of sound on the epileptic brain. Seizure: European Journal of Epilepsy (2022).

Quon et al. Musical components important for the Mozart K448 effect in epilepsy. Scientific Reports (2021).

Rafiee et al. Music in epilepsy: Predicting the effects of the unpredictable. Epilepsy and Behavior (2021).

Stegemann et al. Music Therapy and Other Music-Based Interventions in Pediatric Health Care: An Overview. Medicines (Basel) (2019).