MUSIC & PTSD

by Ricardo Peres

Consonance Clinic
-Neuromusicology & Health-

Consonance-Alpha (Brazil) 55.11.3078.6777

Ave Rebouas 3377, So Paulo-SP-05401-400
1
www.institutoalpha.com.br
 Music & PTSD
1. Clinic Context
2. Music Induction
3. Brain Plasticity
4. Neurochemistry of Music
5. Neuroanatomy of Music
6. Rhythm & Entraiment
7. Emotional and Cognitive Recovery: Two Music Studies
8. PTSD
a. Fear Response
b. Failure of Fear Extinction
c. Memory
d. Anxiety
e. Memory Encoding
9. Brain Cables White Matter
10.Music-Induced White Matter Development
11.Proposed PTSD Music Treatment
12.Clinic Directives 2
1. CLINIC CONTEXT

3
 Clinic Context: Cure vs.
Chronification
We have two types of medicine
practiced today
One that chronifies illness and disorder
by suppressing symptoms and avoiding
causes (Pharma Industry);
One that proposes to cure through
accessing the only rational source of cure
by combining various resources with the
aim of recovering and maintaining the
immune system (Functional Medicine).
4
2. MUSIC INDUCTION

5
 Music Induction
Music operates through induction
Music exhibits an amazing amount of inductive
power on living organisms (plants, animals,
cells, etc.)
Music induces growth and development in both
white and gray matter in humans
Neuromusicology has a groove in the vinyl
of Functional Medicine
The aptitude to automatically recruit great
amounts of neuronal populations to operate
specialized tasks in specific regions of limbic and
cortical brain areas is a unique feature of music
6
 Music recruits neural populations by phase
locking auditory sensory stimuli and brain
response with incomparable fidelity and speed
response to sound and music stimuli is 20-50 ms
faster than visual or tactile stimuli (Thaut et al., 1999a).

7
3. BRAIN PLASTICITY

8
 The structural and functional plasticity
displayed in brain response to sound
and music stimuli takes us still to
anotherCorpus
level Callosum

A) CC musician with
B) CC C) CC frontal e n = 30
musical training nonmusician: central portions
initiated <7 years old: total area present > growth.
total area CC/mm =
709 81.
CC/mm = 649
88.
9
(Schlaug et al. 1995)
 Performance of Rhythmic Task
(Bangert & Schlaug, 2006

1) Children 2) Adults show a 3) Adult n = 30

Superior more extensive musicians
temporal activation pattern more
gyrus superior bilateral
bilateral temporal lobe, as activation in
activation. well as parietal frontal
lobe, parts of the regions, in
frontal lobe (in particular in
10
particular the the inferior
 Arcuate Fasciculus
Various laboratorial studies show evidence of structural plasticity of
the Arcuate Fasciculus in individuals who go through musical training
and therapy involving auditory-motor mapping tasks.(Schlaug et al.,
2009).

A) Arcuate Fasciculus of a B) Arcuate Fasciculus of

65-year old healthy a 63-year old healthy
11
Plasticity reveals that music is a part of us...

Music is a part of the original mental machinery of

humans.
... If I had to live my life again, I would make a rule of
reading poetry and listening to music at least once a
week; for maybe the parts of my brain that are now
atrophied would have been maintained active through
usage.
(C. Darwin, autobiography, 1887).
Undeniably, there is a biology of music. There is no
question that there is specialization within the human
brain for the processing of music. Music is biologically part
of human life, just as music is aesthetically part of human
life." (Dr. Mark Jude Tramo, Harvard University Medical
School Los Angeles Times, November 11, 1998). 12
 that music is among the most
ancient cognitive features of
humans.

Flute from the Upper Paleolithic period with 5 holes with a V-

shaped mouthpiece, made with a vulture wing bone and measuring
34cm X 0.8cm. Radio-carbon dated between 35 and 40 thousand
years. Found in the Hohle Fels Cave in the region of Swabia,
Southern Germany. (Macmillan Publishers, 2009). 13
 ... that music is immemorial
The repository of music is
a registered legacy that is retrievable directly
and indirectly.
a foray into psyche archeology as Music has
been with Mind from day one: children of
Sound.
First came OM.
Because of that preceding memory, we
find no alteration of brain response to
sound or music stimuli during dreams or
under the influence of LSD (Sacks, 2007).
Music can be retrieved outside of
consciousness because it is immemorial. 14
n = 40 Precision
was > in
sung
condition
versus spoken
condition for
patients with
AD but not for
healthy ones.

Music as a
Memory
Enhancer in
Patients with
Alzheimers
(Simmons-Stern,
Budson & Ally,
Neuropsychologia,
15
4. NEUROCHEMISTRY OF
MUSIC

16
 Music Rhythm & Body Rhythm
The heart, blood pressure and breathing conform
to music rhythm as in mimicry
Subsequent chemistry follows compass to induce
gray matter activity and modulate
neurochemicals
the modulation of neurotransmitters, hormones and
peptides, regulation of amygdala output and
hippocampal neurogenesis can be induced.
With proper music input and adequate regular
music activities effective treatments for
neurological disorders can be implemented
mostly using the voice but also through group activity
exploring percussion timbres and rhythmic synchrony.
17
 Repertoire X Neurochemistry
Broad Overview (Chanda & Levitin, 2013
WALTZ natriuretic peptides cortisol
t-PA
20TH CENTURY prolactin cortisol

norepinephrine t-PA
MEDITATIVE cortisol beta-endorphins IL-6
(60 100 bpm)
Ig-A oxytocin
STIMULATING growth hormones norepinephrine
(120 200 bpm) prolactin
ACTH Ig-A oxytocin cortisol

DISSONANT serotonin

CONSONANT serotonin epinephrine corticosteroid

18
IL-1 Ig-A
 Dopamine & Serotonin Pathways
Network representing the neurochemical basis of the musical experience,
the foundation for the emotional processing of music (Koelsch, 2006).

19
Neurochemical Changes X Music Interventions
(Chanda & Levitin, 2013)

Domains Neurochemistry

i) dopamine, opioids;
i) reward, motivation, ii) cortisol, CRH
pleasure; (hormonal peptide),
ii) stress, excitement, ACTH (hormone);
attention; iii) serotonin, POMC
iii) immunity; derived peptides (alpha-
iv) sociability. melanocytes and b-
endorphins);
iv) oxytocin. 20
5. NEUROANATOMY OF
MUSIC

21
 Neuroanatomy of Music
Activating the desired localities inside the brain is
attained and sustained by managing the complexity
of distinct music dimensions in the feeding process
(listening), being that distinct dimensions
correspond to specific brain areas
Once spiral ganglia neurons send out the original
batch of sound data, tones are classed and melodies
are processed in auditory cortices in the temporal
lobe, while rhythms recruit neural populations from
several other regions, including limbic, cerebellar
and parietal substrates, and harmony is processed
in frontal cortices
There is little brain substrate that you cannot activate
with sound and music. 22
23
Regions of the Musical
Brain
(Levitin, 2006)
6. RHYTHM & ENTRAINMENT

25
 Rhythm Induction
A network of neural areas (including motor
regions) is regularly implicated in basic timing
and also processing musical rhythm
Distinctive activity patterns at work are automatic
and cognitive controlled timing process, where
musical rhythm requires both automatic and
controlled processes.
Rhythm: Pattern of interval in a sequence of
stimulus.
Beat: Regularly recurring psychological events
that arise to musical rhythm.
Beat period: Rate of beat, tempo.
Meter perception: Strong and weak beat
patterns, hierarchy.
(Cooper & Meyer, 1960; Large, 2006) 26
 Timing
Timing is the logical place to investigate the
neural instantiation of rhythmic processing
Timing processing happens in several brain regions:
cerebellum, basal ganglia, parietal cortex,
prefrontal cortex, premotor cortex and SMA
(Ferrandez et al., 2003; Macar et al., 2004; Nevadic et al., 2003;
Rao et al., 2001).
The basal ganglia are structures deep in the
brain managing motor control, action selection
and learning through time estimation, duration
discrimination and tapping intervals from
memory (Graybiel, 2005; Mink, 1996; Redgrave et al.,
1999), while the cerebellum integrates sensory
and motor information (Diedrichsen et al., 2007; Gao
et al, 1996; Thach, 1998). 27
 Processing rhythm is about metric
encoding, whereby rhythmic stimulus can
ENTRAIN neuronal groups even by memory,
after stimulus is ceased (Sumbre, Baier & Poo,
2008).
Neural markers of anticipation of the beat
and representations of metric structures
have been found in EEGs and MEGs (Grahn,
2012).
Rhythmic perception activates structures
within key motor networks, such as
premotor and SMA, basal ganglia and
cerebellum (Lim et al., 2005).
28
 Entrainment
Because reaction time to auditory cues are 20-50
ms shorter than for visual and tactile cues
the auditory system has a strong bias to detect
temporal patterns of periodicity and structures
compared to other sensory systems (Thaut et al.,
1999a).
Though the pulse is initially derived from the
auditory stimulus, rhythm induces an internally
generated sense of beat
once the pattern is established it can continue in the
mind of the listener when the rhythm pauses (Benjamin,
1984; Lerdahl & Jackendoff,1983; Palmer & Krumhansl,
1990).
The process of synchronizing endogenous
sensations of beat with an external rhythm of
movement is termed ENTRAINMENT. 29
 Entrainment: Synchronizing internal
rhythmic processes to external regular or
periodic cues.
Internal rhythmic processes are operated by
oscillators with temporal frequencies. Oscillators
can be in phase or out of phase.
Therefore, entrainment must be at the heart
of any therapeutic music program aiming at
psychological and neurological modification
Rhythmically structured sound pattern creates
an anticipatory template of a time sequence that
is marked by a beat, ie: a continuous reference
to map movements (Grahn, 2010).

30
 7. EMOTIONAL AND
COGNITIVE RECOVERY:
TWO MUSIC STUDIES

31
 Depression among working age people
(Jaakko Erkkill et al., 2011)

79 Patients with ICD-10 diagnosis of depression

in music + standard care and only standard
care groups.
Degrees of listening, singing and improvising
applied individually.
The psychodynamic music therapy tradition
retrieves an interaction between free musical
improvisations and discussion, inducing musical
expressiveness and mutual construction of
meaning.
Effects were clinically relevant in the middle to
large range after 20 biweekly sessions of therapy
(0.49 anxiety; 0.65 depression). 32
 n = 79

Erkkil J et al. BJP

2011;199:132-139

Changes in psychiatric tests. (a) Montgomerysberg Depression

Rating Scale; (b) Hospital Anxiety and Depression Scale Anxiety;
(c) Global Assessment of Functioning; (d) Toronto Alexithymia Scale
20; (e) Health-related quality of life scale RAND36. *P<0.05.
Music Listening enhances cognitive recovery and mood
after middle cerebral artery stroke
(Srkmo T, Tervaniemi M, Laitinen S, Forsblom A, Soinila S, Mikkonen M, Autti T,
Silvennoinen HM, Erkkil J, Laine M, Peretz I & Hietanen M Brain, 131, 866-876, 2008)

n = 60
COGNITIVE
RECOVERY
34
EMOTION n = 60
AL
RECOVER
Y

35
8. PTSD

36
 PTSD
PTSD is a disorder associated with changes in neural
circuitry involving frontal and limbic systems
Altered metabolism in such structures are
correlated to PTSD.
It is an anxiety disorder caused by the onset of an
extreme stressor
combat, childhood physical and sexual abuse,
MVAs, rape and natural disasters.
Perceptual induced symptom activation in PTSD is
associated with an emotionally determined motor
preparation, ie: subcortically initiated rather than
cortically controlled memory mechanisms determine
the central pattern (Fancati, Vermetten & Bremner, 2007).
37
 Symptoms are intrusiveness, flashbacks,
hyper vigilance, sleep disturbance,
physiological hyper-responsivity and
numbing of emotions
7.8% of the population exhibit symptoms of
traumatic events (Bremner & Charney,1994).
fMRI has allowed to uncover some of the
neural networks involved in the
pathophysiology of PTSD.
specifically reduced brain activation of the
mPFC and increased activation in the Amygdala.
alterations in functional activity were also
found in the hippocampus, parahippocampus,
orbitofrontal cortex (OFC) and thalamus.
38
 Correspondingly, studies of the
neurobiological mechanisms related
to stress show alteration in:
Fear response mechanism
Behavioral sensitization
Failure of extinction of fear (Charney et
al., 1993)
Also, significant deficits in memory
are shown correlated with specific
brain structures and functional
pathways (Bremner et al., 1993, 1995b)
39
8-a. FEAR RESPONSE - PTSD

40
 Fear Response
Adaptation to danger is normal and crucial for
survival. The alteration referred to as
diagnostic criteria for PTSD resides in the
overgeneralization of danger cues; continuous
perceiving non-threatening situations as
dangerous
Frequent recall is a part of the diagnostic criteria for
PTSD as per the DSM-IV classification for
psychiatric disorders.
Traumatic memories can be elicited via
sensory and cognitive stimuli that are paired
with the traumatic event that was experienced
41
 Structures involved in the fear response
mechanism in humans
sensory cortex, dorsal thalamus, lateral and
central nucleus of the Amygdala and the
mPFC/Anterior Cingulate Cortex (Rauch et al.,
2003; Woodward et al., 2005; Yamasue et al., 2003).
Neurochemical systems that are functional
within and communicate between these
structures
Glutamate, N-methyl-D-aspartate acid (NMDA)
receptors and voltage-gated calcium channels.
The central nucleus of the Amygdala is the main
output center for the response to fearful stimuli,
mediating autonomic, behavioral and endocrine
responses related to fear (Charney, 2004).
42
Data trajectory: the lateral Amygdala
transfers information to the central nucleus
after receiving it via 2 main pathways:
Short subcortical pathway
dorsal thalamus directly to the lateral
Amygdala
Longer cortical pathway
through cortices involving cognition and
assessment of the fearful situation and its
context.
The Hippocampus can also send contextual
data about a stimulus to the lateral Amygdala,
given its memory related role.
43
8-b. FAILURE OF FEAR
EXTINCTION - PTSD

44
 Failure of Fear Extinction
Fear extinction is linked to conditioning of fear
The neural mechanisms dealing with the extinction
of fear greatly overlap with fear acquisition.
The main structures involved in the extinction
of fear are
the mPFC and the Amygdala (Quirk & Gehlert,
2003).
NMDA receptors and voltage-gated calcium
channels are essential neurochemicals to the
process of extinction (Charney, 2004).
GABA, norepinephrine and dopamine are also
involved in extinction processes (Quirk & Gehlert,
2003; Southwick et al., 1999; Pezze & Feldon, 2004).
45
 Normally, during a fearful response of the
Amygdala the mPFC is activated and
modulates the initial response to the
threat.
Fear is contained and managed that way.
If prefrontal activation is absent or
lessened, the Amygdala does not receive
sufficient inhibitory feedback
resulting in autonomic arousal and exaggerated
responses.
The feedback loop between the Amygdala
and the mPFC is mediated by GABA inter-
neurons. (Nutt & Malizia, 2004)
46
8-c. MEMORY - PTSD

47
 Memory
Memory deficits in PTSD have significant
associations with reduction in hippocampal
volume, where spatial and episodic memory,
stress and emotional regulation, and novelty
processing take place (Geuze et al., 2005).
Smaller hippocampal volumes (5 26%
reduction) have been shown in patients
exhibiting combat trauma, physical and sexual
abuse and childhood sex abuse found in
different areas within the structures, depending
on the trauma (Bremner, 2003; Geuze et al., 2005).
Reduction in hippocampal volume is mostly due to
neurotoxicity caused by elevated glucocorticoids, reduced
BDNF and inhibition of regeneration of damaged brain tissue
(Bremner, 2002, 2003). 48
 PTSD patients often show difficulty to
intentionally retrieve a complete memory of
the traumatic event
fragmented, poorly organized and difficulty to
recalling exact temporal order of events (Foa &
Riggs, 1993; Amir et al., 1998).
High frequency of involuntarily triggered intrusive
memories and vivid re-experiencing.
Re-experiencing is mainly about sensory
impressions, rather than thoughts, involving
all sensorial modalities (Ehlers & Steil, 1995)
Sensory impressions are experienced as if they
were happening right now, and emotions,
including physical reaction and motor response,
are the same as the original emotions. 49
 Original emotions and sensory
impressions are re-experienced even if
the person later acquires new data
contradicting the original impression
Affect without recollect are
physiological sensations associated
with the original event without a
recollection of the event
Re-experiencing triggered by cues that
were temporarily associated with the
event, without semantic relationship
50
8-d. ANXIETY - PTSD

51
 Anxiety
Anxiety is a result of appraisals relating to
impending threat
PTSD is a disorder whereby the problem resides in
the memory of an event that has already passed.
PTSD persists when trauma is processed in a
way that produces a sense of serious current
threat, due to individual differences in
appraisal of trauma and in the nature of
memory of event and links to other
autobiographical memory

52
 Persistent PTSD is due to processing
and encoding trauma in a way that
causes a sense of current threat by
excessively negative appraisals of the
trauma and a corrupt autobiographical
memory exhibiting poor elaboration and
contextualization, strong associative
memory and strong perceptual priming
Change in the negative appraisal and the
trauma memory are usually prevented by a
series of problematic albeit well-intended
behavior and cognitive strategies.

53
 Most patients with persistent PTSD
experience a range of negative
emotions, from the possibility of a
loss leading to anxiety to the
certainty of a loss leading to
depression
Appraisals concerning
danger lead to fear
unfairness to anger
personal responsibility to guilt
violation of self to shame
54
loss to sadness.
8-e. MEMORY ENCODING -
PTSD

55
 Encoding Memory
Intrusion characteristics and patterns of retrieval found in
persistent PTSD are due to the way the trauma is encoded
and laid down in memory (Brewin et al, 1996).
There are two routes to retrieve autobiographical data:
1. High-order meaning-based retrieval strategies (first day at
school, etc.)
2. Directly triggered by stimuli associated with event (smell,
music, etc.)
Normal processing selects and incorporates
autobiographical events into an autobiographical memory
knowledge base organized by themes and time periods
(Conway, Pleydell-Pearce, 1997). This elaboration
enhances the first retrieval route and inhibits the second.
When autobiographical memory enters into consciousness
both specific data and general data about the life period
are comprised, and abstract data about the type of event. 56
 Main problem is that trauma memory is poorly
elaborated and inadequately integrated into context
RE time, place, subsequent and previous data and
other biographical memories (Siegel, 1995).
This explains problematic intentional recall arising from the
lack of context in time thus producing the perception of
current threat.
Strong sensory association to traumatic material
increase chance of emotional response to associated
stimuli (Reemtsma, 1997).
where the footsteps and subsequent knocking sounds once
heard by a captured person may become problematic cues
to emotional response.
Associative learning helps the organism in making
predictions: what will happen next?. In PTSD,
distinct stimuli present shortly or during traumatic
event become associated with the default prediction
of severe danger to self.
57
 Retrieval from associative memory is cue-
driven and unintentional
whereby the person is not always aware of the
triggers for the re-experiencing , or of the link to
the emotion reaction taking place.
Failure to spot the origin of the re-experiencing
symptoms makes it hard for patient to learn
that there is no present danger when exposed
to (unidentified) triggers
Strong perceptual priming is like an implicit
memory for stimuli temporarily associated
with the event, ie: reduced perceptual
threshold for the stimuli
Cues able to trigger the trauma memory are
more likely to be noticed
58
 Implicit memory traces are not well
discriminated from other memory traces
(Baddeley, 1997)
whereby a vague physical similarity would
suffice to perceive stimuli as similar (poor
stimulus discrimination).
Reciprocal relationship between the nature
of the trauma memory and the appraisals of
trauma and sequelae
A recall is always biased by appraisals,
selectively retrieving data that is consistent with
these appraisals, preventing the recalling of
aspects contradicting appraisals and thus
preventing change in appraisals.

59
 Encoding Trauma Memory
The nature of the trauma memory depends on
the quality of the encoding (Krystal et al., 1995;
Schacter et al., 1997; Siegel, 1995)
Conceptual vs. data-driven encoding (Roediger,
1990) suggest that persistent PTSD is data-driven
because the degree of conceptual processing
determines nature of memory and ability to
retrieve data from it
Lacking conceptual memory will cause strong
perceptual priming for accompanying stimuli.
Unorganized memories observed in persistent
PTSD indicates a lack of perspective and
dissociation that explains the fragmentation of
traumatic memories (Spiegel,1991).
60
 Bad Memory Encoding...
Impact of high arousal and fear on trauma
memory includes cognitive and biological
pathways
very high levels of cortisol during extreme
stress interfere with memory encoding of
event, thus impairing intentional recall
(Newcomer et al., 1999).
Like a cupboard filled up quickly and in
a disorganized way that does not allow
fully closing the door and then things fall
out at unpredictable times
61
9. BRAIN CABLES

62
 Cables
Brain white matter represents the great avenues of the brain that
allow for rapid and efficient communication between various
cerebral regions
The Corpus Callosum (viewed
from above) divides brain Lateral view of the right hemisphere
hemispheres
 Typical Structures of Fiber
Development

Corpus
Callosum

(Travers et al., 2012)

 Arcuate (AF) and Uncinate Fasciculus (UF)
Images (DTI) of a healthy 8-year old boy and a 8-year old
non- verbal autistic boy

Arcuate (AF) ASD Uncinate (UF) ASD

Arcuate (AF) HEALTHY Uncinate (UF) HEALTHY

(C. Y. Wan & G. Schlaug, 2010, Neuroscient
10. MUSIC-INDUCED WHITE
MATTER DEVELOPMENT

66
A) 8-year old child B) Same child two
without music years later
training

(C. Y. Wan & G. Schlaug, 2010, Neuroscientist)

C) 8-year old child D) Same child after
without music two years of music
Arcuate (AF) and Uncinate (UF) Fasciculus modification after 16 weeks of
Music Intonation Training (MIT) (Zipse, Norton, Marchina & Schlaug,
2012).
(a), (b), (c): Modification of 11-year old stroke female
patient after MIT
(d), (e), (f): Control (twin sister of patient)
 Improvement of trained and non-trained phrases
(a) Phase I Slowly intoned speech, continuous voice,
internal rehearsal
(b) Phase II Reinforced phase I + syntactic structure
training
(Zipse, Norton, Marchina & Schlaug,
2012)
Fluency
improvement
measured in
syllables/phrase
.

Conversation
improvement
measured in
CIUs/conversati
on turn.

Pictoric
description
improvement
measured in
CIUs/minute.

(Zipse, Norton, Marchina & Schlaug, 2012

11. PROPOSED PTSD MUSIC
TREATMENT

71
 PTSD Treatment Model
Gray Matter: induction of specific
neurochemical modulation
Harmonizing Amygdala output via proper music
listening and intonation training.
Inducing neurogenesis in hippocampal volume via
music geared to causing BDNF and other building
blocks.
White Matter: induction of AF and UF fiber
development
by connecting limbic and inferior temporal structures
to frontal cortices via AF and UF we are subsidizing
reliable connection between Amygdala and mPFC,
thus activating the regions responsible for checking
Amygdala output and inhibit it when necessary. 72
 Operational
Preparation of methodology (listening, intoning, improvising)
Health Institution/PTSD partners
fMRI and DTI technology companies partners
Neurobiology substance analysis laboratories partners
Recruitment of human resources for monitoring
Develop instruction protocol for partners and family (wife,
mother, brother, kids, etc.)
Production of step-by-step CD
Total of 20 hours of weekly 60-minute clinic sessions with
patients
Once a week during 4.5 months
Sessions are recorded and used as feedback input
60-minute autonomous sessions 4 times per week
Step by step CD/mp3 to facilitate habituation of procedure
40 minutes of specifically described listening
20 minutes of intonation
12. CLINIC DIRECTIVES

74
Consonance: Clinic Procedure

1. Listening 4. Action

2. Emotion 3. Cognition

75
 Consonance: Music
Listening
Music: acoustic phenomenon that upon
being perceived turns automatically into
a cognitive phenomenon.
Physical before anything else
Transmitted in non-linear acoustic space
Organized on a recursive toroidal surface
Music is fed via LISTENING
Requires due environment, equipment and time
WITHOUT LISTENING THERE IS NO
PERCEPTION
WITHOUT PERCEPTION THERE IS NO
COGNITION
76
 The proper music experience enables meaningful
non-verbal expression and interaction even when
a patient cannot describe his/her inner experience
Operation at protosymbolic levels that triggers
unconscious process beyond the pathology, priming
the patient for fully symbolic expression and eventually
for putting it into words.
Music is an early mode of communication that
extends and complements verbal expression,
leading to insights that are later processed in the
verbal domain
Enables working with emotions associated to trauma
anxiety and depression on a symbolic, distantly safe
level, through the manipulation of creative imagery
and sound patterns.
77
 Consonance: Patient Classification
Leibniz Instructions on Medicine (1671):
The food, the drink and also the music must
figure in the historia naturalis of patients.
Consonance Criteria
- History of person
- History of disorder
- Listening test
- Individuals degree of musicality?
- Degree of familiarity with the repertoire?
- Degree of autobiographical relevance?
- Individuals musical ID? 78
 Consonance: Individuals Musical ID
The Starting Point
Musical Instinct & Musicality
- Identifying the orientation of instinct
- Building musicality through listening
Repertoire
Arranged Repertoire
Unique Content
Musicality is built in conformity with increasing
degree of music complexity
> musicality > cognition > perceptual
feedback > activation of brain circuits of
fibers and cells > emotional, cognitive and
motor modification. 79
 Consonance: Musical Complexity
Example Bach, Monteverdi and Mozart are
efficient in cases of:
Anxiety
Depression
Cardiovascular disturbances
Sleep problems
Why?
Which attributes and components of such music content
actually induce modification?
Which music dimensions are at work?
Which relations exist among the dimensions at work?
Answers allow for granular application of music
input.
80
 Consonance Clinic

Phone: 1-215-716-1978
E-mail: consonanceclinic@gmail.com

Contact: Ricardo Peres

USA Cell: 1-412-515-5457

Consonance-Alpha (Brazil) 55.11.3078.6777

Ave Rebouas 3377, So Paulo-SP-05401-400 81
www.institutoalpha.com.br