Perspectives
Commentary on:
The Musical Brain: Myth and Science
by Montinaro pp. 442-453.
Music and the Brain
Edward R. Laws, Jr.
D r. Montinaro has presented us with a provocative and at times
poetic analysis of the Musical Brain. He begins by highlighting
the amazing parallels between music and the brain, in terms
of structure, organization, and functionanatomic, histologic, and as-
sociative.
The reciprocal relationship between the inner music of brain function
and the outer music that can on occasion stimulate a soothing
reaction that serves to protect us from the outer world is fascinating. It
reminds me of the stories of neurosurgical colleagues who served in
the Viet-Nam War, and often found escape from its horrors by putting
on earphones and surrounding themselves with music as they rested
between cases.
Equally interesting is the analysis of the levels of cerebral perception of
musicfrom mere auditory stimulus to acknowledgment of the intri-
cate structural elements of music, to the ability to identify and recall a
given work of music. Studies of cortical physiology using functional
magnetic resonance imaging enable us to link emotional aspects of
brain function to music, and have uncovered a vast network of
connectivity, cortical and subcortical, involving both hemispheres and
incorporating complex associations and feedback loops.
It is clear that we have much to learn from studies about music and
brain function that derive from our surgical experiences with patients.
Operations for temporal lobe epilepsy produce ablations that give
insight to mechanisms behind musical hallucinations; other such stud-
ies have shown that the right hippocampus is essential for musical
memory.
Genetic studies show that not only aptitude and ability have hereditary
aspects, but that such phenomena as absolute pitch may be genetically
based, and are also enhanced by training. This kind of plasticity in the
From the Pituitary/Neuroendocrine Center, Brigham & Womens Hospital, Boston,
Massachusetts, USA
To whom correspondence should be addressed: Edward R. Laws, M.D.
[E-mail: elaws@partners.org]
Citation: World Neurosurg. (2010) 73, 5:458.
DOI: 10.1016/j.wneu.2010.03.004
458 www.SCIENCEDIRECT.com
Edward R. Laws Jr., M.D.
Professor of Neurosurgery, Harvard Medical School
Director, Pituitary/Neuroendocrine Center
Brigham and Womens Hospital, Harvard University
musical brain is evident in the effects of practicing and in the physio-
logic changes that lead to expert musical talent and performance.
The demonstrations of parallels between language function and musi-
cal function are also provocative. The learning aspects of both use
similar mechanisms. The brainstem auditory responses become habit-
uated both in music and in language. Tone deafness, however, is not
necessarily linked to any aspect of aphasia.
Some forms of music therapy for neurological and emotional problems
date to very primitive cultures, and are noted in the bible, and in the
myths portrayed in opera. Music can provide a link to the psyche and to
the spiritual aspect of brain functionperhaps even the brainmind
dichotomy. We have seen music therapy used in stroke rehabilitation,
treatment of depression and stress, and hypertension. It can alter the
hormonal state, memory processing, learning, and something called
space-time reasoning, and may help in autism.
The Mozart effect has been applied to irritable babies and may lie
behind the sometimes beneficial effect of music in the operating room,
as suggested by the author. Other investigators might have different
choices of music to be played, but the subject of taste in music is not
addressed in Montinaros article.
My own musings on the substrate of taste in music and art lead to a
question of how these aspects of brain function may reflect evolution-
ary progress in the human brain. I am not a fan of modern classical
music, nor am I able to appreciate much of modern art. My worry is
that my own brain has not evolved sufficiently to savor the positive
aspects of these genres. I remain hopeful, however, that my own brain
has evolved to a state adequate for understanding and performing
modern neurosurgery, with or without musical accompaniment!
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WORLD NEUROSURGERY, DOI:10.1016/j.wneu.2010.03.004