Migraines and music

Migraines and Music: How Are They Connected?

By Janvie Naik It’s 7:00am, and the alarm clock emits loud, obnoxious music. With her head pounding, Mrs. N shuts off the insufferable shrieking. Another migraine, she thinks. To her daughter across the hall, the music from the alarm clock sounded peaceful and serene; however, Mrs. N was suffering from what is known as phonophobia, a common migraine symptom characterized by an aversion to sound and heightened auditory sensitivity. Although some migraineurs have symptoms causing music to be unpleasant, music may actually be used to help other migraine patients. June is National Migraine Awareness Month, so we will be delving into an interesting exploration of the links between migraines and music. First, some background information: what are migraines?

Migraine Basics Migraines typically present as recurrent throbbing pain affecting one side of the head, and each episode can last anywhere from a couple hours to several days. Accompanying symptoms include sensitivity to head movement, nausea and vomiting, photophobia, and phonophobia. In about 30% of patients, migraine pain is preceded by an aura, usually manifesting as visual disturbance (Goadsby, 2012). Migraines have a complex etiology, and triggers vary significantly from one patient to another. Potential triggers include hormonal changes, certain foods, stress, and weather changes (Silberstein, 2014). The pathological progression of a migraine is complex and not completely understood, but scientists believe that it involves a dilation of blood vessels (Gobel, 2013). Serotonin is also believed to be involved in migraines. For migraine treatment, a class of drugs known as triptans have been effective and interact with serotonin receptors (“Neuroscience: Science of the Brain,” 2003).

Music in Migraine Symptoms As demonstrated by the example of Mrs. N above, many migraineurs suffer from an aversion to sound, known as phonophobia, which may occur hours before a migraine attack or during the attack itself. A study conducted by a group of researchers in Norway demonstrates that migraine patients who suffer from phonophobia are “significantly more sensitive to sound than

headache-free controls both during and outside of an attack (p < 0.0001)” (Vingen, 1998).

Since phonophobia can be an ever-persistent condition, it can have debilitating consequences in everyday life and cause listening music to be uncomfortable experience.

Music in Migraine Treatment Utilizing music for migraine treatment has become a new and exciting field of research.

Neuroscientists are still investigating the effectiveness of music therapy and how it should be implemented, but existing research has shown promising results. Through the use of EEG technology, a group of researchers created a customized musical pattern for each patient in the study to use for migraine therapy. Their results show that after 12 months of treatment, 56% of participants receiving EEG-based music therapy were relieved of at least half of their symptoms (Meister et al., 1999). The innovative integration of music and brain imaging technology has potential to greatly improve the lives of migraine sufferers. EEG-based music therapy is not the only form of music therapy being investigated; music-aided psychotherapy is also a rich area of research. A group of German scientists compared the effects of butterbur root extract and music therapy on migraines, and the music therapy consisted of “music-aided relaxation training, body awareness techniques, and conflict training in musical role play” (OelkersAx, 2007). In the post-treatment phase, which refers to the 8-week period immediately following treatment, music therapy was shown to be more effective than both butterbur root extract and the placebo drug. Subsequent analysis showed that in the follow-up phase, which is the 8-week period immediately following the post-treatment phase, music therapy and butterbur root extract were both more effective than the placebo drug (Oelkers-Ax, 2007). The promising evidence supporting the effectiveness of migraine therapy merits further investigation and more widespread implementation.

Migraines Expressed Through Music Music serves as a vehicle for expressing human emotions and experiences. A sufferer of migraines himself, Richard Wagner composed “Siegfried,” an opera that vividly depicts a migraine attack. At a superficial level, the story of “Siegfried” has no relation to migraines, but further analysis of the music brings out striking similarities. Describing the persistent and severe nature of Wagner’s migraines, the opera begins with the phrase, “Compulsive plague!

Pain without end!” (Wagner, 1876). Much like a migraine, the music begins gradually, and soon

escalates to a loud, pulsating sound. To symbolize the aura phase, the opera includes flashing lights, and the music conveys a random pattern characteristic of visual auras. In modern music, migraines have been portrayed in a dismal light. The American Headache Society conducted an analysis of popular music and found that as of 2012, 54% of pop music with the word â&#x20AC;&#x153;migraineâ&#x20AC;? in the title had lyrics referring to feelings of hopelessness and despair, and only 11% referred to hopefulness or successful treatment (Roberts, 2012). Although migraine symptoms can be debilitating and extremely painful, music serves as an outlet for many migraineurs to express their pain.

Works Referenced Goadsby, P. J., MD. (2012). Pathophysiology of migraine [Abstract]. Annals of Indian Academy of Neurology, 15. Retrieved May 21, 2016, from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3444225/ Gobel, C. H., Gobel, A., & Gobel, H. (2013). â&#x20AC;&#x153;Compulsive plague! pain without end!â&#x20AC;? How Richard Wagner played out his migraine in the opera Siegfried. Retrieved May 25, 2016, from http://www.bmj.com/content/347/bmj.f6952 Meister, M., Einsle, R., Brunner, J., & Rhyner, K. (1994). Psychofonia--a neurophysiologic music therapy in migraine [Abstract]. Praxis (Bern 1994). Retrieved May 23, 2016, from http://www.ncbi.nlm.nih.gov/pubmed/10412281 Migraine. (2014, June 4). Retrieved May 20, 2016, from http://www.mayoclinic.org/diseasesconditions/migraine-headache/basics/definition/con-20026358 Oelkers-Ax, R., Leins, A., Parzer, P., Hillecke, T., Bolay, H. V., Fischer, J., . . . Resch, F. (2008).

Butterbur root extract and music therapy in the prevention of childhood migraine: An explorative study. European Journal of Pain, 12(3), 301-313. doi:10.1016/j.ejpain.2007.06.003 Pathophysiology of Migraine. (2003). Retrieved May 20, 2016, from http://www.americanheadachesociety.org/assets/1/7/NAP_for_Web__Pathophysiology_of_Migraine.pdf Roberts, D. L., & Vargas, B. B. (2012). The Portrayal of Migraine in Popular Music: Observations and Implications [Abstract]. Headache: The Journal of Head and Face Pain, 52(7), 11641170. Retrieved May 26, 2016, from http://www.ncbi.nlm.nih.gov/pubmed/22568486

Silberstein, S. D., MD. (2014, April). Migraine. Retrieved May 20, 2016, from http://www.merckmanuals.com/professional/neurologic-disorders/headache/migraine Vingen, J. V., Pareja, J. A., Storen, O., White, L. R., & Stovner, L. J. (1998). Phonophobia in migraine. Cephalalgia, 18(5), 243-249. Retrieved May 23, 2016, from http://www.ncbi.nlm.nih.gov/pubmed/9673802