25 minute read
Artistic Anomalies: The Science Behind Musical Prodigies
Advertisement
half of which were child prodigy performances and the other half adult musician performances – and attempted to identify whether each piece had been performed by a prodigy after each clip. Musicians were, on average, able to correctly identify 62.6% of the prodigy audio clips, while the non-musicians could only identify 52.8% of the prodigy audio clips. The participants failed to correctly identify around one-third of the prodigy audio clips in the study (1). The results of this study suggested that musicians and non-musicians both performed only slightly above random chance in their ability to correctly identify the musical prodigy, indicating a degree of difficulty present in distinguishing child prodigies from adult musicians. From these results, Dr. Comeau and his colleagues developed a working definition for musical prodigies: children under the age of 14 who possess a high degree of musical ability that allows listeners to judge their musicianship by the same criteria as the abilities of adult musicians (1). This classification of prodigies as children with significant musical ability on par with that of adult musicians suggests the bounding capabilities of the human mind. For some, like musical prodigies, this extraordinary ability entails an unusually rapid acquisition of a complex skill, but other facets of exceptionalism include creativity, innovativeness, and even mastery of a field as an adult. To refine the common understanding of musical prodigies as children possessing exceptional musical ability, researchers aimed to discern whether there are empirical differences in the musical abilities and motivations of prodigies and typical musicians. In one study, University of Montreal PhD candidate Chanel Marion-St-Onge and her colleagues recruited 19 musical prodigies who, before age 14, had either won a top prize at a national or international music competition, or had their talent acknowledged in another significant way (such as through a television appearance) (2). The research team assessed the participants via questionnaires which measured aspects of prodigiousness and personality, such as practice time and moti-
... concept of a “rage to master,” or an inherent desire to master a skill that provides prodigies with deep internal motivation necessary to undergo intense practice. vation for musical playing, and standardized intellectual quotient (IQ) tests to evaluate problem-solving and reasoning abilities. Marion-St-Onge and her colleagues determined that the prodigies of their study had achieved musical prominence at an average age of approximately ten years old after a mean of about five years of musical play, confirming that mastery was achieved at a very early age. Interestingly, the prodigies on average did not have significantly higher IQs, a greater cumulative amount of practice hours throughout their lifetime, nor a greater sense of fulfillment from their musical play than non-prodigy musicians. However, prodigies spent twice the amount of time practicing during childhood than other musicians who began training at a similar age, had a greater propensity towards experiencing flow (a state of extreme concentration and control) during practice, and exhibited a greater external motivation for playing music, such as parental influence (2). These greater tendencies toward early musical practice suggest a potential proclivity towards excellence in a specific domain, which may be a driving factor in the advancements that humans make across various intellectual and artistic fields. Dr. Comeau et al. also investigated what traits set prodigies apart from traditional musicians through a case study of an 11 year-old piano prodigy, henceforth referred to as LN. Dr. Comeau’s team provided LN with various cognitive tests to assess his musical abilities, and compared his performance to three university students who possessed perfect pitch. LN demonstrated superior skill in some sub-areas within music such as exemplary musical memory and pitch accuracy of a higher standard than the university students. However, LN performed at an average level in other areas such as rhythm, suggesting that prodigies may excel in some areas of their domain, but do not necessarily outperform non-prodigies in every musical aspect. LN also demonstrated a working memory (short-term memory that humans use to perform tasks) that fell between the 95th and 99th percentile, which the researchers posit may contribute to his superior performance in some sub-skills such as pitch memory (the ability to accurately recall a pitch after listening to a piece of music) (3). Dr. Comeau’s study suggests variabil-
Figure 2 Many musical prodigies possess an intense devotion to musical practice during their childhood years, which some research suggests may have genetic explanations.
ity in which ways prodigies demonstrate extraordinary skill. Thus, exceptionalism is not restricted to certain fields, but rather can spur advancement in intellect across diverse domains, and even subdomains.
Innate Influences
Another foundational concept that researchers have assessed is whether genes play a role in the formation of a musical prodigy. Dr. Laura W. Wesseldijk’s research team at Karolinska Institutet in Sweden investigated a potential genetic factor in the age at which a child begins their musical training. The researchers hypothesized that an early start to training would increase the likelihood of an individual developing into a musical prodigy, so a genetic influence on age of onset of training would also influence the development of a prodigy. For the study, Dr. Wesseldijk’s team recruited professional musicians who began their musical training between the ages of two and 18 years old. Additionally, they analyzed a survey of 11,543 twin individuals from the Swedish Study of Twin Adults: Gene and Environment cohort to assess the potential genetic role in an individual’s development into a musical expert. Both the musician and twin samples answered questions pertaining to when they started their musical training, cumulative hours of musical practice, musical proficiency (measured through melody, rhythm, and pitch), and musical achievement (categorized by metrics such as a history of professional performances). Researchers determined that an earlier start to one’s musical training correlated positively with higher musical proficiency and greater achievement. However, in the twin sample – which controls for differences in family environments – the association between early training and musical aptitude is reduced, suggesting that there is a genetic factor which inclines children towards music and starting their training earlier (4). An inherent predisposition to music, and as a result early musical practice,
supports the notion of an innate propensity towards intellect or skill that may contribute to remarkable accomplishment across different domains. Professors of psychology Dr. Ellen Winner of Boston College and Dr. Jennifer Drake of Brooklyn College further explored the idea of a genetic predisposition to musical ability impacting a child’s tendency towards intense musical practice at a young age and their future expertise. Through their examination of child prodigies across various domains – including reading, math, drawing, and music – Drs. Winner and Drake developed the concept of a “rage to master,” or an inherent desire to master a skill that provides prodigies with deep internal motivation necessary to undergo intense practice (5). The researchers evaluated testimonies from parents of prodigies over many years, learning that child prodigies often exhibited exceptionalism at their skill before beginning formal practice and a rapid progression upon beginning formal practice of their skill. Parents even reported this “rage to master” conflicting with normal childhood routines, such as attending school or sleeping, as the children were so invested in dedicating time to their field (5). From their observations and parental testimonials, Drs. Winner and Drake propose an underlying genetic influence on prodigy talents that emerges through a child’s “rage to master.” In fact, this propensity to practice appears 40 to 70 percent heritable. Furthermore, the same genes that control musical aptitude also influence this “rage to master,” a case of genetic pleiotropy. This genetic factor points to an inherent difference present in prodigies that contributes to an intense drive to master a skill, which in turn aids in exceptional development of that skill. A combination of genetic and environmental factors thus play a role in an individual’s ability to make significant intellectual or creative achievements.
Intersection of Life and Music
Scientists also assessed whether non-music related aspects of a prodigy’s life are connected to their prodigal status. Maurits Hafkamp, a PhD candidate at the Netherland’s Leyden Academy on Vitality and Aging, worked with her colleagues to investigate the impact of a person’s age at the beginning of intellectual maturity – which this study defines as the first public performance of a person’s musical composition – on their lifespan. Hafkamp et al. conducted archival research on various composers from 1400 through 1915 and found that those who became composers later in life, an indication of a later development of intellectual maturity, lived longer on average. In fact, for each additional year before publishing their first work, the musicians’ age at death was on average roughly two months later. The researchers thus concluded that child prodigies, who have the earliest published pieces among composers, are more likely to have shorter lifespans than their non-prodigy counterparts (6). Hafkamp and her colleagues suggest a potential reason for this decrease in lifespan may be that the genes which cause a more rapid development in intellectual maturity have a co-occurring effect where bodily maintenance and cell repair is dimin-
Figure 3 Researchers have constructed a working definition for prodigies as children who are able to musically perform at a level that is indistinguishable from adult musicians.
ished. This difference between the lifespan of prodigies and non-prodigies points to differences at the biological level, which in addition to inclining an individual towards immense talent, also impacts other aspects of their life.
Conclusion
Musical prodigies are anomalies defying the norms of progression in acquiring complex skills such as musical ability. As much as musical prodigies influence the musical community, their very existence influences the scientific community too. Researchers seek to learn more about the psychological phenomenon of prodigious talent and investigate other aspects of prodigy status, such as whether exceptionalism in one area may result in diminished ability in another. Musical prodigies also generate interesting biological questions, as genetic explanations for giftedness spur examinations into whether genes play even more of a role in human lives than is currently known. Ultimately, prodigies offer more than their extraordinary talent: research into their abilities provides a more complete understanding of the human mind and its bounding potential. With an intense devotion to any goal, ample practice, and perhaps some genetic influence, humans have the ability to perform incredible accomplishments that push the limits of human potential – progressing humankind both intellectually and artistically. References
1. G. Comeau, et al., Can you tell a prodigy from a professional musician? Music Perception 35, 200-210 (2017). doi:10.1525/MP.2017.35.2.200. 2. C. Marion-St-Onge, et al., What makes musical prodigies? Frontiers in Psychology 11, 1-13 (2020). doi:10.3389/fpsyg.2020.566373. 3. G. Comeau, et al., Measuring the musical skills of a prodigy: a case study. Intelligence 66, 84-97 (2018). doi:10.1016/j.intell.2017.11.008. 4. L. Wesseldijk, et al., Why is an early start of training related to musical skills in adulthood? A genetically informative study. Psychological Science 32, 3-13 (2020). doi:10.1177/0956797620959014. 5. E. Winner and J. Drake, Giftedness and expertise: the case for genetic potential. Journal of Expertise 1, 114-120 (2018). ISSN:2573-2773. 6. M. Hafkamp, et al., Intellectual maturity and longevity: late-blooming composers and writers live longer than child prodigies. Aging 9, 1433-1439 (2017). doi:10.18632/aging.101245.
Images retrieved from:
1. https://commons.wikimedia.org/wiki/File:%D0%A3%D1%98%D1%85% D0%B8%D1%95%D0%B3%D1%95%D0%B3%D1%82%D1%83.jpg 2. https://pixnio.com/miscellaneous/piano-indoors-music-hand-finger 3. https://pixabay.com/photos/violins-musicians-orchestra-1838390/ 4. https://picryl.com/media/5be97a2d-abe0-4ece-a113-f384f68836ef 5. https://picryl.com/media/mirror-83dcab 6. https://picryl.com/media/mirror-221ef8
Introduction
According to the CDC, 5.8 million Americans suffered from Alzheimer’s disease (AD) in 2020, a number projected to triple to 14 million people by 2060 (1). AD is characterized by the progressive decline of cognitive function and behavioral issues, most common in geriatric populations. Given the absence of medications that demonstrate long-term effectiveness, music intervention is a promising treatment for AD, as musical memories remain in contrast to other types of memories which decline with AD (2). Current research has advocated for the increased integration of music in clinical settings as it ameliorates many of the cognitive and behavioral symptoms of AD, such as anxiety and hallucinations. Due to the rehabilitative effects on AD patients and positive recep- tion from caregivers, individualized music therapy should be implemented in conjunction with pharmacological intervention for AD with a focus on active mu-
sic intervention.
Benefits of Individualized Music Intervention
Individualized music intervention, which utilizes music that is familiar to the patient, is especially effective in improving the cognitive and behavioral symptoms of AD. A study conducted by M. Gómez Gallego from Universidad Católica San Antonio de Murcia and J. Gómez García from Universidad de Murcia treated 42 patients with mild to moderate AD with individualized music therapy for six weeks. Music was chosen after the patients completed a questionnaire on musical preference, and songs that most patients enjoyed were used. Researchers measured the effectiveness of treatment by assessing patients before and after intervention with the Hospital Anxiety and Depression Scale (HADS), the Neuropsychiatric Inventory (NPI), and the Mini-Mental State Examination (MMSE). A score of 0-7 on the HADS indicates normal psychiatry, 8-10 borderline depression or anxiety, and 11-21 depression or anxiety. In both mild and moderate AD groups, there was a significant improvement in depression (9.00 to 5.66 and 9.62 to 5.75, respectively) and anxiety (12.66 to 11.33 and 13.37 to 11.50, respectively) (6). The NPI is a questionnaire designed to assess the neuropsychiatric symptoms of the participant over the previous month, including delusions, agitation, and irritability. For each item, a score of 1, 2, or 3 indicates a severity of mild, moderate, and severe, respectively. In the mild AD group, NPI scores suggested a significant improvement in anxiety (2.67 to 0.63) (6). In the moderate AD group, NPI scores suggested a significant improvement in the symptoms of delirium (3.88 to 1.75), hallucinations (3.75 to 2.00), agitation (2.50 to 1.25), irritability (3.25 to 0.88), and disinhibition, or a pattern of norm-violating antisocial behaviors (0.75 to 0.38) (6). The MMSE evaluates behavioral symptoms such as orientation, attention, verbal memory, and motor skills on a scale from 0 to 30, where higher scores indicate better cognition. Music therapy significantly increased MMSE scores in the domains of orientation (3.44 to 6.16) and memory (3.30 to 4.33) for the mild dementia group and the domains of orientation (3.87 to 5.62), language (5.86 to 7.75), and memory (3.37 to 5.03) for the moderate dementia group (6). From Gómez Gallego and Gómez García’s research, it is evident music therapy has positive effects on a broad range of AD symptoms, whereas current pharmaceutical treatments target certain symptoms while potentially exacerbating others. Thus, the long-term use of music interventions may lead to a decrease in dependence on psychotropic drugs, presenting alternative options for patients who do not benefit from these drugs. In addition, individualized music treatment’s potential to improve symptoms regardless of AD severity supports its use across stages of the disease. Further, music therapy is fast-acting—improvements were observable after four sessions in the above study. Therefore, music intervention may reduce symptoms of AD and improve AD patients’ quality of life (6).
Active vs Receptive Music Interventions
Within individualized music interventions, active music interventions (AMI) may be more effective than receptive music interventions (RMI). RMI does not involve direct participation. In contrast, AMI involves active participation from patients individually or between each other. A study led by Maria Gomez-Gallego from the Catholic University of Saint Anthony administered twelve 45-minute sessions of AMI, RMI, or hospital care without music intervention to ninety AD patients. Both AMI and RMI were individualized through questionnaires about patient preferences for musical genres, singers, instruments, and songs. In this study, AMI differentiated from RMI in the form of a welcome song, rhythmic exercises, dance exercises, a music quiz, and a goodbye song. Researchers assessed intervention effectiveness by measuring patient symptoms before and after treatment with the MMSE, NPI, and Barthel Index (BI). MMSE results indicated a greater percentage of AMI patients (92.9%) exhibited improvements in behavioral symptoms compared to
RMI patients (42.9%) and the control group (12.2%). The BI is a 10-item questionnaire that assesses functional state, where a higher score on the BI indicates increased independence in carrying out basic daily living activities. 46.4% of the AMI group exhibited an improvement in functional state as assessed through the BI, compared to 14.3% of the RMI group and 17.1% of the control group (3). The NPI measured changes in cognitive deficits. 85.7% of the AMI group exhibited improvements in cognition compared to 11.9% of the RMI group and 6.3% of the control group (3). Gomez-Gallego’s study suggests AMI is a more effective treatment option than RMI as improvements in mean BI, MMSE, and NPI symptom scores were significantly higher in the AMI group than in the RMI and control groups (3). AMI promotes self-expression, engagement, and socialization (for example, the form of foot-tapping, dancing, and recall), which requires the involvement of task-related brain regions, which may explain AMI’s effectiveness (3). Comparing to what extent active or receptive music intervention improves AD symptoms is key in designing the most effective therapies that work for a greater percentage of AD patients.
Benefits of Music Interventions to Caregivers
In addition to relieving many AD symptoms for patients, individualized music interventions also relieve the burden from caregivers who often struggle to manage the behavioral challenges of AD patients. A study led by Emmali Buller of Saint Francis Ministries surveyed the caregivers of AD patients enrolled in “The Roth Project,” a program implemented by the Alzheimer’s Association of Central and Western Kansas that provided music-based approaches to address symptoms of AD. Researchers measured the effectiveness of treatment through a survey designed to measure caregiver satisfaction and caregiver perception of the impact of individualized music on the mood and behavior of AD patients. 78 of the 79 caregivers who participated in the survey indicated they were either “satisfied” or “very satisfied” with individualized music intervention (5). 94% also indicated they perceived their AD patients to either “like” or “very much like” listening to the individualized music (5). The ability of music intervention to foster a meaningful care environment where both patients and caregivers are satisfied is especially important. If caregivers are satisfied and happy, the quality of care will improve as well. Additionally, the satisfaction of both caregivers and patients would allow for the facilitation of social engagement between each other, which is often not present or strained due to the debilitating behavioral symptoms of AD. Often overlooked, caregiver satisfaction is equally important as patient satisfaction and should be investigated further. As 95% of the patients reported requiring assistance in working the iPod device to listen to music, caregivers must learn how to navigate these music-playing devices for their patients (5). Learning how to operate music devices is a relatively simple procedure that requires a short amount of time to learn compared to procedures caregivers may learn for other interventions. This decrease in time and money spent on training allows music interventions to be eas- ily implemented. As a simple, non-invasive, and cost-effective management strategy of AD, it is quite a breakthrough that music therapy benefits both patients and caregivers.
Drawbacks to Music Interventions
Like every therapeutic intervention, music therapy has its drawbacks. Mahsa Soufineyestani from the University of Minnesota Duluth led a systematic review of studies investigating the effects of music intervention which revealed that while some studies concluded that most AD patients improved by listening to individualized music, some became increasingly agitated (7). A hallmark of music therapy is that it evokes memories, which are linked to emotion which is further linked to behavior such as agitation. However, it is difficult to predict whether these memories and emotions will be positive or negative. Some patients may have music triggers that foster negative memories, and ultimately increase agitation. Sensitivity to a specific song can result in emotional flooding, which overstimulates and agitates the patient. The review also cited a study that observed more behavioral disturbance was observed between experimental groups who were administered Baroque music for 4 hours over a 4-week period than the control group (7). These disturbances could be explained by the fact that not all patients enjoy Baroque music, suggesting the importance of a treatment plan that is specifically catered towards the interests of the patient. Another study that was reviewed showed that AD patients with high levels of depression demonstrated increased levels of sadness after administration of music intervention compared to AD patients with low levels of depression (7). Although music interventions have been successful for some, comorbidities (such as the presence of depression and AD together) may hinder the effectiveness of treatment. This calls for the investigation into the effects of comorbidities of AD and for music treatment approaches to be designed for AD patients with a variety of different illnesses. Lastly, two reviewed studies observed that agitation that was reduced during music therapy returned after the therapy (7). This calls into question the harm of relying on music therapy approaches as the only treatment for AD. Since effects are not sustained, music therapy should be incorporated alongside pharmacological treatments.
Conclusion
Music interventions are effective in managing the symptoms of AD. Therefore, it is important to promote music therapy as an alternative or co-treatment to the therapeutic management of AD symptoms. Though studies suggest interactive and familiar music is most effective in improving cognitive and behavioral symptoms, the impact of other factors, like music genre (for example, rock music versus classical music), may be of interest for further study. Researchers may also study the effectiveness of combining music interventions with pre-existing medications. Lastly, comparing and combining music therapy with other non-pharmacological therapies, such as art therapy and dance therapy, may yield results of clinical interest and allow a greater variety of people to utilize therapies catered to individual interests.
Figure 1 Even as other types of memories decline as an Alzheimer’s brain (top) deteriorates, memory of music is left intact even in late stages of the disease.
References
1. Alzheimer’s disease and related dementias, CDC, (2020). 2. M. Leggieri, et al., Music intervention approaches for Alzheimer’s disease: A review of the literature. Frontiers in Neuroscience 13 (2019). doi: 10.3389/fnins.2019.00132. 3. M. Gómez Gallego, et al., Comparative efficacy of active group music intervention versus group music listening in Alzheimer’s disease. International Journal of Environmental Research and Public Health 18, 8067 (2021). doi: 10.3390/ijerph18158067. 4. J. Enrique de la Rubia Orti, et al., Does music therapy improve anxiety and depression in Alzheimer’s patients?. The Journal of Alternative and Complementary Medicine 24, 33-36 (2018). doi: 10.1089/acm.2016.0346. 5. E. Buller, et al., The Roth Project — music and memory: a community agency initiated individualized music intervention for people with dementia. Kansas Journal of Medicine, 12, 136-140 (2019). 6. M. Gómez Gallego & J. Gómez García, Music therapy and Alzheimer ‘s disease: cognitive, psychological, and behavioural effects. Neurologia (Barcelona, Spain) 32, 300-308 (2017). doi: 10.1016/j. nrl.2015.12.003. 7. M. Soufineyestani, et al., Impacts of music intervention on dementia: a review using meta-narrative method and agenda for future research. Neurology International 13 (2021). doi: 10.3390/ neurolint13010001.
Images retrieved from:
1. https://commons.wikimedia.org/wiki/File:AD_versus_CO.jpg 2. https://www.vecteezy.com/free-vector/treble-clef”>Treble Clef Vectors by Vecteezy 3. https://www.vecteezy.com/free-vector/film-grain”>Film Grain Vectors by Vecteezy
Brain Mapping & MusicTherapy
Linked to Postoperative Success
DAPHNE SIOZIOS `23
Introduction
Though the fields of science and art may seem disconnected, certain art forms such as music can be applied to traditionally scientific operations, and particular scientific phenomena may be influenced by distinct art forms. Music therapy (MT) is an emerging discipline that allows surgeons to address lingering postoperative (after surgery) psychological effects patients face while improving palliative benefits through the implementation of specially-designed music monitoring techniques (1). Noise-canceling headphones placed on conscious but sedated patients allow for the introduction of intraoperative (during surgical procedures) music, which is thought to diminish the likelihood of negative outcomes, such as nerve damage and chronic pain, brought on by surgical complications. These negative outcomes may further be avoided via brain mapping wherein biological data from the human brain is interpreted as spatial representations resembling maps to further study the anatomy of the central nervous system (CNS). As such, combining MT and brain mapping may have positive implications for postoperative outcomes in the neurological context. According to recent studies, the use of MT and mapping of specific cortical sites in the brain during awake surgical procedures in particular have shown postoperative benefits. By creating cortical maps to distinguish different regions in the cerebral cortex, there is an increased ability to pinpoint which part(s) of the cortex experience disturbances to large neural networks (2). Such disruptions may alter the functionality responsible for carrying out high-level cognitive tasks relating to playing music, thus demonstrating the need to further examine the relationship between music and cognitive behaviors. The effects of MT in conjunction with motor control monitoring, examination of cognitive conformability, and analysis of psychological symptoms have the potential to significantly decrease depressive symptoms and pain episodes while providing a lasting increase in postoperative cognitive capabilities for both musicians and nonmusicians.
Music Therapy & Brain Mapping
MT has largely been regarded as a novel application in clinical practice over the past few years, as it has been shown to improve the emotional states of patients experiencing preoperative (before surgery) stress or long postoperative treatment cycles. New approaches in intraoperative MT also continue to gain recognition as they assist in the restoration of mental health in patients post-surgery and increase clinical efficacy (2). The benefits of MT are derived from resonance (the manner in which music affects individuals psychologically and physically), stimulation of dopamine within the limbic system, and brainstem network theory. Brainstem network theory states that music is passed along the brainstem network structure in a series of impulses, ultimately regulating the activity of the CNS and one’s physiological and psychological states. Previous research studies have found that negative preoperative emotions like tension and anxiety lead to adverse outcomes, such as abnormal circadian sleep patterns, hypertension, and irregular heart rhythms, which significantly subside with the use of MT. As established by an evaluation of anxiety levels across liver cancer cases, traditional care only provides adjuvant treatment for such maladies; it does not have the same effect on patient outcomes as MT interventions would. In this study, scientists measured anxiety levels in two differing groups of patients via the Self-Rating Anxiety Scale (SAS). It was found that anxiety levels of non-MT patients (with a mean of 45.2 points +/- a 9.52 standard margin of error) was much higher than that of patients in the MT group (with a mean of 37.65 points +/- a 8.54 standard error) (1). Even though these statistical findings suggest the effectiveness of MT in diminishing postoperative anxiety, there is still uncertainty surrounding the direct implications of this alternative therapy in further facilitating and maintaining a positive resolution throughout surgery. Craniotomies are a specific type of surgical procedure that allow immediate access to the exposed brain through temporary removal of a bone flap from the skull. Specifically, awake craniotomies provide the opportunity for cortical and subcortical brain mapping, which minimizes surgical morbidity (temporary or permanent disability observed during or after surgery) and optimizes the potential for larger amounts of tissue to be successfully resected, or removed during surgery (2). Similarly, intraoperative musical performance during brain lesion resection may prevent potential subsequent neurological disturbances. Because playing musical instruments requires a substantial amount of skill and simultaneous activation of higher level cognitive tasks, performing music during active surgery may very well help uncover the linkage between music and cognitive function in relation to marked regions of the encephalon (3).
Monitoring Motor Control During Awake Craniotomies
Recently, researchers have proposed that musicians may benefit from playing their instruments during awake craniotomies, as it enables surgeons to monitor both motor control and preservation of one’s cognitive state after surgery. While traditional MT methods have indicated vast improvements in the emotional states and cognitive abilities of patients throughout recovery, a more focused study of individuals with instrumental experience can help further evaluate the distinct brain region responsible for dissociative motor behavior. A 2019 case study done by Dr. Vitoria Piai and her colleagues at the Donders Institute for Brain Cognition and Behavior in Nijmegen, Netherlands evaluated the resection of a tumor in the left supplementary motor area (SMA) in the brain of a violinist between the ages of 35-40 with more than sixteen years of musical education (4). The SMA is crucial for fine motor skills involved in music performance. In order
