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Brittany Demircan 1002518723

Music’s Effects on the Dopaminergic Pathways: Pleasure-Evoking Emotions, Mood Improvements and Therapy For ages, people have felt the power of music by its ability to stimulate highly pleasurable emotions and improve mood. People from all over the world listen to music to experience pleasure. This display of pleasure is evident whenever someone sings, taps to a beat or dances during a song. Some preliminary work on the power of music has concluded that music uses the same reward pathways as food, drugs and sexual pleasure (Mallik, Chanda, & Levitin, 2017). These positive reinforcing effects of music can also play an active role in mood improvements (Quarto et al., 2017, White et al., 2009). Music can influence dopaminergic pathways leading to increased pleasure and mood improvements and has potential for therapy. Although music has been around for centuries, its impact on the brain and its efficacy in a therapeutic approach have only been recently studied within the last decade. Music therapy has been used in clinical applications for Parkinson’s disease, depression and schizophrenia thus far. Research on music therapy holds value to understanding and improving treatment for many individuals with dopamine-related disorders.

Pleasure-evoking music has been a center of focus for scientists regarding its role in the dopaminergic systems. From various studies in the past, it has been determined that dopamine is associated with feelings of pleasure, reward and motivation (Arias-Carrion et al., 2007). A study by Mavridis et al. (2015), suggests that music activates the nucleus accumbens, known to be one of the most important reward centres in the brain. Recent findings show that music can

Brittany Demircan 1002518723 increase pleasure-evoking emotions via nigrostriatal, mesolimbic, and mesocortical dopaminergic pathways. Research by Moraes et al. (2018) studied the exposure of melodic music on monoamine activity in the nigrostriatal pathway in rat forebrain areas. The study included two conditions: an experimental group that was exposed to music and a control group that did not have any interventions. After eight music sessions, the rats were euthanized. Their nucleus accumbens and dorsal striatum were dissected and measured for concentrations using high-performance liquid chromatography (Moraes et al., 2018). The results showed evidence that the group exposed to melodic music had increased dopamine concentrations in the dorsal striatum, which is an area linked to reward, pleasure and motor control (Moraes et al., 2018). It was also found that music increased serotonin release in the dorsal striatum, which could mean that serotonergic systems regulate dopamine activity in the dorsal striatum (Moraes et al., 2018). Another study by Salimpoor et al. (2011), also investigated dopamine activity by comparing the effects of a neutral music stimulus with a rewarding music stimulus. The study was done using raclopride tracer (a D2 receptor antagonist) and positron emission tomography (PET) scanning to visualize D2 dopamine receptors in the mesolimbic regions. PET scans revealed there was decreased raclopride binding, suggesting the presence of elevated dopamine activity during the pleasurable music condition in the striatum (Salimpoor et al., 2011). Furthermore, increased activity in the emotional (mesocortical dopaminergic pathway) and cognitive (orbitofrontal cortex) brain structures during music exposure were found further suggesting music increases dopamine release (Levitin et al., 2013) These studies show strong evidence of pleasurable emotions via dopaminergic systems.

Brittany Demircan 1002518723 The perception of music can also strongly influence one’s mood. One of the factors that influences mood is the genre of music. Music with a higher tempo and faster rhythmic units is found to be associated with happiness, while lower tempo with slower rhythmic units is found to be associated with sadness (Fernandez-Sotos et al., 2016). Another factor that has a significant impact on the perception of music is D2 receptors. A study by Quarto et al. (2017), investigated the interaction between two D2 receptor gene variations (a functional type with more D2 receptors in the brain and less functional type with less D2 receptors in the brain) and sound environment (music or noise). Participants that were genotyped for either gene encountered either sound or music while a fMRI was performed. The overall results show that the D2 receptor genes have a direct impact on perception and mood changes after music or noise exposure. The participants with functional D2 receptor genes self-reported mood improvement after music exposure, unlike the participants with less functional D2 receptor types (Quarto et al., 2017). Another study by Hirokawa et al. (2003), found that Japanese students who listened to uplifting music after performing a stressful task self-reported improvement in mood compared to students who did not listen to music. It was found that students reported the uplifting musical experience as “rewarding” (Hirokawa et al., (2003). A study by Mavridis et al. (2015), suggests that musical stimuli can significantly increase the intracellular dopamine levels providing the listener with an abstract reward that strongly influences mood. It was found that music exposure showed less striatal activity in individuals with the less functional D2 receptor gene, suggesting lower levels of dopamine release (Quarto et al., 2017). This study is supported by another study, who found similar results with less striatal binding in participants in less functional variations in D2 receptor genes compared to

Brittany Demircan 1002518723 functional type (White et al., 2009). Furthermore, a correlation between the low functional D2 receptor genes and low sensitivity to musical rewards was found, further suggesting D2 receptors have a role in music perception (Zatorre et al., 2015). Taken together, these findings highlight the positive impact of music on people’s moods.

Music is a new therapeutic approach that has begun to appear in clinical settings. Parkinson’s disease is one of the neurological disorders found to benefit from music therapy. Individuals with Parkinson’s disease have degeneration of dopamine-producing brain regions such as substantia nigra and basal ganglia (Davie et al., 2008). This causes symptoms such as deficient motor control and deterioration of cognitive functions. Music therapy has been found to help Parkinson’s disease by providing rhythmic auditory cues-based training like the Ronnie Gardiner Rhythm and Music (RGRM) Method (Pohl et al., 2013). It has been found to improve speed, step length of movement (Nombela et al., 2013) as well as motor timing abilities (Benoit et al., 2014). It has been found that areas in the brain responsible for processing rhythm are closely related to the brain areas that regulate motor skills such as the putamen (Nombela et al., 2013), premotor cortex (Bengtsson et al., 2009), striatum (Grahn et al., 2009) and cerebellum, (Chen et al., 2008). In addition to physical intervention, music therapy has also been found to help individuals with Parkinson’s disease psychologically. A study by Elefant et al. (2012) found that music therapy helped decrease the common depressive symptoms individuals with Parkinson’s disease experience, by using a Montgomery and Asberg Depression rating scale (MADRS). Another symptom that affects many individuals with Parkinson’s disease is physical pain. It has been found that music therapy helps alleviate pain, suggesting it may act

Brittany Demircan 1002518723 as an endogenous analgesic, but this requires further research (Choi et al., 2018). In addition, research shows music therapy helps develop increased sociability (Bienkiewics et al., 2016) and verbal communication using vocal skills such as singing (Pohl et al., 2013). To conclude, Parkinson’s disease shows great beneficial effects from the music therapy approach.

Depression, a disorder found to be comorbid with many disorders (including Parkinson’s disease) was also found to benefit from music therapy. One of the core symptoms of depression is anhedonia, which is found to involve the downregulation of the dopaminergic system (Belujon et al., 2017). A study by Keller et al. (2013), found that anhedonia is directly associated with reduced connectivity of brain structures associated with the mesolimbic pathway. Another study found evidence that music therapy increased activity in the mesolimbic system in individuals with major depressive disorder, with more activity found in the striatum and anterior cingulate cortex compared to baseline (Lepping et al., 2016). In regards to effectiveness, music therapy was found to be effective in reducing symptoms of depression whether it was administered alone or with another psychotherapy treatment (Assche., 2015). Other studies found that music therapy can also increase the effectiveness of treatment when used with other treatments such as antidepressants or psychiatric counselling (Bruscia et al. 2014, Erkkila et al., 2018). Music therapy was also found to decrease symptoms of depression. It was found to be effective in reducing anxiety (Aalbers et al., 2017) and anhedonia (Gold et al., 2009) in individuals with depression. More frequent treatment sessions were found to have even a greater effect in reducing anxiety, anhedonia and other negative feelings (Gold et al., 2009). Music therapy was also proven to be effective in individuals with depression with low

Brittany Demircan 1002518723 motivation (Gold et al., 2015). Overall, the evidence suggests music therapy is suitable for different severities of depression and symptoms in reducing depression symptoms.

Although it is a new therapy, music shows equally promising results when compared to other therapy options such as pharmaceuticals and psychotherapy (Silverman et al., 2018). It has been found to benefit individuals physiologically, emotionally and socially. It has also been shown to be more cost efficient (Romo et al., 2017) and equally effective (Hamioka et al., 2014) when compared to other therapy options. Music therapy is one of the less invasive therapeutic approaches compared to other treatments, leading to fewer side effects and more enjoyable treatment (Ugur et al., 2016). It was also found to be a more accessible treatment requiring cheaper and less training for therapists (Romo et al., 2017) and easier application when compared to other treatment options (Ugur et al., 2016). Although there are many recent studies on the benefits of music therapy on dopamine-related neurologic disorders, more research is necessary to overcome limitations and understand the mechanisms involved. One limitation that future researchers should try to address is small sample sizes, which decreases the statistical power of the study and reduces the generalizability of the results. The studies were further limited by short duration of treatment and absence of follow-ups during research, which limits the ability to infer causation and restricts understanding of long-term effects. Future researchers should also include more participants with a wider spectrum of severity of disorders in order to understand the effectiveness of the therapeutic approach fully. Additionally, further research on genetics’ role in music therapy would also help researchers to elucidate whether certain genes are liable for the effectiveness of treatment. Furthermore, due

Brittany Demircan 1002518723 to the novelty of music therapy more investigation on neural mechanisms is crucial to understand and improve the therapeutic approach.

In conclusion, music has the ability to induce pleasure-evoking emotions and mood improvements. It engages dopaminergic pathways and increases dopamine activity in the mesolimbic (Salimpoor et al., 2011), nigrostriatal (Moraes et al., 2018) and mesocortical (Levitin et al., 2013) dopaminergic pathways which are associated with reward, pleasure and motivation. These effects were found to be beneficial for individuals who suffer from dopamine-related neurological disorders such as Parkinson’s disease and depression. They showed evidence to help individuals physiologically (Nombela et al., 2013, Benoit et al., 2014, Lepping et al., 2016, Gold et al., 2009), socially (Pohl et al., 2013) and psychologically (Elefant et al., 2012). The findings validate that music therapy is equally effective when compared to other therapy options such as pharmaceuticals and psychotherapy (Silverman et al., 2018). Despite the interest in the therapeutic aspects of music, current research fails to focus on the specific intersections of neural mechanisms and music. Further research is required to understand mechanisms and long-term effects in clinical applications. The universal liking towards music (Ugur et al., 2016), its non-invasiveness, as well as the current findings in research establish an excellent basis and powerful evidence for treating dopamine-related disorders

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Brittany Demircan 1002518723 Citations

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