music article 2013 moore 198 242
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A Systematic Review on the NeuralEffects of Music on Emotion Regulation:Implications for Music Therapy Practice
Kimberly Sena Moore, MM
University of Missouri-Kansas City
Background: Emotion regulation (ER) is an internal process throughwhich a person maintains a comfortable state of arousal by modulatingone or more aspects of emotion. The neural correlates underlying ERsuggest an interplay between cognitive control areas and areas involved inemotional reactivity. Although some studies have suggested that musicmay be a useful tool in ER, few studies have examined the links betweenmusic perception/production and the neural mechanisms that underlie ERand resulting implications for clinical music therapy treatment. Objectivesof this systematic review were to explore and synthesize what is knownabout how music and music experiences impact neural structuresimplicated in ER, and to consider clinical implications of these findingsfor structuring music stimuli to facilitate ER.
Methods: A comprehensive electronic database search resulted in 50studies that met predetermined inclusion and exclusion criteria.Pertinent data related to the objective were extracted and studyoutcomes were analyzed and compared for trends and commonfindings.
Results: Results indicated there are certain music characteristics andexperiences that produce desired and undesired neural activationpatterns implicated in ER. Desired activation patterns occurred whenlistening to preferred and familiar music, when singing, and (in musicians)when improvising; undesired activation patterns arose when introducingcomplexity, dissonance, and unexpected musical events. Furthermore,
Kimberly Sena Moore, MM, Conservatory of Music and Dance, University ofMissouri-Kansas City.
This research was supported in part by a Graduate Assistance Fund award fromthe University of Missouri-Kansas City Women’s Council. The author would like tothank Mirna Herrera and Brittany Slaughter for their assistance as coders, and Dr.Deanna Hanson-Abromeit for her guidance and mentorship with this project. Thisproject was completed in partial fulfillment of a doctoral degree.
Address correspondence concerning this article to Kimberly Sena Moore,Conservatory of Music and Dance, University of Missouri-Kansas City, Kansas City,MO 64119-2229. Email: [email protected]
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the connection between music-influenced changes in attention and itslink to ER was explored.Conclusions: Implications for music therapy practice are discussed andpreliminary guidelines for how to use music to facilitate ER are shared.
Keywords: music; emotion regulation; neuroscience, amygdala
Self-regulation is a complex process of self-directed change. It is theability to implement processes and actions that allow one to effectivelycontrol and manage multiple levels of experiences: cognitive,emotional, behavioral, and physiological (Bandura, 1991; Blaustein& Kinniburgh, 2010; Karoly, 1993; Larsen, 2000; Smith-Donal, Raver,Hayes, & Richardson, 2007). Self-regulation is considered a centraldevelopmental milestone in early childhood (Liebermann, Gies-brecht, & Muller, 2007) that has lifelong implications for one’semotional, cognitive, social, and mental health. An essentialcomponent of self-regulation is emotion regulation (ER) (Diamond& Aspinwall, 2003; Geva & Feldman, 2008) and the development ofER is considered an early marker for the development of appropriateself-regulation (Cole, Dennis, Smith-Simon, & Cohen, 2009).
There has been a significant increase in the past 25 years inexploring the neural correlates underlying a phenomenon; ER isno exception. In addition, there has been increased interest in themusic neurosciences and in studying the neural correlatesunderlying music perception and cognition. Although it has longbeen considered that music influences emotions, there has beenlittle attention given to understanding how music affects emotionregulation. For the music therapist, an understanding of thisphenomenon has therapeutic implications for a variety of clinicalpopulations that find it a challenge to control and manage theiremotional experiences. Thus, the major goal of this review was toexplore what is known about how music and music experiencesimpact neural structures implicated in emotion regulation, and toconsider possible clinical implications of these findings.
Emotion Regulation
Emotion regulation is an internal process through which aperson is able to maintain a comfortable state of arousal bymodulating one or more aspects of emotion (Blaustein &Kinniburgh, 2010; Diamond & Aspinwall, 2003; McRae et al.,
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2010). It involves using strategies and processes designed to create anew emotional response or change a current one (Gyurak, Gross, &Etkin, 2011; McRae et al., 2010; Ochsner & Gross, 2005) that can beexplicit (e.g., effortful or conscious) or implicit (e.g., automatic orunconscious) (Diamond & Aspinwall, 2003; Gyurak et al., 2011).Generally, successful emotion regulation strategies either alter theway an individual attends to a situation, interprets the meaning ofa situation (McRae et al., 2010), or changes the situation itself(Diamond & Aspinwall, 2003). Difficulties with emotion regulationcan have a life-long impact on an individual’s mental health andwell-being (Saxena, Dubey, & Pandey, 2011). Many researchersconsider appropriate emotion regulation to be a marker of mentalhealth as it allows a person flexibility in how he or she responds andreacts to situations and moments of distress (Cole et al., 2009;Gyurak et al., 2011; McRae et al., 2010). There are many disordersand syndromes in which difficulties with emotion regulation can bea challenge, including Attention Deficit/Hyperactivity disorder,Autism and Asperger syndrome (Masao, 2004), Post-TraumaticStress Disorder (PTSD), and trauma (Ehring & Quack, 2010).
The neural correlates underlying emotion regulation suggest aninterplay between frontal lobe areas involved in cognitive controland areas involved in emotional reactivity (Gyurak et al., 2011).More specifically, cognitive control areas include the lateralprefrontal cortex (Gyurak et al., 2011; McRae et al., 2010; Ochsner& Gross, 2005), the orbitofrontal cortex (Masao, 2004; Ochsner &Gross, 2005; Rempel-Clower, 2007; Schore, 2001), and the anteriorcingulate cortex (Gyurak et al., 2011; McRae et al., 2010; Ochsner &Gross, 2005). The amygdala is the primary structure implicated inemotional reactivity (Gyurak et al., 2011; Masao, 2004; McRae et al.,2010; Ochsner & Gross, 2005). In general, emotion regulation ischaracterized by increased activation in the cognitive control andmonitoring areas—the anterior cingulate cortex, orbitofrontalcortex, and lateral prefrontal cortex—which leads to decreasedactivation in the amygdala (Gyurak et al., 2011; Ochsner & Gross,2005; McRae et al., 2010; Rempel-Clower, 2007).
Music and Emotion Regulation
Music has long been thought to influence emotions andemotion control. In his seminal book The Anthropology of Music,Merriam (1964) wrote about music’s role as a producer of
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emotions. It has also been noted that music can evoke emotions inlisteners (Sloboda & Juslin, 2010) and may be an effective moodinduction technique (Thaut & Wheeler, 2010). However, moodinduction is different than emotion regulation; moods areaffective states lower in intensity than emotions (Juslin & Sloboda,2010). Furthermore, evoking emotions is a general conceptwhereas emotion regulation is geared towards the specific goalof maintaining a comfortable state of arousal (Blaustein &Kinniburgh, 2010; Diamond & Aspinwall, 2003; McRae et al.,2010). More recent research has focused on the neural basisunderlying music-evoked emotions, finding that music doesindeed impact neural areas implicated in emotion processing(Blood & Zatorre, 2001; Koelsch, 2010; Trainor & Schmidt, 2003).However, much in the literature is from the music neurosciencefield and focuses on the neural mechanisms underlying musiclistening, playing, or improvisation. There is little that exploresthe connection between music processing and clinical treatment;as such, there is little in the way of clinical implications relevant tothe music therapy clinician. Therefore, the purpose of thisexploratory review was to synthesize findings from studies thatreported on the effect of music and music-based experiences onneural structures implicated in ER, and to create preliminaryclinical considerations based on this synthesis.
Description of the Condition
For the purposes of this review, ER was defined as an internalprocess through which a person is able to maintain a comfortablestate of arousal by modulating one or more aspects of emotion(Blaustein & Kinniburgh, 2010; Diamond & Aspinwall, 2003; McRaeet al., 2010). It is characterized by the involvement of the amygdala(Gyurak et al., 2011; Masao, 2004; McRae et al., 2010; Ochsner &Gross, 2005), the anterior cingulate cortex (Gyurak et al., 2011;McRae et al., 2010; Ochsner & Gross, 2005), the orbitofrontalcortex (Masao, 2004; Ochsner & Gross, 2005; Rempel-Clower, 2007;Schore, 2001), and the lateral prefrontal cortex (Gyurak et al., 2011;McRae et al., 2010; Ochsner & Gross, 2005). There are cases where‘‘emotion regulation’’ has the same meaning as ‘‘affect regulation’’(Schore, 2001), although there are times when affect regulationrefers to a set of intervention techniques (Verheugt-Pleiter, 2008);the latter did not fit the intent of this review.
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Description of the Stimulus
For the purposes of this review, ‘‘music’’ referred to any acousticstimulation provided by a complex, organized sound. As long as thestudy fit other criteria for this review, ‘‘music’’ also included musicalproperties, such as rhythm, musical interval, harmony, and pitch,and music experiences, such as listening to music, playing aninstrument, improvising, or composing. The literature lists ‘‘music’’most often, with occasional references to terms such as ‘‘acousticstimulation,’’ ‘‘music therapy,’’ and ‘‘complex musical soundstimuli.’’ Research using rhythm that was associated with circadianrhythm, cardiac rhythm, respiratory rhythm, dietary rhythm, andother nonmusical references to rhythm were excluded.
Objectives
1. To explore and synthesize results examining the effects ofmusic on neural structures implicated in emotion regulation.
2. To create preliminary clinical considerations for structuringthe music stimulus when facilitating emotion regulation.
Methods
Search Strategies
The search and analysis processes used in this review wereconsistent with those outlined by Cooper (1998) and Khan, Kunz,Kleijnen, and Antes (2011). Studies considered for this reviewwere published through April 2012 and identified through acomprehensive search in the following electronic databases:MEDLINE, PsycINFO, CINAHL, SIGLE, National Institute forHealth Research, Current Controlled Trials, ClinicalTrials.gov,and CAIRSS for Music. Electronic databases were searched usingthe following keyword phrases: ‘‘music and amygdala,’’ ‘‘musicand orbitofrontal cortex,’’ ‘‘music and anterior cingulate,’’ and‘‘music and prefrontal.’’ Search results generated from the ‘‘musicand prefrontal’’ keyword phrase were scanned and included forconsideration if they included the words ‘‘dorsolateral,’’ ‘‘ventro-lateral,’’ or ‘‘lateral.’’
Article Inclusion Criteria
1. The article was a primary research study.
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2. Participants were typically-developing humans, with norestrictions as to age, gender, ethnicity, or type of setting.
3. Music was the primary stimulus, regardless of how it wasimplemented (e.g., singing, listening, improvising, etc.), thegenre of music, or the music instrument(s) incorporated.
4. Study results reported on the impact of music on one ormore of the following neural structures: amygdala, anteriorcingulate cortex, orbitofrontal cortex, and lateral prefrontalcortex.
5. Articles were published in English.6. Articles were published in peer-reviewed journals.
Article Exclusion Criteria
1. The article was a review study or theoretical paper.2. Participants had a disorder, brain damage (such as lesions
and excisions), or a syndrome.3. The study of rhythm was associated with circadian rhythm,
cardiac rhythm, respiratory rhythm, dietary rhythm, andother nonmusical references to rhythm.
Data Collection and Analysis Process
The author and two research assistants independently extractedpertinent information from the included studies related to thefirst objective. This included, as applicable, information aboutparticipant characteristics (i.e., number of participants, sexdistribution, average age, age range, and musical ability), studydesign (i.e., primary research question, neural measurement toolutilized, and other behavioral and neuropsychological toolsutilized), characteristics of the music and/or music experienceutilized (i.e., type of music experience, music characteristicstudied, music instrument used, and genre of musical stimulus),and study outcomes (i.e., general outcomes of the study andneural structure-specific outcomes). Pertinent data related to theobjective were extracted and study outcomes were analyzed andcompared for trends and common findings. Differences in dataextracted were discussed and results agreed upon for dataanalysis. Initial interrater reliability among the three coders was75.5%. When controlled for typographical errors and updates tothe coding sheet that occurred as a result of discussing differencesin data extracted, final inter-rater reliability was 83.6%.
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Results of the Search
The comprehensive electronic database search resulted in 319articles that were evaluated for inclusion according to theinclusion and exclusion criteria listed above. Of those initialstudies, 103 met the criteria. Forty-four (44) studies wereduplicates, which led to the inclusion of 59 unique studies.During the coding process, an additional nine studies wereexcluded for the following reasons: the neural structures were notactivated as a result of music stimulation (Dehaene-Lambertz etal., 2010; Schulze, Zysset, Mueller, Friederici, & Koelsch, 2011;Sluming et al., 2002), music was not used as the intervention(Blasi et al., 2011; Haslinger et al., 2004; Milton, Solodkin,Hlustik, & Small, 2007), the study was a dissertation (Chapin,2010), the study offered preliminary data that was reported in asecond study (Zarate & Zatorre, 2005), and the study did notreport information clearly enough for data extraction (Bodner,Muftuler, Nalciogly, & Shaw, 2001). Thus, this review included 50research studies.
Results
Characteristics of Included Studies
Participant characteristics. There were a total of 811 partici-pants in the studies (M 5 25.1 years; SD 5 6.2 years, range: 12–60 years), 757 adults and 54 adolescents. Over half of theparticipants were male (54.7%) and the rest were female (45.3%).Studies used an average of 16 participants (range: 6–49participants). Almost half of the studies used musicians asparticipants or a combination of musicians and nonmusicians(44.4%) and the remainder either used nonmusicians or authorswere not specific in the reporting (Table 1).
Characteristics of study design. Frequency information, relatedto study design characteristics of the included studies, is reportedin Table 1. The two most common neural measurement toolsused were functional Magnetic Resonance Imaging (fMRI)(65.5%) and Positron Emission Tomography (PET) (18.2%).Other techniques used included electroencephalography(EEG), event-related potentials (ERPs), magnetoencephalogra-phy (MEG), and a brain oxygen measurement tool called an OTsystem. Studies included in this review incorporated a variety of
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musical experiences. The majority of studies (69.6%) usedlistening to recorded music as the experience, followed bysinging, instrument playing, and improvisation. The mostcommon musical instrument used, when specified, was piano(41.7%) followed by voice (18.3%), and the most commonmusical genre used, when specified, was tonal, Western instru-mental music (43.1%), followed by popular or current music, jazzor improvisation, and nonwestern music. Almost half of the time(49.1%) researchers were not investigating a particular musicalelement (i.e., rhythm, pitch, harmony, etc.). If they did, harmonywas investigated the most frequently (21.8%), followed by rhythm,melody, pitch, timbre, and pitch interval.
Synthesis of Results
A summary of pertinent characteristics and outcome measures ofindividual studies is reported in Table 2 and a synthesis of the mainfindings is reported in Table 3. Anterior cingulate cortex activationwas reported and/or described the most frequently (32.9%),followed by lateral prefrontal cortex activation, amygdala activation,and orbitofrontal cortex activation (Table 1). Results will bepresented in a bottom-up fashion, from the deepest neural structure,the amygdala, to the most superficial area, the prefrontal cortex.
Amygdala. Multiple studies reported that the amygdala wasactivated when listening to minor, dissonant, negative, orunpleasant music (Koelsch, Fritz, Cramon, Muller, & Friederici,2006; Lerner, Papo, Zhdanov, Belozersky, & Hendler, 2009;Pallesen et al., 2005). Amygdala activation occurred during anunexpected event (e.g., hearing an irregular chord) and itsactivity could be modulated by a single chord change (Koelsch,Fritz, & Schlaug, 2008). One study reported that the amygdala wasactivated during music listening regardless of consonance ordissonance (Ball et al., 2007). Amygdala activation increased whenlistening to music with eyes closed (Lerner et al., 2009) and wasactivated more strongly when music was paired with visual stimulias compared to no visual stimuli (Baumgartner, Lutz, Schmidt, &Jancke, 2006; Eldar, Ganor, Admon, Bleich, & Hendler, 2007).One study noted a lateralization effect, reporting that the rightamygdala was activated more strongly during an audiovisualcondition than the left amygdala, and its activity increased withexposure over time (Dyck et al., 2011). The right amygdala in
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TABLE 1Frequency of Participant and Study Characteristics
Category Number Relative frequency
Music training of participants1. Nonmusicians only 15 30%1. Musicians only 13 26%1. Not specified 13 26%1. Both musicians and nonmusicians 9 18%
Neural measurement tools used1. fMRI 36 65.5%1. PET 10 18.2%1. Electroencephalography (EEG) 5 9.1%1. Event-related potentials (ERP) 2 3.6%1. Magnetoencephalography (MEG) 1 1.8%1. Event-related potentials (ERP) 1 1.8%
Type of music experience1. Music listening (recorded music) 39 69.6%1. Singing 8 14.3%1. Instrument playing 5 8.9%1. Improvisation 4 7.1%
Music instrument(s) utilized1. Piano 25 41.7%1. Voice 11 18.3%1. Instrumental (orchestral) 8 13.3%1. Instrumental (electronic) 5 8.3%1. Not specified 4 6.7%1. Instrumental (accompaniment) 3 5.0%1. Instrumental (solo) 2 3.3%1. Instrumental (nonwestern) 1 1.7%1. Other 1 1.7%
Genre of music1. Western tonal instrumental music 22 43.1%1. Not specified 13 25.5%1. Popular/current music 6 11.8%1. Jazz/improvisation 4 7.8%1. Nonwestern music 3 5.9%1. Western tonal vocal music 2 3.9%1. Other 1 2.0%
Music element studied1. Not specified 27 49.1%1. Harmony 12 21.8%1. Other 6 10.9%1. Rhythm 3 5.5%1. Melody 2 3.6%
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particular was recruited during ‘‘sad’’ music (Mitterschiffthaler,Fu, Dalton, Andrew, & Williams, 2007), is implicated in earlyneural responses to chord violations (James, Britz, Vuilleumier,Hauert, & Michel, 2008), and exhibited chord-dependentresponses (Pallesen, Brattico, Bailey, Korvenoja, & Gjedde,2009). The left amygdala had consistently similar activationpatterns, with increased activation reported when listening tomusic rated with a higher negative emotional valence (Dyck et al.,2011). The amygdala was deactivated during music improvisation(Limb & Braun, 2008) and when listening to pleasant music(Blood & Zatorre, 2001; Koelsch et al., 2006). A long-termhabituation effect was noted, perhaps due to the amygdala’s rolein evaluating salience (Mutshuler et al., 2010). To summarize,amygdala activation and deactivation patterns changed based onthe type of music experience, the characteristics of the musicstimulus, and perceived valence of the music.
Anterior cingulate cortex (ACC). The ACC was activated duringvoluntary pitch correction (Zarate, Wood, & Zatorre, 2010),discrimination tasks (Brown & Martinez, 2007), when listening tochord violations (James et al., 2008), and when monitoringperformance errors (Ruiz, Jabusch, & Altenmuller, 2009). Inaddition, listening to familiar music activated the ACC (Janata,2009) as did, in musicians, listening to dissonant chords (Foss,Altschuler, & James, 2007). ACC activation increased during bothsinging (Perry et al., 1999) and music listening tasks (Menon &
Category Number Relative frequency
1. Pitch 2 3.6%1. Timbre 2 3.6%1. Interval 1 1.8%
Neural structure reported on1. Anterior cingulate cortex (ACC) 24 32.9%1. Lateral prefrontal cortex (lateral PFC) 21 28.7%1. Amygdala 12 16.4%1. Orbitofrontal (OFC) 9 12.3%
Note. Some studies incorporated multiple types of neural measurement tools, musicexperiences, music instruments, music genres, studied multiple music elements,and reported on multiple neural structures. These numbers are reflected in thereported frequencies.
TABLE 1Continued
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ant
mu
sica
lab
ilit
yT
ype
of
exp
erie
nce
(s)
Mu
sic
char
acte
rist
icN
eura
lst
ruct
ure
(s)
Gen
eral
fin
din
gs
Blo
od
&Z
ato
rre
(200
1)
PE
Tsc
anex
plo
rin
gn
eura
lm
ech
anis
ms
acti
vate
dw
ith
ple
asan
tem
oti
on
alre
spo
nse
sto
mu
sic
10M
usi
cian
sM
usi
cli
sten
ing
(rec
ord
ed)
No
tsp
ecif
ied
Am
ygd
ala,
OFC
,A
CC
(1)
Lis
ten
ing
top
refe
rred
mu
sic
re-
cru
its
neu
ral
syst
ems
asso
ciat
edw
ith
rew
ard
and
emo
tio
nsi
mila
rto
tho
sekn
ow
nto
resp
on
dto
bio
logi
cally
-rel
evan
tst
imu
li;(2
)H
eart
rate
and
resp
irat
ion
incr
ease
dw
hile
liste
nin
gto
mu
sic
that
elic
ited
chill
s.B
row
n&
Mar
tin
ez(2
006)
fMR
Ist
ud
yex
plo
rin
gn
eura
lm
ech
anis
ms
un
der
lyin
gm
elo
dy
and
har
mo
ny
dis
crim
inat
ion
11M
usi
cian
sM
usi
cli
sten
ing
(rec
ord
ed)
Har
mo
ny,
Mel
od
yA
CC
,d
lPF
C(1
)D
iscr
imin
atio
np
roce
ssin
gin
volv
esd
om
ain
-sp
ecif
icse
nso
rim
oto
rar
eaan
dd
om
ain
-gen
eral
wo
rkin
gm
emo
ryan
der
ror
det
ecti
on
area
s;(2
)Si
mil
arac
tiva
tio
np
atte
rns
bet
wee
nm
elo
dy/
har
mo
ny
pro
cess
ing
and
bet
wee
np
erce
pti
on
/p
rod
uct
ion
ofm
usi
c,in
clu
din
gd
lPF
Can
dA
CC
Bro
wn
etal
.(2
004)
PE
Tst
ud
yex
plo
rin
gn
eura
lm
ech
anis
ms
un
der
lyin
gp
leas
ant
feel
ings
10N
on
mu
sici
ans
Mu
sic
list
enin
g(r
eco
rded
)N
ot
spec
ifie
dA
CC
(1)
Spon
tan
eou
sac
tivat
ion
oflim
bic
and
par
alim
bic
area
sd
uri
ng
task
-fr
ee,p
assi
velis
ten
ing
toun
fam
iliar
but
liked
mus
ic;(
2)St
ron
ger
left
-hem
isp
her
eac
tivat
ion
with
mu
sic-
elic
ited
pos
itive
emot
ion
s
TA
BL
E2
Con
tin
ued
210 Journal of Music Therapy
by Argeanu Stefania on July 18, 2014
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escr
ipti
on
of
stu
dy
Stu
dy
char
acte
rist
ics
Ou
tco
mes
NP
arti
cip
ant
mu
sica
lab
ilit
yT
ype
of
exp
erie
nce
(s)
Mu
sic
char
acte
rist
icN
eura
lst
ruct
ure
(s)
Gen
eral
fin
din
gs
Bro
wn
etal
.(2
006)
PE
Tst
ud
yex
plo
rin
gn
eura
lm
ech
anis
ms
un
der
lyin
gm
elo
dic
and
spee
chge
ner
atio
n
10M
usi
cian
sM
usi
cli
sten
ing
(rec
ord
ed),
Sin
gin
g
Mel
od
yA
CC
(1)
Sign
ific
ant
ove
rlap
inst
ruct
ure
sac
tiva
ted
du
rin
gm
elo
dic
imp
rovi
sati
on
and
sen
ten
cege
ner
atio
n,
incl
ud
ing
AC
C;
(2)
Som
ela
tera
liza
tio
nd
iffe
ren
ces,
such
asst
ron
ger
left
-h
emis
ph
ere
acti
vati
on
wit
hse
nte
nce
gen
erat
ion
Cal
lan
etal
.(2
006)
fMR
Ist
ud
yin
vest
igat
ing
the
neu
ral
dif
fere
nce
sb
etw
een
per
ceiv
ing
and
pro
du
cin
gso
ng
and
spee
ch
16N
on
mu
sici
ans
Mu
sic
list
enin
g(r
eco
rded
),si
ngi
ng
No
tsp
ecif
ied
OF
CD
iffu
se,
bil
ater
aln
etw
ork
of
ove
rlap
pin
gn
eura
lp
roce
sses
un
der
lie
per
cep
tio
nan
dp
rod
uct
ion
of
spee
chan
dso
ng,
sup
po
rtin
gre
lati
on
ship
bet
wee
nth
emC
oen
etal
.(2
009)
fMR
Ist
ud
yex
plo
rin
gef
fect
of
neg
ativ
eem
oti
on
alst
imu
lio
nn
eura
lp
roce
ssin
g
12N
ot
spec
ifie
dM
usi
cli
sten
ing
(rec
ord
ed)
Not
spec
ified
AC
C,d
lPFC
(1)
Evi
den
ceo
fri
ght
hem
isp
her
ed
om
inan
cew
hen
pro
cess
ing
neg
ativ
eem
oti
on
s;(2
)R
igh
tin
sula
and
righ
tA
CC
seem
inte
gral
toaw
aren
ess
of
emo
tio
n;
(3)
Sad
nes
sp
erce
pti
on
incr
ease
dw
hen
list
enin
gto
sad
mu
sic
bu
td
idn
ot
affe
ctp
ain
per
cep
tio
n
TA
BL
E2
Con
tin
ued
Vol. 50, No. 3, Fall 2013 211
by Argeanu Stefania on July 18, 2014
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nloaded from
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tho
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escr
ipti
on
of
stu
dy
Stu
dy
char
acte
rist
ics
Ou
tco
mes
NP
arti
cip
ant
mu
sica
lab
ilit
yT
ype
of
exp
erie
nce
(s)
Mu
sic
char
acte
rist
icN
eura
lst
ruct
ure
(s)
Gen
eral
fin
din
gs
de
Man
zan
o&
Ull
en(2
012)
fMR
Ist
ud
yex
plo
rin
gn
eura
lm
ech
anis
ms
un
der
lyin
gre
spo
nse
gen
erat
ion
18M
usi
cian
sIm
pro
visa
tio
n,
inst
rum
ent
pla
yN
otsp
ecifi
edA
CC
,dlP
FC(1
)Si
gnif
ican
to
verl
apin
acti
vati
on
du
rin
gim
pro
visa
tio
nan
dsi
ght-
read
ing,
sugg
esti
ng
thes
ere
gio
ns
fulf
ill
gen
eric
fun
ctio
ns
infr
eege
ner
atio
nre
gard
less
of
goal
;(2
)H
igh
erac
tivi
tyd
uri
ng
pse
ud
o-
gen
erat
ion
task
inat
ten
tio
n,
wo
rkin
gm
emo
ry,
and
exec
uti
veco
ntr
ol
area
sD
yck
etal
.(2
011)
fMR
Ist
ud
yex
plo
rin
gam
ygd
ala
resp
on
sew
hen
pre
sen
ted
wit
hvi
sual
v.au
dio
visu
alin
pu
t
30N
ot
spec
ifie
dM
usi
cli
sten
ing
(rec
ord
ed)
No
tsp
ecif
ied
Am
ygd
ala
(1)
Am
ygd
ala
may
be
imp
lica
ted
inem
oti
on
regu
lati
on
,no
tju
stem
oti
on
per
cep
tio
n;
(2)
Rep
ort
edle
ft-la
tera
lize
dco
gnit
ive/
inte
nti
on
alco
ntr
ol
of
mo
od
and
righ
t-la
tera
lize
dau
tom
atic
ind
uct
ion
of
emo
tio
n;
(3)
Rep
ort
edst
ron
ger
acti
vati
on
wit
hau
dio
visu
alin
pu
tE
ldar
etal
.(2
007)
fMR
Ist
ud
yex
plo
rin
gli
mb
icre
spo
nse
sto
mu
sic
wh
enp
aire
d/
no
tp
aire
din
are
al-
wo
rld
con
text
12N
ot
spec
ifie
dM
usi
cli
sten
ing
(rec
ord
ed)
No
tsp
ecif
ied
Am
ygd
ala,
LP
FC(1
)B
rain
may
hav
ep
refe
ren
tial
re-
spon
seto
emot
ion
alst
imu
liw
hen
asso
ciat
edw
itha
con
cret
eco
n-
text
;(2)
Mu
sic
can
elic
itgr
eate
rem
otio
nal
effe
ctw
hen
pai
red
with
aco
ncr
ete
visu
alst
imu
liv.
wh
enp
rese
nte
don
itsow
n
TA
BL
E2
Con
tin
ued
212 Journal of Music Therapy
by Argeanu Stefania on July 18, 2014
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escr
ipti
on
of
stu
dy
Stu
dy
char
acte
rist
ics
Ou
tco
mes
NP
arti
cip
ant
mu
sica
lab
ilit
yT
ype
of
exp
erie
nce
(s)
Mu
sic
char
acte
rist
icN
eura
lst
ruct
ure
(s)
Gen
eral
fin
din
gs
Flo
res-
Gu
tier
rez
etal
.(2
007)
fMR
Ian
dE
EG
stu
dy
exp
lori
ng
neu
ral
acti
vity
asso
ciat
edw
ith
ple
asan
t/u
np
leas
ant
emo
tio
nal
stat
es
19N
on
mu
sici
ans
Mu
sic
list
enin
g(r
eco
rded
)N
otsp
ecifi
edO
FC
(1)
Mu
sic-
elic
ited
emo
tio
ns
req
uir
eco
gnit
ive-
sen
sory
inte
grat
ion
and
hav
ew
ides
pre
adac
tiva
tio
no
fco
gnit
ive,
lan
guag
e,an
dem
oti
on
pro
cess
ing
area
s;(2
)D
iffe
ren
tst
ruct
ure
sin
volv
edin
pro
cess
ing
po
siti
vean
dn
egat
ive
mu
sica
lem
oti
on
sw
ith
left
sid
eac
tiva
ted
for
ple
asan
tem
oti
on
san
dri
ght
for
un
ple
asan
tF
ord
etal
.(2
011)
fMR
Ist
ud
yin
vest
igat
ing
neu
ral
mec
han
ism
su
nd
erly
ing
auto
bio
grap
hic
alm
emo
ries
asso
ciat
edw
ith
mu
sic
16N
ot
spec
ifie
dM
usi
cli
sten
ing
(rec
ord
ed)
No
tsp
ecif
ied
AC
C,L
PFC
(1)
Dif
fere
nt
neu
ral
stru
ctu
res
and
net
wo
rks
recr
uit
edfo
rd
iffe
ren
tty
pes
of
auto
bio
grap
hic
alm
emo
ry;
(2)
Sup
po
rts
use
of
mu
sic
asan
auto
bio
grap
hic
alre
trie
val
cue
for
mem
ori
esth
atar
ep
osi
tive
,em
oti
on
ally
char
ged
,an
dsu
bje
ctto
reli
vin
gas
itac
tiva
ted
area
sre
late
dto
emo
tio
np
roce
ssin
gan
dm
emo
ryre
trie
val
(e.g
.,V
PF
Can
dA
CC
)
TA
BL
E2
Con
tin
ued
Vol. 50, No. 3, Fall 2013 213
by Argeanu Stefania on July 18, 2014
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escr
ipti
on
of
stu
dy
Stu
dy
char
acte
rist
ics
Ou
tco
mes
NP
arti
cip
ant
mu
sica
lab
ilit
yT
ype
of
exp
erie
nce
(s)
Mu
sic
char
acte
rist
icN
eura
lst
ruct
ure
(s)
Gen
eral
fin
din
gs
Fo
sset
al.
(200
7)fM
RI
stu
dy
exp
lori
ng
neu
ral
mec
han
ism
sim
pli
cate
din
Pyt
hag
ore
anra
tio
rule
s
13B
oth
mu
sici
ans
and
no
nm
usi
cian
s
Mu
sic
list
enin
g(r
eco
rded
)In
terv
alA
CC
(1)
Neu
ral
acti
vati
on
of
dis
son
ant
inte
rval
ssi
gnif
ican
tly
grea
ter
than
con
son
ant
inte
rval
s;(2
)A
ctiv
atio
np
atte
rns
tod
isso
nan
ced
iffe
ren
tin
mu
sici
ans
(lef
t-lat
eral
ized
)v.
no
nm
usi
cian
s(r
igh
t-la
tera
lized
),su
gges
tin
gst
ron
ger
acti
vati
on
inm
usi
cian
s’la
ngu
age
pro
cess
ing
area
sF
uji
saw
a&
Co
ok
(201
1)fM
RI
stu
dy
exp
lori
ng
neu
ral
net
wo
rks
acti
vate
dw
hen
list
enin
gto
dif
fere
nt
Wes
tern
har
mo
nie
s
12N
on
mu
sici
ans
Mu
sic
list
enin
g(r
eco
rded
)H
arm
on
y3O
FC
,d
lPF
C(1
)R
epo
rted
acti
vati
on
pat
tern
sw
hen
pro
cess
ing
har
mo
nie
s;(2
)O
FCsi
gnif
ican
tly
acti
vate
dd
uri
ng
cho
rdch
ange
s;(3
)M
ovi
ng
fro
ma
ten
sio
nch
ord
toa
favo
red
cho
rdel
icit
sa
stro
ng
bra
inre
spo
nse
.G
reen
etal
.(2
008)
fMR
Ist
ud
yex
plo
rin
gn
eura
lre
spo
nse
sto
mu
sica
lm
od
es
21N
on
mu
sici
ans
Mu
sic
list
enin
g(r
eco
rded
)H
arm
on
yA
CC
(1)
Fou
nd
dif
fere
nti
alac
tiva
tio
no
fce
rtai
nst
ruct
ure
sw
hen
liste
nin
gto
min
or
v.m
ajo
rm
usi
c,w
hic
hm
ayb
ed
ue
tod
isso
nan
ceo
ro
vera
llq
ual
ity
of
sad
nes
s;(2
)M
ino
rm
elo
die
sac
tiva
ted
mo
relim
bic
area
sth
anm
ajo
rm
elo
die
s
TA
BL
E2
Con
tin
ued
214 Journal of Music Therapy
by Argeanu Stefania on July 18, 2014
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nloaded from
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tho
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escr
ipti
on
of
stu
dy
Stu
dy
char
acte
rist
ics
Ou
tco
mes
NP
arti
cip
ant
mu
sica
lab
ilit
yT
ype
of
exp
erie
nce
(s)
Mu
sic
char
acte
rist
icN
eura
lst
ruct
ure
(s)
Gen
eral
fin
din
gs
Hu
gdah
let
al.
(199
9)P
ET
scan
exp
lori
ng
acti
vati
on
pat
tern
sas
soci
ated
wit
hd
ich
oti
cli
sten
ing
12N
ot
spec
ifie
dM
usi
cli
sten
ing
(rec
ord
ed)
Tim
bre
dlP
FC
(1)
Asy
mm
etry
effe
cts
wh
enp
rese
nti
ng
dif
fere
nt
stim
uli
inea
chea
r,w
ith
grea
ter
left
hem
isp
her
eac
tiva
tio
nfo
rsp
eech
and
grea
ter
righ
th
emis
ph
ere
acti
vati
on
for
mu
sic;
(2)
Stro
nge
rac
tiva
tio
nfo
rp
roce
ssin
gsp
eech
v.m
usi
c,p
erh
aps
bec
ause
aud
ito
ryco
rtex
spec
iali
zed
for
ph
on
olo
gica
lp
roce
ssin
g;(3
)d
lPF
Cm
ayp
lay
aro
lein
det
ecti
ng
com
ple
xti
mb
reJa
mes
etal
.(2
008)
ER
Pim
agin
gst
ud
yin
vest
igat
ing
neu
ral
dif
fere
nce
sm
usi
cal
trai
nin
gh
asin
har
mo
nic
pro
cess
ing
26B
oth
mu
sici
ans
and
no
nm
usi
cian
s
Mu
sic
list
enin
g(r
eco
rded
)H
arm
on
yrt
.Am
ygd
ala
(1)
Rap
id,
righ
t-la
tera
lize
dn
eura
lre
spo
nse
sto
cho
rdvi
ola
tio
ns
for
mu
sici
ans
v.n
on
mu
sici
ans,
sugg
esti
ng
that
mu
sic
trai
nin
gen
han
ces
righ
th
emis
ph
eric
do
min
ance
;(2
)A
myg
dal
aac
tiva
ted
wh
end
etec
tin
gh
arm
on
icin
con
gru
enci
es
TA
BL
E2
Con
tin
ued
Vol. 50, No. 3, Fall 2013 215
by Argeanu Stefania on July 18, 2014
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nloaded from
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tho
rD
escr
ipti
on
of
stu
dy
Stu
dy
char
acte
rist
ics
Ou
tco
mes
NP
arti
cip
ant
mu
sica
lab
ilit
yT
ype
of
exp
erie
nce
(s)
Mu
sic
char
acte
rist
icN
eura
lst
ruct
ure
(s)
Gen
eral
fin
din
gs
Jan
ata
(200
9)fM
RI
stu
dy
inve
stig
atin
gn
eura
lm
ech
anis
ms
un
der
lyin
gau
tob
iogr
aph
ical
mem
ori
esas
soci
ated
wit
hm
usi
can
dM
PF
Cac
tiva
tio
n
13N
ot
spec
ifie
dM
usi
cli
sten
ing
(rec
ord
ed)
No
tsp
ecif
ied
vlP
FC
(1)
mP
FC
asso
ciat
edw
ith
pro
cess
ing
mu
sic
and
mem
ori
es,
wit
ha
gen
eral
ized
acti
vati
on
incr
ease
bas
edo
nfa
mil
iari
tyan
dau
tob
iogr
aph
ical
sali
ence
of
mu
sic;
(2)
Res
ult
sd
emo
nst
rate
exte
nd
edau
tob
iogr
aph
ical
mem
ory
net
wo
rkth
atin
clu
des
mP
FC
and
late
ral
pre
fro
nta
lan
dp
ost
erio
rco
rtic
esJe
ffri
eset
al.
(200
3)P
ET
stu
dy
inve
stig
atin
gb
rain
net
wo
rks
acti
vate
dd
uri
ng
sin
gin
gan
dsp
eaki
ng
20N
on
mu
sici
ans
Sin
gin
gN
ot
spec
ifie
dd
lPF
C(1
)L
eft
hem
isp
her
em
ore
acti
vate
dw
hen
pro
du
cin
gsp
eech
and
righ
tw
hen
pro
du
cin
gm
usi
c;(2
)Si
ngi
ng
wo
rds
did
no
tac
tiva
te‘‘m
irro
r-im
age’
’st
ruct
ure
sin
righ
th
emis
ph
ere,
sugg
esti
ng
mu
ltip
len
eura
ln
etw
ork
sm
ayb
ein
volv
edin
dif
fere
nt
asp
ects
of
sin
gin
g
TA
BL
E2
Con
tin
ued
216 Journal of Music Therapy
by Argeanu Stefania on July 18, 2014
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TA
BL
E2
Con
tin
ued
Au
tho
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escr
ipti
on
of
stu
dy
Stu
dy
char
acte
rist
ics
Ou
tco
mes
NP
arti
cip
ant
mu
sica
lab
ilit
yT
ype
of
exp
erie
nce
(s)
Mu
sic
char
acte
rist
icN
eura
lst
ruct
ure
(s)
Gen
eral
fin
din
gs
Jerd
eet
al.
(201
1)P
ET
stu
dy
exp
lori
ng
stru
ctu
res
un
der
lyin
gw
ork
ing
mem
ory
for
rhyt
hm
and
mel
od
y
10N
on
mu
sici
ans
Mu
sic
list
enin
g(r
eco
rded
)R
hyt
hm
,M
elo
dy
AC
CR
hyt
hm
and
mel
od
yse
emto
hav
eu
niq
ue
neu
ral
pro
cess
ing
net
-w
ork
sin
earl
yst
ages
of
pro
-ce
ssin
gan
din
hig
her
cogn
itiv
ep
roce
ssin
go
fw
ork
ing
mem
ory
Kle
ber
etal
.(2
007)
fMR
Ist
ud
yex
plo
rin
gn
eura
ln
etw
ork
sin
volv
edin
sin
gin
gan
dim
agin
edsi
ngi
ng
16M
usi
cian
sSi
ngi
ng
No
tsp
ecif
ied
AC
C,
vlP
FC
,A
myg
dal
a
(1)
Bro
adra
nge
ofac
tivat
ion
inxc
par
tlyov
erla
pp
ing
cort
ical
and
subc
ortic
alar
eas
wh
enov
ertly
and
imag
inin
gsi
ngi
ng;
(2)
Imag
ined
sin
gin
gac
tivat
edar
eas
invo
lved
inw
orki
ng
mem
ory;
(3)
Em
otio
np
roce
ssin
gar
eas
show
eden
han
ced
activ
atio
nd
uri
ng
imag
ined
sin
gin
gK
leb
eret
al.
(201
0)fM
RI
stu
dy
exp
lori
ng
effe
cto
fvo
cal
mo
tor
skil
lstr
ain
ing
on
fun
ctio
nal
som
ato
sen
sory
acti
vati
on
49B
oth
mu
sici
ans
and
no
nm
usi
cian
s
Sin
gin
gN
ot
spec
ifie
dd
lPF
C(1
)M
usi
ctr
ain
ing
asso
ciat
edw
ith
incr
ease
dac
tiva
tio
nin
dif
fuse
mo
tor,
sen
sory
,fr
on
tal,
par
ieta
l,su
bco
rtic
al,
and
cere
bel
lar
stru
ctu
res;
(2)
Vo
cal
skil
lstr
ain
ing
corr
elat
edw
ith
incr
ease
dac
tivi
tyin
kin
esth
etic
mo
tor
con
tro
l,se
nso
rim
oto
rgu
idan
ce,
and
imp
lici
tm
oto
rm
emo
ryar
eas
Vol. 50, No. 3, Fall 2013 217
by Argeanu Stefania on July 18, 2014
http://jmt.oxfordjournals.org/
Dow
nloaded from
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tho
rD
escr
ipti
on
of
stu
dy
Stu
dy
char
acte
rist
ics
Ou
tco
mes
NP
arti
cip
ant
mu
sica
lab
ilit
yT
ype
of
exp
erie
nce
(s)
Mu
sic
char
acte
rist
icN
eura
lst
ruct
ure
(s)
Gen
eral
fin
din
gs
Kn
osc
he
etal
.(2
005)
EE
Gan
dM
EG
stu
dy
exp
lori
ng
neu
ral-
bas
edp
erce
pti
on
of
mu
sica
lp
hra
sest
ruct
ure
12M
usi
cian
sM
usi
cli
sten
ing
(rec
ord
ed)
Mel
od
yA
CC
,O
FCT
imin
gan
dto
po
grap
hy
for
pro
cess
ing
mu
sica
lp
hra
ses
sim
ilar
toth
ose
use
dto
pro
cess
pro
sod
icp
hra
seb
ou
nd
arie
sin
spee
chK
oel
sch
etal
.(2
006)
fMR
Ist
ud
yex
plo
rin
gn
eura
lm
ech
anis
ms
invo
lved
inp
roce
ssin
gp
leas
ant
v.u
np
leas
ant
mu
sic
11N
on
mu
sici
ans
Mu
sic
list
enin
g(r
eco
rded
)N
ot
spec
ifie
dA
myg
dal
a(1
)D
iffe
ren
tst
ruct
ure
san
dn
etw
ork
sac
tiva
ted
wh
enp
roce
ssin
gu
np
leas
ant
v.p
leas
ant
mu
sic;
(2)
Act
ivat
ion
sin
crea
sed
ove
rti
me
du
rin
gp
rese
nta
tio
no
fm
usi
c,in
dic
atin
gti
me
effe
cto
fem
oti
on
pro
cess
ing
Ko
elsc
het
al.
(200
8)fM
RI
stu
dy
inve
stig
atin
gn
eura
ln
etw
ork
sin
volv
edin
per
ceiv
edem
oti
on
alva
len
cech
ord
s
20B
oth
mu
sici
ans
and
no
nm
usi
cian
s
Mu
sic
list
enin
g(r
eco
rded
)H
arm
on
yA
myg
dal
a(1
)M
usi
c-sy
nta
ctic
aler
rors
acti
vate
dst
ruct
ure
sre
late
dto
emo
tio
nal
pro
cess
ing,
incl
ud
ing
amyg
dal
a;(2
)Ir
regu
lar
cho
rds
wer
eju
dge
dm
ore
un
ple
asan
tco
mp
ared
to‘‘r
egu
lar’
’ch
ord
end
ing
TA
BL
E2
Con
tin
ued
218 Journal of Music Therapy
by Argeanu Stefania on July 18, 2014
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Au
tho
rD
escr
ipti
on
of
stu
dy
Stu
dy
char
acte
rist
ics
Ou
tco
mes
NP
arti
cip
ant
mu
sica
lab
ilit
yT
ype
of
exp
erie
nce
(s)
Mu
sic
char
acte
rist
icN
eura
lst
ruct
ure
(s)
Gen
eral
fin
din
gs
Lee
etal
.(2
011)
fMR
Ist
ud
yex
plo
rin
gb
rain
regi
on
sim
pli
cati
on
ind
iscr
imin
atio
nm
elo
dic
con
tou
r
12N
on
mu
sici
ans
Mu
sic
list
enin
g(r
eco
rded
)M
elo
dy
AC
C(1
)R
epo
rted
on
3d
isti
nct
cort
ical
area
s,in
clu
din
gA
CC
,w
ho
seac
tivi
tyse
emed
tod
iscr
imin
ate
dif
fere
nt
con
tou
rs;(
2)D
esce
nd
ing
and
asce
nd
ing
par
tso
fth
eco
nto
ur
alte
rb
rain
acti
vati
on
pat
tern
sL
ern
eret
al.
(200
9)fM
RI
stu
dy
exp
lori
ng
dif
fere
nce
sin
neu
tral
net
wo
rks
acti
vate
dw
hen
list
enin
gto
mu
sic
wit
hey
eso
pen
v.cl
ose
d
15N
on
mu
sici
ans
Mu
sic
list
enin
g(r
eco
rded
)N
ot
spec
ifie
dA
myg
dal
a(1
)G
reat
erac
tiva
tio
no
fam
ygd
ala
wh
enli
sten
ing
toem
oti
on
alm
usi
cw
ith
eyes
clo
sed
and
wh
enli
sten
ing
ton
egat
ive
mu
sic;
(2)
Fin
din
gssu
pp
ort
syst
em-b
ased
mo
del
of
per
ceiv
edem
oti
on
alit
yw
ith
amyg
dal
ah
avin
gce
ntr
alro
lein
med
iati
ng
effe
cts
of
con
text
-bas
edp
roce
ssin
gb
yre
cru
itin
g‘‘l
ow
’’(e
.g.,
visc
eral
)an
d‘‘h
igh
’’(e
.g.,
cogn
itiv
e)n
eura
lo
per
atio
ns
TA
BL
E2
Con
tin
ued
Vol. 50, No. 3, Fall 2013 219
by Argeanu Stefania on July 18, 2014
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tho
rD
escr
ipti
on
of
stu
dy
Stu
dy
char
acte
rist
ics
Ou
tco
mes
NP
arti
cip
ant
mu
sica
lab
ilit
yT
ype
of
exp
erie
nce
(s)
Mu
sic
char
acte
rist
icN
eura
lst
ruct
ure
(s)
Gen
eral
fin
din
gs
Lim
b&
Bra
un
(200
8)fM
RI
stu
dy
exp
lori
ng
neu
ral
net
wo
rks
invo
lved
inm
usi
cim
pro
visa
tio
n
6M
usi
cian
sIm
pro
visa
tio
n,
inst
rum
ent
Pla
yN
ot
spec
ifie
dO
FC
,d
lPF
C,
Am
ygd
ala
(1)
Spo
nta
neo
us
imp
rovi
sati
on
char
acte
rize
db
yw
ides
pre
add
eact
ivat
ion
of
lPF
Can
dfo
cal
acti
vati
on
of
mP
FC
,re
gard
less
of
com
ple
xity
,in
dic
atin
gco
gnit
ive
dis
soci
atio
ns
inth
ecr
eati
vep
roce
ss;
(2)
Imp
rovi
sati
on
cau
sed
acti
vati
on
of
cort
ical
sen
sori
mo
tor
area
san
dd
eact
ivat
ion
of
lim
bic
stru
ctu
res
Men
on
&L
evit
in(2
005)
fMR
Ist
ud
yex
plo
rin
gn
eura
ln
etw
ork
sac
tiva
ted
wh
enh
avin
gan
emo
tio
nal
reac
tio
nto
mu
sic
13N
on
mu
sici
ans
Mu
sic
list
enin
g(r
eco
rded
)N
ot
spec
ifie
dO
FC
,A
CC
(1)
Lis
ten
ing
tom
usi
cst
ron
gly
mo
du
late
sac
tivi
tyin
mes
oli
mb
icre
war
d-
pro
cess
ing
net
wo
rk,
incl
ud
ing
the
AC
C,
and
stru
ctu
res
invo
lved
inre
gula
tin
gau
ton
om
ican
dp
hys
iolo
gica
lre
spo
nse
sto
emo
tio
nal
stim
uli
;(2
)M
usi
cli
sten
ing
may
con
nec
taf
fect
ive
and
auto
no
mic
pro
cess
ing
syst
ems
TA
BL
E2
Con
tin
ued
220 Journal of Music Therapy
by Argeanu Stefania on July 18, 2014
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tho
rD
escr
ipti
on
of
stu
dy
Stu
dy
char
acte
rist
ics
Ou
tco
mes
NP
arti
cip
ant
mu
sica
lab
ilit
yT
ype
of
exp
erie
nce
(s)
Mu
sic
char
acte
rist
icN
eura
lst
ruct
ure
(s)
Gen
eral
fin
din
gs
Mit
ters
-ch
ifft
hal
eret
al.
(200
7)
fMR
Ist
ud
yex
plo
rin
gn
eura
ld
iffe
ren
ces
wh
enli
sten
ing
toh
app
yv.
sad
mu
sic
16N
ot
spec
ifie
dM
usi
cli
sten
ing
(rec
ord
ed)
No
tsp
ecif
ied
AC
C,
Am
ygd
ala
(1)
Dif
fere
nt
neu
ral
net
wo
rks
acti
vate
dw
hen
list
enin
gto
hap
py/
sad
/n
eutr
alm
usi
c;(2
)M
usi
c-el
icit
edem
oti
on
pro
cess
ing
may
inte
grat
eve
ntr
alan
dd
ors
alst
riat
um
(fo
rre
war
dex
per
ien
cean
dm
ove
men
t),
AC
C(f
or
atte
nti
on
),an
dm
edia
lte
mp
ora
llo
bes
(fo
rem
oti
on
app
rais
alan
dp
roce
ssin
g);(
3)R
epo
rted
ano
rder
effe
ctin
acti
vati
on
pat
tern
sw
hen
list
enin
gto
hap
py
mu
sic
firs
tv.
sad
mu
sic
Miz
un
o&
Sugi
shit
a(2
007)
fMR
Ist
ud
yin
vest
igat
ing
neu
ral
corr
elat
esto
pro
cess
ing
mo
de-
ind
uce
dem
oti
on
alre
spo
nse
s
18M
usi
cian
sM
usi
cli
sten
ing
(rec
ord
ed)
Har
mo
ny
AC
C(1
)C
erta
inst
ruct
ure
san
dn
etw
ork
sw
ere
acti
vate
dw
hen
list
enin
gto
tria
ds
wit
ha
ton
alst
ruct
ure
than
tho
sew
ith
ou
t;(2
)A
CC
acti
vate
dd
uri
ng
min
or
and
maj
or
mo
de
con
dit
ion
s
TA
BL
E2
Con
tin
ued
Vol. 50, No. 3, Fall 2013 221
by Argeanu Stefania on July 18, 2014
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nloaded from
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tho
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escr
ipti
on
of
stu
dy
Stu
dy
char
acte
rist
ics
Ou
tco
mes
NP
arti
cip
ant
mu
sica
lab
ilit
yT
ype
of
exp
erie
nce
(s)
Mu
sic
char
acte
rist
icN
eura
lst
ruct
ure
(s)
Gen
eral
fin
din
gs
Mu
tsh
ule
ret
al.
(201
0)fM
RI
stu
dy
exp
lori
ng
chan
ges
inb
rain
acti
vity
wh
enh
abit
uat
edto
anaf
fect
ive
mu
sica
lst
imu
li
19N
on
mu
sici
ans
Mu
sic
list
enin
g(r
eco
rded
)H
arm
on
y,te
mp
ovl
PF
C,
Am
ygd
ala
(1)
Rep
ort
edam
ygd
ala-
cort
ical
net
wo
rks
imp
lica
ted
inh
abit
uat
ion
effe
cts
of
emo
tio
nal
exp
erie
nce
s;(2
)D
iffe
ren
tti
me
scal
eso
fh
abit
uat
ion
coex
ist
wit
hp
erce
pti
on
of
mu
sic
Nak
amu
raet
al.
(199
9)P
ET
and
EE
Gst
ud
yex
plo
rin
gn
eura
ln
etw
ork
sac
tiva
ted
wh
enli
sten
ing
tom
usi
c
8N
ot
spec
ifie
dM
usi
cli
sten
ing
(rec
ord
ed)
No
tsp
ecif
ied
AC
CP
assi
vem
usi
cli
sten
ing
cau
sed
incr
ease
acti
vati
on
inp
ost
erio
rtw
o-t
hir
ds
of
scal
p,
sugg
esti
ng
anin
tera
ctio
nb
etw
een
mu
sic
pro
cess
ing
and
cogn
itiv
ep
roce
sses
Oh
nis
hi
etal
.(2
001)
fMR
Ist
ud
yex
plo
rin
gd
iffe
ren
ces
inac
tiva
tio
np
atte
rns
inm
usi
cian
sv.
no
nm
usi
cian
sd
uri
ng
mu
sic
per
cep
tio
n
28B
oth
mu
sici
ans
and
no
nm
usi
cian
s
Mu
sic
list
enin
g(r
eco
rded
)N
ot
spec
ifie
dd
lPF
CR
epo
rted
left
hem
isp
her
ed
om
inan
cew
hen
list
enin
gto
mu
sic
for
mu
sici
ans,
righ
th
emis
ph
ere
do
min
ance
for
no
nm
usi
cian
s,an
dsi
gnif
ican
td
iffe
ren
cein
deg
ree
of
acti
vati
on
ince
rtai
nar
eas
inm
usi
cian
s,in
clu
din
gle
ftd
lPF
C
TA
BL
E2
Con
tin
ued
222 Journal of Music Therapy
by Argeanu Stefania on July 18, 2014
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nloaded from
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escr
ipti
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stu
dy
Stu
dy
char
acte
rist
ics
Ou
tco
mes
NP
arti
cip
ant
mu
sica
lab
ilit
yT
ype
of
exp
erie
nce
(s)
Mu
sic
char
acte
rist
icN
eura
lst
ruct
ure
(s)
Gen
eral
fin
din
gs
Pal
lese
net
al.
(200
9)fM
RI
stu
dy
inve
stig
atin
gch
ange
sin
bra
inac
tiva
tio
nw
hen
cogn
itiv
ely
and
emo
tio
nal
lyp
roce
ssin
gaf
fect
ive
stim
uli
10N
on
mu
sici
ans
Mu
sic
list
enin
g(r
eco
rded
)H
arm
on
yrt
.A
myg
dal
a(1
)N
ote
dd
iffe
ren
ces
inac
tiva
tio
np
atte
rns
du
rin
gm
usi
cli
sten
ing
wit
han
dw
ith
ou
tw
ork
ing
mem
ory
task
;(2
)In
som
ere
gio
ns,
the
grea
ter
the
wo
rkin
gm
emo
ryta
skth
ela
rger
the
dec
reas
e;(3
)T
ask-
rela
ted
dec
reas
esm
ayb
efu
rth
eraf
fect
edb
yem
oti
on
alim
pac
to
fm
usi
cP
alle
sen
etal
.(2
005)
fMR
Ist
ud
yex
plo
rin
gn
eura
ln
etw
ork
sin
volv
edin
pro
cess
ing
emo
tio
nal
resp
on
ses
toch
ord
sin
mu
sici
ans
and
no
nm
usi
cian
s
21B
oth
mu
sici
ans
and
no
nm
usi
cian
s
Mu
sic
list
enin
g(r
eco
rded
)H
arm
on
yA
myg
dal
a(1
)N
eura
lp
roce
ssin
gin
emo
tio
n-r
elat
edb
rain
area
sca
nb
eac
tiva
ted
by
sin
gle
cho
rds;
(2)
Em
oti
on
pro
cess
ing
was
enh
ance
din
abse
nce
of
cogn
itiv
ere
qu
irem
ents
;(3
)M
usi
cian
san
dn
on
mu
sici
ans
do
no
td
iffe
rin
neu
ral
pro
cess
ing
of
sin
gle
cho
rds
TA
BL
E2
Con
tin
ued
Vol. 50, No. 3, Fall 2013 223
by Argeanu Stefania on July 18, 2014
http://jmt.oxfordjournals.org/
Dow
nloaded from
Au
tho
rD
escr
ipti
on
of
stu
dy
Stu
dy
char
acte
rist
ics
Ou
tco
mes
NP
arti
cip
ant
mu
sica
lab
ilit
yT
ype
of
exp
erie
nce
(s)
Mu
sic
char
acte
rist
icN
eura
lst
ruct
ure
(s)
Gen
eral
fin
din
gs
Pal
lese
net
al.
(201
0)fM
RI
stu
dy
exp
lori
ng
dif
fere
nce
sb
etw
een
mu
sici
ans
and
no
nm
usi
cian
sin
wo
rkin
gm
emo
ryo
fm
usi
cal
sou
nd
task
21B
oth
mu
sici
ans
and
no
nm
usi
cian
s
Mu
sic
list
enin
g(r
eco
rded
)H
arm
on
yA
CC
,L
PF
C(1
)M
usi
cian
sp
erfo
rmed
bet
ter
on
cogn
itiv
eta
sks;
(2)
Mu
sici
ans
had
incr
ease
dac
tiva
tio
nin
area
sim
plic
ated
inat
ten
tio
nan
dco
gnit
ive
con
tro
l,es
pec
ially
inri
ght
hem
isp
her
e;(3
)R
elat
ion
-sh
ipb
etw
een
task
per
form
ance
and
mag
nit
ud
eo
fre
spo
nse
mo
rep
osi
tive
inm
usi
cian
sP
erry
etal
.(1
999)
PE
Tsc
anin
vest
igat
ing
neu
ral
acti
vati
on
pat
tern
sas
soci
ated
wit
hsi
ngi
ng
13N
on
mu
sici
ans
Mu
sic
list
enin
g(r
eco
rded
),Si
ngi
ng
No
tsp
ecif
ied
AC
C(1
)R
epo
rted
on
aco
mp
lex,
dis
trib
ute
dn
etw
ork
of
cort
ical
acti
vati
on
pat
tern
sd
uri
ng
sin
gin
gp
rod
uct
ion
;(2)
Sim
ple
,ch
ant-l
ike
sin
gin
gac
tiva
tes
sim
ilar
net
wo
rks
assp
eech
wit
hso
me
hem
isp
her
icd
iffe
ren
ces
inm
oto
ran
dau
dit
ory
regi
on
sR
uiz
etal
.(2
009)
EE
Gst
ud
yex
plo
rin
gn
eura
lco
rrel
ates
asso
ciat
edw
ith
exec
uti
veco
ntr
ol
du
rin
gp
ian
op
layi
ng
19M
usi
cian
sIn
stru
men
tP
lay
No
tsp
ecif
ied
AC
C(1
)E
rro
rm
on
ito
rin
gn
etw
ork
s,ge
ner
ated
by
AC
C,
pro
cess
eser
rors
70m
sp
rio
rto
them
;(2
)R
epo
rted
on
dif
fere
nt
con
trib
u-
tio
ns
of
aud
ito
ryan
dso
mat
o-
sen
sory
info
rmat
ion
toer
ror
mo
nit
ori
ng;
(3)
Au
dit
ory
info
rmat
ion
mo
du
late
der
ror
pro
cess
ing
po
st-e
xecu
tio
n
TA
BL
E2
Con
tin
ued
224 Journal of Music Therapy
by Argeanu Stefania on July 18, 2014
http://jmt.oxfordjournals.org/
Dow
nloaded from
Au
tho
rD
escr
ipti
on
of
stu
dy
Stu
dy
char
acte
rist
ics
Ou
tco
mes
NP
arti
cip
ant
mu
sica
lab
ilit
yT
ype
of
exp
erie
nce
(s)
Mu
sic
char
acte
rist
icN
eura
lst
ruct
ure
(s)
Gen
eral
fin
din
gs
Sato
het
al.
(200
1)P
ET
scan
inve
stig
atin
gd
iffe
ren
ces
mu
sica
lm
od
eh
aso
nn
eura
lac
tiva
tio
np
atte
rns
9M
usi
cian
sM
usi
cli
sten
ing
(rec
ord
ed)
Har
mo
ny
OF
C(1
)A
tten
din
gto
mel
od
iclin
ere
-cr
uit
edar
eas
rela
ted
tose
lect
ive
atte
nti
on
and
ton
al-v
erb
alas
soci
atio
ns
(e.g
.,O
FC);
(2)
Att
end
ing
toh
arm
on
yac
tiva
ted
regi
on
sre
late
dto
emo
tio
nal
pro
cess
ing
and
mem
ory
Sud
aet
al.
(200
8)O
Tsy
stem
stu
dy
exp
lori
ng
effe
cto
fM
oza
rt’s
mu
sic
on
spat
ial-r
easo
nin
gab
ilit
y
10N
ot
spec
ifie
dM
usi
cli
sten
ing
(rec
ord
ed)
No
tsp
ecif
ied
dlP
FC
Exp
osu
reto
Moz
art’
sm
usi
cen
han
ced
per
form
ance
onin
telli
gen
cete
sts
and
reve
aled
diff
eren
tac
tivat
ion
pat
tern
sin
area
sim
plic
ated
insp
atia
l-te
mp
oral
reas
onin
g(e
.g.,
dlP
FC)
Th
aut
etal
.(2
009)
PE
Tsc
anex
plo
rin
gac
tiva
tio
np
atte
rns
asso
ciat
edw
ith
rhyt
hm
icau
dit
ory
mo
tor
syn
chro
niz
atio
n
9N
ot
spec
ifie
dM
usi
cli
sten
ing
(rec
ord
ed)
Rh
yth
md
lPF
C(1
)R
epo
rted
on
stru
ctu
res
invo
lved
ind
iffe
ren
tas
pec
tso
fm
oto
rsy
nch
ron
izat
ion
;(2
)F
ind
ings
sugg
est
dis
tin
ct,
fun
ctio
nal
cort
ico
-cer
ebel
lar
circ
uit
sse
rve
dif
fere
nt
asp
ects
of
rhyt
hm
icsy
nch
ron
izat
ion
,co
nsc
iou
san
dsu
bco
nsc
iou
sre
spo
nse
tote
mp
ora
lst
ruct
ure
,an
dco
nsc
iou
sm
on
ito
rin
go
frh
yth
mic
pat
tern
trac
kin
g
TA
BL
E2
Con
tin
ued
Vol. 50, No. 3, Fall 2013 225
by Argeanu Stefania on July 18, 2014
http://jmt.oxfordjournals.org/
Dow
nloaded from
Au
tho
rD
escr
ipti
on
of
stu
dy
Stu
dy
char
acte
rist
ics
Ou
tco
mes
NP
arti
cip
ant
mu
sica
lab
ilit
yT
ype
of
exp
erie
nce
(s)
Mu
sic
char
acte
rist
icN
eura
lst
ruct
ure
(s)
Gen
eral
fin
din
gs
Vo
gtet
al.
(200
7)fM
RI
stu
dy
exp
lori
ng
effe
cto
fp
ract
icin
go
nn
eura
lac
tiva
tio
np
atte
rns
32B
oth
mu
sici
ans
and
no
nm
usi
cian
s
Inst
rum
ent
Pla
yN
ot
spec
ifie
dd
lPF
C(1
)M
irro
rn
euro
nsy
stem
mo
rest
ron
gly
acti
vate
dd
uri
ng
ob
ser-
vati
on
of
no
n-p
ract
iced
item
s;(2
)L
eft
dlP
FCse
lect
ivel
yin
volv
edd
uri
ng
ob
serv
atio
nan
dm
oto
rp
rep
of
no
n-
pra
ctic
edch
ord
sZ
arat
e&
Zat
orr
e(2
008)
fMR
Ist
ud
yex
plo
rin
gd
iffe
ren
ces
inau
dio
-vo
cal
inte
grat
ion
inm
usi
cian
sv.
no
nm
usi
cian
s
24B
oth
mu
sici
ans
and
no
nm
usi
cian
s
Sin
gin
gP
itch
AC
C(1
)Si
nge
rsm
ore
accu
rate
than
no
n-s
inge
rsin
sin
gin
g(w
ith
sam
en
eura
ln
etw
ork
sre
cru
ited
),at
ign
ori
ng
shif
tin
gfe
edb
ack
(wit
hd
iffe
ren
tn
eura
ln
etw
ork
s),
and
sam
eat
com
pen
sate
task
(wit
hd
iffe
ren
tn
eura
ln
etw
ork
s);
(2)
Au
tho
rsp
rop
ose
two
neu
ral
sub
stra
tes
for
aud
io-v
oca
lin
tegr
atio
nZ
arat
eet
al.
(201
0)fM
RI
stu
dy
inve
stig
atin
gn
eura
ln
etw
ork
sin
volv
edin
volu
nta
ryv.
invo
lun
tary
pit
chre
gula
tio
n
9M
usi
cian
sSi
ngi
ng
Pit
chA
CC
(1)
Sin
gers
less
able
toig
no
rem
ino
rp
itch
-sh
ift
dif
fere
nce
sth
anm
ore
no
tice
able
on
es;(
2)C
om
pen
sate
task
recr
uit
edfu
nct
ion
ally
-co
nn
ecte
dn
eura
ln
etw
ork
,in
clu
din
gA
CC
;(3
)L
arge
rvo
calc
orr
ecti
on
sap
pea
rto
be
un
der
cort
ical
con
tro
l
TA
BL
E2
Con
tin
ued
226 Journal of Music Therapy
by Argeanu Stefania on July 18, 2014
http://jmt.oxfordjournals.org/
Dow
nloaded from
TA
BL
E3
Sum
mar
yof
Mai
nFi
ndi
ngs
and
Cli
nic
alC
onsi
dera
tion
s
Neu
ral
stru
ctu
reSu
mm
ary
of
fin
din
gsC
lin
ical
con
sid
erat
ion
s
Am
ygd
ala
Act
ivat
ion
:N
occ
urr
edw
hen
list
enin
gto
min
or/
dis
son
ant/
neg
ativ
e/u
np
leas
ant
mu
sic,
du
rin
gan
un
exp
ecte
dev
ent,
du
rin
gm
usi
cli
sten
ing
inge
ner
alN
cou
ldb
em
od
ula
ted
by
asi
ngl
ech
ord
chan
geN
incr
ease
dw
hen
list
enin
gto
mu
sic
wit
hey
escl
ose
d,
wh
enp
airi
ng
mu
sic
and
visu
alst
imu
liD
eact
ivat
ion
:N
occ
urr
edd
uri
ng
mu
sic
imp
rovi
sati
on
,w
hen
list
enin
gto
ple
asan
tm
usi
cR
igh
tam
ygd
ala:
Nwas
recr
uit
edd
uri
ng
‘‘sad
’’m
usi
c,im
plic
ated
inea
rly
resp
on
ses
toch
ord
vio
lati
on
s,ex
hib
its
cho
rd-d
epen
den
tre
spo
nse
sN
was
acti
vate
dm
ore
stro
ngl
yd
uri
ng
aud
iovi
sual
con
dit
ion
Nac
tivi
tyin
crea
sed
wit
hex
po
sure
ove
rti
me
Lef
tam
ygd
ala:
Nac
tivi
tyin
crea
sed
wh
enlis
ten
ing
tom
usi
cw
ith
ah
igh
ern
egat
ive
vale
nce
Lo
ng-
term
hab
itu
atio
nef
fect
was
no
ted
To
faci
lita
teE
R:
Nlis
ten
tom
usi
cth
ecl
ien
tco
nsi
der
sp
leas
ant
or
hap
py
Nin
corp
ora
tem
usi
cim
pro
visa
tio
nN
refr
ain
fro
mh
avin
gsu
dd
enan
du
nex
pec
ted
mu
sica
lev
ents
(e.g
.,ab
rup
tch
ord
chan
ges,
sud
den
dyn
amic
chan
ges,
etc.
,)N
con
sid
erth
eef
fect
of
pai
rin
gm
usi
cw
ith
avi
sual
stim
ulu
sN
do
no
tli
sten
tom
usi
cw
ith
eyes
clo
sed
An
teri
or
Cin
gula
teC
ort
ex(A
CC
)A
ctiv
atio
n:
No
ccu
rred
du
rin
gvo
lun
tary
pit
chco
rrec
tio
nan
dm
usi
cd
iscr
imin
atio
nta
sks
No
ccu
rred
wh
enli
sten
ing
toch
ord
vio
lati
on
s,w
hen
list
enin
gto
fam
ilia
r/fa
vora
ble
/en
erge
tic
mu
sic,
du
rin
go
vert
and
imag
ined
sin
gin
gNo
ccu
rred
wh
enlis
ten
ing
tod
isso
nan
tch
ord
s(m
usi
cian
so
nly
)N
incr
ease
dd
uri
ng
sin
gin
gan
dm
usi
cli
sten
ing
task
sNw
asm
ore
pro
no
un
ced
inm
usi
cian
sco
mp
ared
ton
on
mu
sici
ans
Nin
crea
sed
inth
ose
face
dw
ith
am
ism
atch
bet
wee
nin
div
idu
alan
dgr
ou
po
pin
ion
,is
corr
elat
edw
ith
son
gli
kab
ilit
y
To
faci
lita
teE
R:
Nli
sten
tom
usi
ccl
ien
tco
nsi
der
sfa
mil
iar
and
pre
ferr
edN
enga
gecl
ien
tin
acti
vem
usi
cm
akin
g,su
chas
sin
gin
go
rm
usi
cim
pro
visa
tio
nNe
nga
gecl
ien
tin
atte
nd
ing
tosp
ecif
icm
usi
calc
ues
,su
chas
ph
rase
so
rm
elo
dic
lin
es
Vol. 50, No. 3, Fall 2013 227
by Argeanu Stefania on July 18, 2014
http://jmt.oxfordjournals.org/
Dow
nloaded from
Neu
ral
stru
ctu
reSu
mm
ary
of
fin
din
gsC
lin
ical
con
sid
erat
ion
s
Nm
ayb
em
od
e-d
epen
den
t,i.e
.,p
atte
rns
chan
geb
ased
on
mo
des
(res
ult
sm
ixed
)N
sho
wed
dif
fere
nt
pat
tern
sw
hen
per
ceiv
ing
asce
nd
ing
and
des
cen
din
gm
elo
dic
con
tou
rsth
anw
hen
pro
cess
ing
mu
sica
lp
hra
seb
ou
nd
arie
sN
incr
ease
din
ven
tral
AC
Cve
rsu
sd
ors
alA
CC
du
rin
gm
usi
cli
sten
ing
Rig
ht
AC
C:
Nw
asac
tiva
ted
du
rin
gm
usi
cim
pro
visa
tio
nta
skL
eft
AC
CN
was
acti
vate
dd
uri
ng
rhyt
hm
-an
dm
elo
dy-
bas
edw
ork
ing
mem
ory
task
s,w
hen
list
enin
gto
favo
rab
le/
ener
geti
cm
usi
cN
was
acti
vate
dm
ore
stro
ngl
yfo
rrh
yth
mO
rbit
ofr
on
tal
Co
rtex
(OF
C)
Act
ivat
ion
:N
occ
urr
edw
hen
atte
nd
ing
toa
sin
gle
mu
sica
lco
mp
on
ent
(e.g
.,m
elo
dy)
,d
etec
tin
gp
hra
seb
ou
nd
arie
s,p
roce
ssin
gty
pes
of
cho
rds,
resp
on
din
gto
syn
tact
ical
irre
gula
riti
esN
occ
urr
edw
hen
mu
sic
list
enin
gre
gard
less
of
pre
fere
nce
/va
len
ce(r
esu
lts
mix
ed)
Nw
asst
ron
ger
du
rin
gm
usi
cli
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Levitin, 2005; Nakamura et al., 1999) and it was more pronouncedin musicians compared to nonmusicians (Pallesen et al., 2010;Zarate & Zatorre, 2008). ACC activation was correlated withoverall song likability (Berns & Moore, 2012) and increased inindividuals who disliked a song, yet were sensitive to the song’spopularity; the researchers attributed this ACC activation to amismatch between individual and societal opinion (Berns, Capra,Moore, & Noussair, 2010). Reports of activation patterns based onmusical modes are mixed, with studies reporting increasedactivation when listening to happy music or music that elicitschills (Blood & Zatorre, 2001; Mitterschiffthaler et al., 2007),when listening to music in a minor mode as compared to a majormode (Green et al., 2008), or when listening to music in either amajor or minor mode (Mizuno & Sugishita, 2007). Differentactivation patterns were reported when listeners perceivedascending and descending melodic contours (Lee, Janata, Frost,Hanke, & Granger, 2011) and when processing musical phraseboundaries (Knosche et al., 2005). In addition, the ACC wasactivated during both overt and imagined singing (Kleber,Birbaumer, Veit, Trevorrow, & Lotze, 2007) and during singingimprovisation (Brown, Martinez, & Parsons, 2006). The left ACCwas activated during rhythm- and melody-based working memorytasks, though more strongly for rhythm (Jerde, Childs, Handy,Nagode, & Pardo, 2011) and when listening to favorable orenergetic music (Brown, Martinez, & Parsons, 2004), whereas theright ACC was activated during a free generation task (deManzano & Ullen, 2012). Finally, there was increased activity inthe ventral ACC when listening to music compared to the dorsalACC (Green et al., 2008). To summarize, ACC activation occurredwhen listening to preferred music, when engaged in an activemusic-making experience, and when attending to specificcharacteristics of the music stimulus.
Orbitofrontal cortex (OFC). The OFC was activated whenlistening to preferred music (Menon & Levitin, 2005) and in aseparate study was more strongly activated when listening to musicas compared with listening to speech (Callan et al., 2006). OFCactivation related to emotional valence were mixed, with studiesreporting that listening to unpleasant or negative music activatedthe OFC (Flores-Gutierrez et al., 2007) as well as listening topleasant music (Blood & Zatorre, 2001). Several studies reported
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activation patterns related to attending to musical characteristics.The OFC was activated when attending to a single musicalcomponent, such as a melodic line (Satoh, Takeda, Nagata,Hatazawa, & Kuzuhara, 2001), when detecting phrase boundaries(Knosche et al., 2005), when processing types of chords (Fujisawa& Cook, 2011), and when responding to syntactical irregularities(James et al., 2008). OFC activation is reported to be related tosong likability (Berns et al., 2010; Berns & Moore, 2012), withincreased activation for nonliked songs (Berns & Moore, 2012).The right OFC may be implicated as a link between affective andcognitive neural systems that are engaged during music listening(Menon & Levitin, 2005). Its activation is negatively correlatedwith chord instability (e.g., dissonant chords) (Fujisawa & Cook,2011) and it showed increased activation compared to the leftOFC when processing emotionally-salient music (e.g., eitherunpleasant/negative music or pleasant music) (Blood & Zatorre,2001; Flores-Gutierrez et al., 2007). To summarize, OFC activationoccurred when listening to preferred music, when listening tofamiliar music, and when attending to specific characteristics ofthe music stimulus.
Lateral prefrontal cortex (PFC). The majority of studies thatreported on prefrontal cortex activity focused on either thedorsolateral prefrontal cortex (dlPFC) or the ventrolateralprefrontal cortex (vlPFC). Those that reported on the lateralPFC noted enhanced activity during a music-based workingmemory task (Pallesen et al., 2010), stronger activation inresponse to negative music paired with visual stimuli, but notwithout visual stimuli (Eldar et al., 2007), and activation that wascorrelated with song likability (Berns et al., 2010).
Dorsolateral prefrontal cortex (dlPFC). The dlPFC was activat-ed during the observation and motor preparation of nonpracticedchords (Vogt et al., 2007), when listening to Mozart music (Suda,Morimoto, Obata, Koizumi, & Maki, 2008), and when listening tomusic with eyes open, but not closed (Lerner et al., 2009).Increased activation was noted when synchronizing to tempochanges during a motor-rhythm synchronization task (Thaut etal., 2009) and mixed results were reported when exploring dlPFCactivation during a music improvisation task, which either causedactivation of the dlPFC (Bengtsson, Csıkszentmihalyi, & Ullen,2007) or deactivation (Limb & Braun, 2008). The impact of music
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training on dlPFC activation also had mixed results, with onestudy noting that musicians had stronger dlPFC activation (Ohnisiet al., 2001) and another reporting that college-aged music majorshad stronger dlPFC activation than laypersons, but not profes-sional musicians (Kleber, Veit, Birbaumer, Gruzelier, & Lotze,2010). The right dlPFC was activated during singing (Jeffries,Fritz, & Braun, 2003), and during music discrimination tasks(Brown & Martinez, 2007; Hugdahl et al., 1999). The left dlPFCwas activated during a free generation task, i.e., a musicimprovisation task (de Manzano & Ullen, 2012).
Ventrolateral prefrontal cortex (vlPFC). The vlPFC was activat-ed when listening to musical triads (Mutshuler et al., 2010) and itmay be implicated in processing syntactical violations in music(Janata, 2009). In addition, vlPFC activation occurred during animagined singing task, but not when overtly singing, perhapsreflecting its role in emotional recall (Kleber et al., 2007).
To summarize, lateral PFC activation occurred when listeningto preferred or familiar music, when engaged in an active music-making experience, and when attending to specific characteristicsof the music stimulus.
Discussion
The purpose of this exploratory review was to examine theeffects of music on neural structures implicated in emotionregulation and to create preliminary clinical considerations basedon this synthesis. Although the impact of music on emotionprocessing has long been of interest, this is the first attempt tosystematically review and synthesize research specifically investi-gating the neural effect of music on emotion regulation. Resultsindicated that there are certain musical characteristics andexperiences that produce desired neural activation patternsimplicated in emotion regulation. From a clinical perspective,understanding this link between musical elements and the targetgoal—in this case, emotion regulation—helps the music therapistmake informed decisions about the Therapeutic Function ofMusic (TFM). Hanson-Abromeit (2013) defines the TFM as ‘‘thedirect relationship between the treatment goal and the explicitcharacteristics of the musical elements, informed by a theoreticalframework and/or philosophical paradigm in the context of aclient’’ (p. 130). In other words, having an explicit understanding
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of why and how music affects a desired change informs theintentional, therapeutic use of music in clinical practice. For thepurposes of this study, it involves having an explicit understandingof what musical characteristics and experiences impact a person’sability to regulate his or her emotions and how.
Emotion regulation is characterized by increased activation inthe cognitive control and monitoring areas—the anterior cingulatecortex (ACC), orbitofrontal cortex (OFC), and lateral prefrontalcortex (PFC)—which leads to decreased activation of the amygdala(Gyurak et al., 2011; Ochsner & Gross, 2005; McRae et al., 2010;Rempel-Clower, 2007). Overall, results indicated that there arecertain music characteristics and music experiences that producesuch activation patterns. For example, listening to music consideredpleasant or happy activated the ACC (Blood & Zatorre, 2001; Brownet al., 2004; Mitterschiffthaler et al., 2007), the OFC (Berns & Moore,2012; Berns et al., 2010; Berns & Moore, 2012; Blood & Zatorre,2001; Flores-Gutierrez et al., 2007), and decreased activation in theamygdala (Blood & Zatorre, 2001; Koelsch et al., 2006). Similaractivation patterns were found when listening to music, regardless ofemotional meaning for the listener (Callan et al., 2006; Menon &Levitin, 2005; Mizuno & Sugishita, 2007; Nakamura et al., 1999) andwhen singing (Kleber et al., 2007; Perry et al., 1999). These patternswere also reported when musically-trained individuals were impro-vising (Bengtsson et al., 2007; Brown et al., 2006; Limb & Braun,2008). It should be noted, though, that one study reporteddeactivation in the dlPFC during improvisation, which the authorsattributed to its role in providing a framework for goal-directedbehaviors, a role not needed when improvising (Limb & Braun,2008). Although it is premature to make direct clinically-basedgeneralizations until future research is conducted, these resultsprovide preliminary evidence supporting the use of music listening,singing, and improvisation to facilitate emotion regulation.
In addition to desired neural activation patterns for emotionregulation, there can also be undesired activation patterns.Results of this review indicated certain musical characteristicsand experiences that produced increased activation patterns inthe amygdala, namely listening to music that was minor,dissonant, negative, or unpleasant (Koelsch et al., 2006; Lerneret al., 2009; Mitterschiffthaler et al., 2007; Pallesen et al., 2005)and changing chords (Pallesen et al., 2009), especially in an
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unexpected way, as with chord violations (James et al., 2008;Koelsch et al., 2008). In addition, listening to music with eyes closedincreased the amygdala’s activity (Lerner et al., 2009) as didproviding a more complex sensory stimulus by pairing music with avisual stimulus (Baumgartner et al., 2006; Dyck et al., 2011; Eldar etal., 2007). A primary function of the amygdala is to assessemotionally-salient sensory information. If the sensory informationis determined to be unthreatening, amygdala activity decreases.The findings from this review are congruent with this primaryfunction, as they indicate that the amygdala is processing andassessing music stimuli that is new, (e.g., chord changes),unexpected (e.g., chord violations), or complex (e.g., simultaneousaural and visual input). Thus from a clinical perspective, researchalso indicates characteristics of music and music experiences thatshould be avoided when trying to help a person regulate and shifthis or her physiological and emotional state. Based on this review,these include avoiding music that is minor, dissonant, orconsidered unpleasant, as well as avoiding unexpected musicalevents (e.g., sudden dynamic changes), frequent chord changes,and listening to music with eyes closed. It should be noted that thisprocess implies musically-facilitating a shift to a comfortable state ofarousal, back to homeostasis. There may be times when it isclinically indicated to maintain or increase amygdala activation,thus maintaining or intensifying the emotional experience. Thismay involve the incorporation of music and music experiences thatare considered unpleasant, with frequent chord changes andunexpected musical events. Future research and systematic reviewsare recommended to explore and address this phenomenon.
The roles of the cognitive control and monitoring areas aremore complex than that of the amygdala; therefore, theiractivation patterns associated with music characteristics andexperiences are less straightforward. Results indicated that, forthe most part, all the music experiences produced diffuseactivation in those three areas. However, unlike findings relatedto amygdala functioning, they provided no indication of the typesof music and experiences to use or avoid when facilitatingemotion regulation. One possible explanation for this lack ofclarity is that those structures are implicated in other tasks. Forexample, the ACC is thought to be involved in processinguncertainty and conflict (Brown & Martinez, 2007; Mizuno &
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Sugishita, 2007; Pallesen et al., 2010), error monitoring (Ruiz etal., 2009), and response inhibition and selection (de Manzano &Ullen, 2012). Given that music is a complex stimulus, it can behypothesized that once it has been determined that the musicstimulus is not a threat—i.e., the emotion-processing aspect thatresults in decreasing amygdala activity—these neural structuresattend to processing other aspects of the music stimulus.
Another possible explanation relates to their involvement inanother emotion regulation-related process, attention. More specif-ically, this refers to their possible involvement in processing music-influenced changes in attention that facilitate emotion regulation.As indicated previously, a common process involved in emotionregulation is the use of strategies that can create a new emotionalresponse or change a current one (Gyurak et al., 2011; McRae et al.,2010; Ochsner & Gross, 2005). Successful strategies either changehow we interpret the meaning of a situation or alter how we attendto a situation (McRae et al., 2010). All three cognitive control areasexplored in this review are thought to be implicated in networksinvolved in attention, a role reflected in the results of several studiesincluded in this review (de Manzano & Ullen, 2012; Jerde et al.,2011; Knosche et al., 2005; Satoh et al., 2001). One commondenominator in those studies was that the participants wereinstructed to focus on a specific cognitive task related to the musicstimulus, such as processing the melodic phrase structure (Knoscheet al., 2005) or attending to the melodic line and harmonic changes(Satoh et al., 2001). In other words, the participants were instructedto attend to the music stimulus in a different, more analytical way.From a clinical standpoint, one emotion regulation strategy theseresults suggest is to instruct the client to attend to a specificcharacteristic of the music (e.g., the melodic line, a musical cue,etc.), thus removing their focus from the emotional event. Thisstrategy is analogous to using music to reduce pain perception, acommon phenomenon reported in the medical literature (Fra-tianne et al., 2001; Tan, Yowler, Super, & Fratianne, 2010), andsupports the use of effortful, explicit strategies when facilitatingemotion regulation (Gyurak et al., 2011).
Limitations
One major limitation of this review is the lack of interventionreporting in the included studies, specifically that related to the
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music stimulus used. There has been a call in the literature toinclude clear and detailed explanations of the interventions usedand why that intervention was selected (Robb, Burns, &Carpenter, 2011). However, many of the studies included in thisreview were not specific as to the type of music used, the names ofmusical pieces, the structure and characteristics of the musicstimulus, whether the music was original or improvised, or theinstrument(s) that were used. This lack of explicit interventionreporting is problematic for two reasons. One, it makes it difficultto understand the mechanisms underlying the neural activations,thus decreasing the reliability of the results. In other words, itmakes it difficult to explore and understand what characteristicsof the music stimulus are responsible for the desired activationpatterns. Two, without a clear understanding of the musicstimulus used, it is difficult to replicate the stimulus in futurestudies, as well as in clinical practice.
There are other limitations in this review that affect thegeneralizability of the findings. First, as the inclusion criteriastipulated that study participants be typically-developing humans,studies included in this review reflect a nonclinical populationand findings may not easily generalize to clinical populations.Second, the majority of the studies utilized Western music as thestimulus (Table 1), making it unclear how these findings mightgeneralize from a multicultural perspective. As such, the resultsand clinical implications of this review should be consideredpreliminary and should be interpreted with caution. Futureresearch can explore the effect music has on emotion regulationin clinical populations and through a multicultural perspective.Furthermore, clearer intervention reporting is needed in futureresearch to inform the translation of research to clinical practice.
Conclusions
This systematic review indicates that music experiences mayhave an impact on emotion regulation. Furthermore, the resultsprovide preliminary guidelines for music characteristics andspecific strategies that might assist in the emotion regulationprocess when using music as an intervention strategy. Theseguidelines include using music considered happy and pleasant,with predictable, consonant harmonies. In addition, the musictherapy clinician should be aware of multimodal implications,
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such as asking a client to close his or her eyes or pairing musicwith a visual stimuli, as these might heighten the emotionalresponse. Music listening, singing, and improvisation may assist infacilitating emotion regulation, as might instructing the client toattend to another task related to the music stimulus, such asfocusing on noticing harmonic changes. As noted, these arepreliminary guidelines and more research is needed. Futureresearch can further explore the Therapeutic Function of Music,teasing apart the different elements of music (e.g., pitch, rhythm,harmony, melody, etc.) and studying their role, if any, on emotionregulation (Hanson-Abromeit, in press). Following that, clinicalstudies are needed to move this exploration from the theoreticalrealm to functional, clinical use. This review provides preliminarysupport for the use of music to facilitate emotion regulation, butstudies are also needed to explore the clinical efficacy of musicinterventions on emotion regulation.
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