Piano lessons may improve cognition among people undergoing chemotherapy
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Music may help improve cognitive function among people undergoing chemotherapy, according to results of a preliminary study.
Jennifer A. Bugos, PhD, associate professor of music education at University of South Florida’s College of Design, Art & Performance, collaborated with breast surgical oncologist Melissa Mallory, MD, a breast surgical oncologist at Moffitt Cancer Center, to assess the effects of private and group piano lessons on cognition in patients undergoing chemotherapy.
The protocol — called Keys to Staying Sharp — includes more patterns and repetition than traditional piano lessons.
Outcomes from 15 individuals who participated in the protocol showed improvements in executive function after group piano lessons. Participants also self-reported finding learning the piano to be enjoyable and relaxing, according to a press release.
“It’s important for people to understand that getting involved in music isn’t something you have to do when you’re a child. You can start later in life and experience benefits,” Bugos told Healio. “There are opportunities to learn a musical instrument throughout your lifespan, and to learn a new skill that is challenging. These opportunities foster strategies for our brains to readapt and potentially contribute to our cognition as we age.”
Healio spoke with Bugos about the motivation for the study, her reaction to the findings and their potential impact, and next steps in research.
Healio: What cognitive issues are associated with treatment for cancer?
Bugos: Chemotherapy-related cognitive impairment affects many people undergoing treatment for cancer. These treatments could include chemotherapy, surgery or a combination of the two. These patients may experience cognitive impairment in terms of attention, executive function, motivation and interest, as well as in psychosocial function and well-being.
Healio: What motivated you to study the effects of music on cognitive function in the context of cancer or other conditions?
Bugos: For my doctoral work at USF, I conducted a study sponsored by the McKnight Brain Research Foundation that looked at the effects of piano training on healthy aging. I also have a background in gerontology and previously was a secondary caregiver to my grandparents. I would visit them every afternoon. I noticed that my grandmother, who had Alzheimer’s disease, would start tapping her toes when I played piano for her. My grandfather, who had sundown syndrome and could barely utter a complete sentence, started singing the “Battle Hymn of the Republic.” So, I started to see these remarkable effects music could have.
Healio: What does your piano training protocol entail?
Bugos: Our piano program is a bit more rigorous than most piano lessons. The Keys to Staying Sharp program involves lots of training and technique. It focuses on fine motor skills accompanied by Mayo Clinic finger exercises to warm up the hands. On top of that, we include opportunities for playing standard piano repertoire, but we also teach technique in terms of scale performances, music theory and reading music. It’s a very all-encompassing program. It does require that participants practice a half-hour a day to keep up with all of the tasks involved in the program. They have these classes once a week for 9 weeks.
Healio: What benefits did you see from group and individual piano training provided through Keys to Staying Sharp?
Bugos: This was a preliminary study but, so far, we are seeing an increase in attention and focus. We also have seen increases in the participants’ executive functions. We also looked at their well-being through a series of measures related to mood and quality of life, as well as their self-efficacy. We are noticing improvements in self-efficacy — particularly music-related self-efficacy, which is perhaps not a surprise.
Both individual and group piano lessons have demonstrated some benefit but, in this case, our preliminary data show that the group-based program is yielding significant improvements in cognition. This is over and above what we would see in an individual lesson.
Healio: You are also exploring the possibility that music could have benefits for individuals with COVID-19. Can you elaborate on this?
Bugos: We are actively conducting that study right now and we are recruiting more participants. In our pilot, with the very small sample we have, we’ve noticed significant increases in participants’ respiration rates. In this study we are providing breath control through a novel woodwind instrument, the jSax (Nuvo) — a small, lightweight instrument similar to a saxophone that is used to instruct children. We also are looking at performance in several different areas of cognitive function that have been associated with impairment in cases of COVID-19. One symptom people with COVID-19 or long COVID often report is a feeling of “brain fog.” Offering these types of group-based classes can engage these individuals in fine-motor temporal skills. The use of note reading also seems to foster cognitive performance benefits. We’re also looking more at the mechanisms that may contribute to these benefits. We’ve seen more improvement with activities that include fine motor control. We think that may be due to the fine-motor mechanisms involved in accessing different parts of the brain, like the cerebellum.
Healio: Could the improvements in respiration seen in this intervention be applied to other conditions beyond COVID-19?
Bugos: This is still preliminary, but we did see a significant difference in respiration rates and air volume using spirometer readings. Being able to breathe effectively is also a huge issue for those with chronic obstructive pulmonary disease and those with lung cancer. We’ve also had many people in our studies who have had asthma, and they reported that this has been helping them with some of the symptoms related to that.
Healio: What are your next steps in research?
Bugos: We are offering these interventions to larger clinical populations and trying to see which interventions will work best for different populations. Our laboratory — the Cognition and Coordination Across the Lifespan in Music (CALM) — has been fortunate to receive sponsorship from the National Endowment for the Arts, and we look forward to developing interventions to target various aspects of cognition and memory while fostering music skills.
Reference:
- University of South Florida. How music can help boost cognition in cancer patients and COVID-19 survivors (press release). Available at: https://www.usf.edu/news/2024/how-music-can-help-boost-cognition-in-cancer-patients-and-covid-survivors.aspx. Published Oct. 2, 2024. Accessed Nov. 14, 2024.
For more information:
Jennifer A. Bugos, PhD, can be reached at bugosj@usf.edu.
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