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Parkinson’s response to music stimulation
- 1 day ago
- 7 min read
Whether you are a musician, a dancer, a concert enthusiast, or even someone who rarely listens to anything but their favorite song, music is a crucial part of the human experience. In fact, our brain craves music: its melodic contours, its variability, its tones, and the emotions and memories it brings to mind.
This harmony between the brain and music is able to aid those who can’t perform anymore, can’t dance anymore, can’t maintain their rhythm, but can still find hope in listening: Parkinsonian patients.
What Is Parkinson’s Disease?
Parkinson’s is a neurodegenerative disease that occurs when the brain loses dopamine-producing neurons residing in a specific area called the substantia nigra. Estimates suggest that Parkinson’s affects more than 10 million people worldwide and it’s projected to impact 1.2 million Americans by 2030 (Parkinson's Foundation, 2022).
Parkinson’s Disease (PD) is characterized by various symptoms that progress over time. It usually starts with tremors on one side of the body, changes in posture, walking, and facial expressions. Then, daily tasks are compromised with rigidity and tremors on both sides. Over time, balance is lost and slowness of movements become more common (Parkinson's Foundation, 2021).
Unfortunately, the causes that trigger this disease are unknown, ranging from genetic to environmental factors. Still, the effects are the same. The neurons mentioned before are in charge of coordinating movement. Thus, dopamine deficiency disrupts communication in the motor circuits, leading to progressive breakdown of the neural network integrity. (Minetti et al., 2025)
Rhythm's control over the brain
When listening to music, we can find ourselves spontaneously synchronizing our movements to a rhythm’s beat. Various studies have even shown that there is variation in movement stimulated by differences in tone intensity or loudness (Chen et al., 2006). This suggests a connection between the auditory and motor regions of the brain.
Figure 1: brain areas activated while listening to music
As shown in Figure 1, most areas of the brain are engaged while listening to music, including those which control movement, emotions, and creativity. In fact, there is a strong link between the auditory and motor regions. The cerebellum- mainly in charge of controlling movement and timing- is actively working to get into sync with the beat.
Accordingly, this integration is evidenced to a higher degree in musicians or dancers, able to execute precisely timed sequences. In addition, motor and auditory systems interact in terms of feedforward and feedback relationships. This means that neural firing happens analogous to talking back and forth (Zatorre et al., 2007).
Music’s pathway to recovery
In the case of Parkinsonian patients, the neural web between the auditory and motor region is mainly intact. Music provides entertainment in the form of a rhythmic structure, which cannot be ignored by the auditory cortex, which in turn activates other regions, but most importantly the motor circuits. These last have no choice but to oblige and sync to the beat. In other words, this external timing harnesses the innate internal timing process (Bengtsson et al., 2008) - which as aforementioned, in Parkinsonian patients is disrupted.
This is where rhythmic auditory stimulation (RAS) comes into play. This involves providing a consistent cue- whether by metronome or music- so that the patient synchronizes their footsteps with the rhythm heard. Studies have shown that over time, this increases the accuracy of motor impulses and coordination. In fact, these rhythms are chosen according to the patient’s preferred walking rate, trying to find the closest ones (Physiopedia contributors, 2024).
Studies conducted on the benefits of RAS exhibit similar findings. This evidence shows that music-based movement therapy is an effective approach for improving motor function, balance, freezing of gait, walking velocity, and mental health for patients with Parkinson’s disease (Zhou et al., 2021).
Melodic pulses
But what is the significance of using music instead of just a metronome? It all comes down to the pleasure and reward centers of our brains, which are stimulated by music, trigger the release of dopamine. This natural increase of dopamine levels can partially counteract the deficiency in PD patients. Studies carried out follow similar procedures, where Parkinsonian patients walk on a treadmill while listening to music or a metronome. “Music but not metronome cues produced a significant increase in group mean gait velocity of 4.6 cm/s, due mostly to a significant increase in group mean stride length of 3.1cm” (Wittwer et al., 2013).
Of course, this is not only related to the active decision to follow the beat, but the motivation that arises from the dopamine provided. This emotional engagement transforms music into a powerful tool. “Specifically, salient music selections increased measures of cadence, velocity, and stride length; in contrast, gait was unaltered by the presence of non-salient music” (de Bruin et al., 2015). As stated, even variations in salience -referring to outstanding musical features- can produce different results. Once again proving our brain’s sensitivity to music, its longing for amusement in this melodic form.
Along these lines, a study was carried out on the impact of familiar music: “enhanced familiarity with music improved stride amplitude and variability along with increased enjoyment and reduced cognitive demand in people with PD” (Park et al., 2021). Music that we especially like, engraves itself deep into our memory. Thus, providing not only a deeper sense of pleasure, but also evoking vivid recollections, often involuntarily. For instance, think about a time when a song triggered an impactful memory: graduation, a nice Christmas, or even a loss. In any case, music is so intrinsic to our brain that -as evidenced in the mentioned study- it is enough to improve motion while reducing effort.
Where the music is brought to a halt
Now, it’s important to highlight that not any type of song is bound to work. Therapists work precisely, timing the patient’s gait rate and finding the rhythm that closely matches it. A much slower or faster cue won’t improve the patient’s condition. At the end of the day, they are not looking to speed up the patient’s natural walking rate, but rather make the movements uniform and harmonic.
Our brain is not something static, but rather malleable, and bound to change according to our experiences. In other words, not only the progress, but the improvement of this condition varies from patient to patient. Thus, this method may not reach the desired results, and depending on the progress of the disease, patients may take more time to sync in with the beats.
A symphony of possibilities
There is just a handful of research on the impact of music on a larger scale. However, this only means that there is still much room for optimization. For instance, technological developments such as smart watches that could aid patients throughout the day by producing beats, improve not only their therapy sessions. Not to mention, large-scale studies on rhythms that boost rehabilitation, if there's a difference between musical genres, if lyrical or classical music works better, and so on
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It is a very peculiar matter how music is able to enthrall all of us, to varying degrees. How our brain is bound to respond to this external stimulus, and how it is able to activate such a wide range of mechanisms from the first note. Maybe it is not so much about the nervous system, but about culture, memories, belonging, that is able to motivate, unconsciously, even the weakest to carry those melodies in their steps.
Written by Emilia Serrano
References
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Minetti, A., Montagni, E., Meneghetti, N., Macchi, F., Éléa Coulomb, Martello, A., Tiberi, A., Capsoni, S., Mazzoni, A., Letizia, A., & Spalletti, C. (2025). Parkinsonism disrupts cortical function by dysregulating oscillatory, network and synaptic activity of parvalbumin positive interneurons. Npj Parkinson S Disease, 11(1).
Parkinson’s Foundation. (2021, April 1). Parkinson’s 101: We Answer Your Top Parkinson’s Questions | Parkinson’s Foundation. Www.parkinson.org.
https://www.parkinson.org/blog/awareness/parkinsons-questions
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