Music in Epilepsy
Epilepsy is among the most common chronic neurological conditions. The medical management generally involves prescribing one or more anti-seizure medications (ASMs). During the last decades different treatment options have been provided for individuals with epilepsy and their caregiver, aiming to give a better control on their seizure frequency. However, some people are unable to obtain seizure freedom\adequate control from ASMs, or other treatment options such as resective epilepsy surgery, deep brain stimulation (DBS), Vagus nerve stimulation (VNS), and ketogenic diet for different reasons.
The promising effect of listening to Mozart’s compositions in individuals with epilepsy has been reported in the past 15-20 years, demonstrating a reduction in seizure frequency during the periods of daily listening to Mozart. Despite the promising results, one of the most important questions yet needed to be answered is whether individuals would show a similar reduction on their seizure frequency in case of daily listening to any other auditory stimulus as the control one comparing to Mozart.
What did we do to fill the gap of knowledge?
The Rhyme and Rhythm of Music in Epilepsy was a clinical research study designed in 2016, aiming both to provide a clear answer on whether listening daily to Mozart could help individuals with epilepsy to reduce their seizure counts, and to build a meaningful collaboration among individuals with epilepsy and our research team.
In this clinical research study, we reported for the first time the effect on seizure frequency of daily listening to Mozart K.448 as compared to a carefully selected control piece. Our control piece was a scrambled version of the original Mozart piece, having similar mathematical features (i.e. similar power spectrum) as the original piece, but shuffled randomly and lacking rhythmicity completely, sounding like noise. Using a spectrally similar control piece, our study advances previous reports that were limited by a “no music” control condition. Our manuscript has been submitted to Epilepsia for the publication and is currently under review.
How did we achieve this?
Using randomized controlled crossover design, our participants were randomly assigned to either start the intervention by listening to Mozart K.448 as the treatment piece or the scramblemed Mozart K.448 as the control piece once a day for six months. Additionally, there were three-month baseline, and three-month follow-up periods before and after the six-month listening period. Seizure diaries were collected from the participants as the main outcome of the study, in addition to the brain recording for our exploratory research purposes. The medications kept unchanged for the participants during the one year intervention.
What did we find?
Employing three methodologies to investigate the existence of the treatment effect, our results revealed a reduction in seizure counts during the period of daily listening to Mozart K.448, which was not observed for the scrambled Mozart during the control period (p-value < 0.001).
Using a spectrally similar control piece, our study advanced previous studies that were limited by a “no music” control condition. Our results showed daily listening to Mozart K.448 was associated with reducing seizure frequency in adult individuals with epilepsy. These results suggest that daily Mozart listening may be considered as an adjunctive therapeutic option to reduce seizure burden in individuals with epilepsy.
What are our potential future steps?
In this work, we have been aiming to share the obtained data completely, to create transparency and to provide the people a general perspective about our study design and observations. We are currently planning to continue the research on the topic of music in epilepsy in here, using the structure we have built between individuals with epilepsy, the epilepsy clinic at the Toronto Western Hospital, and the Krembil Research institute. Our manuscript has been submitted to the Epilepsia for publication and is currently under the review process. Our aim is to distribute knowledge and to create novel research studies through which we can create the opportunity for individuals with epilepsy to potential benefits from listening to music by their participation, in addition to providing us the chance to improve our understanding about the topic.
For more information, please refer to our publication: https://onlinelibrary.wiley.com/doi/full/10.1002/epi4.12400