In the Mahabharata, Abhimanyu (Arjun’s son) is said to have learned a war skill (entering the Chakravyuh) when he was in the womb of his mother. Babies in the womb can hear the sounds and voices of their mothers. Their brain networks get stimulated with the input of sound given to them. Even premature babies, born before the 32nd week of pregnancy, given customized music therapy at the intensive care unit, can develop neural brain networks significantly, according to research.
Like most developed nations, approximately 1% of babies in Switzerland are born “very prematurely,” meaning that they are born before the 32nd week of pregnancy. This amounts to about 800 babies born each year. These babies have an excellent chance of surviving thanks to advancements in neonatal medicine, but they also run a significant risk of developing cognitive impairments. Researchers at the University of Geneva (UNIGE) and the University Hospitals of Geneva (HUG), Switzerland, have come up with a novel idea to assist the brains of these vulnerable babies in developing as much as possible despite the demanding environment of intensive care: music composed specifically for them.
The initial findings, which were reported in the Proceedings of the National Academy of Sciences (PNAS) in the US, are startling: brain imaging shows that premature babies who listened to this music had significantly better-developing neural networks, particularly a network that is involved in numerous sensory and cognitive processes.
Brain development can continue in the intensive care unit
Every year, 80 babies who were delivered between 24 and 32 weeks of pregnancy—roughly four months ahead of plan for some of them—are admitted to the HUG Neonatal Intensive Care Unit. The great majority will live, but half will go on to experience neurodevelopmental issues in the future, which include attentional and emotional problems as well as learning challenges. “At birth, these babies’ brains are still immature. Brain development must therefore continue in the intensive care unit, in an incubator, under very different conditions than if they were still in their mother’s womb,” explains Petra Hüppi, professor at the UNIGE Faculty of Medicine and Head of the HUG Development and Growth Division, who directed this work. “Brain immaturity, combined with a disturbing sensory environment, explains why neural networks do not develop normally.”
A tailor-made music
The Geneva researchers began with a pragmatic notion: since unexpected and stressful stimuli, as well as a lack of stimuli tailored to the infant’s condition, are at least partially responsible for the neural deficits of premature babies, their environment should be enhanced by the introduction of pleasant and structuring stimuli. Music seemed a nice fit as the hearing system worked well from the start. What music, though? “Luckily, we met the composer Andreas Vollenweider, who had already conducted musical projects with fragile populations and who showed great interest in creating music suitable for premature children,” says Petra Hüppi.
Lara Lordier, PhD in neurosciences and researcher at the HUG and UNIGE, unfolds the musical creation process. “It was important that these musical stimuli were related to the baby’s condition. We wanted to structure the day with pleasant stimuli at appropriate times: music to accompany their awakening, music to accompany their falling asleep, and music to interact during the awakening phases.”
In the company of a nurse who specializes in developmental support care, Andreas Vollenweider played a variety of instruments to the infants to select instruments appropriate for these very young children. “The instrument that generated the most reactions was the Indian snake charmers’ flute (the punji),” recalls Lara Lordier. “Very agitated children calmed down almost instantly, their attention was drawn to the music!” The composer thus wrote three sound environments of eight minutes each, with punji, harp, and bells pieces.
More efficient brain functional connections through music
To determine whether the brain development of premature infants who had listened to the music would be more similar to that of full-term babies, the study was carried out in a double-blind fashion with a group of premature infants who listened to the music, a control group of premature infants, and a control group of full-term newborns. On each of the three child groups, functional MRI was performed at rest by researchers. Premature babies showed unfavourable effects of prematurity, as seen by the fact that, in general, they had worse functional connections between brain areas without music than full-term babies. “The most affected network is the salience network which detects information and evaluates its relevance at a specific time, and then makes the link with the other brain networks that must act. This network is essential, both for learning and performing cognitive tasks as well as in social relationships or emotional management,” says Lara Lordier.
Children in intensive care are overstimulated by stimuli unrelated to their illness, such as doors opening and closing and sirens going off. In contrast to a full-term infant that in utero synchronizes its heartbeat with its mother, a premature infant in critical care finds it difficult to understand the relationship between a stimulus’s meaning and its surroundings. However, the children who listened to Andreas Vollenweider’s music had much better neural networks: there was a noticeable increase in the functional connectivity between the salience network and the auditory, sensorimotor, frontal, thalamus, and precuneus networks, which led to a brain network organisation more akin to that of full-term infants.
When children grow up
By now, the first kids in the project are six years old, which is when cognitive issues start to show up. Researchers will now get together with their young patients once more to perform a comprehensive cognitive and socioemotional evaluation and see if the favourable results noted during their initial weeks of life have persisted.
This study is financed by the Swiss National Science Foundation as well as, among others, by the Prim’Enfance Foundation.
Materials provided by Université de Genève. Note: Content may be edited for style and length.
Lara Lordier, Djalel-Eddine Meskaldji, Frédéric Grouiller, Marie P. Pittet, Andreas Vollenweider, Lana Vasung, Cristina Borradori-Tolsa, François Lazeyras, Didier Grandjean, Dimitri Van De Ville, Petra S. Hüppi. Music in premature infants enhances high-level cognitive brain networks. Proceedings of the National Academy of Sciences, 2019; 201817536 DOI: 10.1073/pnas.1817536116
Université de Genève. “Music helps to build the brains of very premature babies.” ScienceDaily. ScienceDaily, 28 May 2019. <www.sciencedaily.com/releases/2019/05/190528095220.htm>.
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