James Hudziak, MD, and David Rettew, MD, are both child psychiatrists at the UVM Medical Center.

James Hudziak, MD, and David Rettew, MD, are both child psychiatrists at the UVM Medical Center.

Patients who come to see child psychiatrists like Dr. Jim Hudziak at the Vermont Center for Children, Youth, and Families may leave with a prescription, but it often is not for a medication. 

As part of a model he developed called The Vermont Family Based Approach (VFBA), there is increased emphasis on incorporating wellness and health promotion strategies into the overall treatment plan.  As Hudziak explains in a podcast related to the study, “One of my life goals is to see if there is a chance to move medicine away from its preoccupation with negative events and negative outcomes to argue that the opposite is also true, and that when positive things happen, positive outcomes will follow.”  Thus, the goal of this model for children and families is to help them take steps not only to overcome whatever symptoms they have but to propel them towards true mental health and wellness.  To get there requires attention to domains such as nutrition, parental mental health, sleep, mindfulness, and physical activity, often given short shrift in traditional approaches.   Music and the arts are also highly encouraged within the VFBA. According to the Department of Education, approximately 75 percent of American high school students rarely or never participate in music or art training outside of the school.

Music: A New Path in Brain Research

While participation in music and the arts is widely viewed as positive for child development, how it affects the brain remains only partially understood.  To investigate this question further and to bolster the scientific evidence behind the push for more involvement in music, Dr. Hudziak and his postdoctural associate Matt Albaugh, along with a team comprised of scientists from the University of Vermont, Montreal Neurological Institute, Harvard, and Washington University, examined brain scan data from the National Institutes of Health MRI Study of Normal Brain Behavior.  Their study was published as the lead article in the November edition of the Journal of the American Academy of Child & Adolescent Psychiatry.

About the Study

The subjects for the study were 232 typically developing children without psychiatric illness between the ages of 6 and 18, all of whom received structural MRI scans at up to three different time points.   With these serial MRI scans the examiners were able to see how the thickness of the brain cortex changed with age.  Prior studies have indicated that the cortex generally thins across adolescence as the brain undergoes a normal “pruning” process that may be related to more efficient brain functioning.  A delay in this cortical thinning process, particularly in regions such as the prefrontal and orbitofrontal cortex, which are thought to be important for “executive control” functions such as inhibiting impulses and regulating attention, has recently been shown among those with clinical attention problems and ADHD.

The amount of musical training a child had was also measured to see if this variable interacted with age in its association to cortical thickness.  The average time playing an instrument was about two years.

Results of the Study

The main result of the study was that years of musical training were indeed related to age-related cortical thinning. Specifically, more musical training was associated with accelerated thinning, not only in the expected motor cortices but also in some of the very same regions implicated in those with more pronounced attention problems. “What was surprising was to see regions that play key roles in emotional regulation also modified by the amount of musical training one did.”

The authors concluded that musical training was associated with more rapid cortical maturation across many brain areas, and they hypothesized that musical training may have beneficial effects on brain development for children whether or not they suffered from attention or executive function difficulties.

Certainly, much more research is needed to support the notion of musical training as an effective treatment for diagnoses such as ADHD, but this study raises some thought-provoking possibilities.   In the article, Hudziak and colleagues  highlight Venezuela’s El Sistema program that has brought musical training and performance to millions of disadvantaged children both abroad and here in the U.S.. Studies have shown important improvements in drop-out rates, employment, and community involvement among participants of the program.  Such efforts are critical as many families are unable to access music lessons due to their cost.   Dr. Hudziak, who has done research on the genetic influence of various traits and abilities, notes that our culture seems to have it backwards in promoting certain activities only for children who seem born to excel at them.  He questions why “only the great athletes compete, only the great musicians play, and only the great singers sing,” especially as children age.  He and his team have worked to improve local access to musical training through research studies and mentorship programs. The need is still high, however, and is now underscored by the increasing data linking wellness activities to measurable changes in brain development.

David C. Rettew, MD, is a child psychiatrist at the UVM Medical Center and director of the Child & Adolescent Psychiatry Residency Program. Follow him on Facebook and on Twitter

Reference

Hudziak JJ, Albaugh MD, et al.  Cortical thickness maturation and duration of music training: Health-promoting activities shape brain development.  JAACAP. 2014;11:1153-1161.

Subscribe to Our Blog

Comments