How music can help boost cognition in cancer patients and COVID-19 survivors

In a first-of-its-kind study, University of South Florida researchers are finding that music can help boost cognition in patients undergoing chemotherapy. In partnership with Moffitt Cancer Center, Jennifer Bugos, USF professor of music education, and breast surgical oncologist Dr. Melissa Mallory, have been examining the effects of private and group piano lessons on cognition and everyday functioning in patients.

“We are interested in examining whether social support while learning a musical instrument can increase cognition in patients undergoing treatment for cancer when holding curriculum constant, which areas of cognition may be improved and what duration of music training is optimal for patients,” Bugos said.

The piano training protocol, Keys to Staying Sharp, includes more comprehensive instruction than your typical piano lesson, with more patterns and repetition. While studies have been conducted on cancer patients in remission, never before has piano training been offered to those undergoing chemotherapy.

“Receiving a cancer diagnosis and undergoing cancer treatment can significantly impact mental health and overall patient wellness. Identifying new strategies to improve outcomes in these arenas—especially medication-free options—is needed to facilitate truly comprehensive patient-centric cancer care,” Mallory said.

Preliminary data suggests the musicians demonstrated enhanced executive functions after receiving group piano lessons and have self-reported that they found learning the piano to be enjoyable and relaxing.

“There were a lot of outside stressors contributing to my mood, but piano practice and going to lessons were always something good and positive that I would look forward to, no matter what else was happening,” said Robin Hesselink, who’s undergoing treatment for stage IV metastatic breast cancer. “Even for those 30 minutes or an hour, I could forget about the other stuff and have something enjoyable. At least temporarily, while I’m doing it, it has a very positive effect on me.”

According to the American Cancer Society, patients undergoing chemotherapy may have difficulty remembering things, focusing, finishing tasks or learning something new. Bugos believes that music education interventions can help overcome cancer-related cognitive impairment.

While the sample size is just a start—15 individuals—Bugos said that it’s helped launch new support from the National Endowment for the Arts, which just provided a two-year funding renewal for several of her studies conducted in the Coordination and Cognition Across the Lifespan in Music (CALM) lab, including another study specific to those who have been diagnosed with COVID-19.

Bugos found that playing the JSax—a smaller version of the saxophone—can not only improve the respiration of adults who’ve suffered breathing difficulties following COVID-19, but can also sharpen their minds. From her pilot study, using a spirometer, she found that all seven participants doubled their respiration and decreased their error rates on a cognition test. The research team also found that the participants experienced an increase in their inhibition and executive functions.

“It was a privilege to participate in the JSax program and I had a lot of fun being part of it,” said study participant Darlene DeMarie. “It definitely was challenging at first, but it was rewarding when I noted my progress over time. Music is like therapy, and it definitely adds to our lives.”

Bugos is broadening her research to include adults interested in learning an instrument who never played before or had limited formal music training, such as private lessons. Her team is working to identify the effects of music training interventions on cognitive and motor performance and distinguish which types of fine and gross motor music interventions have the greatest impact.

Researchers are currently recruiting adults ages 18–25 and older than 60. Participants will be randomly assigned to a musical intervention and receive 90-minute lessons, twice a week, for 12 weeks and complete four memory testing sessions.

The research team will study how music training interventions improve executive functions, such as memory, attention and processing speed, and the differences between the two age groups. They’ll also work to identify which technologies are most effective in measuring outcomes and how much training is necessary to maintain the benefits of music intervention. Preliminary data suggests that adults in both age groups can increase cognitive performance after learning a musical instrument.

“Aging is associated with an increased demand on cognitive resources,” Bugos said. “Learning a challenging new activity such as learning a musical instrument can increase sensorimotor activity leading to strengthened neural pathways and enhanced cognition.”