parkinson’s and music -- 6/1/22
Today's selection -- from Musicophilia by Oliver Sacks. The influence of music on Parkinson’s disease:
"A fundamental problem in parkinsonism is the inability to initiate movement spontaneously; parkinsonian patients are always getting 'stuck' or 'frozen.' Normally there is a virtually instantaneous commensuration between our intentions and the subcortical machinery (the basal ganglia, especially) that allows their automatic enaction. (Gerald Edelman, in The Remembered Present, refers to the basal ganglia, along with the cerebellum and hippocampus, as the 'organs of succession.') But it is the basal ganglia especially which are damaged in parkinsonism. If the damage is very severe, the parkinsonian may be reduced to virtual immobility and silence -- not paralyzed but in a sense 'locked in,' unable by himself to initiate any movement, and yet perfectly able to respond to certain stimuli. The parkinsonian is stuck, so to speak, in a subcortical box, and can only emerge from this (as Luria brings out) with the help of an outside stimulus. Thus parkinsonian patients can be called into action, sometimes by something as simple as throwing them a ball (though once they catch the ball or throw it back, they will freeze again). To enjoy any real sense of freedom, a longer release, they need something which can last over time, and the most potent unlocker here is music.
"This was very clear with Rosalie B., a post-encephalitic lady who tended to remain transfixed for hours each day, completely motionless, frozen -- usually with one finger 'stuck' to her spectacles. If one walked her down the hallway, she would walk in a passive, wooden way, with her finger still stuck to her spectacles. But she was very musical, and loved to play the piano. As soon as she sat down on the piano bench, her stuck hand came down to the keyboard, and she would play with ease and fluency, her face (usually frozen in an inexpressive parkinsonian 'mask') full of expression and feeling. Music liberated her from her parkinsonism for a time -- and not only playing music, but imagining it. Rosalie knew all of Chopin by heart, and we had only to say 'Opus 49' to see her whole body, posture, and expression change, her parkinsonism vanishing as the F-minor Fantasie played itself in her mind. Her EEG, too, would become normal at such times."