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How Mozart’s music treats epilepsy

Mozart's Sonata for Two Pianos in D Major (K448) can help reduce seizures in epilepsy patients.
Credit: Giambettino Cignaroli / Wikipedia / Public domain
Key Takeaways
  • The "Mozart K448 effect" in epilepsy patients was first described nearly 30 years ago. 

  • With the exception of Mozart's Piano Sonata in C Major (K545), no other music has been shown to reduce seizures.

  • Emotional responses to Mozart's music, as well as the structure of the music itself, may contribute to its therapeutic effect.

Classical music remains a staple of high culture in modern society. Many of us enjoy listening to these timeless pieces while reading, studying, or going to sleep. Indeed, some people think so highly of classical music that they have bestowed magical powers upon it — for instance, believing somehow that babies will be smarter if they listen to Beethoven rather than nursery rhymes.

While the claims of intelligence boosting are dubious, one assertion that sounds just as implausible but is absolutely real is that classical music can help treat epilepsy. But not just any classical music — specifically, Mozart’s Sonata for Two Pianos in D Major (K448). Known as the “Mozart K448 effect,” this bizarre phenomenon was first described nearly 30 years ago.

Since then, researchers have learned more about the Mozart K448 effect. It seems to work by reducing so-called interictal epileptiform discharges (IEDs) — abnormal brainwaves that occur in between seizures in epileptic patients. IEDs are linked to seizure frequency, so reducing the number of IEDs should also reduce the number of seizures, and this already has been demonstrated in other research.

Epileptiform discharges (left) vs. normal EEG (right). (Credit: Qiong Li et al., Front. Physiol., 2020.)

The Mozart K448 effect is nearly impossible to replicate. Researchers tried testing patients with other music written by Mozart, Beethoven’s Für Elise, and even a string version of K448. Nothing worked, with the lone exception of another Mozart composition: Piano Sonata in C Major (K545). A team of researchers mostly from Dartmouth College and led by Robert Quon showed that a low bass tone of 40 Hz also helped treat epileptic patients, but they described the sound as “not especially pleasant.”

So, for therapeutic and aesthetic reasons, Mozart wins, but nobody knows why. To dig deeper into the mystery, Quon’s team aimed to determine where in the brain Mozart’s music was working its magic.

The Mozart K448 effect: assessing Amadeus

In their new paper, published in Scientific Reports, Quon’s team recruited 16 volunteers who had brain implants for the treatment of refractory focal epilepsy — that is, epileptic seizures that originate in one side of the brain and do not respond to treatment. His team first showed that, for the K448 effect to take place, a patient must be exposed to the music for a certain period of time: at least 30 seconds. If a patient doesn’t hear the music for at least 30 seconds, there is no reduction in IEDs.

mozart k448 effect
IED rate reductions were observed only after patients heard at least 30 seconds of Mozart’s Sonata for Two Pianos in D Major (K448) (upper panel). Wagner’s Lohengrin (Prelude to Act I) (middle panel) and noise (lower panel) served as controls.

Further investigation revealed that the IED rate reductions occurred specifically in the subjects’ bilateral frontal cortices. Additionally, the team found evidence that emotional responses to Mozart’s music, as well as the musical structure of the sonata itself, may contribute to its therapeutic effect.

There is still much to figure out. But the fact that scientists are closer to understanding how Mozart can bring relief to refractory epilepsy patients must be music to their ears.

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