There's more to singing than meets the ear.
Because Parkinson's predominantly affects older adults, as the population of the United States ages, its prevalence is increasing.
Drugs can help reduce symptoms, but they tend to "become less effective as the disease progresses," and the side effects can also become worse.
Finding nonpharmaceutical ways of managing Parkinson's disease is a priority, and one intervention that is gaining traction is singing.
Singing as therapy
Recently, researchers from Iowa State University in Ames ran a pilot study to investigate the impact of singing on a small group of individuals with Parkinson's disease.
The study was headed up by Elizabeth Stegemöller, an assistant professor of kinesiology at the university. The researchers presented their findings earlier this week at the Society for Neuroscience 2018 conference, held in San Diego, CA.
Stegemöller has been investigating the benefits of singing therapy for people with Parkinson's disease for some time. Her previous work has already shown that singing might improve respiratory control.
Because singing demands tighter control over muscles in the mouth and throat, these previous findings make sense. However, the latest results identify a much wider range of potential benefits.
The research focused on a therapeutic singing group; the group consisted of 17 people who had been attending for an average of 2.4 years. The researchers measured their heart rate, blood pressure, and cortisol levels before and after a session.
The participants also completed a questionnaire that rated levels of anxiety, sadness, anger, and happiness.
Although heart rate, blood pressure, and cortisol levels dropped across the board, in this small sample, the changes were not significant. There was also a noted drop in levels of anxiety and sadness following the sessions.
"We see the improvement every week when they leave singing group. It's almost like they have a little pep in their step. We know they're feeling better and their mood is elevated."
As for specific symptoms, the researchers measured statistically significant improvements in some motor symptoms that are often unaffected by drugs. In particular, upper extremity bradykinesia (slowness of movement), tremor, and walking were most improved.
Why might singing work?
These findings beg the question: Why does singing have any impact on a neurodegenerative condition at all? This will be a tougher question to unpick.
The researchers wonder whether oxytocin might play a part. This hormone, which people sometimes refer to as the love hormone, is released during bonding. The scientists are currently checking blood samples for oxytocin.
As researcher Elizabeth "Birdie" Shirtcliff, an associate professor in human development family studies, explains:
"Part of the reason cortisol is going down could be because the singing participants feel positive and less stress in the act of singing with others in the group. This suggests we can look at the bonding hormone, oxytocin."
Alongside oxytocin, the scientists are also checking for levels of inflammation (a marker of disease progression) and neuroplasticity (how well the brain can compensate for damage caused by the disease).
They are also searching for answers in the heart. As Shirtcliff outlines, "We're also looking at heart rate and heart rate variability, which can tell us how calm and physiologically relaxed the individual is after singing."
Although the recent study was only a small-scale pilot study, it forms part of an ever-growing bank of evidence. Singing, it seems, could be a cost-effective, side effect-free, and enjoyable therapy for people with Parkinson's disease.
Hopefully, it is only a matter of time before joining a choir enters clinical guidelines for the treatment of Parkinson's disease.
With Stegemöller at the helm, we may not have to wait too long; when Medical News Today spoke with her in 2016, she said, "I would like to develop methods to bring this music therapy-led intervention to as many persons with Parkinson's disease as possible."