In Switzerland as well as in most industrialized countries almost 1% of children, around 800 a year, are born ” preterm “, that is to say before the 32nd week. Despite the progress of neonatal medicine in terms of survival, these children still run the risk of developing neuropsychological disorders.
To promote the growth of their fragile brain, despite the stressful environment of intensive care, researchers at the University of Geneva (UNIGE) and the University Hospitals of Geneva (HUG) have proposed an original solution: listening to music written especially for them.
And the first results, published in the journal Proceedings of the National Academy of Sciences (PNAS), in the United States, are surprising: medical imaging reveals that the neuronal networks of premature babies subjected to listening to this music develop better, and the process concerns, in particular, a network involved in many sensory and cognitive functions .
The neonatal intensive care unit at the HUG annually welcomes 80 preterm-born babies – between the 24th and 32nd week of pregnancy, ie almost four months before the expected date of birth (DDP). The majority will survive, but half will develop disorders of a neurological nature, including learning difficulties, attention disorders or emotional disorders.
” At birth, the brains of these children are still immature, so the development must continue in the intensive care unit, in an incubator, in very different conditions to those present in the maternal uterus “, this is the explanation of Petra Hüppi, professor at the UNIGE Faculty of Medicine and Head of the Development and Growth Division of HUG. ” The immaturity of the brain, combined with a disturbing sensory environment motivates the abnormal development of neural networks. ”
The Geneva researchers started from the concept of a practical nature: given that the neural deficits of preterm children are due, at least in part, to sudden and stressful stimuli, as well as to a lack of adequate stimuli, the environment in which children live should be enriched by the introduction of structured and pleasant inputs.
Since the auditory system is among the first to function, music could be decisive in perceptive terms. But what music? ” Fortunately, we met the composer Andreas Vollenweider, who had already been in charge of musical projects with weaker populations and who showed great interest when it came to having to compose music suitable for preterm infants “, this is the comment of Petra Hüppi.
” It was important that musical stimuli were linked to the child’s condition. We wanted to organize his day with the right inputs at the appropriate times: music to accompany the awakening, another for the hour of sleep and finally a melody to interact during the phases of awakening “, explains Lara Lordier, Ph.D. neuroscience, and researcher at HUG and UNIGE.
” To choose the right tools for these very young patients, Andreas Vollenweider had to play different types of them in the presence of both preterm infants and a nurse who specialized in practices to support the development of premature babies. ”
” The instrument that generated the greatest number of reactions was the Pungi, which is the flute of Indian snake charmers. The children in a strong state of agitation calmed down almost instantly, their attention was caught by the music! “. The composer was thus able to write three soundscapes of eight minutes each, characterized by pungi, harp, and bells.
More efficient brain functional connections thanks to music
The experiment, conducted in double-blind, involved three groups of newborns: two composed of premature and one of the full-term babies. One group of preterm babies was subjected to listening to music, the other was not, being a control group. The third group, always in control, was instead made up of full-term babies, accepted in the experimentation to assess whether the brain development of premature babies subjected to listening to music was similar to that of full-term babies.
Scientists used magnetic resonance tomography on all three groups of children. Premature babies not listening to music have shown poorer functional connectivity between brain areas than full-term babies, effectively confirming the negative effect of prematurity.
” The network most involved was that of salience which usually detects information and assesses its relevance at a specific time and then creates a connection with other brain networks appointed to act. This network is essential, both for learning and for carrying out cognitive activities, both in social relations and in emotional management, “said Lara Lardier.
In intensive care, preterm infants are overwhelmed by stimuli not suited to their condition: doors that open and close, alarms that sound all the time…
Unlike a child born after nine months of pregnancy who, in the womb, is in able to regulate its rhythm to the maternal one, the premature child in the TIN will hardly be able to develop the link between the meaning of a stimulus and the specific context.
On the other hand, the neural networks of newborns subjected to listening to the music of Andreas Vollenweider have improved significantly: the functional connectivity between the salience network and the auditory, sensorimotor, frontal, thalamic and precuneus networks has undergone a clear increase to the point of favoring a brain organization more similar to that of full-term babies.
Newborns are once grown-up…
The first children involved in the trial are now 6 years old, an age in which it is possible to begin to detect the first cognitive problems. Researchers are organizing to meet their young patients again in order to conduct a complete cognitive and socio-emotional assessment and to see if the positive results measured in the first weeks of life have been maintained.
This study is funded by the Swiss National Science Foundation and, among others, the Prim’Enfance Foundation.