Cognitive decline in the elderly can be measured using musical tests and a portable electroencephalography (EEG) machine while the subject performs simple tasks, according to researchers at Tel Aviv University (TAU). The 15-minute procedure does not need a neurologist or other specialist and can be performed easily by staff members in any clinic.
The study was led at doctoral student Neta Maimon from the School of Psychological Sciences and the Buchmann-Mehta School of Music, and Lior Molcho from Neurosteer Ltd, headed by Prof. Nathan Intrator, a brain researcher from the Blavatnik School of Computer Science and the Sagol School of Neuroscience.
The article has just been published in the journal Frontiers in Aging Neuroscience under the title “Single-Channel EEG Features Reveal an Association with Cognitive Decline in Seniors Performing Auditory Cognitive Assessment.”
“Our method enables routine monitoring and early detection of cognitive decline to provide treatment and prevent rapid, severe deterioration,” the researchers wrote. “Prophylactic tests of this kind are commonly accepted for a variety of physiological problems such as diabetes, high blood pressure or breast cancer. However, to date, no method has yet been developed to enable routine, accessible monitoring of the brain for cognitive issues.”
They added that tests of this kind are especially important in view of increasing longevity and an expanding elderly population.
Neurosteer, founded in 2015 and located in Herzliya, invented a pocket-sized, portable device weighing about 55 grams that is easier-to-use than traditional multi-electrode EEGs. It has up to 256 electrodes, delivers objective biomarkers in real time and can be used for up to 10 hours. The device was invented by Intrator, while the musical test was developed by Maimon.
During the test, the subject is connected to the portable EEG device by means of an adhesive band with only three electrodes attached to the forehead. The subject performs a series of musical-cognitive tasks according to audible instructions given automatically through earphones.
The tasks include short melodies played by different instruments, with the subjects instructed to perform various tasks at varying levels of difficulty, like pressing a button every time a melody is played or pressing it only when the violin plays.
The test also includes several minutes of musically guided meditation designed to bring the brain to a resting state, as that is known to indicate cerebral functioning in various situations.
Music's effect on the brain
Maimon, who specializes in musical cognition, explained that music has a great influence on different centers in the brain. On the one hand, music is known to be a quick mood stimulant, particularly of positive emotion. On the other hand, in different situations, music can be cognitively challenging, activating the frontal parts of the brain, especially if one tries to concentrate on different aspects of the music simultaneously while performing a certain task.
If these two capabilities are combined, cognitive tests that are quite complex but also pleasant and easy to perform can be created. In addition, music that is positive and reasonably rhythmic will enhance concentration and performance of the task.
FOR EXAMPLE, the famous “Mozart effect” showing improved performance on intelligence tests after listening to Mozart’s music, actually has nothing to do with Mozart’s music. Instead, the music creates a positive mood and stimulates us to a state that is optimal for performing tests of intelligence and creativity.
The researchers hypothesized that with musical tools, it would also be possible to challenge the subjects to an extent that would enable testing of the brain’s frontal activity. The music would also raise their spirits, they speculated, enhancing the subject’s test performance while keeping the overall experience pleasant.
“We have actually succeeded in proving that music is indeed an effective tool for measuring brain activity. The brain activity and response times to tasks correlated to the subjects’ cerebral conditions (correlating to the mini-mental score assigned to them). More importantly, all those who underwent the experiment reported that, on the one hand, it challenged the brain, but on the other, it was very pleasant to perform.”Neta Maimon
Other participants included Adi Sasson, Sarit Rabinowitz, and Noa Regev-Plotnick from the Dorot-Netanya Geriatric Medical Center.
The 'mini-mental' test
Anyone hospitalized at Dorot, or any other geriatric rehabilitation facility, undergoes a standard “mini-mental” test. The test is designed to evaluate cognitive condition as a routine part of the intake process, explained Maimon.
The test is conducted by a specially trained occupational therapist and includes a variety of tasks, such as listing the days of the week or months of the year backwards. Up to 30 points can be earned in this test. A high score indicates normal cognition.
The experiment included testing 50 elderly people at Dorot who scored 18 to 30 on the mini-mental test, indicating various levels of cognitive functioning. The participants performed the musical-cognitive tasks, administered automatically.
The EEG machine registered electrical activity in the brain during the activity, with the results analyzed using machine-learning technology. This allowed mathematical indices to be identified that were precisely correlated with the mini-mental test scores.
In other words, the researchers obtained new brain markers that may stand alone as indices of the subject’s cognitive status.
“We have actually succeeded in proving that music is indeed an effective tool for measuring brain activity,” stressed Maimon. “The brain activity and response times to tasks correlated to the subjects’ cerebral conditions [correlating to the mini-mental score assigned to them]. More importantly, all those who underwent the experiment reported that on the one hand, it challenged the brain, but on the other, it was very pleasant to perform.”
The researchers concluded, “Our method makes possible the monitoring of cognitive capability and detection of cognitive decline already in the early stages – all by simple and accessible means – with a quick and easy test that can be conducted in any clinic.
“Today, millions of people around the world already suffer or are liable to suffer soon from cognitive decline and its dire consequences, and their numbers will only increase in the coming decades. Our method could pave the way toward efficient cognitive monitoring of the general population, and thus detect cognitive decline in its early stages, when treatment and prevention of severe decline are possible. It is therefore expected to improve the quality of life of millions around the world.”
Keren Primor Cohen, CEO of Ramot, Tel Aviv University’s technology transfer company, said, “We are pleased that a company based on a technology developed at TAU continues its collaboration on creative and multidisciplinary research. Ramot will continue to promote and invest in novel technologies and help TAU researchers to maximize the potential of their research.”