Influenţa stimulării muzicale timpurii asupra dezvoltării neurocomportamentale a nou-născutului

Music is traditionally present in a variety of important rituals in human society. There are melodies appropriate for weddings, anniversaries, lullabies, civic events, religious rituals, funerals, etc. Accordingly, music is found in all cultures around the world – even in those most technologically undeveloped.

According to the dictionary, music is the art of combining sounds in such a way that it pleases the ear, engages the intellect, speaks to the senses and moves the soul. As a science, music is the arrangement of sounds so as to include three elements: melody, rhythm and harmony.

Researchers state that the agitation of air molecules is very similar for any ear, whether that of a frog, a cow, or a human. However, a psychologist will assert that the sensations derived from these vibrations vary greatly from one species to another⁽¹⁾.

According to Isenberg-Grzeda (1995), the intrauterine sound environment, although beyond conscious recollection, may leave a wordless and amorphous memory trace that serves as a template for all future rhythmic responses and provides us with a symbolic sonic and rhythmic image of safety throughout life, thus ensuring continuity between intrauterine and extrauterine life⁽²⁾.

At approximately 16 weeks, while still inside the mother’s uterus, the fetus may be able to hear sounds, although it is not yet capable of interpreting them⁽³⁾. The majority of fetuses are able to hear and interpret voices and sounds by around the 27^th week of gestation. Previous studies have shown that fetal heart rate increases in response to sounds, especially high-frequency sounds. Prenatal musical stimulation also enhances fetal motor responses, including head, arm or leg movements⁽⁴⁾. Starting from the 30^th week of gestation, the fetus as well as the premature newborn are capable of processing complex auditory stimuli⁽⁵⁾.

Medical personnel endeavor to establish conditions that optimize the care of premature infants. Familiar auditory stimuli within the infant’s environment can contribute to a stable, secure and comforting milieu, which may be challenging to replicate even within the most advanced neonatal intensive care units. Evidence indicates that infants possess an innate propensity to respond to environmental sounds. Furthermore, their capacity to recognize the maternal voice suggests that deliberate consideration of this factor may yield beneficial outcomes, particularly when integrated with intensive medical care⁽⁶⁾.

Music therapy inspired by intrauterine sounds supports the physiological development and regulation of newborns. This approach replicates uterine sounds – such as the heartbeat, maternal or paternal voice and other bodily noises – in a manner adapted to the neonatal intensive care environment. Instruments such as the Gato Box, Ocean Disk, guitar and the therapist’s voice are employed to mimic these sounds, providing a familiar and reassuring environment for the infant⁽⁷⁾. Studies on the effects of music indicate that rhythmic music can synchronize neuronal activity, which may help regulate respiratory rhythm, heart rate and, consequently, oxygenation – particularly when the infant is stimulated following invasive procedures, such as suctioning, during which physiological responses are altered⁽⁸⁾.

Studies conducted by researchers at Stanford University have shown that music stimulates brain regions involved in attention, prediction and memory updating. Musical training has been found to exert a positive impact on creativity, according to research conducted with both preschool and school-aged children^(9,10). Music contributes to the enhancement of central auditory processing, which in turn underpins the subsequent development of language⁽¹¹⁾. Moreover, high school students and music majors have demonstrated higher levels of creativity, confirming that prolonged engagement with music enhances the development of creative abilities^(9,10). In contrast, newborns who were cared for in private and relatively quiet rooms exhibited deficits in brain maturation, particularly with respect to language development, and a tendency toward the emergence of motor deficits was also observed⁽¹²⁾.

On the other hand, disorders arising from genomic imprinting also alter music perception, supporting the notion that songs directed at infants convey signals related to parental investment. Compared to the relaxation response typically observed in individuals with normative development during passive music listening, Prader-Willi syndrome is associated with an enhanced relaxation response, whereas Angelman syndrome is associated with a diminished relaxation response. These effects are specific to music and are not elicited by listening to pleasant speech, suggesting that singing represents a particularly effective means of fulfilling parental investment requirements in Prader-Willi syndrome, whereas it is relatively ineffective in this regard in Angelman syndrome⁽¹³⁾.

Listening can be classified as either passive or active. Passive listening primarily engages the auditory system, in contrast to active listening, which involves direct interaction with musical stimuli, often through interactive activities with caregivers, participation in musical play, or the use of instruments, as well as engagement of multiple sensory modalities, including tactile and visual pathways. In the context of neurodevelopmental impact, the study by Remijn and Kojima (2010)⁽¹⁴⁾ highlights differences in neural processing between passive and active listening. This distinction is critical for understanding music’s influence, as passive and active modes of listening can affect infant development via distinct neural pathways and cognitive processes. For premature infants in neonatal intensive care units (NICUs), where active engagement is not always feasible, passive music listening may represent the only practical means of auditory enrichment, while simultaneously providing a calming and stabilizing effect for infants at rest or during periods of limited caregiver interaction^(14,15).

Musical perception extends beyond basic sound processing, involving cognitive, motor and emotional responses that engage multiple brain regions. These processes are both lateralized – for example, pitch and melody processing is predominantly localized in the right hemisphere – and bilateral, activating a broad range of “musical subfunctions”. The widespread effects of music on brain functions, including auditory perception, language processing, attention, memory, emotion, mood and motor skills, underscore its potential as a therapeutic tool for neuropsychiatric patients, including infants at neurodevelopmental risk. Numerous systematic reviews have investigated the therapeutic role of music in premature infants. Most studies have focused on the effects of music on cardiorespiratory parameters, growth, feeding outcomes, length of hospital stay, behavioral state and pain management, with a relatively limited understanding of its direct influence on brain function or long-term neurodevelopmental outcomes⁽¹⁶⁾.

According to Chanda and Levitin, group music-making and singing increase the production of oxytocin in the brain, a hormone synthesized by parvocellular neurons of the hypothalamic paraventricular nuclei and released into circulation via the pituitary gland. Oxytocin plays a crucial role in the formation and maintenance of social bonds, both in adulthood and during the formative periods of childhood, thereby facilitating the social bonding effects of music. Humans derive pleasure from a variety of stimuli and activities, including food, sex and social contact (primary rewards), as well as from esthetic experiences such as listening to music. Music elicits a wide range of physiological effects on the human body, including alterations in respiration, heart rate, skin conductance, blood pressure, skin temperature, muscle tone and biochemical responses⁽¹⁷⁾.

All rewarding events, regardless of their type, are processed by the ventral tegmental area (VTA), ventral striatum, anterior cingulate cortex, orbitofrontal cortex, insula and amygdala. The ventral striatum is considered a key hub of the reward circuit, as it receives inputs from limbic regions, such as dopaminergic neurons of the VTA activated during rewarding experiences (e.g., addictive drug use), as well as from the ventromedial prefrontal cortex, anterior cingulate cortex and amygdala. A substantial body of research has demonstrated the involvement of the reward system in musical emotions. Neuroimaging studies have shown that the benefits associated with music are linked to the activation of the brain’s monoaminergic circuits, including dopaminergic and serotonergic pathways, and their interaction with opioid pathways. Endogenous opioids are implicated not only in positive responses to pleasurable music, but also in negative responses, such as sadness^(18,19).

Human subcortical activity can be recorded with high fidelity using the brainstem evoked response. The neuronal origins of this response have been inferred from studies employing simultaneous surface and direct recordings during neurosurgery, investigations of brainstem pathologies and animal research. Contributors to the first five scalp-recorded peaks include the auditory nerve, the superior olivary complex, the lateral lemniscus and the inferior colliculus. It is important to note that these peaks typically have multiple anatomical sources, and each source can contribute to multiple peaks. The latencies of these peaks are consistent with subcortical origins. Moreover, brainstem nuclei exhibit high-frequency phase-locking characteristics, which are evident in high-pass filtered recordings that attenuate the low-frequency components of electroencephalographic activity (e.g., cortical signals)⁽²⁰⁾.

EEG signals across different frequency bands are associated with human conscious activities. Based on the frequency differences of the EEG signal, these signals can be categorized into five types: delta (0.5-4 Hz), theta (4-8 Hz), alpha (8-13 Hz), beta (13-30 Hz) and gamma (>30 Hz). In various studies, the specific ranges of each frequency band may vary slightly⁽²¹⁾. Delta waves commonly occur during unconscious deep, dreamless sleep. Theta waves are present during sleep, dreaming and drowsiness, and are associated with the subconscious. Positive emotions evoke an increase in theta activity in the midfrontal region. Alpha waves appear when a person is relaxed yet alert. Alpha wave asymmetry in the frontal lobe reflects the valence of emotions, with the mid-sagittal channel playing a key role in EEG signal analysis. During neutral and negative emotions, alpha waves exhibit greater oscillatory power than beta and gamma waves.

Beta waves arise when the mind is active and highly focused, and significant frontal beta activity may reflect emotional valence. The mean power ratio between beta and alpha waves can indicate the brain’s active state. Gamma waves are associated with cerebral hyperactivity. Studies indicate that the simultaneous use of alpha, beta and gamma waves provides greater reliability for emotion recognition⁽²²⁾.

Near-infrared imaging spectroscopy (NIRSI) is a noninvasive technique used to measure concentrations of oxygenated hemoglobin (HbO₂) and deoxygenated hemoglobin (HbR) in tissues. A notable application of this method is the study of hemodynamic responses to brain activation. NIRSI measures local changes in near-infrared light absorption, which are influenced by variations in cerebral blood volume and oxygenation. This technique is safe, noninvasive, does not involve ionizing radiation, and can be combined with EEG, MEG or MRI, making it particularly useful for monitoring newborns⁽²³⁾.

The prenatal and early postnatal auditory environment of infants supports slow, experience-dependent development, allowing cortical neurons to learn behaviorally relevant sound categories, such as music and speech. This “bottom-up” perspective on cortical development predicts that, in very young infants, the auditory cortex would contain neurons tuned to frequency but not to spectrotemporal parameters. In this view, sounds producing similar excitation patterns at the cochlear level would elicit comparable activations in primary and non-primary auditory cortical regions. Subsequently, extended auditory experience would enable neurons in the auditory cortex to acquire sensitivity to specific spectrotemporal modulation statistics. In the final stage of development, subpopulations of neurons in non-primary auditory cortex (NPAC) would develop selective responses to particular sound categories⁽²⁴⁾.

Conversely, it is possible that, even in the earliest stages of childhood, populations of neurons already respond preferentially to musical and vocal sounds, beyond a mere analysis of the spectrotemporal modulation statistics of these sounds. The essential difference between these hypotheses lies in the extent to which neuronal tuning specific to music and speech perception is gradually constructed through auditory experience or, conversely, emerges largely independently of any instructive influence from experience⁽²⁴⁾.

Winkler et al. (2009)⁽²⁵⁾ reported that newborns are sensitive to musical rhythm. Kotilahti et al. (2010)⁽²⁷⁾ used near-infrared spectroscopy and found that brain responses to speech and music are significantly correlated. Hernandez-Reif et al. (2006)⁽²⁶⁾ observed that lullabies, whether vocalized or not, induced a deceleration of heart rate; however, infants of depressed mothers exhibited delayed responses compared to those of non-depressed mothers^(25-27).

Van der Heijden and colleagues reported that music can, in certain cases, have an overstimulating effect on newborns; however, this observation must be considered in the context of the difference between recorded music and live performance. Playing a Mozart piano concerto or a complex pop song for a newborn can indeed lead to overstimulation of the brain and body, which, during prematurity or early term, may not yet be equipped to process such complex stimuli⁽²⁸⁾.

Magnetoencephalography (MEG) is a noninvasive brain imaging technique that measures the magnetic fields generated by neuronal activity in the brain. It provides high temporal and spatial resolution and is used to study brain functions, sensory and cognitive processing, as well as to localize cortical regions involved in various tasks. MEG is valuable for researching brain development, diagnosing epilepsy and identifying cortical areas responsible for language and motor functions, without the use of radiation or invasive procedures⁽²⁹⁾.

A study conducted by Dehaene-Lambertz et al. (2002) demonstrated that 4-day-old newborns and 2-month-old infants can discriminate sentences in their native language from sentences in a foreign language. Both speech and music contain rapid temporal auditory transitions and phonetic information conveyed through temporally symmetric phonemes. Accordingly, it was expected that brain regions sensitive to these properties would be commonly activated under both conditions⁽³⁰⁾.

Issard et al. (2018) found that speech and music stimuli, balanced in duration and frequency content, elicited clear and significant responses in healthy neonates. In five newborns, responses to the speech stimulus were stronger in both hemispheres, whereas in five out of thirteen, responses to the music stimulus were stronger in both hemispheres. The maximal significant responses were located more posteriorly in the left hemisphere (LH) than in the right hemisphere (RH). This is consistent with auditory MEG responses in adults, which are approximately 10 mm more anterior in the right hemisphere than in the left hemisphere⁽²³⁾.

Keidar et al. (2014) demonstrated that exposure to Mozart’s music is associated with a reduction in resting energy expenditure (REE) in healthy, metabolically stable preterm infants within 30 minutes of listening. In contrast, Bach’s music did not produce such an effect. The exact mechanism underlying this “Mozart effect” requires further investigation⁽³¹⁾. Two music medicine studies used resting energy expenditure as an outcome measure. Both found that Mozart’s music led to a significant decrease in REE, as measured by a Deltatrac II metabolic monitor. It should be noted that, although indirect calorimetry is an effective test when performed correctly, it is subject to certain inaccuracies⁽³²⁾.

Indirect calorimetry is a widely used method for esti­ma­ting metabolic rate by measuring oxygen consumption (VO₂) and carbon dioxide production (VCO₂). It is considered the noninvasive gold standard for assessing energy metabolism. Common sources of inaccuracy include: improper equipment calibration, which can distort VO₂ and VCO₂ measurements; air leaks in the measurement system (e.g., face mask, tubing), which reduce accuracy; patient movement or irregular breathing, which alter actual oxygen consumption; assumptions regarding the respiratory exchange ratio (RER), which may not hold under all physiological conditions (e.g., in ketoacidosis or mechanically ventilated patients); and a measurement duration that is too short to capture steady-state metabolism^(24,33).

A randomized study conducted on a cohort of 45 neonates in an intensive care unit in Turkey over a nine-month period (November 2014 – August 2015) demonstrated an improvement in overall condition and a reduction in stress during exposure to classical music, irrespective of the composer. The intervention had a positive effect on oxygenation and the maintenance of optimal body temperature⁽³⁴⁾.

Full-term and post-term infants who are medically and neurologically stable are capable of tolerating and benefiting from progressively more complex musical stimuli as they grow, including vocal and instrumental music (including orchestral pieces). However, exposure must be intentional. Given that newborns have limited wakeful periods, it is recommended to use this time for active engagement. Combining recorded music with movement/dance, tactile/massage stimulation, and multisensory visual stimuli (excluding screens) is appropriate and recommended in later stages of development, when the range of activities and the infant’s “readiness” for more complex sensory processing are expanded⁽³⁵⁾.

Electrophysiological responses generated in the human brainstem reflect the frequency characteristics and temporal variations of sound and have been extensively studied in the context of click, tonal, and speech stimuli. The brainstem response to a speech syllable can be divided into two components: a transient component and a sustained component. The transient response at the onset of speech is similar to the click-evoked response, which is used clinically to assess hearing. The sustained component, known as the frequency-following response, synchronizes with the periodicity of a sound, and the interspike intervals are aligned with the fundamental frequency. Measurements of speech-evoked onset responses and frequency-following responses, such as peak latencies and spectral amplitudes, have been extensively studied. Moreover, these two main features of the brainstem response have been shown to be influenced by visual observation of phoneme articulation and auditory training, making these responses suitable tools for investigating the effects of musicality⁽³⁶⁾.

In preterm infants, brainstem auditory evoked responses emerge around 27-29 weeks of gestation, reflecting synchronous activity of the eighth cranial nerve and brainstem responses. According to fetal magnetoencephalography studies, absolute latencies progressively decrease with increasing gestational age, and there is an inverse relationship with auditory stimulus intensity. In the following weeks, initial cortical evoked potentials are observed, manifesting as a pattern of alternating low- and high-voltage activity. Low-voltage activity is asynchronous and is referred to as “relative quiescence”, whereas high-voltage activity is already present simultaneously in corresponding regions of both hemispheres, being thus synchronous, starting from the occipital lobe and extending to the temporal regions. Auditory evoked potentials in preterm neonates at 33 weeks of gestation have demonstrated early cortical activity, with nearly mature biomechanical function of the cochlear signal. The absence of electrical activity in the olivocochlear system in preterm infants before 32 weeks of gestation may indicate that, prior to this stage, immature auditory pathways are unable to transmit information from the periphery to the cortex⁽³⁷⁾.

In a study conducted by Sá de Almeida et al. (2023)⁽³⁸⁾, it was observed that in the preterm brain, from 33 weeks of gestational age (GA) to term-equivalent age, there was a statistically significant longitudinal increase in fractal density (FD), functional connectivity (FC), and functional connectivity density (FDC) across all major white matter (WM) fiber tracts. This includes commissural fibers such as the body, splenium and genu of the corpus callosum, the major and minor forceps, and the anterior commissure; bilateral association fibers such as the cingulum, superior longitudinal fasciculus, arcuate fasciculus, inferior frontooccipital fasciculus, inferior longitudinal fasciculus and uncinate fasciculus; and bilateral projection fibers, including the superior corona radiata, fibers traversing the internal capsule (such as the corticospinal tract) and external capsule, as well as the fornix, optic radiations and acoustic radiations. Additionally, a significant increase in fractal density, functional connectivity and functional connectivity density was observed in the thalamus (the origin of the main ascending projection fibers), the brainstem (through which projection fibers pass), and the cerebellum and cerebellar peduncles. Beyond these white matter changes, an increase in functional connectivity was also noted in specific cortical regions of the gray matter⁽³⁸⁾. Moreover, the findings in thalamic regions indicate that deep gray matter also undergoes significant maturation processes, which is consistent with the rapid development and establishment of thalamocortical functional connections occurring during this critical period of brain development^(39,40).

The development of neural networks during the perinatal period is highly dependent on both internal and external multisensory activity, which drives the maturation of neural circuits. Notably, prenatal and early postnatal music exposure in rats has been shown to modulate brain development, enhancing learning abilities. Since prematurity affects socioemotional development and the associated neural correlations, musical interventions, as a framework for brain plasticity, have demonstrated a significant impact on the reward system. Music induces activity in limbic structures (e.g., amygdala and hippocampus) and paralimbic regions (e.g., orbitofrontal cortex, parahippocampal gyrus and temporal poles), which are involved in the generation and regulation of emotions, and can thus influence the maturation of socioemotional development⁽⁴¹⁾.

An example of macrostructural adaptation was reported by Wan and Schlaug, who demonstrated that, in musicians, the anterior corpus callosum is larger. This structure is a bundle of millions of myelinated axons (200-250 million) involved in interhemispheric communication and essential for the execution of complex bimanual motor sequences. This effect is time-dependent: musicians who began musical training at an early age (under 7 years old) exhibit a larger corpus callosum than those who started later. Additionally, the primary motor cortex is generally larger in the right hemisphere of musicians compared to non-musicians, and its volume is closely associated with the age at which musical training commenced^(42,43).

In addition to processing information related to negative emotions, the amygdala is highly sensitive to auditory stimuli. The amygdala may possess an independent regulatory mechanism for negative stimuli associated with sounds. This highly specialized brain region plays a crucial role in modulating negative stimuli. In one study, weaned piglets were exposed to noise-induced stress to investigate whether this type of stress triggers apoptosis in the cells of the amygdala, inflammation and oxidative damage⁽¹⁰⁾.

The study of human emotions exhibits a similar tendency to prioritize research on negative experiences, much like animal studies. This preference is likely driven by the fact that expressions of negative experiences are more intense and easier to investigate than positive emotions, which are often considered less salient, being more labile and subtle⁽⁴⁴⁾.

One study on pigs showed that the ones in the noise-exposed group remained awake longer than those in the other groups. Histidine, a precursor of histamine in the central nervous system (CNS), is converted into histamine via decarboxylation, and represents one of the main sources of histamine. Taurine concentration was higher in the music-exposed group than in the control group, supporting the idea of music’s beneficial effect on amygdala cognitive development. Interestingly, although piglets in the noise-exposed group were more active, concentrations of the inhibitory neurotransmitters GABA and glycine were elevated. In other words, the heightened agitation of the noise-exposed piglets does not appear to be due to reduced inhibitory neurotransmitter release. In the process of managing external pressures, the organism is subjected to constant stress and counteracts the effects of negative stimuli through feedback regulatory systems. These regulatory mechanisms may mitigate stress caused by external negative stimuli via compensatory processes. For example, compensatory mechanisms can increase neurotransmitter release, which could explain the elevated GABA concentration in the amygdala of noise-exposed piglets as a countermeasure against abnormal secretion. However, such compensatory increases may carry unforeseen risks. Maintaining physiologically normal neurotransmitter levels is essential for homeostasis⁽⁴⁵⁾.

Recent direct evidence of the link between dopamine and pleasure was provided by Ferreri et al. (2019). The study participants received an oral dopamine precursor (levodopa), a dopamine antagonist (risperidone), or a placebo (lactose). Levodopa was found to enhance both hedonic experience and music-related motivational responses, whereas risperidone reduced the participants’ ability to experience musical pleasure, and the placebo had no effect. These findings demonstrate that pharmacological manipulation of dopamine modulates affective responses to music. More recently, it has been hypothesized that dopamine-dependent musical reward may enhance memory not only through explicit and/or primary consolidation processes, but also via the esthetic reward provided by music⁽⁴⁶⁾.

Classification of emotions

Dalla Bella et al. (2001), in a study, asked children aged 3-4 years old to match emotions with various melodies (based on rhythm, melodic contour, etc.). The children were largely unsuccessful, which led the researchers to suggest that the ability to associate emotions with musical features is a learned trait, and that different emotions follow distinct developmental trajectories⁽⁴⁷⁾.

Infants display focused attention and reduced bodily movements when their mothers sing. Moreover, fetuses attend to and remember music to which they have been previously exposed. The earliest fetal responses to sound appear at 16 weeks of gestation⁽⁴⁸⁾.

Tempo is a feature of melodies that distinguishes “sad” from “happy” music, and it is associated with arousal in music across different cultures. Fast, happy music can induce arousal and increase heart rate. If newborns are capable of differentiating between “happy” and “sad” music, this could be reflected in heart rate deceleration in response to sad music and acceleration in response to happy music^(49,50).

Positive emotions can be categorized into three temporal domains: i) past (e.g., post-consumatory satisfaction), ii) present (e.g., pleasurable sensory activities), and iii) future (e.g., positive anticipation, anticipatory joy). Focusing on present-oriented positive emotions has led to the proposal of three types of pleasures in humans: sensory pleasures, higher-order pleasures (non-homeostatic sensory experiences), and rewards (internal intellectual experiences). At least the first two categories are considered relevant for investigating emotions in animals^(51,52).

Hedonism, in its narrow sense, refers to pleasure or positive affect. In a broader sense, it can denote a general affective disposition, either positive or negative. Studies have demonstrated the presence of behavioral and physiological signs of pleasure in animals, akin to human euphoria. These signs can be elicited by both natural rewards and addiction-like patterns induced by treatments with rewarding substances, such as heroin, other opioids or dopaminergic drugs. Animals anticipating food or engaging in play often exhibit a characteristic behavioral pattern, marked by short, abrupt movements and rapid changes in posture⁽⁵³⁾.

The responses to music, however, are susceptible to prenatal shaping. When fetuses at 28-30 weeks of gestation (third trimester) were exposed to classical music, significant changes were observed in the number of uterine contractions and fetal movements. It has been suggested that listening to classical music may even help prevent preterm birth. Fetuses exposed to a set of musical pieces starting at 32 weeks of gestation exhibited more accelerations and decelerations in heart rate in the presence of music by 38 weeks of gestation. Moreover, this effect persisted postnatally, with infants showing a preference for the music they had heard in utero and continuing to display increased movements while listening to these pieces, compared with a control group at six weeks of age⁽⁵⁴⁾.

The study conducted by Bainbridge et al. (2021) concludes that the effect of music on infant relaxation is not merely a result of familiarity, as the infants were not familiar with the lullabies used, including the languages and cultures from which they originated. Thus, music exerts a specific calming effect, independent of mere familiarity with sounds. Although lullabies exhibit universal acoustic features, there is significant variability among the different songs presented to the infants. Their responses, however, remain consistent and robust in the face of this musical variability, confirming the capacity of infant-directed songs to induce relaxation⁽¹³⁾.

Music represents an independent and individualized experience, distinct from prior encounters, up to the moment a musical piece is heard. Depending on the principles, environment and upbringing in which a child develops, they are capable of appreciating a melody. Their prior experiences provide the foundation for experiencing a particular emotion. In the case of a newborn, the infant perceives the emotion conveyed by the mother at the time she listened to the melody during pregnancy. Thus, the infant’s emotions are influenced by maternal authority and by what the mother herself felt in that moment. While some studies support this notion, others have not observed changes in maternal physiology upon listening to a piece of music; nonetheless, alterations were detected in the fetus.

Emotions are also determined by similar variables, including environment, ethnicity and other cultural factors. Depending on the responses of the child’s caregivers, the child will interpret an emotion as either positive or negative.

What a child experiences when listening to a melody – including rhythm, tempo, meter, harmony, tonality, texture, timbre and lyrics – can be indirectly monitored through physiological responses such as heart rate, neural activity and physical manifestations (e.g., limb movements). These responses can be assessed using tools such as pulse oximetry, near-infrared spectroscopy (NIRS), electroencephalography (EEG), magnetoencephalography (MEG), as well as through direct behavioral observation.

Thus, music constitutes a complex experience that intertwines both the subject’s emotions and the historical imprint of entire generations. Music does not take away; it offers an alternative perspective, guiding us through emotional states we may not have previously recognized, across the cultures of the world. Music unites what language might divide, and “heals” wounds that are invisible to the naked eye.

Autor corespondent: Bogdan-Aurelian Stana E-mail: bogdan.stana@gmail.com

CONFLICT OF INTEREST: none declared.

FINANCIAL SUPPORT: none declared.

This work is permanently accessible online free of charge and published under the CC-BY.