Kathleen Stephenson

Background: The increasing prevalence of Attention Deficit Hyperactivity Disorder (ADHD) in the United States presents a multifaceted challenge, affecting approximately 11% of children and spurring an increase in demand for stimulant medications¹. National shortages, along with growing parental apprehension regarding the long-term effects of prescription stimulant use in children, contribute to an increasing desire for alternative therapies for ADHD. Many children no longer present with symptoms by adulthood, potentially due to macroscopic changes to affected brain structures as they grow. Learning to play a musical instrument is analogous to exercise for the brain: the simultaneous fine motor movements, motor learning, symbol association, and auditory feedback processing required for performance engage several neural networks. It is known that musical training induces neuroplastic effects that may augment cognitive functions, such as memory and fine motor control, but there is lacking evidence exploring its applications for ADHD².

Methods: Google Scholar and PubMed search terms included: “Music ADHD”, “Music Training ADHD”, “ADHD etiology”, “ADHD music training”, “neuroplasticity musician”, “music training and the brain”, and “music therapy MRI”. Results were filtered from 2019-2024. Many of the citations within the resulting papers were also utilized for supporting evidence.

Results: Volumetric imaging studies consistently conclude varying degrees of gray matter reductions in patients with ADHD, primarily affecting the hippocampus, amygdala, basal ganglia, and nucleus accumbens³. Additionally, MRI studies indicate decreased overall gray matter volume, predominantly in the frontal, temporal, and parietal lobes, in individuals with ADHD³. Contrarily, musicians exhibit increased gray matter volume of the frontal lobe, motor cortex, premotor cortex, hippocampus, and cerebellum². The degree of growth correlates to the intensity and age of onset of musical training⁴. Current research indicates that musical training in children and adolescents with ADHD can decrease cortisol levels, increase serotonin, and alleviate self-reported symptoms, such as restlessness and inattention^5,6. Following 2 years of musical training, children with ADHD displayed heightened fMRI activation in brain areas implicated in the disorder, suggesting that musical training may enhance the functionality of these regions⁷.

Conclusions: Evidence supports music training as an adjuvant therapy for children with ADHD, potentially enhancing motor control, attention, and memory, key aspects of the disorder. Music training may be safer and more accessible than current treatments, notably stimulant medications. Future imaging studies should investigate the structural alterations induced by musical training in patients with ADHD and monitor the severity of symptom presentation over extended training durations.

Work Cited:

1. Abdelnour E, Jansen MO, Gold JA. ADHD Diagnostic Trends: Increased Recognition or Overdiagnosis? Mo Med. 2022;119(5):467-473.
2. Olszewska AM, Gaca M, Herman AM, Jednoróg K, Marchewka A. How Musical Training Shapes the Adult Brain: Predispositions and Neuroplasticity. Frontiers in Neuroscience. 2021;15.
3. Albajara Sáenz A, Villemonteix T, Massat I. Structural and functional neuroimaging in attention-deficit/hyperactivity disorder. Developmental Medicine & Child Neurology. 2019;61(4):399-405.
4. Hutchinson S, Lee LH-L, Gaab N, Schlaug G. Cerebellar Volume of Musicians. Cerebral Cortex. 2003;13(9):943-949.
5. Nigg JT, Sibley MH, Thapar A, Karalunas SL. Development of ADHD: Etiology, Heterogeneity, and Early Life Course. Annual Review of Developmental Psychology. 2020;2(1):559-583.
6. Park J-I, Lee I-H, Lee S-J, et al. Effects of music therapy as an alternative treatment on depression in children and adolescents with ADHD by activating serotonin and improving stress coping ability. BMC Complementary Medicine and Therapies. 2023;23(1):73.
7. Fasano MC, Semeraro C, Cassibba R, et al. Short-Term Orchestral Music Training Modulates Hyperactivity and Inhibitory Control in School-Age Children: A Longitudinal Behavioural Study. Frontiers in Psychology. 2019;10.