Statement of Verax Technologies, Inc.
MUSIC THERAPY PILOT PROGRAM
Today's audio technology derives from the early days of the industry when two channels were all that sound engineers had to work with. However, advances in digital signal processing (including low-cost, high-capacity computing power, distributed network architectures, and component miniaturization), mean that technology no longer has to be a limiting factor in sound reproduction, and in the last decade the number of audio innovations has exploded. Because Verax got there first, the company has been able to develop a rich portfolio of patents relating to audio capture, modeling and reproduction techniques, including sound source separation, 3D sound modeling and reproduction, all of which may be rapidly deployed using off-the-shelf components. By combining these technologies with others such as advanced EEG diagnostics, we can open up a world of new treatment possibilities for music therapists, patients and their families, who will be able to optimize the location, spatial direction, volume, tone and other characteristics of individual sound stimuli for maximum therapeutic effect.
What makes this unprecedented level of control possible? The answer is "Sound Source Separation." This means that individual sounds from an unlimited number of sources can each have their own loudspeaker, which other systems (e.g. surround sound) cannot replicate. Because each sound can be controlled separately without any special technical training, patients and/or family members can make the most imperceptible, yet highly meaningful adjustments to what is heard. This is a fundamentally new approach to sound reproduction, not the typical minor modification to existing sound reproduction techniques that add marginal improvement at significant cost.
The following section provides an overview of how Verax solutions can add measurable value to standard music therapy interventions for PTSD and other disorders.
Music Therapy is the use of music and/or its musical elements (sound, rhythm, melody and harmony) by a qualified music therapist, with a client or group, in a process designed to facilitate and promote communication, relationships, learning, mobilization, expression, organization and other relevant therapeutic objectives in order to meet physical, emotional, mental, social and cognitive needs. Music therapy aims to develop potentials and/or restore functions of the individual so that he or she can achieve better interpersonal and/or interpersonal integration and, consequently, a better quality of life, through prevention, rehabilitation or treatment. (Source: World Federation of Music Therapy, 1996).
3. THERAPEUTIC INTERVENTIONS
Music therapists use various active and receptive intervention techniques according to the needs and preferences of the individuals with whom they work. Using Verax's audio technologies in combination with medical and other technologies, therapists will be able to administer a range of therapeutic interventions, including but not limited to the following:
Listening. Listening to music has many therapeutic applications. Music reduces stress (Stratton, 1992) and anxiety levels (Mornhinweg, 1992). Music has improved mood according to self-report (Kenealy, 1988), and heart rate and systolic blood pressure have also been shown to improve (Pignatello, Camp, Elder, Thomas, & Rasar, 1989). Music helps to develop cognitive skills such as attention and memory. For example, for those facing surgical procedures, it allows the individual an opportunity to exert a sense of control over their unpredictable environment. In situations where cognitive perceptions are comprised, such as by PTSD, listening can provide a sense of the familiar, and increase orientation to reality. Music listening can facilitate increased openness to discussion by helping patients feel safe and provide motivation for engaging in social activity. Verax's "object oriented" technology (enabling one or more sounds to have its own dedicated speaker) creates unprecedented opportunities to "break the sound barrier"— to go beyond what is ordinarily possible with music. This is because of the unique ability to control not only the placement of individual sounds in 360 degree space (i.e. around the patient), but also their directionality—effects that may be accentuated through the use of speakers designed specifically for a given frequency band. In addition, music (and all sorts of special effects) can be played much louder because amplification is possible without distortion.
Rhythmic based activities. These can be used to facilitate and improve an individual's range of motion, joint mobility/agility/strength, balance, coordination, gait consistency and relaxation. Rhythm and beat are important in "priming" the motor areas of the brain, in regulating autonomic processes such as breathing and heart rate, and maintaining motivation or activity level following the removal of a musical stimulus. The use of rhythmic patterns can likewise assist those with receptive and expressive processing difficulties (i.e. aphasia, tinnitus) to improve their ability to tolerate and successfully process sensory information. Verax's object oriented technology also creates unprecedented therapeutic opportunities using rhythmic based activities. For example, with a bedside user interface, patients and/or therapists can change the location and distribution of sound sources, ranging from a purely binaural (stereo) presentation to a more immersive distribution comprising multiple speakers arranged in 360-degree space.
Singing: Singing is a therapeutic tool that assists in the development of articulation, rhythm, and breath control. Singing in a group setting can improve social skills and foster a greater awareness of others. Singing can encourage reminiscence and discussions of the past, while reducing anxiety and fear. For individuals with compromised breathing, singing can improve oxygen saturation rates. Music may stimulate the language centers in the brain promoting the ability to sing. One advantage of Verax's technology is the ability to reproduce live events that are virtually indistinguishable from the original, allowing the patient to re-experience the event repeatedly on demand.
Playing instruments. This can improve gross and fine motor coordination in individuals with motor impairments, neurological trauma and other conditions. Instrumental ensembles can enhance cooperation, attention, and provide opportunities for practicing various leadership-participant roles. Playing instruments may assist those with prior musical experience to revisit previously learned skills, thereby allowing the individual to experience a renewed sense of pleasure and enjoyment. It can also develop increased wellbeing and self-esteem in those who are learning to play an instrument for the first time. Again, the ability to reproduce live events that are virtually indistinguishable from the original will enable patients to learn at a faster pace.
Improvising. Improvising offers a creative, nonverbal means of expressing thoughts and feelings. Improvisation is non-judgmental, easily approached, and requires no previous musical training. As such, it helps the therapist to establish a three-way relationship between the patient/family, themselves and the music. Where words fail or emotions are too hard to express, music can fill the void. Where trust and interaction with others has been comprised due to trauma, disorder or other causes, improvisation provides a safe opportunity for restoration of meaningful interpersonal contact. Where learning ability is limited, the opportunity to try different instruments, musical sounds, timbres and mediums may provide an opportunity for mastery of a new skill and increase life satisfaction. The flexibility of the Verax solution will make it possible to create customized solutions for each patient, enhancing the therapeutic effect of improvisation.
Composing/Songwriting. This is utilized to facilitate the sharing of feelings, ideas and experiences. For example, with hospitalized veterans, writing songs is a means of expressing and understanding fears. It may also provide an opportunity for creating a legacy or a shared experience with a comrade. Lyric discussion and songwriting can help patients deal with painful memories, trauma, and express feelings and thoughts that are normally socially unacceptable, while fostering a sense of identification with a particular group. Verax's technology provides unprecedented opportunities for musical expression, since the system is customizable to patient needs. (Source: adapted from Canadian Music Therapy Association, 2008).
4. PERSONALIZED TREATMENT PROTOCOLS
From the data harvested from multiple patients, evidence-based standards may be developed, along with highly calibrated treatment protocols to address disorders like PTSD with much greater efficacy. For example, by combining Verax technology with EEG and other medical imaging technologies, we will be able to analyze brain activity in real time, and through advanced diagnostics determine the optimal therapeutic intervention for each patient. We may then develop a spectrum of optimization templates, each suited for a given patient profile.
The following chart compares the expanded diagnostic and treatment possibilities of the Verax approach to music therapy (outer circle corresponding to upper diagram) with the limited possibilities of the conventional stereophonic approach (inner circle corresponding to lower diagram). Verax's approach may include stereophonic protocols, but then can do so much more since the number of points of intervention is limited only by the imagination of the therapist.
ADVANCED MUSIC THERAPY SYSTEM
Music Therapy: The New Frontier
According to a 2008 study of 1.65 million service members by the Rand Corp, 20 percent of Iraq and Afghanistan veterans (over 300,000 individuals) suffer from depression or post-traumatic stress disorder (PTSD). Experts predict that the percentage could grow in coming years, because stress disorders often take months or years to appear, and also because of the upsurge in guerrilla tactics such as roadside bombings. Victims need help dealing with issues (including flashbacks, withdrawal symptoms, and heightened arousal) and resetting their pattern to 'default.' Left untreated, serious conditions such as PTSD can become chronic disabling disorders, so effective diagnosis and treatment must be given at the earliest opportunity. Music therapy first emerged to help victims develop compensatory mechanisms. But new field of Neurologic Music Therapy (NMT) has demonstrated that music can achieve much more by actually restoring neurological function. Verax offers the prospect of raising the bar still further, by enabling music to be calibrated and optimized in ways that are not possible with existing technology.
Neurologic Music Therapy (NMT)
With the rise of psychological ailments among Iraq and Afghanistan war vets, military and VA hospitals have begun to rethink how they deal with this age-old scourge of war. Music therapy in particular has shown great promise as a powerful non-invasive therapeutic tool. Furthermore, new research findings indicate that music therapy can not only help the patient develop compensatory behaviors, but also restore neurological function. The scientific, evidence-based field of Neurologic Music Therapy has emerged with the goal of treating patients with various neurologic issues (cognitive, speech/language, sensorimotor). NMT is based on the principle of leveraging the physiological mechanisms inherent in music perception and production.
A common task of music therapists is to induce a meditative condition so as to influence brain neurophysiology. In order to accomplish this, it is necessary to discover the most effective rhythmic and tonal parameters for each patient. Individualized music has superior healing properties to regular "relaxation music," because everybody's EEG (the pattern of electrical impulses produced by chemical reactions in brain cells) is as unique as their fingerprint. To demonstrate this, one study sponsored by the University of Toronto used computers to transform EEG traces into 'brain music.' Sixteen EEG channels were employed, each channel providing a selection from 120 musical instruments. Researchers were able to create changes in tempo, vary the volume of each channel, transpose the music of each channel to different octaves, change musical parameters (e.g., legato or staccato), add major and minor chords, and analyze the note patterns of each channel. Through a process of optimization they were able to entrain and re-balance patients' brains. However, this level of individualization is beyond the reach of practicing therapists, who have relatively few audio channels to work with, and limited opportunities for output control (master volume, left-right balance, control of frequencies across all channels).
Verax Value Proposition
Today's audio technology derives from the early days of the industry when two channels were all that sound engineers had to work with. However, advances in digital signal processing (including low-cost, high-capacity computing power, distributed network architectures, and component miniaturization), mean that technology no longer has to be a limiting factor in sound reproduction. Using Verax's patented audio technologies in conjunction with advanced EEG diagnostics, music therapists will be able to optimize the location, spatial direction, volume, tone and other characteristics of individual sound stimuli for maximum therapeutic effect. From the data harvested, evidence-based standards may be developed, along with highly calibrated treatment protocols to address disorders like PTSD with much greater efficacy.
Problem, Hypothesis and Military Relevance
•Psychological health & traumatic brain injury
•Advanced music therapy systems can build upon the proven success of traditional music therapy treatments and protocols
•Next-generation music therapy systems can be deployed throughout the Military Health System (MHS) as a cost effective, non-invasive method to assist in the tasks of:
•Chronic pain management
•Diagnosis and treatment of PTSD
•Diagnosis and treatment of deployment-related psychological health problems
•Music therapy has shown great promise as a powerful, non-invasive therapeutic tool
•New research findings indicate that music therapy can help patients develop compensatory behaviors and restore neurological function
•Individualized music has superior healing properties to regular relaxation music because EEG patterns are as unique as fingerprints
•Today's audio technology derives from the early days of the industry when two channels were all that sound engineers had to work with
•Verax's patented audio technologies, in conjunction with advanced brain diagnostics, will enable music therapists to optimize sound stimuli for maximum therapeutic effect
•From the data harvested, evidence-based standards may be developed along with highly calibrated treatment protocols to address an array of psychological disorders with much greater efficacy
 Baker F., Roth EA. (2004). Neuroplasticity and functional recovery: training models and compensatory strategies in music therapy. Nordic Journal of Music Therapy. 13(1): 20-32.