2002 Symposium Summary


	2002 Symposium: Dialogues Across Disciplines: Cognitive Neuroscience and Music Processing in Human Function In December of 2002, the Institute for Music and Neurologic Function successfully presented a full-day conference called "Dialogues Across Disciplines: Cognitive Neuroscience and Music Processing in Human Function". Distinguished international music researchers shared their work in areas such as music processing and motor function, language, and cognitive functioning, in line with the IMNF's continuous efforts to fulfill its mission to seek to establish new knowledge and develop more effective therapies which awaken, stimulate, and heal by incessant scientific explorations of music and the brain. A summary of presentations and panels is presented below. If you would like to find out how you can obtain copies of the abstracts from the symposium, please call (718) 519-5840. Summary of Presentations and Panels
	Karl Pribram, M.D., Ph.D. Distinguished Research Professor in Psychology and Cognitive Science Georgetown University, Washington, D.C. pribramk@georgetown.edu *Keynote Address* In an attempt to point out the formalistic nature that is essential in musical processing and the brain function, Dr. Pribram proposes three important aspects to be reviewed. First, the formal parallel between music and the brain function is illuminated. By showing the “Fourier relationship” between the spectral (formal) domain and space/time domain, Dr. Pribram suggests one way of understanding the physiological correlates of musical experience. It is stressed that “the form within” both of music and the responding brain activities can be revealed most essentially by their formal structures – i.e., the formal structure of music and that of the brain activities (how the waveforms of brain cell activities relate to one another in response to music). The predictive nature and the problem of uncertainty (indeterminacy), both inherent in musical sequences and the brain activities, are re-illuminated in light of temporal aspects of the formalism. Second, the structure of redundancy in music is discussed in terms of its perceived complexity and the electrical activity of neuronal cells measured by EEG in recording the perceived complexity. Here again, the neurological correlate of cognitive threshold is illuminated from the perspective of formalism – i.e. energy elicited (or complexity perceived) in relation to the amount of formal structure. Lastly, the projective nature of brain function in relation to music-making is discussed. It is pointed out that the brain does not refer to itself but “projects out”. By relating this knowledge to human music-making behaviors (both receptive and expressive), Dr. Pribram once again emphasizes the significance of a formalistic view in trying to understand how the brain processes music: it is the formal patterns of the brain activities that are projected to sound patterns, through which a person’s mind perceives music.
	Michael Thaut, Ph.D. Colorado State University Center for Biomedical Research, Fort Collins, Colorado www.colostate.edu/depts/cbrm “Neurophysiology of Neural Timing Networks in Musical Rhythm and Rhythmic Synchronization” Dr. Thaut presents the mechanism of rhythmic and motor synchronization and its clinical implication for neurologic music therapy. He explains that, through a brain mechanism called “coupling”, the temporal regularity in the auditory rhythm entrains and synchronizes motor rhythm. This is demonstrated by electrophysiological data showing how phase error (perturbation in ongoing temporal cortical activity created by subtle changes in the auditory rhythm) quickly and accurately drives itself back into synchronization and coupling between auditory and motor system. He emphasizes that the rhythmic entrainment can be both below (subliminal) or above (supraliminal) the level of perception, as well as on the level perception. It is shown that the interval timing both in subliminality and supraliminality is depicted in the amplitude of N100 brain potential. This suggests that time coding and rhythmic perception are already occurring in the primary auditory cortex through synaptic plasticity and synaptic synchronicity. In particular, the Heschl’s gyrus is proposed to be involved in the interval measurement. Anatomically, findings from neuroimaging studies reveal a robust contralateral neuronetwork system between auditory input and the motor output in music. With these data, Dr. Thaut proposes that the mechanism of rhythmic entrainment provides a strong implication for neurologic music therapy as it targets at sensory-motor and speech rehabilitation, and furthermore improvement of memory/attention.
	Jack Feldman, Ph.D. Professor, Department of Neurobiology University of California Los Angeles, California Feldman@ucla.edu *“Neural Mechanisms Underlying Movement and Homeostasis”* Dr. Feldman calls a special attention to timing aspect of neuronal activities in illuminating on the brain mechanisms underlying a range of behaviors, from hitting abaseball, playing a musical instrument to regulating blood pressure or breathing. With the given property of the brain in general, whose activity is stable yet at the same time labile to what it is exposed to, he explains how input and output neuronal activities are temporally related. Dr. Feldman shows how the stimulation of input neurons placed shortly before the activation of the output neurons increases the association between the input and output neuronal activities whereas the stimulation of input neurons placed after the activation of the output neurons decreases the response. This indicates the causality between input and output neuronal activities. He also explains how the temporal property of inputs affects that of the outputs, by showing the low-pass filtered input frequencies resulting in the decrease of the output frequencies. With this, he proposes that the rhythmic activity of neurons, i.e., oscillations, is important in determining the reliability of the response of the neurons as well as the precision of activation of single, individual output neurons. Furthermore, it is demonstrated that presentation of stimulus in separate periods is more effective, than one that is continuous, for generating rhythmic response of behaviors including breathing and motor activity. These insights can lend themselves to further clinical implications as to how to manipulate the temporal and rhythmic components of music in order to elicit targeted behavioral outputs.
	Gottfried Schlaug, M.D., Ph.D. Director of Neuroimaging Assistant Professor of Neurology Harvard Medical School Boston, Massachusetts www.musicianbrain.com *“The Musical Brain: Cerebral Correlates of Musical Functions”* In an attempt to propose cerebral correlates of musical functions, Dr. Schlaug reports studies that indicate both functional and structural differences in the brain between musicians and non-musicians. Included in the findings of the studies is the hemispheric symmetry of musicians, as opposed to the left hemispheric dominance in non-musicians, which may be attributed to the significant increase in the right hemispheric activation. Other studies show similar findings with regard to the responses in the auditory cortex in that musicians and non-musicians show different size of Heschl’s gyrus, a portion that is importantly involved in tone processing. In order to illuminate on whether these structural differences that musicians’ brains show are due to learning or innate abilities – a problem largely unknown yet – Dr. Schlaug presents several other studies investigating the effect of prolonged musical training on the overall brain structure. These studies show different representation (i.e., enlarged sizes or heightened activations) of the brain regions, mainly in the auditory cortex but also in the cerebellum – possibly suggesting some form of adaptation of these areas to the challenges and requirements involved in the acquisition of musical skills. Another study compares the overall structural differences of the brain among three different groups, professional musicians, amateur musicians and non-musicians, who engage themselves in musical activities for a significantly different amount of hours daily. The result shows enlarged morphological representations of the regions of the sensory-motor system (primary- and pre-motor cortex, primary auditory cortex, and some areas of parietal cortex) in the professional musicians’ brains. This supports the notion that musical training has a significant affect on the cortical morphology of the brain. The problem of whether more or bigger in the cortical representation is better – and to what extent so – remains yet to be further investigated, which necessitates a close collaboration between experimental studies and empirical/clinical observations.
	Aniruddh. D. Patel, Ph.D. Associate Fellow The Neuroscience Institute La Jolla, California www.nsi.edu/users/patel *“Language and Music”* Dr. Patel presents recent studies that challenge the traditional view of language and music as being independent brain functions, and suggest that the two can involve similar brain areas and functions. Through a series of systematically conducted investigations, using EEG and brain imaging techniques, he attempts to establish neurocognitive basis of commonality between the syntactic processing of music and that of language. An EEG study comparing the cortical electrical activities in response to “structural distances” in music (the level of distance in musical chord sequences) and language (the level of distance in syntactic relationship of words in a sentence) showed similar results in that, in both language and music, the farther the syntactic relation was, the more delayed and the less stronger were the cortical responses. The same experiment was followed upon by studies co-registering the previous EEG results with MRI and fMRI. The MRI study revealed that the electrical responses shared for language and music were localized to the Broca’s area and the right hemispheric analogue to the Broca’s area. Similarly, the fMRI study showed that the entire brain network activated by music largely shared with one that is responsible for language processing. These findings strongly suggest that musical syntax is processed in the brain areas and through their networks that are known to be involved in processing linguistic syntax. In an attempt to link this to clinical implications for using music for language rehabilitation, Dr. Patel suggests for further studies comparing the abilities and deficits in language and music for the brain damaged patients.
	Wendy Magee, Ph.D., RMTh. Head of Music Therapy Royal Hospital for Neuro-disability London, England wmagee@rhn.org.uk *“Music and Rehabilitation of Language Skills”* Dr. Magee presents clinical findings from her music therapy work with patients with speech and language disorders due to brain damage. Three major music therapy techniques are introduced in this presentation: first, vocal instruction, including breathing, vocal-syllable exercise and song-singing; second, pacing, including metered rhythmic cueing (each syllable cued by steady beat) and passioned rhythmic cueing (speech prosody matched by differentiated duration of rhythmic beats); and third, melodic intonation therapy, modified by enhanced musical components (e.g., more melodic structure) or focus on target words. Dr. Magee reports that latest researches show the pacing technique is effective in improving speech intelligibility. It is suggested that the effect is most prominent for patients with severe dysarthria, while it is rather contraindicated for patients with mild dysarthria. There are also empirical findings that support both metered and passioned rhythmic cues are equally effective in increasing speech intelligibility. Singing technique and pacing technique, although effective differently according to the types of speech and language disorder, were both found useful in improving speech intelligibility.
	Mark Jude Tramo, M.D., Ph.D. Assistant Professor of Neurology Director, The Institute for Music & Brain Science Harvard Medical School Boston, Massachusetts www.researchmatters.harvard.edu *“Music and Cognition – Overview of Knowledge”* In this presentation, Dr. Tramo summarizes the functional levels and areas of the brain into three basic processing systems, and relates them to various levels of musical experiences. Musical stimuli as auditory sound patterns are first represented and analyzed in the unimodal (modality-specific) auditory cortex, the area thatis organized both hierarchicallyand in parallel. Further musical perception or action engaging two or more unimodal processings (e.g., playing, or listening to music while reading the score) involves multimodal system distributed in the areas including parietal and superior temporal cortex. However, the most essential musical experience accompanied by meanings and emotions requires an even further level of brain processing called the supramodal system. Dr. Tramo summarizes the supramodal system into three time-specific regions, i.e., future, primordial and past. These regions are anterior frontal cortex, limbic areas, and mediotemporal cortex, respectively. It is pointed out that musical meanings and emotions occur in associations with intrinsic or extrinsic components, and their processing involves the time-specific supramodal regions. The intrinsic or extrinsic components in association with musical emotions and meanings include certain musical expectations (futuristic component), body language or facial expression (primordial component), or association with memories of past events (past component). Dr. Tramo stresses the multiple levels and intricately connected features of music processing in the brain, thus a wide range of therapeutic implications for areas encompassing psychological, neurological and psychiatric treatments.
	Josef Rauschecker, Ph.D., D.Sc. Professor, Department of Neurology Georgetown Institute for Cognitive and Computational Science Director, Laboratory for Integrative Neuroscience and Cognition Georgetown University Medical Center Washington, D.C. www.giccs.georgetown.edu “Cortical Plasticity and Music” One of the fundamental properties of the brain is its ability to reorganize its structures and functions based on learning and daily exposure -- a property called plasticity. Dr. Rauschecker presents studies that represent cortical plasticity of the brain in relation to music, meaning, how the brain changes and reorganizes itself in musical experience. He conducted a study that compares the brain activation by listening to music and the activation by anticipating music. The result of the study shows activations in different brain regions in listening and anticipating. While there were massive bilateral activations of the auditory cortex and medial parietal cortex in listening, the activations of the inferior frontal cortex and the cerebellum as well as the robust connections between the two regions were prominent in anticipating. Another study compared the differences in the structural organizations of brain activities of a classical vocalist while she was singing a song of “her genre” and a song of non-familiar genre, as well as while listening to herself singing. The findings show that there were heightened activations of the inferior cortex and the cerebellum both in singing a song of her genre and listening to herself singing. However, there was no cerebella activation in singing a non-familiar song; instead there were bilateral activations in the auditory cortex. With these results, Dr. Rauschecker points out that constant exposure to certain types of music activates certain structures of the brain, thereby suggesting therapeutic implications of differentiated use of music to stimulate different brain areas and functions. In doing so, he adds that the cerebellum in particular may play an important role in temporal processing and learning of musical relationships.
	Edward Large, Ph.D. Assistant Professor Florida Atlantic University Center for Complex Systems and Brain Science Boca Raton, Florida www.ccs.fau.edu *“Direction of Research and Gaps in Knowledge”* In considering the role of timing in cognitive representations of music, Dr. Large presents two studies showing functional and anatomical properties, respectively, of beat/meter processing in the brain. First, he presents an EEG study investigating the neural activity in processing metrical structures (beat/ metered-accents) of music in the gamma band (25-60Hz). Both the evoked responses (responsesthat are phase-locked to the stimulus) and the invoked responses (responses that are not phase-locked) were measured and compared. The results showed that the neural activity in the gamma band is closely related to the auditory patterns of metered-accents, thus suggesting a cognitive property of accent-specific listening in music; and that there is anticipation of metered-accents even in the absence of accents, which, Dr. Large suggests, may be corresponding to internal feeling of musical pulse. The other study investigated emotional response in relation to musical timing using fMRI. The subjects listened to a piece of music twice, conditioned differently each time -- the music was first mechanically played by computer, then expressively played by an expert performer. The results showed different activations of the brain regions in the musical conditions: activations of the parahippocampal gyrus and the Broca’s area while listening to mechanically played music; and those of the anterior cingulate, the temporal pole, and the orbitofrontal cortex while listening to expressively played music. These findings strongly indicate the relationship between musical timing andemotional responses.
	Claude P. Ghez, M.D. Professor, Columbia University College of Physicians and Surgeons Center for Neurobiology and Behavior New York, New York http://cpmcnet.columbia.edu “Neural Mechanisms Underlying the Control of Voluntary Movements” Dr. Ghez presents the effect of auditory feedback on coordination and learning of limb movement in the absence of proprioception. The proprioception is afferent transmission of information from the muscle receptors from the brain and essential for the brain to construct internal model of movement. Patients whose proprioception is deafferented lack sensations in the joints and muscles in their limbs. As a result, they have difficulties coordinating familiar movements or learning new movements in proper distance and intensity either with or without vision. Dr. Ghez suggests that the use of auditory feedback can replace these patients’ deficient proprioception. A study is presented to show a patient training movement with the use of musical feedback. In the experiment, the patient’s shoulder and elbow was connected to musical feedback device through deconverter, while the different rhythm/ timber components of music were synchronized with the movements of the shoulder and the elbow respectively. The study showed that, by gradually decreasing synchronization intervals between the shoulder and the elbow, the whole arm movement had become increasingly sharp. This result provides a strong clinical implication for music therapy in treating patients with movement disorder due to brain damage.
	Lawrence M. Parson, Ph.D. Director, National Science Foundation Social, Behavioral and Economic Sciences Directorate Cognitive Neuroscience Program Arlington, Virginia “Functional Brain Organizations for Musical Skills” Dr. Parson presents a range of brain imaging studies to reveal functional brain organization for musical skills. An fMRI study was conducted to determine the neurological correlates of musical performance of an expert player (a piano player playing a piece of Bach’s and a simple scale). The result showed a noticeable bilateral blood flow increase in the middle-anterior temporal area while the musician played Bach, but not while he played scale. In the mean while, a bilateral deactivation of neural activity (decreased blood flow) was found in the dorso lateral prefrontal area (an area that is responsible for reasoning and planning things other than music) while playing Bach, but not while playing scale, indicating a correlation between playing a familiar tune and deactivation of dorso lateral prefrontal area. These findings provide a strong evidence for a neural circuit specifically involved in emotionally engaging musical performance. In the mean while, a series of studies compared musicians’ and non-musicians’ brain responses to specific musical properties and tasks: For pitch (melody) discrimination, musicians’ brains showed more activations in the middle temporal region mostly in the left hemisphere whereas while non-musicians’ brains showed activations in the superior temporal region mostly in the right hemisphere. A noticeable activation was observed in the midbrain in non-musicians for phrasing, but not in musicians. The broadman area 47 (ventrolateral frontal area) was found to be involved in meter processing for non-musicians, but not for musicians. The cerebellum, the midbrain, and the anterior frontal region were activated in general tempo processing for non-musicians, but not for musicians. These results suggest the significant effect of musical training on the functional brain organization. Furthermore, it is noteworthy that Dr. Parson strongly suggests a possibility of cerebella role in auditory pitch perception. A behavioral study investigating cerebellar patients’ musical abilities revealed that the patients not only showed a significant level of deficiency in pitch discrimination, but also the degree of the pitch discrimination deficiency was correlated with that of apraxia. Another important line of comparison made in the presentation was one between music-related neural circuits and language/speech related neural circuits. A positron emission tomography (PET) study revealed that the right supplementary motor area, the bilateral mouth-motor area, and the auditory areas were activated specifically during singing, suggesting a neural mechanism for singing production that may be distinct from that for speech production. Similarly, another PET study comparing circuits for musical invention (i.e., completing musical melody) and sentence improvisation (i.e., completing spoken sentence) showed that adjacent brain regions were involved, yet no overlap between those regions was found. With this result, Dr. Parson suggests that the brain areas that sub serve speech meaning may be distinct from those sub serving musical meaning.
	David Ramsey, D.A., ACMT Assistant Director Institute for Music and Neurologic Function Beth Abraham Family of Health Services Bronx, New York dramsey@bethabe.org *“Expanding Our Understanding of Music and Learning”* In presenting his clinical work of “musically assisted speech” with stroke patients, Dr. Ramsey emphasizes on importance of the balance between speech rehabilitative exercise and the restoration of “communal” experience, i.e., the “essential human experience” that was once lost due to the illness. Dr. Ramsey briefly introduces the speech exercise techniques invented or modified by himself, such as articulation exercise, breathing exercise, and using familiar tunes in normal speech phrase (i.e., musically cued recall). These techniques are, however, even further elaborated in terms of how they can, and should, be integrated into the therapeutic effort of enhancing the patients’ communal experience. Dr. Ramsey stresses that it is through this socially expressive and interactive communal experience that the patients are allowed to enter into a realm of personal, emotional communication and strive for conversing. The notion of shared body of knowledge and dynamics that exist both in ordinary conversation and music is the central basis of Dr. Ramsey’s musically assisted speech. Musical components and dynamics are used to facilitate conversational dynamics. Negotiation of time or manipulation of tones and physical cues are, therefore, fundamental across different speech exercise techniques.
	Mitchell Steinschneider, M.D., Ph.D. Professor, Albert Einstein College of Medicine The Saul R Korey Department of Neurology Bronx, New York www.aecom.yu.edu “High-Frequency Gamma Band Activity Recorded from Human Auditory Cortex” The mechanism of neural synchrony and binding has been lately suggested to account for the mechanism of perception and cognition, i.e., how the separate sensory encodings of different neurons and regions of the brain integrate in order to represent an object. In particular, the gamma band cortical activity (around 40 Hz) has been noted to play an important role in the binding process. The grand hypothesis is that oscillatory activity in the gamma range helps synchronize the patterns of activity within physically disparate groups of neurons, and it is this synchronization of activity that helps bind together neurons engaged in the processing of sensory objects. Dr. Steinschneider present a study conducted in an attempt to further characterize sound evoked, gamma band activity. The study investigated auditory evoked gamma band activity by examining its frequency distribution, timing, location, and stimulus-response characteristics using intracranial recording of EEG in auditory cortex of patients undergoing surgical evaluation for medically intractable epilepsy. From the results of the study, Dr. Steinschneider presents conclusions as follows: 1) Gamma-band activity is evoked by sound and occurs in multiple auditory cortical fields; 2) It peaks 50-200 ms after following stimulus onset, and temporally overlaps with evoked potentials; 3) It is evoked by stimulus onsets and offsets, varies with stimulus parameters and location in the auditory cortex (including the Heschl’s gyrus, the Planum Tempole, and the right and the left lateral superior temporal gyri), and maybe a more sensitive measure of stimulus-response relationships than the evoked potential. Dr. Steinschneider adds that studies in the animal models relate this activity to associated neural mechanisms. Integration of this work with that obtained in human examining neural functions and its dysfunction in conditions such as dyslexia, ADHD may offer prospects for future investigations.
	Elizabeth Cohen, Ph. D. Visiting Professor of Information Studies University of California Los Angeles, California eacohen@ucla.edu *“Psychoacoustics: From the Fundamentals to Developments of New Constructs for Music Perception Research”* In this presentation, Dr. Cohen emphasizes the significance of psychoacoustic understanding of auditory perception as well as its implementation in research, clinical practice, and interdisciplinary communications. In doing so, she specifically points out that metadata, i.e., data about data, must be comprehensible across “fields”. For example, clinical case study data should be conveyed through new delivery tools, through which more complex issues of music perception and cognition, including layers of physical variables, can be illuminated. By this, Dr. Cohen promotes the idea that, in the age of high-speed networks, vast data storage capacity, real time video-audio streaming, professionals across different principles should have ways of sharing critical information in illuminating on new discovery.
	Hope Young, MT-BC Founder and President Center for Music Therapy Austin, TX www.centerformusictherapy.com *“Gaps in Knowledge/Research to Affect Better Treatment of Early Child Developmental Delays”* In the area of sensory-motor and gait rehabilitation of music therapy, Ms. Young introduces a Neurologic Music Therapy (NMT) technique called Rhythmic Auditory Stimulation (RAS) developed by Dr. Michael Thaut. In an attempt toapply this NMT technique that has been mostly established for adult patients to treatment of early child developmental delays, a clinical case of a 4-year-old boy with pervasive developmental delay is compared with another clinical case of 47-year-old man with traumatic head injury. In comparatively describing these two cases, Ms. Young emphasizes the difference between the two cases in terms of the natures of the illnesses and the therapeutic implications they entail. In the adult’s case, the illness originates from the traumatic head injury on a fully developed brain, while, in the child’s case, it is a still developing brain and its deficiency that causes the disability. This is directly related to distinguished therapeutic implications. While the treatment focus for an adult with traumatic head injury lies on regaining one’s lost ability by musically stimulating pathways that may involve undamaged cells, it is not the case for a developmentally disabled child. Ms. Young proposes a few discussion points for future studies and interdisciplinary works for music therapy for developmentally delayed children. First, children have not had as much musical and rhythmic experience as adults, therefore may not have established as strong neural circuits for music. Second, music therapists working with children should always keep in mind that it is a still developing brain they are working with, and that they must rely on damaged or underdeveloped pathways rather than those involving undamaged cells -- individuals who experienced normal gait patterning prior to the onset of the illness may not have some undamaged cortical cells that could reestablish old motor pathways as well as new motor pathways. Third, because they are working with a still developing brain, music therapists may have to allow a longer treatment period than the length of period required for an adult. Fourth, in musical implement, it should be always considered that developmentally disabled children generally have much shorter attention span. Fifth, a child’s developmental age versus chronological age should be significantly considered. Sixth, environmental sources are limited for children with autism or cerebral palsy (lack awareness of how their body is related to the environment), and it is suggested that their motor delays may be related to their sensory deficits.
	Robert Zatorre, Ph.D. Professor, McGill University Montreal Neurological Institute Montreal, Quebec www.zlab.mcgill.ca *“Music and Emotions”* In an attempt to study neural mechanisms underlying intensely pleasant emotional responses to music, Dr. Zatorre presents a study investigating “musical chills” response using positron emission tomography (PET). In the investigation, cerebral blood flow changes were measured in response to subject-selected music that elicited highly pleasurable experiences of “chills”. Subjective reports of chills were accompanied by changes in heart rate, electromyogram, and respiration. As intensity of these chills increased, cerebral blood flow increases were observed in the ventral striatum (nucleus accumbance, in particular), the midbrain, and the orbitofrontal cortex, while its decreases were observed in the amygdula and the ventral medial prefrontal cortex. This suggeststwo possible systems that may be involved in emotional response to music. The brain regions comprising these two systems, activated or deactivated, are thought to be involved in reward and motivation, emotion and arousal. These brain structures are also known to be active in response to other euphoria-inducing stimuli, such as food, sex, and drugs and abuse. This finding links music with biologically relevant, survival-related stimuli via their common recruitment of brain circuitry involved in pleasure and reward. Dr. Zatorre points to the fact that ancient reward/ motivation systems are present in musical emotional response, despite the fact that music has no direct biological survival value, based on which he also shares an interesting speculation on the evolutionary link between phylogenically older, survival-related brain systems and newer more cognitive systems. He suggests that music may possibly represent a special interaction between emotion and cognition.
	William Benzon, Ph.D. Independent Scholar Jersey City, New Jersey bbenzon@mindspring.com *“Healing Sounds”* As a human activity, music unites mind and body, and one person with another. Current research shows that music involves most areas of the brain and that it can affect the immune system. Clinical practice and research shows that music affects a wide range of mental, neurological, developmental, and gerontological disorders. As a therapeutic activity, music helps the body summon resources to ease the mind, and helps the mind to direct activity that heals the body.
	This Symposium is partially supported through a grant from Administration on Aging,United States Department of Health & Human Services, # 90AM2618.