Dance-based exercise and, by extension, rehabilitation, can serve as models for learning and memory, visuospatial orientation, mental imagery, and multimodal sensory-motor integration. A great deal of research currently seeks to determine how brain structure/function correlates with dance and/or creative movement, as well as the cognitive processes that accompany such activities. This article highlights cutting-edge research that demonstrates how movement principles can mold the brain, as well as how best to understand and harness movement for clinical and rehabilitation purposes.
Defining Dance
When attempting to truly understand the concept of dance, the challenge lies in the movement’s breadth and uniqueness. In broad terms, we might define dance as a form of expressive or creative movement, often, though not always, performed to music, that involves coordinated, rhythmic actions of the body. However, to complete the picture, we must also consider the translation of creative cognition into action and how, in this capacity, dance differs greatly from other movements such as yoga or gymnastics.
In many cultures, dance serves as a medium for storytelling. Emotional and aesthetic elements beautifully intertwine with the physical act of dancing, creating a unique non-verbal communication both within and across cultures.
How Dance Influences Cognition
The field of cognitive neuroscience, a multidisciplinary approach to conceptualizing the neural mechanisms underlying cognitive functions, integrates methods and concepts from both neuroscience and psychology. The field aims to understand how brain structure and activity align with a variety of cognitive processes, including attention, memory (short-term, working, and long-term memory), language skills, processing speed, social awareness, and executive function.
Neuroimaging studies have uncovered the neural mechanisms underlying dance movement, identifying key neural markers and adaptive brain changes associated with dance training. Although the literature provides evidence of the cognitive and psychological benefits of dance, scientists recognize the need for more interdisciplinary research to fully understand how dance relates to enhanced cognitive outcomes.
Previous research found that professional ballet dancers demonstrate superior motor recall for structured choreography compared with novice dancers. A similar study of modern dance also showed superior choreographic performance among expert dancers in both structured and unstructured scenarios, suggesting that dancers’ stronger memory performance may extend beyond domain-specific knowledge of dance structure typically associated with classical ballet.
Brain Activity and Mood
Learning choreography typically involves watching others perform a series of connected dance steps and then practicing one’s own movements in front of a mirror. Therefore, the action observation network (AON), a set of brain regions activated when watching others perform an action and which remain crucial for planning, coordinating, and executing movements, serves as a perfect paradigm for studying brain function as it relates to dance. Brain activations within the AON (premotor, intraparietal, posterior superior temporal, and parietal cortices) are significantly higher when an individual views familiar movements compared with unfamiliar movements, even in expert dancers. Years of training and performance experience also influence AON activation. It would seem that professional dancers can activate the AON on demand to a greater extent than their novice counterparts.
As one often witnesses during a classical ballet performance, the art of dance can evoke significant moods and emotions. MRI studies have shown that dance activates brain regions typically associated with reward, as well as the amygdala and insula, regions responsible for processing emotional stimuli and feelings. Synchronized group dance also elicits brain activation in regions associated with empathy and social cognition, such as the medial prefrontal cortex and anterior cingulate cortex.
Capitalizing on these developments, the field of dance/movement therapy (DMT) works wonders when applied to populations with various mental health conditions, including post-traumatic stress disorder (PTSD), depression, and anxiety. DMT integrates body movement with emotional processing, helping individuals express emotions that they often find difficult to convey verbally. Studies show that DMT can lead to decreased cortisol levels and enhanced mood, suggesting that dance has the potential to regulate emotional distress.
One research study undertook the task of identifying the effects of dance therapy in adults with psychological trauma, as well as the barriers and facilitators associated with its therapeutic use. The data points in a positive direction with respect to the following:
- Dance therapy for the therapeutic management of psychological trauma, as it can address both psychological and physical symptoms
- Therapist skills and training serve as important factors to consider when evaluating the impact of dance therapy on post-traumatic symptoms
- Dance/movement therapy appears to foster improvements in sensory-motor perceptions and motor skills
Overall, DMT has the potential to evolve into a promising trauma treatment, as it mobilizes the key factors involved in the management of psychological trauma (body, relaxation, diminution of stress, and interpersonal therapy). In this regard, dance can help promote emotional regulation and social bonding. More research in this area can clarify the neural correlates of affective aspects of dance.
Eurocentric versus Neurocentric
Experts traditionally view the art of dance from a Eurocentric perspective as a mode of self-expression that involves the human body moving through space, performed for artistic purposes, and viewed by an audience. However, the Synchronicity Hypothesis of Dance states that humans dance to enhance both intra- and inter-brain synchrony, presenting what they refer to as a neurocentric definition of dance.
While the term Eurocentric refers to a worldview that places European culture, history, and values at the center of dance, often viewing them as superior to non-Western perspectives, the term neurocentric encompasses a health-focused perspective stating that everything individuals feel and do relates to brain function, emphasizing brain-based movement as well as the health of the nervous system. Such a theory suggests that the art of dance involves a network of brain regions that might support neurobehavior processes in seven key areas:
- Rhythmic
- Motor
- Cognitive
- Sensory
- Creative
- Emotional
- Social
Given this approach, we can now explore how dance may serve a rehabilitative role for individuals with a variety of neurological conditions.
Dance as a Tool for Neurocognitive/Motor Rehabilitation
Over the last 10 years, research has demonstrated evidence supporting the use of dance in rehabilitation for chronic neurological diseases such as spinal cord injury, Alzheimer’s disease, Parkinson’s disease, multiple sclerosis, chronic pain, cerebral palsy, and severe/persistent mental illness like PTSD and even depression. These benefits may have resulted from dance combining physical movement with cognitive learning/training, thereby inducing beneficial, lasting effects on the brain’s structure and function. As mentioned previously, some of the advantages of using dance as a treatment modality stem from the combined experience of learning to move one’s body to music and rhythms while also engaging in social interaction. This supports theories of neural plasticity regarding the gain and loss of function.
Some forms of dance may require a certain degree of adaptation for a given patient population, since the goals of dance used as a treatment differ significantly from dance engaged in purely for exercise or professional performance. A growing body of evidence suggests that participation in partner dance can induce long-term neuroplasticity in human movement, enhance independence, and delay the deleterious effects of aging and neurodegenerative diseases. While this seems promising, the precise neuroanatomical mechanisms underlying these benefits remain unknown.
The goals of dance used therapeutically include enhancing behavioral, cognitive function, motor function, and emotional function; however, many researchers show great interest in discovering whether dance rehabilitation can positively impact the underlying pathophysiology of neurological disease and/or the efficacy of pharmacological treatments used to treat the conditions. Since this area of research remains largely untapped, time and experimental results will hopefully bring greater clarity.
Technique Training Benefits
Both rodent and human studies have shown that motor activity, in the form of any type of physical activity, significantly improves affective state and cognitive functioning, thereby supporting beneficial applications for a range of neurodegenerative and neuropsychiatric disorders. However, among the neurobehaviors examined, dance most clearly activates the motor system, with technique training, in particular, incorporating skills that enhance both gross and fine motor movements.
When an individual engages in serious dance training early in life, they tend to exhibit enhanced motor development. Notably, such young dancers show better balance, equilibrium, postural control and alignment, an expanded range of motion, fine motor skills, and the planning and sequencing of movement (praxis). Classically trained dancers likewise optimize motor synergies, efficiently combining movements across related joints; this, in turn, leads to reduced muscular tension and increased accuracy when executing movements and choreography.
Tapping into the Hippocampus and Prefrontal Cortex Through Dance
Research studies have revealed that rodents that spend time on a running wheel and run on a treadmill show increased hippocampal theta activity. Because the prefrontal cortex receives neuronal input, including activity from the hippocampus, prefrontal cortical neurons exhibit similar predictive or preparatory behavior during movement. Similarly, human hippocampal theta activity occurs during movement and correlates positively with movement speed.
Cognitive processes develop in close conjunction with motor processes and are adjunctively supported by coherent neural activity. As a complex form of physical activity, dance incorporates the cognitive processes of learning and remembering choreographic sequences. Dance and choreography link directly to a range of cognitive functions, including attention, imagery, problem-solving, short- and long-term memory, and declarative memory (the conscious recall of events and facts), as well as procedural memory (the unconscious memory of habits and skills). For example, dancers show excellent recall of complex motor movement sequences, a skill inherent in dance training that reflects improved learning and memory performance. Additionally, compared to individuals who lack formal dance technique training, proficient dancers tend to demonstrate an enhanced ability to mentally rotate images, a skill that certainly depends on one’s spatial processing abilities.
Music and Dancing with Parkinson’s Disease
The majority of individuals who choose to dance for pleasure, from the foxtrot to ballet to break -dancing, probably fail to realize how significantly and positively their bodies and brains respond. Dance elicits such incredibly beneficial effects on the brain that it may usher in a novel approach to treating individuals diagnosed with Parkinson’s disease, a progressive neurological movement disorder. “There’s no question, anecdotally at least, that music has a very stimulating effect on physical activity,” says Daniel Tarsy, MD, an HMS professor of neurology and director of the Parkinson’s Disease and Movement Disorders Center at Beth Israel Deaconess Medical Center (BIDMC). “And I think that applies to dance, as well.”
In 2003, the New England Journal of Medicine published results from researchers at the Albert Einstein College of Medicine, clearly illustrating how dance can decidedly improve brain health. The study investigated the effect of leisure activities on the risk of dementia in an elderly population. The researchers examined the effects of 11 types of physical activity, including cycling, golf, swimming, and tennis, but found that only one—dance—reduced participants’ risk of dementia. According to the researchers, because dancing involves both mental effort and social interaction, this combined form of stimulation helped reduce the risk of dementia.
Parkinson’s disease belongs to a group of conditions called motor-system disorders, which develop when the dopamine-producing cells in the brain lessen or are lost entirely. The chemical dopamine serves as an essential component of the brain’s system for controlling movement and coordination. As Parkinson’s disease progresses, an increasing number of these cells die off, drastically reducing the amount of dopamine available to the brain.
Rhythmic Auditory Stimulation and Movement Disorders
According to the Parkinson’s Foundation, the primary motor symptoms of Parkinson’s disease include the following:
- bradykinesia (slowed movement)
- stiffness of the limbs and trunk
- tremors
- impaired balance and coordination
Learning to and participating in dance may help alleviate each of these symptoms. “A lot of this research is observational, not hard science,” says Tarsy, “but it’s consistent and there’s a lot of it.”
Dr. Tarsy further explains how dance can serve as a form of rhythmic auditory stimulation (RAS). In experiments designed to test this technique, patients listen to a series of fixed rhythms and then attempt to move to the rhythms. Studies of the effects of such a technique have found significant improvements in patients’ gait and upper extremity function. Although no studies have directly compared RAS to the use of music alone or dance steps alone, Tarsy says people with Parkinson’s “speak and walk better if they have a steady rhythmic cue.”
The Benefits of Ballroom Dance
When dancers first learn a new routine, they must engage their working memory, that area responsible for temporarily holding and manipulating information. They must remember the sequence of steps, the timing of each movement, and the coordination with a partner, all while maintaining proper technique and expression. As dancers practice and repeat these routines, they reinforce the neural connections associated with memory, making them stronger and more efficient.
The connection between dance and memory once again points to the brain’s hippocampus, a key region involved in the formation and retrieval of memories. Research has shown that engaging in activities that require learning and memory, such as dance, can stimulate the hippocampus and promote its plasticity. Ballroom dancing serves as a prime example of how such movement complexity may contribute to the growth and strengthening of the hippocampus, leading to improved memory function.
Whether you have ever participated in or merely observed dedicated ballroom dancers, you can tell immediately that this form of movement demands a high level of cognitive flexibility and attention. The dance floor transforms itself into a dynamic environment, one in which dancers must adapt to changing rhythms, partner movements, and spatial configurations. This adaptability requires quick decision-making and mental flexibility, as dancers must adjust their steps and movements in response to the music, their partner’s cues, and the overall choreography.
We can easily understand how engaging in ballroom dancing might enable individuals to sharpen their cognitive flexibility: the ability to seamlessly switch between different tasks, mental strategies, or perspectives. The constant need to adapt and make split-second decisions on the dance floor strengthens the brain’s ability to flexibly switch between different movement patterns and respond to changing circumstances.
Neuroplasticity refers to the brain’s remarkable ability to adapt and reorganize itself in response to new experiences, learning, and environmental changes. It fosters the brain’s capacity to form new neural connections, strengthen existing ones, and even reassign functions to different areas. Neuroplasticity plays a critical role in learning, memory, and cognitive flexibility.
When we engage in activities that challenge the brain, such as learning to dance, neural connections are activated, and the brain undergoes structural and functional changes. These changes enable us to acquire new skills, consolidate memories, and enhance cognitive abilities. Ballroom dancing requires participants to quickly adapt to different music styles, tempos, and partner cues. This constant need for flexibility and mental agility strengthens the brain’s capacity for cognitive flexibility. Scientists are currently studying the potential of ballroom dance as a therapeutic tool for individuals with neurocognitive challenges.
Along with using neuroimaging techniques and evaluating blood biomarkers, dance as rehabilitation might evolve into a mainstream endeavor, further looking at its synergistic effects with pharmacological and surgical regimens. As such, dance research needs and deserves continued scrutiny, all the while adhering to principles in neuroscience, neurocognitive, and neurorehabilitation research. With teams working in partnership, major advances should occur in the next decade in understanding the neurological and neuroscientific mechanisms underlying dance-based therapeutic approaches. As personal trainers, there may come a time when we work with our senior clientele on the dance floor as well as the gym floor!
References
pmc.ncbi.nlm.nih.gov/articles/PMC10334851/#:~:text=Dancing%20through%20emotional%20burden%20allows,symbolic%20in%20space%20and%20form).
gbhi.org/news-publications/dance-cognition-and-brain-health-evidence-action
scribd.com/document/898096680/Neuroscience-in-Dance
psycnet.apa.org/record/2021-87310-008
fredastaire.com/lambertville/blog/alzheimers-and-brain-awareness/ballroom-dancing-and-neuroplasticity-rewiring-the-brain-for-success/#:~:text=The%20intricate%20movements%2C%20coordination%2C%20and,performance%20and%20a%20sharper%20mind.
hms.harvard.edu/news-events/publications-archive/brain/dancing-brain
pubmed.ncbi.nlm.nih.gov/25773628/
pmc.ncbi.nlm.nih.gov/articles/PMC7832346/#:~:text=Dance%20and%20choreography%20have%20been,et%20al.%2C%202019)
frontiersin.org/research-topics/70195/dance-brain-and-cognition-advancing-understanding-through-movement-science
pmc.ncbi.nlm.nih.gov/articles/PMC11539675/
