Neuroscience of Art

Where Ancient Medical Tradition meets Modern NeuroEngineering

Estimated reading time: 11 minutes

Brain researcher and clinical neurophysiologist, Dr Nicholas Tsarouchas, is exploring an interesting area of medicine: the effects of music on our brains, health, emotions, thinking, and behaviour. He collects scientific data by organising a unique series of concerts with brain-computer interface devices on performers and audience members that allow him to map brain waves and measure the impact of music on emotion. Nicholas believes in the connection between Art and Science, which can lead to a healthier, more harmonious and fulfilling life. Below we discuss his life and work, and how engineering, art and medicine can be combined to deliver a more holistic healthcare.

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Dr Nicholas Tsarouchas

Where and how did your career start? Can you tell us a little bit about your roots, and your motivation to become a medical doctor and researcher?

I was born in a village by the seaside called Asminio, at the northern promontory of the 2nd largest island of Greece, Evia. This was the site of one of the great battles of ancient Greek history, the Battle of Artemisium in 480 BC. North Evia was one of the early cradles of civilisation, in the heart of a magical triangle among legend, myth, and history. To the west is the village of Achillion, where the Great Achilles was born. Achilles defied Apollo, the God of Light, Music and Healing.

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Apollo, the God of Light, Music, Dance, Poetry and Healing in ancient Greece.

To the north, the land of Magnesia (named after the discovery of Magnesium) surrounds the Bay of Pagasetes that harbours the port of Volos (ancient Iolkos), where Jason and the Argonauts set out on the quest for the Golden Fleece.

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Greece

To the south, in the middle of Evia, is Chalkida where Aristotle retired at his mother’s estate in the end of his life. Aristotle, the greatest philosopher and polymath of the Classical Greek period, was taught at the Academy of Plato in Athens, travelled and founded his own Peripatetic School and Lyceum, tutored Alexander the Great, and influenced scientists and scholars through the centuries.

Music is not just about joy or pleasure for the individual, it is a powerful way of changing one’s way of thinking, feeling and behaving

My scientific ambitions were thus inspired by the rich intellectual heritage of Evia. My father was a great mathematical mind and local entrepreneur, who built and ran the first textile industry in northern Evia. Later on in his life, he contributed to the development of the region. My mother was a high school teacher. Both encouraged me to learn and progress in life. My scientific inclination towards mathematics and natural sciences showed early on, with distinctions at school and in mathematical competitions. I was an inquisitive mind, participating from a young age in philosophical discussions about Science, the Universe and God. Since then I have lived, trained and worked in many places around the world – Athens, Patras, Szeged, Budapest, New York, New Jersey, Houston, Toronto, Cardiff, Canterbury, London – but I am always proud of my roots.

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“I have lived, trained and worked in many places around the world”.

I understand you are exploring the effects of music on the human brain. Could you talk more about that, as I am sure that would be of interest to our readers?

In May 2022 I led a pioneering live classical music concert in Tallinn Estonia with mezzo-soprano Elizabeth Sillo and piano performer Irina Zahharenkova, organised by Heili Vaus-Tam from Eesti Kontsert and Opera Co-Pro Ltd. We recorded electrical brain waves via Brain-Computer Interface (BCI) devices, and gauged the effects of music in real-time for the artists/performers and the audience. It became obvious that music affects our brain waves, as well as allows us to tap further into the limbic system of the brain. This is a primordial structure across the boundary between the cerebral hemispheres and brainstem, which helps us make sense of our environment by processing emotion and semantics, forming memories from a unique human perspective.

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Joy, music, happiness, mental health.

We seem to further integrate emotional semantics with frontal lobe functions that determine and modify our behaviours. So, music is not just about joy or pleasure for the individual, it is a powerful way of changing one’s way of thinking, feeling and behaving. In 2023 we are planning a series of concerts in the UK and Estonia showing how music can influence Mental Health.

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Brain Research at the Concert Hall. Elizabeth Sillo opera singer and Dr Nicholas Tsarouchas.

What projects are you currently working on?

Among other projects, I am working on developing my complex Epilepsy Specialist Clinic and expanding our Video-EEG Telemetry services at Kent University Hospitals NHS Trust. I am planning an emergency/ambulatory EEG service for first-time seizures and neurological emergencies – epileptic status, encephalopathies, encephalitides, cerebral cortical dysfunction – sleep studies and intensive care (ITU) in the adult and paediatric populations. I want to expand peripheral nerve and neuromuscular clinics including the investigation of complex movement disorders and deliver a Neuromodulation (TMS/tDCS) Service with the Kent Neuroplasticity Group for diagnosing and managing neurological and psychiatric conditions with neurorehabilitation and neurobiofeedback methods. This innovative therapeutic approach could target a wide range of affective, addictive and pain disorders, movement or spasticity disorders and neurodegenerative conditions, as an alternative or adjunct to pharmacological treatments.

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Dr Nicholas Tsarouchas

What made you interested in the fields of medicine and engineering?

Because I find it fascinating – involving both, Science and Art. And through this interaction, it is basically applying science to everyday life that changes the world around us. I believe that we can and should make a difference in people’s lives, supporting and guiding them to live healthier and more meaningful lives. Combining medicine and engineering further, gives us the opportunity today to discover new ways of delivering healthcare, and brings about cutting-edge technologies that could have an impact on patients. For instance, advancing the diagnostics of neurological conditions with artificial intelligence (AI) or their therapeutics with neuromodulation and biofeedback methods, discovering new medicines and neurosurgical approaches, looking into the effects of music on the human brain and tapping directly into emotional, cognitive and behavioural brain functions. In 2009, I submitted my first project in advanced brain-computer interfaces (BCI), using brain signals to guide and give feedback to the brain itself to improve its function or control artificial/prosthetic limbs and robotic devices.

Are there any particular people who have inspired you in your life?

I truly admire the great doctors of human history, such as Hippocrates – the father of modern medicine. He was the first doctor who developed medicine and its teaching as a systematic approach to observation, diagnosis and prognosis.

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Hippocrates

My medical career was much inspired by a visit to the island of Kos where I was stunned by Hippocrates’ Tree, a huge hollowed out plane tree under which Hippocrates used to teach his students, being still alive after 2400 years! This experience lit my mind. This tree symbolises the ancient Greek way of thinking, a collective growth mind-set for the mankind throughout history. It forms the basis of medicine from ethics to diagnostics and therapeutics, governed by the same principles: care for human life and quality of life, balance within oneself and with Nature. I have used this extraordinary experience to channel my passion for medicine and taken this journey to the past in order to shape the future.

What do you like to do in your spare time?

The things I love to do in my free time are reading books, writing, studying math and natural sciences, computer programming, music composition, playing piano, basketball, swimming, biking, fishing, and excursions to nature. With my wife, who is an opera singer, musician and mathematician, we enjoy discussions, travelling and a lot of music concerts and opera performances.

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Dr Nicholas Tsarouchas

Dr Nicholas Tsarouchas

Has there been an award given to you that you have been rightly pleased to receive?

In July 2021 I was awarded a Postgraduate Certificate in Medical and Clinical Education (PGCME) after creating the scaffolding of an online resource (with mobile app features) for a comprehensive Neuroprognostication Tool, designed for Intensive Care Medicine (ITU) consultants and registrars to help them make clinical decisions in ITU based on EEG patterns and electroclinical information. I have also received local Clinical Excellence Awards from East Kent University Hospitals NHS Trust.

What advice would you give to anyone training for the medical profession today?

Go for it! Indulge yourself and keep dreaming in the wonderful world of science and biomedical engineering. Medicine is about applying science and using evidence-based knowledge to change for better people’s lives. It is worth investing in science and medicine, engineering and new technologies, as these can improve the quality of human life and interaction, with great positive feelings and rewarding outcomes for individuals and the society at large.

A few words on Clinical Neurophysiology:

Clinical Neurophysiology is a medical neurological superspecialty that studies the central and peripheral nervous systems through the recording of bioelectrical activity and other biosignals, whether spontaneous or stimulated (evoked). It comprises advanced research regarding the pathophysiology, along with clinical methods used to diagnose and treat, diseases involving both central and peripheral nervous systems. Examinations in clinical neurophysiology are not limited to laboratory tests and can be conducted as a high-tech extension of the neurological consultation. Neurophysiology tests measure the dynamic bioelectrical functions of the brain, spinal cord, peripheral nerves and muscles in the limbs, and allow us to correlate this information with the clinical picture of the patient for diagnostic and therapeutic purposes. Clinical Neurophysiology can give the precise definition of the site, the type and degree of a lesion, along with revealing the pathophysiological abnormalities in question. Nowadays Clinical Neurophysiology is mostly employed to diagnose and optimise treatment of seizures and epilepsy or encephalopathies (including neurosurgical interventions and intraoperative monitoring), movement and peripheral nerve or neuromuscular disorders. However, its usefulness has been extended to other aspects of neurology (stroke, brain injury, neuroinflammation, neurodegeneration, neurorehabilitation, etc), paediatrics, orthopaedics, general (internal, rheumatology, diabetes, etc.) or intensive care medicine, ophthalmology, etc.

A remarkable professional career:

“I am a medical doctor, biomedical engineer, brain researcher, and highly specialised consultant in clinical neurophysiology. I travelled a lot, having lived, trained and worked in Europe, USA and Canada. I moved back to the UK 15 years ago where I completed most of my medical, neurological and more specialised training. After I majored in Medicine and Neurosciences at the University of Szeged, I was exposed to Clinical Neurology Research at the Downstate Medical Centre, State University of New York, under the supervision of Professor Ivan Bodis-Wollner, ex-president of the Electroencephalography and Clinical Neuroscience Society. I rotated next in Emergency and Intensive Care Medicine at Baylor College of Medicine, Texas Medical Centre. I further rotated in Neurology at Krembil Neuroscience Centre at Toronto Western Hospital in Canada under the supervision of Professor Anthony Lang, a world-renown master of Movement Disorders. Later on, I trained in Electrical, Electronic and Computer Engineering through the National Technical University of Athens, having obtained a Master of Science in Biomedical Engineering, specialising in Neuroengineering, advanced Biosignal Processing and Analysis Methods applied to the Electroencephalogram (EEG). A lot of my medical and neurological training was undertaken in the UK, especially at the University Hospital of Wales in Cardiff where I trained in Seizures and Epilepsy, Movement, Peripheral Nerve and Neuromuscular disorders. I also served on-calls in Acute Neurology and Stroke for SE Wales Stroke Service and conducted research at Cardiff University Brain Research Imaging Centre (CUBRIC). Lifelong studies into the brain and its functions from the fundamental single-neuron to the complex neuronal network level have pushed forward my research, especially through my role as Honorary Consultant in Clinical Neurophysiology at King’s College Hospital, London. The results of my research in epileptology and clinical neurophysiology have recently been published online https://www.intechopen.com/chapters/84451 in the Neurophysiology book of Professor Heinbockel, from Howard University College of Medicine, Washington D.C., USA”.

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