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Review Multiple Sclerosis Therapeutic use of the Arts for Patients with Multiple Sclerosis Lisa M Gallagher 1 and Francois Bethoux 1,2 1. Cleveland Clinic, Arts and Medicine Institute, Cleveland OH, US; 2. Cleveland Clinic, Neurological Institute, Cleveland OH, US P eople with multiple sclerosis (MS) face a wide variety of physical, emotional, and social challenges. A multidisciplinary comprehensive care approach is recommended for the management of MS and its consequences, and non-traditional treatments are increasingly considered by patients and health care providers, particularly for the promotion of wellness in the context of this chronic disease. Previous research has demonstrated the benefits of the therapeutic arts (art therapy, dance and movement therapy, and music therapy) in addressing some of the physiological, psychological, cognitive, social, and spiritual needs of patients facing a variety of chronic illnesses. Our review of the literature suggests that therapeutic art can be beneficial to individuals with MS, particularly in promoting self-efficacy, emotional well-being, and motor control. However, the body of evidence is limited, and further research is needed regarding the outcomes and mechanism of action of therapeutic arts in MS to better understand their role in the management of the consequences of the disease. Keywords Music therapy, art therapy, dance therapy, multiple sclerosis Disclosure: Lisa Gallagher and Francois Bethoux have nothing to disclose in relation to this article. No funding was received in the publication of this article. Compliance with Ethics: This article involves a review of the literature and did not involve any studies with human or animal subjects performed by any of the authors. Authorship: All named authors meet the International Committee of Medical Journal Editors (ICMJE) criteria for authorship of this manuscript, take responsibility for the integrity of the work as a whole, and have given final approval to the version to be published. Open Access: This article is published under the Creative Commons Attribution Noncommercial License, which permits any noncommercial use, distribution, adaptation, and reproduction provided the original author(s) and source are given appropriate credit. Received: June 3, 2017 Accepted: July 17, 2017 Citation: US Neurology, 2017;13(2):82–9 Corresponding Author: Lisa M Gallagher, Cleveland Clinic Arts & Medicine Institute, 1950 Richmond Rd/TR308, Lyndhurst, OH 44124, US. E: Multiple sclerosis (MS) is a chronic neurological disorder which causes demyelination and axonal damage in the central nervous system (CNS), leading to various neurological impairments and worsening disability over time in a majority of affected individuals. MS is presumed to be an autoimmune disease, although its cause remains unknown. 1 The direct and indirect consequences of MS often negatively impact activities, participation, and quality of life; and may lead to a loss of functional independence. In addition, comorbidities such as depression are frequently associated with MS. 2 The comprehensive management of MS includes disease-modifying therapies, symptom management, rehabilitation, and lifestyle changes to optimize wellness. 3 Patient empowerment and promotion of self-efficacy are important strategies in the management of MS. Individuals with MS have been encouraged to utilize coping strategies that are problem-focused and provide a sense of control. 4 It has been found that interacting with others and engaging in leisure activities can improve mental and physical health in individuals with MS. 5 A large number of people with MS have expressed interest in using complementary and alternative therapies (CAT), including yoga, mindfulness, stress management exercises, acupuncture, meditation, and journaling, among many others. 5–12 Indeed, in one survey, 84% of respondents reported using at least one CAT modality in the past year. 13 Therapeutic arts constitute a group of CAT modalities which have been seldom investigated in MS. 14 Therapeutic arts and multiple sclerosis Using the arts for therapeutic purposes is not a new idea. Philosophers in ancient Greece referred to the healing power of music, and for Plato: “Man’s music is seen as a means of restoring the soul, as well as confused and discordant bodily afflictions, to the harmonic proportions that it shares with the world soul of the cosmos.” (Timaeus, 429-347 BC). More recently, publications directed to a general audience, such as Dr. Oliver Sacks’ Musicophilia: Tales of Music and the Brain, have highlighted the potential benefits of music in individuals with various medical conditions, including neurological disorders. 15 Therapeutic uses of the arts can take many forms and involve a variety of professionals. We will mostly limit our discussion to therapeutic art disciplines including art therapy (AT), dance/ movement therapy (D/MT), and music therapy (MT). These therapies are performed by individuals with degrees and specialized training in these areas, and who are registered or certified. The American Art Therapy Association (AATA) defines AT as “an integrative mental health profession that combines knowledge and understanding of human development and psychological theories and techniques with visual arts and the creative process to provide a unique approach 82 TOUCH ME D ICA L ME D IA