Golden oldies and silver brains: Deficits, preservation, learning, and rehabilitation effects of music in ageing-related neurological disorders

The underlying architecture of musical sensibility: One general factor, four subdimensions, and strong genetic effects

Current evidence suggests moderate heritability of music phenotypes, such as music listening and achievement. However, other fundamental traits underlying people's interest in music and its relevance for their lives have been largely neglected, and little is known about the genetic and environmental etiology of what we refer to as musical sensibility-the tendency to be emotionally and aesthetically engaged by music. This study investigated the latent structure, as well as the genetic and environmental factors influencing individual variability in multiple domains of musical sensibility, and the etiological architecture of the relationship between the dimensions. To this end, we used phenotypic confirmatory factor analytic and biometric twin modeling to analyze self-reported ratings on four dimensions of musical sensibility in a sample of Norwegian twins (N = 2600). The results indicate a phenotypic higher-order structure, whereby both the resulting general musical sensibility factor and the conceptually narrower domains were strongly heritable (49-65%). Multivariate analyses of the genetic and environmental covariance further revealed substantial overlap in genetic variance across domains.

The use of audio-biographical cues in dementia care: a four-year evaluation in Swiss hospitals, care, and domestic homes

Introduction

In dementia care, the integration of innovative interventions is essential to enhancing the wellbeing and quality of life of people with dementia. Among these interventions, the Music Mirror intervention has emerged as a promising tool to provide personalized audio-biographical cues aimed at soothing, motivating, and engaging people with dementia. This study examined the effects of a Music Mirror intervention on the (a) wellbeing, emotions, and behavioral and psychological symptoms of 155 individuals with dementia, (b) perceived burden, relationship quality, and gains of their informal/formal caregivers, and (c) momentary closeness, wellbeing and stress of caregivers.

Methods

This four-year study employed a quasi-experimental waiting-control group design, utilizing before-after measurements in Swiss hospitals, care homes, and domestic homes. For four 6-week intervention phases, Music Mirrors, i.e., brief written resources of acoustic material, associated with practical activities of daily life, were applied at least twice a week by the caregivers during critical moments such as staff handover. Repeated measures' analysis of variance and other tests were used to analyze the data.

Results

Individuals with dementia had a higher wellbeing after the Music Mirror use across different care situations. While the Music Mirrors were played, individuals with dementia showed more positive than negative emotions at each measurement occasion, but emotion scores did not significantly change over time. After the MM use, caregivers felt better, closer to the person with dementia, and less stressed. Caregivers also reported significant gains at the end of the intervention. However, there were no significant changes in the frequency of the behavioral and psychological symptoms of dementia, care-related burden and relationship quality over time, regardless of the treatment condition.

Discussion

By incorporating personalized audio-biographical cues into their care routines, the wellbeing of people with dementia was improved as well as it had positive momentary effects on their caregivers. The Music Mirror intervention addresses the preferences and needs of people with dementia and helps build bonds between care-recipients and caregivers. Therefore, Music Mirrors can be seen as a highly adaptive and individualized instrument to improve momentary wellbeing of people with dementia in various care situations during daily life.

Structural Neuroplasticity Effects of Singing in Chronic Aphasia

Singing-based treatments of aphasia can improve language outcomes, but the neural benefits of group-based singing in aphasia are unknown. Here, we set out to determine the structural neuroplasticity changes underpinning group-based singing-induced treatment effects in chronic aphasia. Twenty-eight patients with at least mild nonfluent poststroke aphasia were randomized into two groups that received a 4-month multicomponent singing intervention (singing group) or standard care (control group). High-resolution T1 images and multishell diffusion-weighted MRI data were collected in two time points (baseline/5 months). Structural gray matter (GM) and white matter (WM) neuroplasticity changes were assessed using language network region of interest-based voxel-based morphometry (VBM) and quantitative anisotropy-based connectometry, and their associations to improved language outcomes (Western Aphasia Battery Naming and Repetition) were evaluated. Connectometry analyses showed that the singing group enhanced structural WM connectivity in the left arcuate fasciculus (AF) and corpus callosum as well as in the frontal aslant tract (FAT), superior longitudinal fasciculus, and corticostriatal tract bilaterally compared with the control group. Moreover, in VBM, the singing group showed GM volume increase in the left inferior frontal cortex (Brodmann area 44) compared with the control group. The neuroplasticity effects in the left BA44, AF, and FAT correlated with improved naming abilities after the intervention. These findings suggest that in the poststroke aphasia group, singing can bring about structural neuroplasticity changes in left frontal language areas and in bilateral language pathways, which underpin treatment-induced improvement in speech production.

Effects of Music Therapy on Aphasia and Cognition of Patients with Post-stroke: A Systematic Review and Meta-analysis

PURPOSE

This investigation sought to systematically assess music therapy's impact on aphasia and cognition in patients with post-stroke.

METHODS

Comprehensive searches were performed across major databases, including PubMed, Web of Science, Embase, Cochrane Library, China National Knowledge Infrastructure, and Vip Chinese sci-tech periodicals (VIP), covering publications up to December 2023. After screening and extracting data from the retrieved literature, its quality was appraised, which was followed by a meta-analysis using RevMan software (version 5.4, Cochrane Collaboration, Oxford, UK).

RESULTS

Nine articles, which were published from 2008 to 2022, were covered in this investigation, comprising 309 stroke patients in total. Meta-analysis results from these variations were found to be not statistically significant in the degree of functional communication improvement between the experimental group and the control group (standardized mean difference [SMD] = 0.23, 95% confidence interval [CI] (-0.19; 0.77), P > 0.05). These variations were found to be not statistically significant in the improvement of understanding ability in the experimental group compared with that in the control group (SMD = 0.21, 95% CI [-0.66; 1.09], P > 0.05). The degree of improvement in repetitive ability of the experimental group was considerably greater than that of the control group (SMD = 0.37, 95% CI [0.01; 0.76], P < 0.05). These variations were found to be not statistically significant in the improvement of naming ability in the experimental group compared with that in the control group (SMD = 0.30, 95% CI [-0.19; 0.80], P > 0.05). The cognitive score of the experimental group was considerably greater than that of the control group (SMD = 0.75, 95% CI [0.44; 1.06], P < 0.05).

CONCLUSION

Music therapy can effectively ameliorate the repetition ability of patients with aphasia after stroke. It can also improve the cognitive ability of patients. Thus, music therapy could be further applied to treat this type of patients.

Phase I trial of the MuSic to CONnect (MuSiCON) protocol: feasibility and effect of choir participation for individuals with cognitive impairment

BACKGROUND

Individuals living in residential aged care facilities with cognitive decline are at risk of social isolation and decreased wellbeing. These risks may be exacerbated by decline in communication skills. There is growing awareness that group singing may improve sense of wellbeing for individuals with dementia. However, to date few studies have examined broader rehabilitative effects on skills such as communication of individuals with dementia.

AIMS

To determine the feasibility and acceptability of the MuSic to Connect (MuSiCON) choir and language/communication assessment protocol in people with cognitive impairment living in non-high-care wards of a residential facility.

METHODS

Six individuals with mild-moderate cognitive impairment participated (age range 55-91 years, five female, one male). A mixed method approach was used. Quantitative outcomes included attendance rates, quality of life and communication measures. The qualitative measure was a brief survey of experience completed by participants and carers post-intervention.

RESULTS

Overall, MuSiCON was perceived as positive and beneficial, with high attendance, perception of improved daily functioning and high therapeutic benefit without harmful effects. While there was no reliable change in communication skills over the course of the six-week intervention, most participants successfully engaged in the conversational task, suggesting it is a suitable and ecologically valid method for data collection.

CONCLUSIONS

The MuSiCON protocol demonstrated feasibility and was well received by participants and staff at the residential facility. A co-design approach is recommended to improve upon feasibility, acceptability and validity of the assessment protocol prior to Phase II testing.

It's quite good fun: A qualitative study of a singing/songwriting programme for people with Parkinson's disease and their spouses

BACKGROUND

Group singing for people with Parkinson's disease (PD) is an established intervention not only to improve voice and speech difficulties but also for emotional and social benefit. Less is known about the experiences of group singing on the couple-the person with PD and their spouse or partner together-and studies have not specifically tracked impact through time or in combination with songwriting.

AIMS

To understand the impact of group singing/songwriting on couples (participants with PD and their spouses) to unpack whether this broader view might help explain why such interventions are reported as beneficial. Using a trajectory approach, a form of longitudinal research and focused ethnography, the research sought a deeper appreciation of participation through time for the couple in a singing/songwriting group.

METHODS & PROCEDURES

Four couples attending a singing/songwriting programme were observed for 10 weeks, and interviewed formally and informally weekly. Data were analysed thematically across-case through framework analysis but also within-case to explore the couples' experiences and narratives over time.

OUTCOMES & RESULTS

The theme of 'improved relationships' between the couples was new and extended previous studies' findings of positivity, physical benefit, sense of self and social opportunity. The stories of each couple highlighted the importance of musical reminiscence and emotional respite, and demonstrated changes with time through the singing and songwriting group.

CONCLUSIONS & IMPLICATIONS

The benefits of offering singing/songwriting groups may be felt not only by participants with PD but also by their spouses/partners even if they choose not to attend themselves. Such benefits may include improved relationships related to the shared joy of music, musical reminiscence and emotional respite. The addition of songwriting encourages creativity and agency. A longitudinal trajectory approach is one way to appreciate how these benefits may unfold over time for participants.

WHAT THIS PAPER ADDS

What is already known on the subject Group singing for people with PD has been shown to have physical, emotional and social benefits as measured on mainly pre-post-assessments of vocal, speech, respiratory function and quality of life questionnaires. What this study adds to the existing knowledge This study adds three new aspects: studying the benefits for the couple (both people with PD and their spouse/partner); taking an in-depth focused ethnographic approach over time to collect couples' narratives and experiences; and exploring the potential for adding songwriting to the intervention. What are the potential or actual clinical implications of this work? A qualitative trajectory approach may help clinicians understand why such interventions are experienced as beneficial. Clinicians running singing groups for people with PD should offer attendance to spouses/partners because of the potential for such groups to improve relationships and build new points of connection for the couple, as well as provide peer support for spouses. Songwriting is a useful addition for creativity, cognitive flexibility and self-expression.

Effect of music therapy on older adults with depression: A systematic review and meta-analysis

BACKGROUND AND PURPOSE

Depression is becoming more prevalent in older adults. Music therapy appears to have a positive effect on older adults with depression, but the effects of specific interventions (such as active music therapy and passive music therapy) are not fully known. This review aims to evaluate the therapeutic effects of music therapy and the effects of specific interventions on older adults with depression.

METHODS

A systematic search was conducted from inception to June 2022, and an updated search was conducted in July 2023 on PubMed, Web of Science, Cochrane Library, Embase, VIP, Wanfang Data, CNKI, and CBM. This review solely targeted randomized controlled trials. Two reviewers independently reviewed the retrieved studies. The risk of bias was evaluated using the Cochrane risk of bias assessment tool 2.0, and statistical analysis was made using the RevMan 5.4 software.

RESULTS

Twenty-one studies with a total of 1777 participants were included. Music therapy was beneficial in reducing depression, anxiety, and blood pressure and increasing cognitive ability (p < 0.05). Subgroup analysis showed that passive music therapy, single intervention for 60 min, individual intervention format, and total duration of 20 h had a more significant effect on depressive symptoms in older adults.

CONCLUSION

Music therapy reduces symptoms of depression and anxiety, improves blood pressure, and enhances cognitive ability in older adults with depression. Further rigorously designed studies are warranted to confirm the effects of music therapy on older adults with depression.

Longitudinal effects of choir singing on aging cognition and wellbeing: a two-year follow-up study

Introduction

While increasing evidence points toward the benefits of musical activities in promoting cognitive and emotional well-being in older adults, more longitudinal studies are needed to establish their long-term effects and uncover the mechanisms through which musical activities affect well-being. Most previous research has focused on instrumental musical activities, but little is currently known about the long-term effects of singing, even though neuroimaging evidence suggests that it is a versatile activity for the brain, involving a multitude of neural processes that are potentially beneficial for well-being.

Methods

We conducted a 2-year follow-up study to assess aging-related changes in cognitive functioning and emotional and social well-being with self-report questionnaires and standardized tests in 107 older adult choir singers and 62 demographically matched non-singers. Data were collected at baseline (T1), and at 1-year (T2) and 2-year (T3) follow-ups using questionnaires on subjective cognitive functioning, depression, social engagement, and quality of life (QOL) in all participants and neuropsychological tests in a subgroup of participants (45 choir singers and 41 non-singers).

Results

The results of linear mixed model analysis showed that in verbal flexibility (phonemic fluency task), the choir singers had higher scores already at T1 and showed no change over time, whereas the non-singers showed enhancement from T1 to T3. Furthermore, active retrieval of word knowledge (WAIS-IV Vocabulary task) showed significantly different changes from T1 to T2 between the groups (enhancement in choir singers and decline in non-singers), however lacking significant change within groups. Similar opposite trajectories of QOL related to social inclusion and safety of the environment (WHOQOL-Bref Environmental subscale) were significant from T1 to T3, but these changes were not significant within groups or at each timepoint. Within the choir singers, shorter experience in choir singing was associated with greater improvement in the vocabulary task over the follow-up period, suggesting that initiation of choir singing at older age induces some verbal benefits. There were no group differences in any other questionnaire or neuropsychological measure over time.

Discussion

In conclusion, our results suggest that choir singing at older age is associated with a sustained enhancement of phonemic fluency, while the effects on other verbal skills and quality of life are less clear.

The neuroscience of music – towards ecological validity

Studies in the neuroscience of music gained momentum in the 1990s as an integrated part of the well-controlled experimental research tradition. However, during the past two decades, these studies have moved toward more naturalistic, ecologically valid paradigms. Here, I introduce this move in three frameworks: (i) sound stimulation and empirical paradigms, (ii) study participants, and (iii) methods and contexts of data acquisition. I wish to provide a narrative historical overview of the development of the field and, in parallel, to stimulate innovative thinking to further advance the ecological validity of the studies without overlooking experimental rigor.

Frontal aslant tract in the non-dominant hemisphere: A systematic review of anatomy, functions, and surgical applications

Knowledge of both the spatial organization and functions of white-matter fiber tracts is steadily increasing. We report here the anatomy and functions of the frontal aslant tract (FAT) in the non-dominant hemisphere (usually the right hemisphere). Despite the structural symmetry between the right and left FAT, these two tracts seem to display functional asymmetry, with several brain functions in common, but others, such as visuospatial and social cognition, music processing, shifting attention or working memory, more exclusively associated with the right FAT. Further studies are required to determine whether damage to the right FAT causes permanent cognitive impairment. Such studies will constitute the best means of testing whether this tract is a critical pathway that must be taken into account during neurosurgical procedures and the essential tasks to be incorporated into intraoperative monitoring during awake craniotomy.

Benefits of choir singing on complex auditory encoding in the aging brain: An ERP study

Aging is accompanied by difficulties in auditory information processing, especially in more complex sound environments. Choir singing requires efficient processing of multiple sound features and could, therefore, mitigate the detrimental effects of aging on complex auditory encoding. We recorded auditory event-related potentials during passive listening of sounds in healthy older adult (≥ 60 years) choir singers and nonsinger controls. We conducted a complex oddball condition involving encoding of abstract regularities in combinations of pitch and location features, as well as in two simple oddball conditions, in which only either the pitch or spatial location of the sounds was varied. We analyzed change-related mismatch negativity (MMN) and obligatory P1 and N1 responses in each condition. In the complex condition, the choir singers showed a larger MMN than the controls, which also correlated with better performance in a verbal fluency test. In the simple pitch and location conditions, the choir singers had smaller N1 responses compared to the control subjects, whereas the MMN responses did not differ between groups. These results suggest that regular choir singing is associated both with more enhanced encoding of complex auditory regularities and more effective adaptation to simple sound features.

Post-stroke enriched auditory environment induces structural connectome plasticity: secondary analysis from a randomized controlled trial

Post-stroke neuroplasticity and cognitive recovery can be enhanced by multimodal stimulation via environmental enrichment. In this vein, recent studies have shown that enriched sound environment (i.e., listening to music) during the subacute post-stroke stage improves cognitive outcomes compared to standard care. The beneficial effects of post-stroke music listening are further pronounced when listening to music containing singing, which enhances language recovery coupled with structural and functional connectivity changes within the language network. However, outside the language network, virtually nothing is known about the effects of enriched sound environment on the structural connectome of the recovering post-stroke brain. Here, we report secondary outcomes from a single-blind randomized controlled trial (NCT01749709) in patients with ischaemic or haemorrhagic stroke (N = 38) who were randomly assigned to listen to vocal music, instrumental music, or audiobooks during the first 3 post-stroke months. Utilizing the longitudinal diffusion-weighted MRI data of the trial, the present study aimed to determine whether the music listening interventions induce changes on structural white matter connectome compared to the control audiobook intervention. Both vocal and instrumental music groups increased quantitative anisotropy longitudinally in multiple left dorsal and ventral tracts as well as in the corpus callosum, and also in the right hemisphere compared to the audiobook group. Audiobook group did not show increased structural connectivity changes compared to both vocal and instrumental music groups. This study shows that listening to music, either vocal or instrumental promotes wide-spread structural connectivity changes in the post-stroke brain, providing a fertile ground for functional restoration.

Musicianship-Related Structural and Functional Cortical Features Are Preserved in Elderly Musicians

Background

Professional musicians are a model population for exploring basic auditory function, sensorimotor and multisensory integration, and training-induced neuroplasticity. The brain of musicians exhibits distinct structural and functional cortical features; however, little is known about how these features evolve during aging. This multiparametric study aimed to examine the functional and structural neural correlates of lifelong musical practice in elderly professional musicians.

Methods

Sixteen young musicians, 16 elderly musicians (age >70), and 15 elderly non-musicians participated in the study. We assessed gray matter metrics at the whole-brain and region of interest (ROI) levels using high-resolution magnetic resonance imaging (MRI) with the Freesurfer automatic segmentation and reconstruction pipeline. We used BrainVoyager semiautomated segmentation to explore individual auditory cortex morphotypes. Furthermore, we evaluated functional blood oxygenation level-dependent (BOLD) activations in auditory and non-auditory regions by functional MRI (fMRI) with an attentive tone-listening task. Finally, we performed discriminant function analyses based on structural and functional ROIs.

Results

A general reduction of gray matter metrics distinguished the elderly from the young subjects at the whole-brain level, corresponding to widespread natural brain atrophy. Age- and musicianship-dependent structural correlations revealed group-specific differences in several clusters including superior, middle, and inferior frontal as well as perirolandic areas. In addition, the elderly musicians exhibited increased gyrification of auditory cortex like the young musicians. During fMRI, the elderly non-musicians activated predominantly auditory regions, whereas the elderly musicians co-activated a much broader network of auditory association areas, primary and secondary motor areas, and prefrontal and parietal regions like, albeit weaker, the young musicians. Also, group-specific age- and musicianship-dependent functional correlations were observed in the frontal and parietal regions. Moreover, discriminant function analysis could separate groups with high accuracy based on a set of specific structural and functional, mainly temporal and occipital, ROIs.

Conclusion

In conclusion, despite naturally occurring senescence, the elderly musicians maintained musicianship-specific structural and functional cortical features. The identified structural and functional brain regions, discriminating elderly musicians from non-musicians, might be of relevance for the aging musicians’ brain. To what extent lifelong musical activity may have a neuroprotective impact needs to be addressed further in larger longitudinal studies.

Neuroanatomical correlates of speech and singing production in chronic post-stroke aphasia

A classical observation in neurology is that aphasic stroke patients with impairments in speech production can nonetheless sing the same utterances. This preserved ability suggests a distinctive neural architecture for singing that could contribute to speech recovery. However, to date, these structural correlates remain unknown. Here, we combined a multivariate lesion-symptom mapping and voxel-based morphometry approach to analyse the relationship between lesion patterns and grey matter volume and production rate in speech and singing tasks. Lesion patterns for spontaneous speech and cued repetition extended into frontal, temporal and parietal areas typically reported within the speech production network. Impairment in spontaneous singing was associated with damage to left anterior-posterior superior and middle temporal gyri. Preservation of grey matter volume in the same regions where damage led to poor speech and singing production supported better performance in these tasks. When dividing the patients into fluent and dysfluent singers based on singing performance from demographically matched controls, we found that preservation of left middle temporal gyrus was related to better spontaneous singing. These findings provide insights into the structural correlates of singing in chronic aphasia and may serve as biomarkers to predict treatment response in clinical trials using singing-based interventions for speech rehabilitation.

The effect of music therapy on language recovery in patients with aphasia after stroke: a systematic review and meta-analysis

OBJECTIVE

The aim of this meta-analysis was to evaluate the evidence on the effectiveness of music therapy in the recovery of language function in post-stroke aphasia, compared with conventional therapy or no therapy.

METHODS

We searched studies that explored the effect of music therapy on language function in post-stroke aphasia and published in PubMed, Embase, the Cochrane Library, Web of Science, CINAHL, ProQuest Digital Dissertations, and ClinicalTrials.gov from inception to March 2021. Six reviewers independently screened out eligible studies, extracted data, and evaluated the methodological quality. Results were pooled using mean difference (MD) with 95% confidence interval (CI). Heterogeneity was assessed by the chi-square test and I² statistic.

RESULTS

Six studies were included in this meta-analysis involving 115 patients. The methodological quality of these studies ranged from poor to excellent. There was significant mean difference in functional communication for post-stroke aphasia by 1.45 (95% CI: 0.24, 2.65; P = 0.02, from poor to excellent evidence), in repetition by 6.49 (95% CI: 0.97, 12.00; P = 0.02, from acceptable to excellent evidence), and in naming by 11.44 (95% CI: 1.63, 21.26; P = 0.02, from acceptable to excellent evidence). But there was no significant difference in comprehension for post-stroke aphasia by 7.21 (95% CI: - 10.88, 25.29; P = 0.43, from acceptable to excellent evidence).

CONCLUSIONS

Music therapy can improve functional communication, repetition, and naming in patients with post-stroke aphasia, but did not significantly improve comprehension.

TRIAL REGISTRATION

CRD42021251526.

The Power of Musification: Sensor-Based Music Feedback Improves Arm Swing in Parkinson's Disease

Background

Reduction of arm swing during gait is an early and common symptom in Parkinson's disease (PD). By using the technology of a mobile phone, acceleration of arm swing can be converted into a closed‐loop musical feedback (musification) to improve gait.

Objectives

To assess arm swing in healthy subjects and the effects of musification on arm swing amplitude and other gait parameters in patients with PD.

Methods

Gait kinematics were analyzed in 30 patients during a 320 m walk in 3 different conditions comprising (1) normal walking; (2) focused swinging of the more affected arm; and (3) with musification of arm swing provided by the iPhone application CuraSwing. The acceleration of arm swing was converted into musical feedback. Arm swing range of motion and further gait kinematics were analyzed. In addition, arm swing in patients was compared to 32 healthy subjects walking at normal, slow, and fast speeds.

Results

Musification led to a large and bilateral increase of arm swing range of motion in patients. The increase was greater on the more affected side of the patient (+529.5% compared to baseline). In addition, symmetry of arm swing, sternum rotation, and stride length increased. With musical feedback patients with PD reached arm swing movements within or above the range of healthy subjects.

Conclusions

Musification has an immediate effect on arm swing and other gait kinematics in PD. The results suggest that closed‐loop musical feedback is an effective technique to improve walking in patients with PD.

Beneficial effects of choir singing on cognition and well-being of older adults: Evidence from a cross-sectional study

Background and objectives

Choir singing has been associated with better mood and quality of life (QOL) in healthy older adults, but little is known about its potential cognitive benefits in aging. In this study, our aim was to compare the subjective (self-reported) and objective (test-based) cognitive functioning of senior choir singers and matched control subjects, coupled with assessment of mood, QOL, and social functioning.

Research design and methods

We performed a cross-sectional questionnaire study in 162 healthy older (age ≥ 60 years) adults (106 choir singers, 56 controls), including measures of cognition, mood, social engagement, QOL, and role of music in daily life. The choir singers were divided to low (1–10 years, N = 58) and high (>10 years, N = 48) activity groups based on years of choir singing experience throughout their life span. A subcohort of 74 participants (39 choir singers, 35 controls) were assessed also with a neuropsychological testing battery.

Results

In the neuropsychological testing, choir singers performed better than controls on the verbal flexibility domain of executive function, but not on other cognitive domains. In questionnaires, high activity choir singers showed better social integration than controls and low activity choir singers. In contrast, low activity choir singers had better general health than controls and high activity choir singers.

Discussion and implications

In healthy older adults, regular choir singing is associated with better verbal flexibility. Long-standing choir activity is linked to better social engagement and more recently commenced choir activity to better general health.

Use of dual-flow bioreactor to develop a simplified model of nervous-cardiovascular systems crosstalk: A preliminary assessment

Chronic conditions requiring long-term rehabilitation therapies, such as hypertension, stroke, or cancer, involve complex interactions between various systems/organs of the body and mutual influences, thus implicating a multiorgan approach. The dual-flow IVTech LiveBox2 bioreactor is a recently developed inter-connected dynamic cell culture model able to mimic organ crosstalk, since cells belonging to different organs can be connected and grown under flow conditions in a more physiological environment. This study aims to setup for the first time a 2-way connected culture of human neuroblastoma cells, SH-SY5Y, and Human Coronary Artery Smooth Muscle Cells, HCASMC through a dual-flow IVTech LiveBox2 bioreactor, in order to represent a simplified model of nervous-cardiovascular systems crosstalk, possibly relevant for the above-mentioned diseases. The system was tested by treating the cells with 10nM angiotensin II (AngII) inducing PKCβII/HuR/VEGF pathway activation, since AngII and PKCβII/HuR/VEGF pathway are relevant in cardiovascular and neuroscience research. Three different conditions were applied: 1- HCASMC and SH-SY5Y separately seeded in petri dishes (static condition); 2- the two cell lines separately seeded under flow (dynamic condition); 3- the two lines, seeded in dynamic conditions, connected, each maintaining its own medium, with a membrane as interface for biohumoral changes between the two mediums, and then treated. We detected that only in condition 3 there was a synergic AngII-dependent VEGF production in SH-SY5Y cells coupled to an AngII-dependent PKCβII/HuR/VEGF pathway activation in HCASMC, consistent with the observed physiological response in vivo. HCASMC response to AngII seems therefore to be generated by/derived from the reciprocal cell crosstalk under the dynamic inter-connection ensured by the dual flow LiveBox 2 bioreactor. This system can represent a useful tool for studying the crosstalk between organs, helpful for instance in rehabilitation research or when investigating chronic diseases; further, it offers the advantageous opportunity of cultivating each cell line in its own medium, thus mimicking, at least in part, distinct tissue milieu.

Could Self-Consciousness Be Enhanced in Alzheimer’s Disease? An Approach from Emotional Sensorial Stimulation

Alzheimer’s disease (AD) provides a valuable field of research into impairment of self-consciousness (SC), because AD patients have a reduced capacity to understand their mental world, to experience and relive previous personal events, as well as to interpret thoughts, feelings, and beliefs about themselves. Several studies observed that AD patients had an altered SC, but not a complete abolition of it. Emotions are an integral part of the construction of personal identity, therefore of Self. In general, most studies on emotion in AD patients have observed that emotion is not completely abolished and it lets them better remember autobiographical events with greater emotional charge. The positive effect of autobiographical memories rich in emotional content, evoked directly/automatically by sensorial stimuli such as familiar odors or music, could be used to reestablish/reinforce the permanence and coherence of the Self in AD. We studied the research of empirical evidence supporting the power of the sensorial cues associated with emotion, which could be capable of enhancing the SC in AD. We presented the studies about “Emotional stimulations” using odor, music, or taste cues in AD. All studies have shown to have a positive impact on SC in AD patients such as odor-evoked autobiographical memories, taste/odor-evoked autobiographical memories, emotional sensorial stimulation using musical cues, and multi-sensorial stimulations using healing gardens. We found research supporting the notion that emotional sensorial stimulations can even temporarily exalt memory, affective state, and personal identity, that is, the SC in AD. The emotional sensory stimulations could be used as a tool to activate the SC in AD and hence improve the quality of life of patients and caregivers.

Lost in sound: auditory perceptual abilities in neurodegenerative diseases

This scientific commentary refers to ‘Impairments of auditory scene analysis in posterior cortical atrophy’, by Hardy et al. (doi:10.1093/brain/awaa221).

Links Between the Neurobiology of Oxytocin and Human Musicality

The human species possesses two complementary, yet distinct, universal communication systems—language and music. Functional imaging studies have revealed that some core elements of these two systems are processed in closely related brain regions, but there are also clear differences in brain circuitry that likely underlie differences in functionality. Music affects many aspects of human behavior, especially in encouraging prosocial interactions and promoting trust and cooperation within groups of culturally compatible but not necessarily genetically related individuals. Music, presumably via its impact on the limbic system, is also rewarding and motivating, and music can facilitate aspects of learning and memory. In this review these special characteristics of music are considered in light of recent research on the neuroscience of the peptide oxytocin, a hormone that has both peripheral and central actions, that plays a role in many complex human behaviors, and whose expression has recently been reported to be affected by music-related activities. I will first briefly discuss what is currently known about the peptide’s physiological actions on neurons and its interactions with other neuromodulator systems, then summarize recent advances in our knowledge of the distribution of oxytocin and its receptor (OXTR) in the human brain. Next, the complex links between oxytocin and various social behaviors in humans are considered. First, how endogenous oxytocin levels relate to individual personality traits, and then how exogenous, intranasal application of oxytocin affects behaviors such as trust, empathy, reciprocity, group conformity, anxiety, and overall social decision making under different environmental conditions. It is argued that many of these characteristics of oxytocin biology closely mirror the diverse effects that music has on human cognition and emotion, providing a link to the important role music has played throughout human evolutionary history and helping to explain why music remains a special prosocial human asset. Finally, it is suggested that there is a potential synergy in combining oxytocin- and music-based strategies to improve general health and aid in the treatment of various neurological dysfunctions.

An integrative cognitive rehabilitation using neurologic music therapy in multiple sclerosis: A pilot study

BACKGROUND

Multiple sclerosis (MS) is a demyelinating disease, affecting both the sensorimotor and cognitive systems. The typical pattern of cognitive impairment includes reduced speed of information processing, decreased phonological and semantic speech fluency, deficits in verbal and visual episodic memory, as well as attention and executive dysfunctions. We aimed to investigate the influence of the neurologic music therapy (NMT) on mood, motivation, emotion status, and cognitive functions in patients with MS.

METHODS

Thirty patients with MS were randomly divided in 2 groups: the control group (CG) undergoing conventional cognitive rehabilitation (CCR), 6 times a week for 8 weeks, and the experimental group (EG) undergoing CCR 3 times a week for 8 weeks plus NMT techniques, performed 3 times a week for 8 weeks. All the participants were submitted to the same amount of treatment. Each patient was evaluated before (baseline: T0) and immediately after the end of each training (T1).

MAIN OUTCOMES MEASURES

We used as main outcome measure: the brief repeatable battery of neuropsychological test to assess various cognitive abilities; and the multiple sclerosis quality of life-54 (MSQoL-54).

RESULTS

Both the groups benefit from 8 weeks of CR. In particular, the EG got better results in cognitive function, with regard to selective reminding test long term storage (P < .000), long term retrieval (P = .007), and delayed recall of the 10/36 spatial recall test (P = .001), as compared with the CG. Moreover, the improvement in emotional status, motivation, mood and quality of life (with regard to the mental component; P < .000) was more evident in the EG.

CONCLUSIONS

NMT could be considered a complementary approach to enhance CCR in patients affected by MS.

Music and emotion in Alzheimer's disease

BACKGROUND

Alzheimer's disease may compromise several musical competences, though no clear data is available in the scientific literature. Furthermore, music is capable of communicating basic emotions, but little is known about the emotional aspect of music in patients with Alzheimer's disease. We present a systematic investigation of music processing in relation to extra-musical skills, in particular emotional skills in patients with Alzheimer's disease.

METHODS

We tested 30 patients with mild or moderate Alzheimer's disease and 30 control subjects. We essentially evaluated (a) musical competences, using the extra-linguistic test, Solfeggio test and the recognition test of musical emotions-elaborated by our research team-and the Seashore test, and (b) emotional capacities using emotional memory and emotional prosody tests-made by our research group.

RESULTS

We significantly observed lower total results of every test assessing cognitive, emotional and music competences in Alzheimer's disease patients than those in control subjects, but the score of musical emotion recognition test did not reach to a significant difference between the subjects groups.

CONCLUSIONS

Our findings found a global impairment of music competences in Alzheimer patients with cognitive and emotional troubles. Nevertheless, the performances in the recognition test of musical emotions showed a trend towards a performance difference. We can suggest that Alzheimer's disease currently presents an aphaso-agnoso-apractic-amusia syndrome.

Cognitive and neural mechanisms underlying the mnemonic effect of songs after stroke

Sung melody provides a mnemonic cue that can enhance the acquisition of novel verbal material in healthy subjects. Recent evidence suggests that also stroke patients, especially those with mild aphasia, can learn and recall novel narrative stories better when they are presented in sung than spoken format. Extending this finding, the present study explored the cognitive mechanisms underlying this effect by determining whether learning and recall of novel sung vs. spoken stories show a differential pattern of serial position effects (SPEs) and chunking effects in non-aphasic and aphasic stroke patients (N = 31) studied 6 months post-stroke. The structural neural correlates of these effects were also explored using voxel-based morphometry (VBM) and deterministic tractography (DT) analyses of structural MRI data. Non-aphasic patients showed more stable recall with reduced SPEs in the sung than spoken task, which was coupled with greater volume and integrity (indicated by fractional anisotropy, FA) of the left arcuate fasciculus. In contrast, compared to non-aphasic patients, the aphasic patients showed a larger recency effect (better recall of the last vs. middle part of the story) and enhanced chunking (larger units of correctly recalled consecutive items) in the sung than spoken task. In aphasics, the enhanced chunking and better recall on the middle verse in the sung vs. spoken task correlated also with better ability to perceive emotional prosody in speech. Neurally, the sung > spoken recency effect in aphasic patients was coupled with greater grey matter volume in a bilateral network of temporal, frontal, and parietal regions and also greater volume of the right inferior fronto-occipital fasciculus (IFOF). These results provide novel cognitive and neurobiological insight on how a repetitive sung melody can function as a verbal mnemonic aid after stroke.

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Non-aphasic stroke patients show more stable recall of sung than spoken stories.

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Aphasic patients show larger recency and chunking effects to sung vs. spoken stories.

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The left dorsal pathway mediates better recall of sung stories in non-aphasics.

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The right ventral pathway mediates better recall of sung stories in aphasics.

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Large-scale bilateral cortical networks are linked to musical mnemonics in aphasia.

The functional neuroanatomy of musical memory in Alzheimer's disease

Background

Memory for music has attracted much recent interest in Alzheimer's disease but the underlying brain mechanisms have not been defined in patients directly. Here we addressed this issue in an Alzheimer's disease cohort using activation fMRI of two core musical memory systems.

Methods

We studied 34 patients with younger onset Alzheimer's disease led either by episodic memory decline (typical Alzheimer's disease) or by visuospatial impairment (posterior cortical atrophy) in relation to 19 age-matched healthy individuals. We designed a novel fMRI paradigm based on passive listening to melodies that were either previously familiar or unfamiliar (musical semantic memory) and either presented singly or repeated (incidental musical episodic memory).

Results

Both syndromic groups showed significant functional neuroanatomical alterations relative to the healthy control group. For musical semantic memory, disease-associated activation group differences were localised to right inferior frontal cortex (reduced activation in the group with memory-led Alzheimer's disease); while for incidental musical episodic memory, disease-associated activation group differences were localised to precuneus and posterior cingulate cortex (abnormally enhanced activation in the syndromic groups). In post-scan behavioural testing, both patient groups had a deficit of musical episodic memory relative to healthy controls whereas musical semantic memory was unimpaired.

Conclusions

Our findings define functional neuroanatomical substrates for the differential involvement of musical semantic and incidental episodic memory in major phenotypes of Alzheimer's disease. The complex dynamic profile of brain activation group differences observed suggests that musical memory may be an informative probe of neural network function in Alzheimer's disease. These findings may guide the development of future musical interventions in dementia.