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Music-Based Intervention Ameliorates Mecp2-Loss-Mediated Sociability Repression in Mice through the Prefrontal Cortex FNDC5/BDNF Pathway. Int J Mol Sci 2021; 22:ijms22137174. [PMID: 34281226 PMCID: PMC8269182 DOI: 10.3390/ijms22137174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2021] [Revised: 06/22/2021] [Accepted: 06/30/2021] [Indexed: 11/19/2022] Open
Abstract
Patients with Rett syndrome (RTT) show severe difficulties with communication, social withdrawl, and learning. Music-based interventions improve social interaction, communication skills, eye contact, and physical skills and reduce seizure frequency in patients with RTT. This study aimed to investigate the mechanism by which music-based interventions compromise sociability impairments in mecp2 null/y mice as an experimental RTT model. Male mecp2 null/y mice and wild-type mice (24 days old) were randomly divided into control, noise, and music-based intervention groups. Mice were exposed to music or noise for 6 h/day for 3 consecutive weeks. Behavioral patterns, including anxiety, spontaneous exploration, and sociability, were characterized using open-field and three-chamber tests. BDNF, TrkB receptor motif, and FNDC5 expression in the prefrontal cortex (PFC), hippocampus, basal ganglia, and amygdala were probed using RT-PCR or immunoblotting. mecp2 null/y mice showed less locomotion in an open field than wild-type mice. The social novelty rather than the sociability of these animals increased following a music-based intervention, suggesting that music influenced the mecp2-deletion-induced social interaction repression rather than motor deficit. Mechanically, the loss of BDNF signaling in the prefrontal cortex and hippocampal regions, but not in the basal ganglia and amygdala, was compromised following the music-based intervention in mecp2 null/y mice, whereas TrkB signaling was not significantly changed in either region. FNDC5 expression in the prefrontal cortex region in mecp2 null/y mice also increased following the music-based intervention. Collective evidence reveals that music-based interventions improve mecp2-loss-induced social dysfunction. BDNF and FNDC5 signaling in the prefrontal cortex region mediates the music-based-intervention promotion of social interactions. This study gives new insight into the mechanisms underlying the improvement of social behaviors in mice suffering from experimental Rett syndrome following a music-based intervention.
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Yang D, Robertson HL, Condliffe EG, Carter MT, Dewan T, Gnanakumar V. Rehabilitation therapies in Rett syndrome across the lifespan: A scoping review of human and animal studies. J Pediatr Rehabil Med 2021; 14:69-96. [PMID: 32894256 DOI: 10.3233/prm-200683] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
PURPOSE To perform a scoping review of the evidence for therapeutic interventions to manage functional impairments associated with Rett syndrome (RTT) throughout the lifespan. METHODS MEDLINE, EMBASE, PsycINFO, CENTRAL, CINAHL, Scopus and Index to Chiropractic Literature were searched systematically up to December 2019. Two investigators independently reviewed all search results and extracted those that met the inclusion criteria. Human and animal model studies pertaining to therapies that increase functional ability or treat RTT-associated symptoms in all age groups were included. Relevant studies were grouped into intervention categories and rated using the Oxford Centre of Evidence Based Medicine Levels of Evidence. Demographics of participants, interventions, and outcomes were summarized. RESULTS Ninety-one articles representing 88 studies met the inclusion criteria, of which 80 were human clinical studies and eight were studies using animal models. Study designs were primarily case series and only six studies involved participants above the age of 40. CONCLUSION A small number of rigorously studied rehabilitation interventions have been published. Published studies aim to address a wide variety of functional impairments. Research regarding implementation of therapies for older patients with RTT is lacking and requires further exploration.
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Affiliation(s)
- David Yang
- University of Calgary Cumming School of Medicine, Calgary, AB, Canada
| | - Helen Lee Robertson
- Liaison Librarian, Clinical Medicine, Health Sciences Library, University of Calgary, Calgary, AB, Canada
| | - Elizabeth G Condliffe
- Departments of Clinical Neurosciences and Pediatrics, University of Calgary Cumming School of Medicine, Calgary, AB, Canada
| | - Melissa T Carter
- Department of Pediatrics, University of Ottawa, Ottawa, ON, Canada
| | - Tammie Dewan
- Department of Pediatrics, University of Calgary Cumming School of Medicine, Calgary, AB, Canada
| | - Vithya Gnanakumar
- Departments of Clinical Neurosciences and Pediatrics, University of Calgary Cumming School of Medicine, Calgary, AB, Canada
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Hirano D, Taniguchi T. What are patients with Rett syndrome interested in? J Phys Ther Sci 2018; 30:258-261. [PMID: 29545689 PMCID: PMC5851358 DOI: 10.1589/jpts.30.258] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2017] [Accepted: 11/15/2017] [Indexed: 11/24/2022] Open
Abstract
[Purpose] Rett syndrome is a severe neurodevelopmental disease; individuals typically
have no verbal skills or purposeful hand movements. In clinical settings, knowledge of
their interests would be helpful for therapy. Therefore, we investigated the interests of
Rett syndrome patients. [Subjects and Methods] In 2016, we sent a questionnaire regarding
the interests of individuals with Rett syndrome to 1,016 directors of schools for special
needs education and 204 directors of rehabilitation departments (130 facilities for
persons with severe motor and intellectual disabilities, 73 wards for patients with severe
motor and intellectual disabilities, and the National Hospital Organization and National
Center Hospital, and the National Center of Neurology and Psychiatry) in Japan. We used
descriptive statistics and content analysis to examine the answers to the questionnaires.
[Results] Information was acquired from 216 individuals (3–53 years old) with Rett
syndrome. 92.9% of the individuals were reported to have some interests (e.g., in people,
music, things to see, animation, or books). [Conclusion] Individuals with Rett syndrome
were observed to be interested in various things despite their having severe motor and
intellectual disabilities. These findings suggest that family members and care staff might
facilitate various changes or developments of these individuals and discover their hidden
strengths by focusing on their interests.
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Affiliation(s)
- Daisuke Hirano
- Graduate School of Health and Welfare Sciences, International University of Health and Welfare: 2600-1 Kitakanemaru, Ohtawara, Tochigi 324-8501, Japan
- Department of Occupational Therapy, School of Health Sciences at Narita, International University of Health and Welfare, Japan
| | - Takamichi Taniguchi
- Graduate School of Health and Welfare Sciences, International University of Health and Welfare: 2600-1 Kitakanemaru, Ohtawara, Tochigi 324-8501, Japan
- Department of Occupational Therapy, School of Health Sciences at Ohtawara, InternationalUniversity of Health and Welfare, Japan
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Bergström-Isacsson M, Lagerkvist B, Holck U, Gold C. Neurophysiological responses to music and vibroacoustic stimuli in Rett syndrome. RESEARCH IN DEVELOPMENTAL DISABILITIES 2014; 35:1281-1291. [PMID: 24691354 DOI: 10.1016/j.ridd.2014.03.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/02/2013] [Revised: 03/03/2014] [Accepted: 03/07/2014] [Indexed: 06/03/2023]
Abstract
People with Rett syndrome (RTT) have severe communicative difficulties. They have as well an immature brainstem that implies dysfunction of the autonomic nervous system. Music plays an important role in their life, is often used as a motivating tool in a variety of situations and activities, and caregivers are often clear about people with RTTs favourites. The aim of this study was to investigate physiological and emotional responses related to six different musical stimuli in people with RTT. The study included 29 participants with RTT who were referred to the Swedish Rett Center for medical brainstem assessment during the period 2006-2007. 11 children with a typical developmental pattern were used as comparison. A repeated measures design was used, and physiological data were collected from a neurophysiological brainstem assessment. The continuous dependent variables measured were Cardiac Vagal Tone (CVT), Cardiac Sensitivity to Baroreflex (CSB), Mean Arterial Blood Pressure (MAP) and the Coefficient of Variation of Mean Arterial Blood Pressure (MAP-CV). These parameters were used to categorise brainstem responses as parasympathetic (calming) response, sympathetic (activating) response, arousal (alerting) response and unclear response. The results showed that all participants responded to the musical stimuli, but not always in the expected way. It was noticeable that both people with and without RTT responded with an arousal to all musical stimuli to begin with. Even though the initial expressions sometimes changed after some time due to poor control functions of their brainstem, the present results are consistent with the possibility that the RTT participants' normal responses to music are intact. These findings may explain why music is so important for individuals with RTT throughout life.
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Affiliation(s)
| | | | - Ulla Holck
- Department of Communication and Psychology, Aalborg University, Denmark
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Bergström-Isacsson M, Lagerkvist B, Holck U, Gold C. How facial expressions in a Rett syndrome population are recognised and interpreted by those around them as conveying emotions. RESEARCH IN DEVELOPMENTAL DISABILITIES 2013; 34:788-794. [PMID: 23220055 DOI: 10.1016/j.ridd.2012.10.011] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/31/2012] [Revised: 10/19/2012] [Accepted: 10/24/2012] [Indexed: 06/01/2023]
Abstract
Rett syndrome (RTT) is a neurodevelopmental disorder, including autonomic nervous system dysfunctions and severe communication impairment with an extremely limited ability to use verbal language. These individuals are therefore dependent on the capacity of caregivers to observe and interpret communicative signals, including emotional expressions. People in general, including therapists tend to focus on changes in facial expressions to interpret a person's emotional state or choices, but with this population it is difficult to know if the interpretations are correct. The aims of this study were to investigate if the Facial Action Coding System (FACS) could be used to identify facial expressions, and differentiate between those that expressed emotions and those that were elicited by abnormal brainstem activation in RTT. The sample comprised 29 participants with RTT and 11 children with a normal developmental pattern, exposed to six different musical stimuli during non-invasive registration of autonomic brainstem functions. The results indicate that FACS makes it possible both to identify facial expressions and to differentiate between those that stem from emotions and those caused by abnormal brainstem activation. This knowledge may be a great help to an uninitiated observer, who otherwise might incorrectly interpret the latter as an expression of emotion.
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Gold C, Rolvsjord R. Citation Patterns and Scientific Impact of the Nordic Journal of Music Therapy, 1992–2005. NORDIC JOURNAL OF MUSIC THERAPY 2010. [DOI: 10.1080/08098130609478160] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Bergström-Isacsson M, Julu PO, Witt-Engerström I. Autonomic Responses to Music and Vibroacoustic Therapy in Rett Syndrome. NORDIC JOURNAL OF MUSIC THERAPY 2007. [DOI: 10.1080/08098130709478172] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Elefant C, Wigram T. Learning ability in children with Rett syndrome. Brain Dev 2005; 27 Suppl 1:S97-S101. [PMID: 16182495 DOI: 10.1016/j.braindev.2005.03.020] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2004] [Revised: 09/09/2004] [Accepted: 03/02/2005] [Indexed: 10/25/2022]
Abstract
The purpose of this article is to present results of a research study examining learning ability in individuals with Rett syndrome. The material for this article was drawn from a more extensive doctoral study, designed to investigate intentional communication in this population, through the use of songs in music therapy. Rett syndrome is a neurological disorder resulting from an X-linked mutation, affecting mainly females, and found across racial and ethnic groups worldwide. One of the main areas affecting functioning in individuals with Rett syndrome is a severe impairment of receptive and expressive communication. This creates difficulties when attempting to reveal their potential learning abilities. This population has been observed as very responsive to music hence music therapy intervention has been advocated in promoting and motivating them to communicate and to learn. Seven girls with Rett syndrome, between ages 4 and 10 participated in the study. A single subject, multiple probe design was applied during 30-min trials, three times per week and lasted 8 months. During the trials the participants were asked to choose from a selection of 18 familiar and unfamiliar songs, while their ability to learn was observed and measured. Findings revealed that all seven girls demonstrated an ability to learn and to sustain learning over time. This intervention demonstrated that individuals with Rett syndrome could be promoted and motivated to communicate and learn when therapeutically employed by a trained music therapists.
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Elefant C, Lotan M. Rett Syndrome: Dual Intervention – Music and Physical Therapy. NORDIC JOURNAL OF MUSIC THERAPY 2004. [DOI: 10.1080/08098130409478114] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Kerr AM, Ravine D. Review article: breaking new ground with Rett syndrome. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2003; 47:580-587. [PMID: 14641805 DOI: 10.1046/j.1365-2788.2003.00506.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Affiliation(s)
- A M Kerr
- Department of Psychological Medicine, University of Glasgow, Gartnavel Royal Hospital, Glasgow, UK.
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Kerr A. Annotation: Rett syndrome: recent progress and implications for research and clinical practice. J Child Psychol Psychiatry 2002; 43:277-87. [PMID: 11944872 DOI: 10.1111/1469-7610.00021] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Rett syndrome was first described 40 years ago as a profoundly disabling condition in girls. METHOD Over the last 20 years' national surveys, neuropathological and neurophysiological research have steadily improved understanding of its character and natural history. RESULTS In the last two years identification of the causative mutations in the gene methyl CpG binding protein 2 (Xq28) has led to a sudden expansion in knowledge about the underlying developmental disorder, with important implications for clinical practice and new opportunities to develop more effective intervention. CONCLUSIONS It is now clear that the disorder occurs in males and females and that there is a wide range in severity.
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Affiliation(s)
- Alison Kerr
- Department of Psychological Medicine, Glasgow University and the Royal Hospital for Sick Children, UK.
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Tyler HP. Frederick Kill Harford - Dilettante Dabbler or Man of Our Time? NORDIC JOURNAL OF MUSIC THERAPY 2002. [DOI: 10.1080/08098130209478041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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