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Zhang X, Talifu Z, Li J, Li X, Yu F. Melodic intonation therapy for non-fluent aphasia after stroke: A clinical pilot study on behavioral and DTI findings. iScience 2023; 26:107453. [PMID: 37744405 PMCID: PMC10517365 DOI: 10.1016/j.isci.2023.107453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 05/13/2023] [Accepted: 07/19/2023] [Indexed: 09/26/2023] Open
Abstract
Music-based melodic intonation therapy (MIT) has shown promise as a treatment for non-fluent aphasia after stroke. This trial compared the efficacy of music-based MIT and speech therapy (ST) in aphasia, focusing on arcuate fasciculus connectivity in brain structural and language ability scores. A total of 62 patients were enrolled, of whom 40 completed the trial. The experimental group received MIT for 30 min/d, five days per week for four weeks, while the control group received ST with the same dose. The BDAE and fMRI-DTI were performed at T0 and T1. The music-based MIT group demonstrated better language levels. DTI showed that FA, FN, and path length of the MIT group in the right hemisphere were significantly increased. Music-based MIT had positive effects on reorganization and activation of arcuate fasciculus in aphasia after stroke. This research is funded by NSFC No. T2341003 and No.2020CZ-10. Clinical Trials ChiCTR2000037871. Ethics approval number: 2020-013-1.
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Affiliation(s)
- Xiaoying Zhang
- School of Rehabilitation Medicine, Capital Medical University, Beijing 100068, China
- Department of Music Artificial Intelligence and Music Information Technology, Central Conservatory of Music, Beijing 100038, China
- Institute of Advanced Science and Technology, Xi’an Jiaotong University, Xi’an 710079, Shanxi, China
- Music Therapy Center, China Rehabilitation Research Center, Beijing 100068, China
- Department of Neurorehabilitation, China Rehabilitation Research Center, Beijing 100068, China
| | - Zuliyaer Talifu
- School of Rehabilitation Medicine, Capital Medical University, Beijing 100068, China
- Music Therapy Center, China Rehabilitation Research Center, Beijing 100068, China
- Department of Neurorehabilitation, China Rehabilitation Research Center, Beijing 100068, China
| | - Jianjun Li
- School of Rehabilitation Medicine, Capital Medical University, Beijing 100068, China
- Music Therapy Center, China Rehabilitation Research Center, Beijing 100068, China
- Department of Neurorehabilitation, China Rehabilitation Research Center, Beijing 100068, China
| | - Xiaobing Li
- Department of Music Artificial Intelligence and Music Information Technology, Central Conservatory of Music, Beijing 100038, China
- Institute of Advanced Science and Technology, Xi’an Jiaotong University, Xi’an 710079, Shanxi, China
| | - Feng Yu
- Department of Music Artificial Intelligence and Music Information Technology, Central Conservatory of Music, Beijing 100038, China
- Institute of Advanced Science and Technology, Xi’an Jiaotong University, Xi’an 710079, Shanxi, China
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Popescu T, Stahl B, Wiernik BM, Haiduk F, Zemanek M, Helm H, Matzinger T, Beisteiner R, Fitch WT. Melodic Intonation Therapy for aphasia: A multi-level meta-analysis of randomized controlled trials and individual participant data. Ann N Y Acad Sci 2022; 1516:76-84. [PMID: 35918503 PMCID: PMC9804200 DOI: 10.1111/nyas.14848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Melodic Intonation Therapy (MIT) is a prominent rehabilitation program for individuals with post-stroke aphasia. Our meta-analysis investigated the efficacy of MIT while considering quality of outcomes, experimental design, influence of spontaneous recovery, MIT protocol variant, and level of generalization. Extensive literature search identified 606 studies in major databases and trial registers; of those, 22 studies-overall 129 participants-met all eligibility criteria. Multi-level mixed- and random-effects models served to separately meta-analyze randomized controlled trial (RCT) and non-RCT data. RCT evidence on validated outcomes revealed a small-to-moderate standardized effect in noncommunicative language expression for MIT-with substantial uncertainty. Unvalidated outcomes attenuated MIT's effect size compared to validated tests. MIT's effect size was 5.7 times larger for non-RCT data compared to RCT data (g̅case report = 2.01 vs. g̅RCT = 0.35 for validated Non-Communicative Language Expression measures). Effect size for non-RCT data decreased with number of months post-stroke, suggesting confound through spontaneous recovery. Deviation from the original MIT protocol did not systematically alter benefit from treatment. Progress on validated tests arose mainly from gains in repetition tasks rather than other domains of verbal expression, such as everyday communication ability. Our results confirm the promising role of MIT in improving trained and untrained performance on unvalidated outcomes, alongside validated repetition tasks, and highlight possible limitations in promoting everyday communication ability.
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Affiliation(s)
- Tudor Popescu
- Department of Behavioural and Cognitive BiologyUniversity of ViennaViennaAustria,Department of NeurologyMedical University of ViennaViennaAustria,Centre for Mind and Brain SciencesUniversity of TrentoRoveretoItaly
| | - Benjamin Stahl
- Faculty of ScienceMedical School BerlinBerlinGermany,Department of NeurologyCharité UniversitätsmedizinBerlinGermany,Department of NeurophysicsMax Planck Institute for Human Cognitive and Brain SciencesLeipzigGermany,Department of NeurologyUniversitätsmedizin GreifswaldGreifswaldGermany
| | | | - Felix Haiduk
- Department of Behavioural and Cognitive BiologyUniversity of ViennaViennaAustria
| | | | - Hannah Helm
- Faculty of ScienceMedical School BerlinBerlinGermany
| | - Theresa Matzinger
- Department of Behavioural and Cognitive BiologyUniversity of ViennaViennaAustria,Department of EnglishUniversity of ViennaViennaAustria,Centre of Language Evolution StudiesNicolaus Copernicus University ToruńToruńPoland
| | | | - W. Tecumseh Fitch
- Department of Behavioural and Cognitive BiologyUniversity of ViennaViennaAustria
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Zhang X, Li J, Du Y. Melodic Intonation Therapy on Non-fluent Aphasia After Stroke: A Systematic Review and Analysis on Clinical Trials. Front Neurosci 2022; 15:753356. [PMID: 35153655 PMCID: PMC8829877 DOI: 10.3389/fnins.2021.753356] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Accepted: 12/07/2021] [Indexed: 01/05/2023] Open
Abstract
Melodic intonation therapy (MIT) is a melodic musical training method that could be combined with language rehabilitation. However, some of the existing literature focuses on theoretical mechanism research, while others only focus on clinical behavioral evidence. Few clinical experimental studies can combine the two for behavioral and mechanism analysis. This review aimed at systematizing recent results from studies that have delved explicitly into the MIT effect on non-fluent aphasia by their study design properties, summarizing the findings, and identifying knowledge gaps for future work. MIT clinical trials and case studies were retrieved and teased out the results to explore the validity and relevance of these results. These studies focused on MIT intervention for patients with non-fluent aphasia in stroke recovery period. After retrieving 128 MIT-related articles, 39 valid RCT studies and case reports were provided for analysis. Our summary shows that behavioral measurements at MIT are excessive and provide insufficient evidence of MRI imaging structure. This proves that MIT still needs many MRI studies to determine its clinical evidence and intervention targets. The strengthening of large-scale clinical evidence of imaging observations will result in the clear neural circuit prompts and prediction models proposed for the MIT treatment and its prognosis.
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Affiliation(s)
- Xiaoying Zhang
- School of Rehabilitation Medicine, Capital Medical University, Beijing, China
- Beijing Key Laboratory of Neural Injury and Rehabilitation, China Rehabilitation Research Center, Beijing, China
- Center of Neural Injury and Repair, Beijing Institute for Brain Disorders, Beijing, China
- Department of Psychology, Music Therapy Center, China Rehabilitation Research Center, Beijing, China
| | - Jianjun Li
- School of Rehabilitation Medicine, Capital Medical University, Beijing, China
- Beijing Key Laboratory of Neural Injury and Rehabilitation, China Rehabilitation Research Center, Beijing, China
- Center of Neural Injury and Repair, Beijing Institute for Brain Disorders, Beijing, China
- Department of Psychology, Music Therapy Center, China Rehabilitation Research Center, Beijing, China
- Chinese Institute of Rehabilitation Science, Beijing, China
| | - Yi Du
- Key Laboratory of Behavioral Science, Institute of Psychology, Chinese Academy of Sciences (CAS), Beijing, China
- Departments of Psychology, University of Chinese Academy of Sciences, Beijing, China
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Hatayama Y, Yamaguchi S, Kumai K, Takada J, Akanuma K, Meguro K. Music intonation therapy is effective for speech output in a patient with non-fluent aphasia in a chronic stage. Psychogeriatrics 2021; 21:430-433. [PMID: 33594749 DOI: 10.1111/psyg.12667] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Revised: 01/27/2021] [Accepted: 02/01/2021] [Indexed: 11/28/2022]
Affiliation(s)
| | - Satoshi Yamaguchi
- The Tajiri SKIP Centre, Osaki, Japan.,Geriatric Behavioural Neurology Project, Tohoku University New Industry Creation Hatchery Centre, Sendai, Japan
| | - Keiichi Kumai
- Geriatric Behavioural Neurology Project, Tohoku University New Industry Creation Hatchery Centre, Sendai, Japan
| | - Junko Takada
- Geriatric Behavioural Neurology Project, Tohoku University New Industry Creation Hatchery Centre, Sendai, Japan
| | - Kyoko Akanuma
- Geriatric Behavioural Neurology Project, Tohoku University New Industry Creation Hatchery Centre, Sendai, Japan
| | - Kenichi Meguro
- The Tajiri SKIP Centre, Osaki, Japan.,Geriatric Behavioural Neurology Project, Tohoku University New Industry Creation Hatchery Centre, Sendai, Japan.,Cyclotron Radioisotope Centre, Tohoku University, Sendai, Japan.,Tohoku University Graduate School of Medicine, Sendai, Japan
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Rossi S, Gugler MF, Rungger M, Galvan O, Zorowka PG, Seebacher J. How the Brain Understands Spoken and Sung Sentences. Brain Sci 2020; 10:E36. [PMID: 31936356 PMCID: PMC7017195 DOI: 10.3390/brainsci10010036] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2019] [Revised: 12/19/2019] [Accepted: 01/06/2020] [Indexed: 11/24/2022] Open
Abstract
The present study investigates whether meaning is similarly extracted from spoken and sung sentences. For this purpose, subjects listened to semantically correct and incorrect sentences while performing a correctness judgement task. In order to examine underlying neural mechanisms, a multi-methodological approach was chosen combining two neuroscientific methods with behavioral data. In particular, fast dynamic changes reflected in the semantically associated N400 component of the electroencephalography (EEG) were simultaneously assessed with the topographically more fine-grained vascular signals acquired by the functional near-infrared spectroscopy (fNIRS). EEG results revealed a larger N400 for incorrect compared to correct sentences in both spoken and sung sentences. However, the N400 was delayed for sung sentences, potentially due to the longer sentence duration. fNIRS results revealed larger activations for spoken compared to sung sentences irrespective of semantic correctness at predominantly left-hemispheric areas, potentially suggesting a greater familiarity with spoken material. Furthermore, the fNIRS revealed a widespread activation for correct compared to incorrect sentences irrespective of modality, potentially indicating a successful processing of sentence meaning. The combined results indicate similar semantic processing in speech and song.
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Affiliation(s)
- Sonja Rossi
- ICONE-Innsbruck Cognitive Neuroscience, Department for Hearing, Speech, and Voice Disorders, Medical University of Innsbruck, 6020 Innsbruck, Austria
| | - Manfred F Gugler
- Department for Medical Psychology, Medical University of Innsbruck, 6020 Innsbruck, Austria
| | - Markus Rungger
- Department for Hearing, Speech, and Voice Disorders, Medical University of Innsbruck, 6020 Innsbruck, Austria
| | - Oliver Galvan
- Department for Hearing, Speech, and Voice Disorders, Medical University of Innsbruck, 6020 Innsbruck, Austria
| | - Patrick G Zorowka
- Department for Hearing, Speech, and Voice Disorders, Medical University of Innsbruck, 6020 Innsbruck, Austria
| | - Josef Seebacher
- Department for Hearing, Speech, and Voice Disorders, Medical University of Innsbruck, 6020 Innsbruck, Austria
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Abstract
Current research has noted that auditory stimuli via rhythmic cues can enhance speech in patients with basal ganglia lesions. The contribution of basal ganglia function in music perception and performance is a matter of discussion. The French composer Maurice Ravel suffered from a progressive degenerative cerebral disease of uncertain etiology, probably primary progressive aphasia. Based on the case of the famous composer, we present the hypothesis that the fact he adopted different uses of timbre could be attributed to the altered basal ganglia function during the disease evolution. Our assumption would like to add a point of view to the current diagnostic debate.
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Affiliation(s)
- Athanasia Alexoudi
- Department of Neurosurgery, University of Athens Medical School, "Evangelismos" Hospital, Athens, Greece
| | - Damianos Sakas
- Department of Neurosurgery, University of Athens Medical School, "Evangelismos" Hospital, Athens, Greece
| | - Stylianos Gatzonis
- Department of Neurosurgery, University of Athens Medical School, "Evangelismos" Hospital, Athens, Greece
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Steinhoff N, Heine AM, Vogl J, Weiss K, Aschraf A, Hajek P, Schnider P, Tucek G. A pilot study into the effects of music therapy on different areas of the brain of individuals with unresponsive wakefulness syndrome. Front Neurosci 2015; 9:291. [PMID: 26347603 PMCID: PMC4543917 DOI: 10.3389/fnins.2015.00291] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2015] [Accepted: 08/03/2015] [Indexed: 12/31/2022] Open
Abstract
The global cerebral network allows music “ to do to us what it does.” While the same music can cause different emotions, the basic emotion of happy and sad songs can, nevertheless, be understood by most people. Consequently, the individual experience of music and its common effect on the human brain is a challenging subject for research. Various activities such as hearing, processing, and performing music provide us with different pictures of cerebral centers in PET. In comparison to these simple acts of experiencing music, the interaction and the therapeutic relationship between the patient and the therapist in Music Therapy (MT) provide us with an additional element in need of investigation. In the course of a pilot study, these problems were approached and reduced to the simple observation of pattern alteration in the brains of four individuals with Unresponsive Wakefulness Syndrome (UWS) during MT. Each patient had three PET investigations: (i) during a resting state, (ii) during the first exposure to MT, and (iii) during the last exposure to MT. Two patients in the MT group received MT for 5 weeks between the 2nd and the 3rd PET (three times a week), while two other patients in the control group had no MT in between. Tracer uptake was measured in the frontal, hippocampal, and cerebellar region of the brain. With certain differences in these three observed brain areas, the tracer uptake in the MT group was higher (34%) than in the control group after 5 weeks. The preliminary results suggest that MT activates the three brain regions described above. In this article, we present our approach to the neuroscience of MT and discuss the impact of our hypothesis on music therapy practice, neurological rehabilitation of individuals in UWS and additional neuroscientific research.
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Affiliation(s)
| | - Astrid M Heine
- Department of Music Therapy, IMC University of Applied Sciences Krems, Austria
| | - Julia Vogl
- Department of Social and Cultural Anthropology, University of Vienna Vienna, Austria
| | - Konrad Weiss
- Department of Nuclear Medicine, Regional Hospital Wiener Neustadt Wiener Neustadt, Austria
| | - Asita Aschraf
- Department of Neurology, Regional Hospital Hochegg Grimmenstein, Austria
| | - Paul Hajek
- Department of Nuclear Medicine, Regional Hospital Wiener Neustadt Wiener Neustadt, Austria
| | - Peter Schnider
- Department of Neurology, Regional Hospital Hochegg Grimmenstein, Austria
| | - Gerhard Tucek
- Department of Music Therapy, IMC University of Applied Sciences Krems, Austria
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