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Ong A, Namasivayam-MacDonald A, Kim S, Werden Abrams S. The use of music and music-related elements in speech-language therapy interventions for adults with neurogenic communication impairments: A scoping review. INTERNATIONAL JOURNAL OF LANGUAGE & COMMUNICATION DISORDERS 2024. [PMID: 39169848 DOI: 10.1111/1460-6984.13104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Accepted: 07/28/2024] [Indexed: 08/23/2024]
Abstract
BACKGROUND A growing body of research indicates that music-based interventions show promising results for adults with a wide range of speech, language and communication disorders. AIMS The purpose of this scoping review is to summarize the evidence on how speech-language therapists (SLTs) use music and music-related elements in therapeutic interventions for adults with acquired neurogenic communication impairments. METHODS This scoping review was completed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews guidelines. A systematic search of three databases (Allied and Complementary Medicine Database, Cumulative Index to Nursing and Allied Health Literature and OVID Medline) was conducted and articles were included if they (1) incorporated adult human participants; (2) received an assessment or intervention facilitated by an SLT; (3) incorporated techniques and interventions which included music-related elements (e.g., rhythm, melody, harmony and dynamics); (4) were written in the English language; and (5) were peer-reviewed full-text articles. Data were extracted using the Rehabilitation Treatment Specification System framework. MAIN CONTRIBUTION A total of 25 studies met the inclusion criteria. The studies included participants with neurogenic communication impairments secondary to stroke, Parkinson's disease, dementia and traumatic brain injury. Musical interventions identified in the studies were Melodic Intonation Therapy, Modified Melodic Intonation Therapy, choral singing, singing therapy and songwriting. The majority of the studies reported interprofessional collaboration between SLTs and at least one other healthcare clinician and/or musician. Many studies also included music-based interventions lead and facilitated by musically trained SLTs. CONCLUSION The results of the studies included in this review indicate that SLTs are using music-based interventions to target therapeutic goals to improve speech, language, voice and quality of life in collaboration with other clinicians and professional musicians. WHAT THIS PAPER ADDS What is already known on this subject A growing body of research indicates that interventions using music (i.e., choirs and songwriting) and musical elements (i.e., rhythm and dynamics) show promising results for adults with neurogenic communication impairments. Currently, however, there is no clear indication of how speech-language therapists (SLTs) are using music in their clinical practice. What this study adds This scoping review collates the current evidence on how SLTs use music and musical elements in their clinical practice. SLTs are using music and musical elements for individuals with neurogenic communication impairments in populations such as Parkinson's disease, dementia and traumatic brain injury. Common interventions described in the literature include Melodic Intonation Therapy, choral singing, singing therapy and songwriting. What are the clinical implications of this work? Many SLTs collaborate when delivering music-based interventions, particularly with music therapists (MTs). This scoping review suggests that SLTs should continue to explore music-based interventions in collaboration with MTs and professional musicians to target therapeutic goals to improve speech, language, voice and quality of life.
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Affiliation(s)
- Antonette Ong
- Institute for Applied Health Sciences, School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
| | - Ashwini Namasivayam-MacDonald
- Institute for Applied Health Sciences, School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
| | - Sunny Kim
- Institute for Applied Health Sciences, School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
| | - Sophia Werden Abrams
- Institute for Applied Health Sciences, School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
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Gu J, Long W, Zeng S, Li C, Fang C, Zhang X. Neurologic music therapy for non-fluent aphasia: a systematic review and meta-analysis of randomized controlled trials. Front Neurol 2024; 15:1395312. [PMID: 38846040 PMCID: PMC11153767 DOI: 10.3389/fneur.2024.1395312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2024] [Accepted: 05/07/2024] [Indexed: 06/09/2024] Open
Abstract
Introduction The efficacy of neurologic music therapy (NMT) techniques for the treatment of non-fluent aphasia has been widely accepted by the rehabilitation medical community. However, consensus on which dimensions of speech function can be improved by NMT techniques and standardized intervention dosage remains elusive. This study aimed to provide evidence regarding the efficacy of NMT in improving speech function and explore the optimal intervention dose. A systematic review and meta-analysis were conducted to search for randomized clinical trials and open-label trials that evaluated speech functions after NMT. Methods We searched all papers and reviews published from database inception to July 2023, including PubMed, Cochrane Library, Web of Science, Embase, and CNKI. Statistical analyses were mainly carried out on RevManV5.4.1 and pooled using a random-effects model. The primary outcome was the standardized mean difference (SMD) in speech functions, determined by calculating the change in speech functions score from baseline to the primary endpoint in the NMT group versus the control arm. Results A total of 11 studies with 329 patients were included. NMT had a positive effect on repetition ability (SMD = 0.37, 95%CI [0.12, 0.62], p < 0.05), but did not lead to significant differences in naming, comprehension, spontaneous speech, or communication. When the intervention time was >20 h, NMT exhibited a significant advantage at improving repetition ability (SMD = 0.43, 95%CI [0.06, 0.79], p < 0.05). Discussion This study provides evidence supporting the NMT enhancement of repetition ability in patients with non-fluent aphasia. Future large-sample studies are required to determine the optimal intervention dose of music therapy for different subtypes of non-fluent aphasia. Systematic review registration PROSPERO, identifier CRD42023470313.
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Affiliation(s)
- Jiayi Gu
- Department of Rehabilitation, Hunan Provincial People’s Hospital, The First Affiliated Hospital of Hunan Normal University, Changsha, China
| | - Wei Long
- Department of Rehabilitation, Hunan Provincial People’s Hospital, The First Affiliated Hospital of Hunan Normal University, Changsha, China
| | - Siqin Zeng
- Medicine College, Hunan Normal University, Changsha, China
| | - Chengjuan Li
- Department of Rehabilitation, The First Hospital of Changsha, The Affiliated Changsha Hospital of Xiangya School of Medicine, Central South University, Changsha, China
| | - Cuini Fang
- Department of Rehabilitation, Hunan Provincial People’s Hospital, The First Affiliated Hospital of Hunan Normal University, Changsha, China
| | - Xiaoying Zhang
- School of Rehabilitation Medicine, Capital Medical University, Beijing, China
- Music Therapy Center, China Rehabilitation Research Center, Beijing, China
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van Tellingen M, Hurkmans J, Terband H, van de Zande AM, Maassen B, Jonkers R. Speech and Music Therapy in the Treatment of Childhood Apraxia of Speech: An Introduction and a Case Study. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2023:1-19. [PMID: 37625142 DOI: 10.1044/2023_jslhr-22-00619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/27/2023]
Abstract
PURPOSE Speech-Music Therapy for Aphasia (SMTA), a method that combines speech therapy and music therapy, is introduced as a treatment method for childhood apraxia of speech (CAS). SMTA will be evaluated in a proof-of-principle study. The first case study is presented herein. METHOD SMTA was evaluated in a study with a single-subject experimental design comparing 10 weeks of treatment with 2 months of no treatment. The research protocol included a pretest, baseline phase, treatment phase, posttest, no-treatment phase, and follow-up test. The participant was a boy with CAS aged 5;8 (years;months). Outcome measures were selected to reflect both intelligibility in daily communication as well as features of CAS and speech motor planning and programming. RESULTS Results on the Intelligibility in Context Scale-Dutch (ICS-Dutch) and in the analysis of a spontaneous speech sample suggest generalization of treatment effects. Improvements were found in measures that reflect complex speech motor skills, that is, the production of consonant clusters and consistency. CONCLUSIONS This case study showed that speech production of the participant improved after treatment with SMTA. Although intelligibility as measured with the ICS-Dutch improved over the study period, objectifying changes at the level of intelligibility in daily communication proved to be difficult. Additional measures may be necessary to gain more insight into treatment effects at this level. Overall, the results of this first case study provide sufficient support and important leads for further evaluation of SMTA in the treatment of CAS in a proof-of-principle study.
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Affiliation(s)
- Mirjam van Tellingen
- Rehabilitation Centre "Revalidatie Friesland," Beetsterzwaag, the Netherlands
- University of Groningen, the Netherlands
| | - Joost Hurkmans
- Rehabilitation Centre "Revalidatie Friesland," Beetsterzwaag, the Netherlands
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van Tellingen M, Hurkmans J, Terband H, Jonkers R, Maassen B. Music and musical elements in the treatment of childhood speech sound disorders: A systematic review of the literature. INTERNATIONAL JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2023; 25:549-565. [PMID: 35900281 DOI: 10.1080/17549507.2022.2097310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
PURPOSE Music-based interventions are used in the treatment of childhood speech sound disorders (SSDs). Hypotheses on working mechanisms are being developed, focussing on shared neural processes. However, evidence of the effect of treatment with musical elements in SSDs in children is lacking. This study reviews the literature regarding the use of music-based interventions in the treatment of childhood SSDs. METHOD A systematic search in six databases was conducted, yielding 199 articles, eight of which met the inclusion criteria. Included articles were reviewed on study characteristics, patient characteristics, interventions, outcomes and methodological quality. RESULT This review included four case studies, three single-subject design studies and one cohort study. Seven studies reported positive outcomes on speech production, but outcome measures in the four studies with experimental design were not all aimed at the level of speech (motor) processes. Methodological quality was sufficient in one study. CONCLUSION Seven out of eight studies in this review report positive outcomes of music-based interventions in the treatment of SSDs. However, these outcomes are not sufficiently supported by evidence due to insufficient methodological quality. Suggestions for improving methodological quality in future research are presented.
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Affiliation(s)
| | - Joost Hurkmans
- Rehabilitation Centre "Revalidatie Friesland", Beetsterzwaag, The Netherlands
| | - Hayo Terband
- Utrecht Institute of Linguistics-OTS, Utrecht University, Utrecht, The Netherlands
- Department of Communication Sciences and Disorders, University of Iowa, Iowa City, IA, USA
| | - Roel Jonkers
- Centre for Language and Cognition Groningen, University of Groningen, Groningen, The Netherlands
| | - Ben Maassen
- Centre for Language and Cognition Groningen, University of Groningen, Groningen, The Netherlands
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Afshangian F, Wellington J, Pashmoforoosh R, Farzadfard MT, Noori NK, Jaberi AR, Ostovan VR, Soltani A, Safari H, Abolhasani Foroughi A, Resid Onen M, Montemurro N, Chaurasia B, Akgul E, Freddi T, Ermis A, Amirifard H, Habibi SAH, Manzarinezad M, Bozkurt I, Yagmurlu K, Sirjani EB, Wagner AP. The impact of visual and motor skills on ideational apraxia and transcortical sensory aphasia. APPLIED NEUROPSYCHOLOGY. ADULT 2023:1-11. [PMID: 37134206 DOI: 10.1080/23279095.2023.2204527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
BACKGROUND Patients with extensive left hemisphere damage frequently have ideational apraxia (IA) and transcortical sensory aphasia (TSA). Difficulty with action coordination, phonological processing, and complex motor planning may not be indicative of higher-order motor programming or higher-order complex formation. We report on the effects of IA and TSA on the visual and motor skill of stroke patients. PURPOSE The study aims to address the question of whether IA and TSA in bilingual individuals are the results of an error of motor function alone or due to a combined motor plus and cognitive dysfunction effect. METHOD Twelve bilingual patients (seven males, and five females) were diagnosed with IA and TSA, and are divided into two groups of six patients. Then, 12 healthy bilingual controls were evaluated for comparing with both groups. Bilingual aphasia testing (BAT) and appropriate behavioral evaluation were used to assess motor skills, including coordination, visual-motor testing, and phonological processing. RESULTS Findings (pointing skills) show that the performance of the L1 and L2 languages are consistently significant (p < 0.001) in healthy individuals compared to the IA and TSA groups. Command skills for L1 and L2 languages were significantly higher in healthy individuals compared to IA and TSA controls (p < 0.001). Further, the orthographic skills of IA and TSA vs controls in both groups were significantly reduced (p < 0.01). Visual skills in the L1 language were significantly improved (p < 0.05) in IA and TSA patients compared to healthy controls after 2 months. Unlike orthographic skills which were improved in IA and TSA patients, languages in bilingual patients did not simultaneously improve. CONCLUSION Dyspraxia is a condition that affects both motor and visual cognitive functions, and patients who have it often have less referred motor skills. The current dataset shows that accurate visual cognition requires both cognitive-linguistic and sensory-motor processes. Motor issues should be highlighted, and skills and functionality should be reinforced along with the significance of treatment between IA and TSA corresponding to age and education. This can be a good indicator for treating semantic disorders.
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Affiliation(s)
- Fazlallah Afshangian
- Department of English, Faculty of Foreign Languages, Rodaki Institute of Higher Education, Tonekabon, Iran
| | - Jack Wellington
- Cardiff University School of Medicine, Cardiff University, Cardiff, UK
| | | | | | | | | | - Vahid Reza Ostovan
- Department of Neurology, Shiraz University of Medical Science, Shiraz, Iran
| | - Ahmad Soltani
- Department of Neurosurgery, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Hosein Safari
- Ahvaz Jundishapur University of Medical Science, Ahvaz, Iran
| | - Amin Abolhasani Foroughi
- Department of Radiology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
- iMedical Imaging Research Center , Shiraz University of Medical Sciences , Shiraz , Iran
| | | | - Nicola Montemurro
- Azienda Ospedaliera Universitaria Pisana (AOUP), University of Pisa, Pisa, Italy
| | | | - Erol Akgul
- Radiology Department, International School of Medicine, Istanbul Medipol University, Istanbul, Turkey
| | - Tomas Freddi
- Radiology, Faculty of Medicine, Sao Paulo University, Sao Paulo, Brazil
| | - Abdulkadir Ermis
- Department of Neurology, School of Medicine, Istanbul Medipol University, Istanbul, Turkey
| | - Hamed Amirifard
- Department of Neurology, Tehran University of Medical Sciences, Tehran, Iran
| | | | | | - Ismail Bozkurt
- Department of Neurosurgery, Medical Park Ankara Hospital, Ankara, Turkey
| | - Kaan Yagmurlu
- Department of Neuroscience, University Virginia Health System, Charlottesville, VA, USA
| | - Ehsan Baradran Sirjani
- Research Development Center, Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Aurel Popa Wagner
- Center for Clinical and Experimental Medicine, University of Medicine and Pharmacy, Craiova, Romania
- Dementia and Ageing Research, Department of Neurology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
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Spinosa V, Vitulli A, Logroscino G, Brattico E. A Review on Music Interventions for Frontotemporal Aphasia and a Proposal for Alternative Treatments. Biomedicines 2022; 11:biomedicines11010084. [PMID: 36672592 PMCID: PMC9855720 DOI: 10.3390/biomedicines11010084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 12/08/2022] [Accepted: 12/20/2022] [Indexed: 12/31/2022] Open
Abstract
Frontotemporal dementia (FTD) is a rare neurodegenerative disease, characterized by behavioral and language impairments. Primary progressive aphasia (PPA) is the linguistic variant of this heterogeneous disorder. To date, there is a lack of consensus about which interventions are effective in these patients. However, several studies show that music-based interventions are beneficial in neurological diseases. This study aims, primarily, to establish the state of the art of music-based interventions designed for PPA due to FTD and, secondarily, to inform the planning of PPA-dedicated future interventions for Italian neurological institutions. The first aim is fulfilled by a review which critically screens the neurological studies examining the effects of music- and/or rhythm-based interventions, especially, on language rehabilitation in aphasic FTD. We found that only two papers fulfilled our criteria and concerned specifically aphasic patients due to FTD. Of those, one paper reported a study conducted in an Italian institution. Most of the reviewed studies focused, instead, on aphasia in post-stroke patients. The results of our review invite further studies to investigate the role of music as a valuable support in the therapy for neurodegenerative patients with language problems and in particular to PPA due to FTD. Moreover, based on this initial work, we can delineate new music-based interventions dedicated to PPA for Italian institutions.
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Affiliation(s)
- Vittoria Spinosa
- Center for Neurodegenerative Diseases and the Aging Brain, Department of Clinical Research in Neurology, University of Bari “Aldo Moro”, Pia Fondazione Cardinale G. Panico, 73039 Tricase, Italy
- Department of Basic Medicine, Neuroscience, and Sense Organs, University of Bari “Aldo Moro”, 70121 Bari, Italy
| | - Alessandra Vitulli
- Center for Neurodegenerative Diseases and the Aging Brain, Department of Clinical Research in Neurology, University of Bari “Aldo Moro”, Pia Fondazione Cardinale G. Panico, 73039 Tricase, Italy
| | - Giancarlo Logroscino
- Center for Neurodegenerative Diseases and the Aging Brain, Department of Clinical Research in Neurology, University of Bari “Aldo Moro”, Pia Fondazione Cardinale G. Panico, 73039 Tricase, Italy
- Department of Basic Medicine, Neuroscience, and Sense Organs, University of Bari “Aldo Moro”, 70121 Bari, Italy
| | - Elvira Brattico
- Center for Music in the Brain, Department of Clinical Medicine, Aarhus University, 8000 Aarhus, Denmark
- Department of Education, Psychology, Communication, University of Bari “Aldo Moro”, 70121 Bari, Italy
- Correspondence:
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Biel M, Enclade H, Richardson A, Guerrero A, Patterson J. Motivation Theory and Practice in Aphasia Rehabilitation: A Scoping Review. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2022; 31:2421-2443. [PMID: 36264648 DOI: 10.1044/2022_ajslp-22-00064] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
PURPOSE In the aphasia literature, motivation has been described as potentially influencing rehabilitation outcomes, and there are reports that researchers and clinicians have acted to promote it. However, studies directly investigating the range of beliefs and practices surrounding motivation do not exist currently. The purpose of this scoping review is to develop themes related to the beliefs and practices appearing in the recent aphasia literature. METHOD Four databases (CINAHL, PsycINFO, PubMed, and Google Scholar) were searched using keywords aphasia and motivation (including derivatives such as motiv*) for articles published between 2009 and 2020. Searches returned 19,731 articles; after deleting duplicates and applying inclusionary criteria, 365 articles remained. In each article, text surrounding the term motivation was highlighted and thematic analysis was applied to these quotations. RESULTS Sixteen themes were developed through thematic analysis and placed into two groups. The first group contained five themes suggesting that researchers believed that motivation should be studied and recognized the value of motivation in person(s) with aphasia when participating in research or clinical activities. The second group contained 11 themes reporting diverse beliefs and practices in how motivation is incorporated in research and clinical activities. CONCLUSIONS Results from this scoping review suggest that aphasia researchers, clinicians, and persons with aphasia hold beliefs about motivation that can influence clinical and research decisions. In general, beliefs and decisions related to motivation appeared to be guided by intuition rather than theories of motivation. These themes are discussed within the context of three psychological needs proposed by self-determination theory: competency, autonomy, and relatedness. Applying theories of motivation to future study in aphasia rehabilitation will guide work that can provide empirical support for these beliefs.
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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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Melodic Intonation Therapy in Post-Stroke Non-Fluent Aphasia and Its Effects on Brain Plasticity. J Clin Med 2022; 11:jcm11123503. [PMID: 35743571 PMCID: PMC9225206 DOI: 10.3390/jcm11123503] [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: 03/30/2022] [Revised: 06/10/2022] [Accepted: 06/11/2022] [Indexed: 12/04/2022] Open
Abstract
Melodic Intonation Therapy (MIT) is one of the most well-known therapies for the rehabilitation of speech in patients with non-fluent aphasia and which is thought to promote right-hemisphere involvement in language processing. This review focuses on the study of language lateralization and/or neuroplastic reorganization with neuroimaging and/or neurophysiological techniques in non-fluent aphasic patients post-stroke during or after MIT. A systematic search was carried out according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) in databases (PubMed, Scopus, EMBASE, Dialnet, Web of Science, Cochrane) with the keywords melodic intonation therapy, neuroimaging, functional magnetic resonance, and positron emission tomography and the boolean operators AND and OR. Articles including patients of all ages and either sex with any type of aphasia post-stroke and in any language, which studied language lateralization and/or neuroplastic reorganization after or during MIT were included. Articles which did not achieve the objectives, revisions and conferences were excluded. Different results were obtained from the 16 studies included in the review: predominantly greater activation of the right hemisphere but also of the left hemisphere or both. MIT is an effective therapy to rehabilitate non-fluent aphasic patients post-stroke. It involves different neurobiological mechanisms and depends on multiple individual factors. Studies with larger samples are necessary.
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Behaghel E, Zumbansen A. Singing for the Rehabilitation of Acquired Neurogenic Communication Disorders: Continuing the Evidence Dialogue with a Survey of Current Practices in Speech-Language Pathology. Healthcare (Basel) 2022; 10:healthcare10061010. [PMID: 35742061 PMCID: PMC9222374 DOI: 10.3390/healthcare10061010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 05/15/2022] [Accepted: 05/24/2022] [Indexed: 12/05/2022] Open
Abstract
Therapeutic applications of singing (e.g., melodic intonation therapy) for acquired neurogenic communication disorders (ANCD) such as post-stroke aphasia, dysarthria, or neurodegenerative diseases have emerged from innovations by clinical speech-language pathologists (SLPs). However, these specialists have never been systematically consulted about the use of singing in their practices. We report a survey of 395 SLPs in France using an online questionnaire (September 2018–January 2019). Most (98%) knew that singing could be a therapeutic tool. A wide variety of uses emerged in our data. Some practices (e.g., song games) have not yet been investigated in research settings. Melodic therapy, which is supported by scientific evidence, is familiar to clinicians (90%), but they lack training and rarely follow a full protocol. Over half of respondents (62%) recognize group singing for various benefits, but do not often use it, mainly due to the lack of adapted or welcoming choirs in their area. These results provide key information for continued dialogue between researchers, clinicians, and the community. Considering the aging population and the associated increase in the prevalence of ANCD, access to group singing in particular could be facilitated for these patients from a social prescription perspective with further research evidence.
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Affiliation(s)
- Estelle Behaghel
- Department of Speech-Language Pathology, Université de Limoges, 87036 Limoges, France;
| | - Anna Zumbansen
- School of Rehabilitation Sciences, University of Ottawa, Ottawa, ON K1H 8M5, Canada
- Music and Health Research Institute, University of Ottawa, Ottawa, ON K1N 6N5, Canada
- Correspondence:
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Hackett K, Sabat SR, Giovannetti T. A person-centered framework for designing music-based therapeutic studies in dementia: current barriers and a path forward. Aging Ment Health 2022; 26:940-949. [PMID: 34139133 PMCID: PMC8678363 DOI: 10.1080/13607863.2021.1931029] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Objectives: Music-based interventions have received growing attention to improve quality of life for people diagnosed with dementia. Results of randomized controlled trials and meta-analytic reviews to date, however, reveal a lack of conclusive evidence for or against the effectiveness of such interventions. Herein, we critically review the basic assumptions and methodological issues ingrained in the cultures of research and care as they relate to evaluating music-based treatments for people with dementia, and propose a shift in the methodology by which music interventions are empirically evaluated.Method: We begin by reviewing existing barriers to achieving clarity on the effectiveness of music interventions, and we highlight methodological and sociocultural constraints that have limited our ability to reach concrete conclusions in research studies to-date. We then consider several key factors that have demonstrated relevance in matching people to specific music-based interventions. Based on these key factors, we developed a person-centered framework integrating elements from precision-medicine methodology to guide intervention studies.Results: Our organizing framework systematically integrates the following factors to inform the design of intervention studies: 1) person-centered goals and desired outcomes; 2) differences among individuals in clinical, cognitive, and historical attributes; and 3) the context of intervention and access to resources.Conclusion: Integration of the proposed framework into empirical investigations of music interventions for people living with dementia will inform precise and tailored interventions that will bring clarity to this growing body of research. Another aim of this framework is to foster a more humane, person-centered approach to our culture of care.
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Affiliation(s)
| | - Steven R. Sabat
- Department of Psychology, Georgetown University, Washington, DC, USA
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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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13
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An Introduction to Musical Interactions. MULTIMODAL TECHNOLOGIES AND INTERACTION 2022. [DOI: 10.3390/mti6010004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
The article presents a contextual survey of eight contributions in the special issue Musical Interactions (Volume I) in Multimodal Technologies and Interaction. The presentation includes (1) a critical examination of what it means to be musical, to devise the concept of music proper to MTI as well as multicultural proximity, and (2) a conceptual framework for instrumentation, design, and assessment of musical interaction research through five enabling dimensions: Affordance; Design Alignment; Adaptive Learning; Second-Order Feedback; Temporal Integration. Each dimension is discussed and applied in the survey. The results demonstrate how the framework provides an interdisciplinary scope required for musical interaction, and how this approach may offer a coherent way to describe and assess approaches to research and design as well as implementations of interactive musical systems. Musical interaction stipulates musical liveness for experiencing both music and technologies. While music may be considered ontologically incomplete without a listener, musical interaction is defined as ontological completion of a state of music and listening through a listener’s active engagement with musical resources in multimodal information flow.
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14
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Haro-Martínez A, Pérez-Araujo CM, Sanchez-Caro JM, Fuentes B, Díez-Tejedor E. Melodic Intonation Therapy for Post-stroke Non-fluent Aphasia: Systematic Review and Meta-Analysis. Front Neurol 2021; 12:700115. [PMID: 34421802 PMCID: PMC8371046 DOI: 10.3389/fneur.2021.700115] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2021] [Accepted: 07/05/2021] [Indexed: 11/13/2022] Open
Abstract
Introduction: Melodic intonation therapy (MIT) is one of the most studied speech and language therapy (SLT) approaches for patients with non-fluent aphasia, although the methodological quality of the studies has been rated as low in previous reviews. The aim of this study is to update current evidence on the possible efficacy of MIT for the treatment of non-fluent post-stroke aphasia. Methods: A systematic review and meta-analysis. We selected randomized clinical trials (RCT) that included adult patients over 18 years of age with non-fluent post-stroke aphasia, whose intervention was MIT vs. no therapy or other therapy. We excluded non-RCT studies, mixed populations including patients with aphasia of non-stroke etiology, studies with no availability of post-stroke aphasia-specific data, and incomplete studies. Three sections of communicative ability were analyzed as outcomes: functional communication, expressive language (naming and repetition), and comprehension. Results: We identified a total of four eligible RCTs involving 94 patients. Despite the heterogeneity in the psychometric tests employed among the trials, a significant effect of MIT on functional communication (evaluated by the Communication Activity Log) was found (SMD 1.47; 95% CI 0.39–2.56). In addition, a positive effect of MIT on expressive language (repetition) was found (SMD 0.45; 95% CI 0.01–0.90). No significant effects on comprehension measurements were found, despite a lack of significant statistical heterogeneity. Conclusion: This systematic review and meta-analysis shows a significant effect of MIT on improving functional communication and on repetition tasks. Future larger RCT specifically addressing those outcomes should provide the definite evidence on the efficacy of MIT on post-stroke aphasia recovery. Systematic Review Registration:PROSPERO-URL https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020144604.
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Affiliation(s)
- Ana Haro-Martínez
- Doctoral Programme, Department of Medicine, Universidad Autónoma de Madrid, Madrid, Spain
| | | | - Juan M Sanchez-Caro
- Department of Medicine, Department of Neurology and Stroke Center, Hospital Universitario La Paz, Universidad Autónoma de Madrid, IdiPAZ Health Research Institute, Madrid, Spain
| | - Blanca Fuentes
- Department of Medicine, Department of Neurology and Stroke Center, Hospital Universitario La Paz, Universidad Autónoma de Madrid, IdiPAZ Health Research Institute, Madrid, Spain
| | - Exuperio Díez-Tejedor
- Department of Medicine, Department of Neurology and Stroke Center, Hospital Universitario La Paz, Universidad Autónoma de Madrid, IdiPAZ Health Research Institute, Madrid, Spain
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15
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Zhang XY, Yu WY, Teng WJ, Lu MY, Wu XL, Yang YQ, Chen C, Liu LX, Liu SH, Li JJ. Effectiveness of Melodic Intonation Therapy in Chinese Mandarin on Non-fluent Aphasia in Patients After Stroke: A Randomized Control Trial. Front Neurosci 2021; 15:648724. [PMID: 34366768 PMCID: PMC8344357 DOI: 10.3389/fnins.2021.648724] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2021] [Accepted: 06/10/2021] [Indexed: 01/31/2023] Open
Abstract
Melodic intonation therapy (MIT) positively impacts the speech function of patients suffering from aphasia and strokes. Fixed-pitch melodies and phrases formulated in MIT provide the key to the target language to open the language pathway. This randomized controlled trial compared the effects of music therapy-based MIT and speech therapy on patients with non-fluent aphasia. The former is more effective in the recovery of language function in patients with aphasia. Forty-two participants were enrolled in the study, and 40 patients were registered. The participants were randomly assigned to two groups: the intervention group (n = 20; 16 males, 4 females; 52.90 ± 9.08 years), which received MIT, and the control group (n = 20; 15 males, 5 females; 54.05 ± 10.81 years), which received speech therapy. The intervention group received MIT treatment for 30 min/day, five times a week for 8 weeks, and the control group received identical sessions of speech therapy for 30 min/day, five times a week for 8 weeks. Each participant of the group was assessed by a Boston Diagnostic Aphasia Examination (BDAE) at the baseline (t1, before the start of the experiment), and after 8 weeks (t2, the experiment was finished). The Hamilton Anxiety Scale (HAMA) and Hamilton Depression Scale (HAMD) were also measured on the time points. The best medical care of the two groups is the same. Two-way ANOVA analysis of variance was used only for data detection. In the spontaneous speech (information), the listening comprehension (right or wrong, word recognition, and sequential order) and repetitions of the intervention group were significantly higher than the control group in terms of the cumulative effect of time and the difference between groups after 8 weeks. The intervention group has a significant time effect in fluency, but the results after 8 weeks were not significantly different from those in the control group. In terms of naming, the intervention group was much better than the control group in spontaneous naming. Regarding object naming, reaction naming, and sentence completing, the intervention group showed a strong time accumulation effect. Still, the results after 8 weeks were not significantly different from those in the control group. These results indicate that, compared with speech therapy, MIT based on music therapy is a more effective musical activity and is effective and valuable for the recovery of speech function in patients with non-fluent aphasia. As a more professional non-traumatic treatment method, MIT conducted by qualified music therapists requires deeper cooperation between doctors and music therapists to improve rehabilitating patients with aphasia. The Ethics Committee of the China Rehabilitation Research Center approved this study (Approval No. 2020-013-1 on April 1, 2020) and was registered with the Chinese Clinical Trial Registry (Registration number: Clinical Trials ChiCTR2000037871) on September 3, 2020.
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Affiliation(s)
- Xiao-Ying Zhang
- School of Rehabilitation Medicine, Capital Medical University, Beijing, China.,China Rehabilitation Science Institute, Beijing, China.,Beijing Key Laboratory of Neural Injury and Rehabilitation, Beijing, China.,Center of Neural Injury and Repair, Beijing Institute for Brain Disorders, Beijing, China.,Music Therapy Center, Department of Psychology, China Rehabilitation Research Center, Beijing, China
| | - Wei-Yong Yu
- School of Rehabilitation Medicine, Capital Medical University, Beijing, China.,Department of Imaging, China Rehabilitation Research Center, Beijing, China
| | - Wen-Jia Teng
- School of Rehabilitation Medicine, Capital Medical University, Beijing, China.,Music Therapy Center, Department of Psychology, China Rehabilitation Research Center, Beijing, China
| | - Meng-Yang Lu
- School of Rehabilitation Medicine, Capital Medical University, Beijing, China.,Music Therapy Center, Department of Psychology, China Rehabilitation Research Center, Beijing, China
| | - Xiao-Li Wu
- School of Rehabilitation Medicine, Capital Medical University, Beijing, China.,Department of Neurorehabilitation, China Rehabilitation Research Center, Beijing, China
| | - Yu-Qi Yang
- School of Rehabilitation Medicine, Capital Medical University, Beijing, China.,Department of Neurorehabilitation, China Rehabilitation Research Center, Beijing, China
| | - Chen Chen
- Department of Music Education, Xinghai Conservatory of Music, Guangzhou, China
| | - Li-Xu Liu
- School of Rehabilitation Medicine, Capital Medical University, Beijing, China.,Department of Neurorehabilitation, China Rehabilitation Research Center, Beijing, China
| | - Song-Huai Liu
- School of Rehabilitation Medicine, Capital Medical University, Beijing, China.,Music Therapy Center, Department of Psychology, China Rehabilitation Research Center, Beijing, China
| | - Jian-Jun Li
- School of Rehabilitation Medicine, Capital Medical University, Beijing, China.,China Rehabilitation Science Institute, Beijing, China.,Beijing Key Laboratory of Neural Injury and Rehabilitation, Beijing, China.,Center of Neural Injury and Repair, Beijing Institute for Brain Disorders, Beijing, China
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16
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Brancatisano O, Baird A, Thompson WF. Why is music therapeutic for neurological disorders? The Therapeutic Music Capacities Model. Neurosci Biobehav Rev 2020; 112:600-615. [PMID: 32050086 DOI: 10.1016/j.neubiorev.2020.02.008] [Citation(s) in RCA: 46] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Revised: 02/04/2020] [Accepted: 02/08/2020] [Indexed: 12/19/2022]
Abstract
Music has cognitive, psychosocial, behavioral and motor benefits for people with neurological disorders such as dementia, stroke, Parkinson's disease (PD) and Autism Spectrum Disorder (ASD). Here we discuss seven properties or 'capacities' of music that interact with brain function and contribute to its therapeutic value. Specifically, in its various forms, music can be engaging, emotional, physical, personal, social and persuasive, and it promotes synchronization of movement. We propose the Therapeutic Music Capacities Model (TMCM), which links individual properties of music to therapeutic mechanisms, leading to cognitive, psychosocial, behavioral and motor benefits. We review evidence that these capacities have reliable benefits for people with dementia, stroke, PD and ASD when employed separately or in combination. The model accounts for the profound value that music affords human health and well-being and provides a framework for the development of non-pharmaceutical treatments for neurological disorders.
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Affiliation(s)
- Olivia Brancatisano
- Department of Psychology and Centre for Ageing, Cognition, and Wellbeing, Macquarie University, Sydney, Australia
| | - Amee Baird
- Department of Psychology and Centre for Ageing, Cognition, and Wellbeing, Macquarie University, Sydney, Australia
| | - William Forde Thompson
- Department of Psychology and Centre for Ageing, Cognition, and Wellbeing, Macquarie University, Sydney, Australia.
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17
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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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18
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Bird LJ, Jackson GD, Wilson SJ. Music training is neuroprotective for verbal cognition in focal epilepsy. Brain 2019; 142:1973-1987. [PMID: 31074775 DOI: 10.1093/brain/awz124] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2018] [Revised: 02/18/2019] [Accepted: 03/07/2019] [Indexed: 12/21/2022] Open
Abstract
Focal epilepsy is a unilateral brain network disorder, providing an ideal neuropathological model with which to study the effects of focal neural disruption on a range of cognitive processes. While language and memory functions have been extensively investigated in focal epilepsy, music cognition has received less attention, particularly in patients with music training or expertise. This represents a critical gap in the literature. A better understanding of the effects of epilepsy on music cognition may provide greater insight into the mechanisms behind disease- and training-related neuroplasticity, which may have implications for clinical practice. In this cross-sectional study, we comprehensively profiled music and non-music cognition in 107 participants; musicians with focal epilepsy (n = 35), non-musicians with focal epilepsy (n = 39), and healthy control musicians and non-musicians (n = 33). Parametric group comparisons revealed a specific impairment in verbal cognition in non-musicians with epilepsy but not musicians with epilepsy, compared to healthy musicians and non-musicians (P = 0.029). This suggests a possible neuroprotective effect of music training against the cognitive sequelae of focal epilepsy, and implicates potential training-related cognitive transfer that may be underpinned by enhancement of auditory processes primarily supported by temporo-frontal networks. Furthermore, our results showed that musicians with an earlier age of onset of music training performed better on a composite score of melodic learning and memory compared to non-musicians (P = 0.037), while late-onset musicians did not differ from non-musicians. For most composite scores of music cognition, although no significant group differences were observed, a similar trend was apparent. We discuss these key findings in the context of a proposed model of three interacting dimensions (disease status, music expertise, and cognitive domain), and their implications for clinical practice, music education, and music neuroscience research.
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Affiliation(s)
- Laura J Bird
- Melbourne School of Psychological Sciences, The University of Melbourne, Grattan Street, Parkville, Victoria, Australia.,The Florey Institute of Neuroscience and Mental Health, Melbourne Brain Centre, 245 Burgundy Street, Heidelberg, Victoria, Australia
| | - Graeme D Jackson
- The Florey Institute of Neuroscience and Mental Health, Melbourne Brain Centre, 245 Burgundy Street, Heidelberg, Victoria, Australia.,Department of Medicine, The University of Melbourne, Grattan Street, Parkville, Victoria, Australia
| | - Sarah J Wilson
- Melbourne School of Psychological Sciences, The University of Melbourne, Grattan Street, Parkville, Victoria, Australia.,The Florey Institute of Neuroscience and Mental Health, Melbourne Brain Centre, 245 Burgundy Street, Heidelberg, Victoria, Australia
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19
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Kasdan A, Kiran S. Please don't stop the music: Song completion in patients with aphasia. JOURNAL OF COMMUNICATION DISORDERS 2018; 75:72-86. [PMID: 30031236 DOI: 10.1016/j.jcomdis.2018.06.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/21/2016] [Revised: 05/02/2018] [Accepted: 06/15/2018] [Indexed: 06/08/2023]
Abstract
Aphasia, an acquired language disorder resulting from brain damage, affects over one million individuals in the United States alone. Many persons with aphasia (PWA), particularly those with non-fluent aphasia, have been observed to be able to sing the lyrics of songs more easily than they can speak the same words. Remarkably, even humming a melody can facilitate speech output in PWA, and this has been capitalized on in therapies such as Melodic Intonation Therapy. The current study examined PWA's ability to complete phrases from songs by either singing, speaking, or intoning them in an experimental stem-completion format. Twenty PWA of varying severity, all but one of whom had aphasia as a result of stroke, and 20 age-matched healthy controls participated in the task. The task consisted of three conditions (sung, spoken, and melodic) each consisting of 20 well-known songs. Participants heard the first half of a phrase that was either sung in its original format (sung condition), spoken (spoken condition), or intoned on the syllable "bum," (melodic condition) and were asked to complete the phrase according to the format in which the stimulus was presented. PWA achieved the highest accuracy in the sung condition, followed by the spoken and then melodic conditions, while controls scored comparably in the sung and spoken condition and much lower in the melodic condition. PWA and controls were better able to access and produce both the melody and lyrics of songs in the sung condition (when both components were presented together), compared to when the melody and lyrics of songs were presented in isolation. Here, melody confers an advantage for word retrieval for PWA, as lyric production is better in a sung context, and these results substantiate the theoretical framework of MIT. Additionally, the present results may be attributed to the integration hypothesis, which postulates that the text and tune of a song are integrated in memory. Interestingly, a subset of the most severe PWA scored higher in the melodic condition relative to the spoken condition, while this pattern was not found for less severe PWA and for controls. Taken together, our results suggest that singing appears to influence PWA when trying to access the lyrics of songs; access to melody is preserved in PWA even while they exhibit profound and diverse language impairments. Findings may have implications for using music as a more widely implemented tool in speech therapy for PWA.
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Affiliation(s)
- Anna Kasdan
- Vanderbilt Brain Institute, Neuroscience Graduate Program U-1205, Medical Research Building III, 465 21st Avenue, South Nashville, TN 37232-2050; Neuroscience Program, Boston University, 635 Commonwealth Ave, Boston, MA 02215, USA.
| | - Swathi Kiran
- Speech and Hearing Sciences, Boston University, 635 Commonwealth Ave, Boston, MA 02215, USA
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20
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Haro-Martínez AM, Lubrini G, Madero-Jarabo R, Díez-Tejedor E, Fuentes B. Melodic intonation therapy in post-stroke nonfluent aphasia: a randomized pilot trial. Clin Rehabil 2018; 33:44-53. [DOI: 10.1177/0269215518791004] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective: To collect data to estimate the sample size of a definitive randomized controlled trial to evaluate the effects of Melodic Intonation Therapy in post-stroke nonfluent aphasia. Design: A randomized, crossover, interventional pilot trial. Setting: Departments of Neurology and Rehabilitation from a university general hospital. Participants: Stroke survivors with post-stroke nonfluent aphasia. Interventions: Patients randomized to group 1 had treatment with Melodic Intonation Therapy first (12 sessions over six weeks) followed by no treatment; the patients in group 2 started active treatment between three and six months after their inclusion in the study, serving as waiting list controls for the first phase. Main measures: The Communicative Activity Log (CAL) questionnaire and the Boston Diagnostic Aphasia Examination (BDAE) were evaluated at baseline, and at six and 12 weeks. Results: Twenty patients were included. Four of the patients allocated to group 2 crossed over to group 1, receiving the treatment at first. Intention-to-treat analysis: after adjustment for baseline scores, the mean difference in the CAL evaluation from baseline in the treated group was 8.5 points (95% confidence interval (CI), 0.11–17.0; P = .043), with no significant change in any of the BDAE sections. Per-protocol analysis showed similar results with a clear treatment effect ( P = .043) on the CAL. Conclusion: Melodic Intonation Therapy might have a positive effect on the communication skills of stroke survivors with nonfluent aphasia as measured by the CAL questionnaire. A full-scale trial with at least 27 patients per group is necessary to confirm these results.
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Affiliation(s)
- Ana M Haro-Martínez
- PhD Program, School of Medicine, Autonomous University of Madrid, Madrid, Spain
| | - Genny Lubrini
- Department of Neurology and Stroke Center, La Paz University Hospital, IdiPAZ Health Research Institute, Autonomous University of Madrid, Madrid, Spain
- School of Health Sciences, Francisco de Vitoria University, Madrid, Spain
| | - Rosario Madero-Jarabo
- Department of Biostatistics, La Paz University Hospital, IdiPAZ Health Research Institute, Autonomous University of Madrid, Madrid, Spain
| | - Exuperio Díez-Tejedor
- Department of Neurology and Stroke Center, La Paz University Hospital, IdiPAZ Health Research Institute, Autonomous University of Madrid, Madrid, Spain
| | - Blanca Fuentes
- Department of Neurology and Stroke Center, La Paz University Hospital, IdiPAZ Health Research Institute, Autonomous University of Madrid, Madrid, Spain
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21
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Al-Shdifat KG, Sarsak J, Ghareeb FA. Exploring the efficacy of melodic intonation therapy with Broca's aphasia in Arabic. SOUTH AFRICAN JOURNAL OF COMMUNICATION DISORDERS 2018; 65:e1-e8. [PMID: 29943587 PMCID: PMC6018128 DOI: 10.4102/sajcd.v65i1.567] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2017] [Revised: 02/09/2018] [Accepted: 03/07/2018] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Even though the efficacy of melodic intonation therapy (MIT) with persons with aphasia (PWA) has been explored in different languages, the efficacy of MIT with Arabic-speaking PWA has never been explored. Aims: To explore the efficacy of MIT, adapted to Arabic, in promoting the expressive abilities of a 70-year-old Jordanian Arabic-speaking male subject with severe Broca's aphasia 3 months post-onset. Methods: An 8-week MIT therapy programme with tapping (1.5 h daily, 6 days a week) was used in a multiple baseline design across two types of trained phrases (i.e. automatic and self-generated phrases). Outcome measures included accuracy of production of trained (at the end of each session) and untrained phrases (at the end of each week). Pre- and post-treatment measures used, were the bilingual aphasia test, the American Speech-Language Hearing Association Functional Assessment of Communicative Skills, the communicative effectiveness index and the American Speech and Hearing Association Quality of Communication Life Scale. Accuracy of production for the trained and untrained phrases was also measured 2 weeks and 4 weeks after the treatment programme was finished. Results: The patient, (MK), improved his expressive productions post-treatment in automatic and self-generated phrases. Automatic phrases exceeded the established 75% accuracy criterion, whereas the self-generated phrases reached criterion and remained constant at follow-up. Moreover, MK gradually started improving on the generalisation stimuli, once the treatment on the self-generated phrases started and maintained the gains 2 weeks and 4 weeks post-treatment. Conclusion: MIT appears to be a viable treatment option for Jordanian Arabic-speaking persons with Broca's aphasia. However, more research is needed with larger groups of Jordanian Arabic-speaking persons with Broca's aphasia to provide more support to the present findings. Moreover, future studies might focus on the efficacy of MIT with persons with Broca's aphasia from different Arab countries and from countries where Arabic is part of the multicultural structure like South Africa and other countries on the African continent.
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Affiliation(s)
- Khalid G Al-Shdifat
- Department of Rehabilitation Sciences, Faculty of Applied Medical Sciences, Jordan University of Science and Technology.
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22
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Leonardi S, Cacciola A, De Luca R, Aragona B, Andronaco V, Milardi D, Bramanti P, Calabrò RS. The role of music therapy in rehabilitation: improving aphasia and beyond. Int J Neurosci 2017; 128:90-99. [PMID: 28689476 DOI: 10.1080/00207454.2017.1353981] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Music is part of the human nature, and it is also philogenically relevant to language evolution. Language and music are bound together in the enhancement of important social functions, such as communication, cooperation and social cohesion. In the last few years, there has been growing evidence that music and music therapy may improve communication skills (but not only) in different neurological disorders. One of the plausible reasons concerning the rational use of sound and music in neurorehabilitation is the possibility to stimulate brain areas involved in emotional processing and motor control, such as the fronto-parietal network. In this narrative review, we are going to describe the role of music therapy in improving aphasia and other neurological disorders, underlying the reasons why this tool could be effective in rehabilitative settings, especially in individuals affected by stroke.
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Affiliation(s)
| | | | | | - Bianca Aragona
- a IRCCS Centro Neurolesi "Bonino Pulejo" , Messina , Italy
| | | | - Demetrio Milardi
- a IRCCS Centro Neurolesi "Bonino Pulejo" , Messina , Italy.,b Department of Biomedical , Dental Sciences and Morphological and Functional Images, University of Messina , Messina , Italy
| | - Placido Bramanti
- a IRCCS Centro Neurolesi "Bonino Pulejo" , Messina , Italy.,b Department of Biomedical , Dental Sciences and Morphological and Functional Images, University of Messina , Messina , Italy
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23
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Van Der Meulen I, Van De Sandt-Koenderman MWME, Heijenbrok MH, Visch-Brink E, Ribbers GM. Melodic Intonation Therapy in Chronic Aphasia: Evidence from a Pilot Randomized Controlled Trial. Front Hum Neurosci 2016; 10:533. [PMID: 27847473 PMCID: PMC5088197 DOI: 10.3389/fnhum.2016.00533] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2016] [Accepted: 10/07/2016] [Indexed: 11/13/2022] Open
Abstract
Melodic Intonation Therapy (MIT) is a language production therapy for severely non-fluent aphasic patients using melodic intoning and rhythm to restore language. Although many studies have reported its beneficial effects on language production, randomized controlled trials (RCT) examining the efficacy of MIT are rare. In an earlier publication, we presented the results of an RCT on MIT in subacute aphasia and found that MIT was effective on trained and untrained items. Further, we observed a clear trend in improved functional language use after MIT: subacute aphasic patients receiving MIT improved considerably on language tasks measuring connected speech and daily life verbal communication. Here, we present the results of a pilot RCT on MIT in chronic aphasia and compare these to the results observed in subacute aphasia. We used a multicenter waiting-list RCT design. Patients with chronic (>1 year) post-stroke aphasia were randomly allocated to the experimental group (6 weeks MIT) or to the control group (6 weeks no intervention followed by 6 weeks MIT). Assessments were done at baseline (T1), after 6 weeks (T2), and 6 weeks later (T3). Efficacy was evaluated at T2 using univariable linear regression analyses. Outcome measures were chosen to examine several levels of therapy success: improvement on trained items, generalization to untrained items, and generalization to verbal communication. Of 17 included patients, 10 were allocated to the experimental condition and 7 to the control condition. MIT significantly improved repetition of trained items (β = 13.32, p = 0.02). This effect did not remain stable at follow-up assessment. In contrast to earlier studies, we found only a limited and temporary effect of MIT, without generalization to untrained material or to functional communication. The results further suggest that the effect of MIT in chronic aphasia is more restricted than its effect in earlier stages post stroke. This is in line with studies showing larger effects of aphasia therapy in earlier compared to later stages post stroke. The study was designed as an RCT, but was underpowered. The results therefore have to be interpreted cautiously and future larger studies are needed. CLINICAL TRIAL REGISTRATION www.ClinicalTrials.gov, identifier NTR 1961.
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Affiliation(s)
- Ineke Van Der Meulen
- Rijndam Rehabilitation InstituteRotterdam, Netherlands; Department of Rehabilitation Medicine, Erasmus MC University Medical CentreRotterdam, Netherlands
| | - Mieke W M E Van De Sandt-Koenderman
- Rijndam Rehabilitation InstituteRotterdam, Netherlands; Department of Rehabilitation Medicine, Erasmus MC University Medical CentreRotterdam, Netherlands
| | - Majanka H Heijenbrok
- Rijndam Rehabilitation InstituteRotterdam, Netherlands; Department of Rehabilitation Medicine, Erasmus MC University Medical CentreRotterdam, Netherlands
| | - Evy Visch-Brink
- Department of Neurology, Erasmus MC University Medical Centre Rotterdam, Netherlands
| | - Gerard M Ribbers
- Rijndam Rehabilitation InstituteRotterdam, Netherlands; Department of Rehabilitation Medicine, Erasmus MC University Medical CentreRotterdam, Netherlands
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Vanden Bosch der Nederlanden CM, Hannon EE, Snyder JS. Finding the music of speech: Musical knowledge influences pitch processing in speech. Cognition 2015; 143:135-40. [PMID: 26151370 DOI: 10.1016/j.cognition.2015.06.015] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2014] [Revised: 06/25/2015] [Accepted: 06/27/2015] [Indexed: 10/23/2022]
Abstract
Few studies comparing music and language processing have adequately controlled for low-level acoustical differences, making it unclear whether differences in music and language processing arise from domain-specific knowledge, acoustic characteristics, or both. We controlled acoustic characteristics by using the speech-to-song illusion, which often results in a perceptual transformation to song after several repetitions of an utterance. Participants performed a same-different pitch discrimination task for the initial repetition (heard as speech) and the final repetition (heard as song). Better detection was observed for pitch changes that violated rather than conformed to Western musical scale structure, but only when utterances transformed to song, indicating that music-specific pitch representations were activated and influenced perception. This shows that music-specific processes can be activated when an utterance is heard as song, suggesting that the high-level status of a stimulus as either language or music can be behaviorally dissociated from low-level acoustic factors.
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Klineburger PC, Harrison DW. The dynamic functional capacity theory: A neuropsychological model of intense emotions. COGENT PSYCHOLOGY 2015. [DOI: 10.1080/23311908.2015.1029691] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Affiliation(s)
- Philip C. Klineburger
- Clinical Psychology, Virginia Polytechnic Institute and State University, Blacksburg 24060, VA, USA
| | - David W. Harrison
- Clinical Psychology, Virginia Polytechnic Institute and State University, Blacksburg 24060, VA, USA
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Clarke S, Bindschaedler C, Crottaz-Herbette S. Impact of Cognitive Neuroscience on Stroke Rehabilitation. Stroke 2015; 46:1408-13. [DOI: 10.1161/strokeaha.115.007435] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2015] [Accepted: 02/11/2015] [Indexed: 11/16/2022]
Affiliation(s)
- Stephanie Clarke
- From the Service de Neuropsychologie et de Neuroréhabilitation, CHUV, Lausanne, Switzerland
| | - Claire Bindschaedler
- From the Service de Neuropsychologie et de Neuroréhabilitation, CHUV, Lausanne, Switzerland
| | - Sonia Crottaz-Herbette
- From the Service de Neuropsychologie et de Neuroréhabilitation, CHUV, Lausanne, Switzerland
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Stahl B, Kotz SA. Facing the music: three issues in current research on singing and aphasia. Front Psychol 2014; 5:1033. [PMID: 25295017 PMCID: PMC4172097 DOI: 10.3389/fpsyg.2014.01033] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2014] [Accepted: 08/29/2014] [Indexed: 11/21/2022] Open
Affiliation(s)
- Benjamin Stahl
- Brain Language Laboratory, Department of Philosophy and Humanities Freie Universität Berlin, Berlin, Germany ; Max Planck Institute for Human Cognitive and Brain Sciences Leipzig, Germany
| | - Sonja A Kotz
- Max Planck Institute for Human Cognitive and Brain Sciences Leipzig, Germany ; School of Psychological Sciences, University of Manchester Manchester, UK
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Zumbansen A, Peretz I, Hébert S. The Combination of Rhythm and Pitch Can Account for the Beneficial Effect of Melodic Intonation Therapy on Connected Speech Improvements in Broca's Aphasia. Front Hum Neurosci 2014; 8:592. [PMID: 25157222 PMCID: PMC4127945 DOI: 10.3389/fnhum.2014.00592] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2014] [Accepted: 07/16/2014] [Indexed: 11/13/2022] Open
Abstract
Melodic intonation therapy (MIT) is a structured protocol for language rehabilitation in people with Broca's aphasia. The main particularity of MIT is the use of intoned speech, a technique in which the clinician stylizes the prosody of short sentences using simple pitch and rhythm patterns. In the original MIT protocol, patients must repeat diverse sentences in order to espouse this way of speaking, with the goal of improving their natural, connected speech. MIT has long been regarded as a promising treatment but its mechanisms are still debated. Recent work showed that rhythm plays a key role in variations of MIT, leading to consider the use of pitch as relatively unnecessary in MIT. Our study primarily aimed to assess the relative contribution of rhythm and pitch in MIT's generalization effect to non-trained stimuli and to connected speech. We compared a melodic therapy (with pitch and rhythm) to a rhythmic therapy (with rhythm only) and to a normally spoken therapy (without melodic elements). Three participants with chronic post-stroke Broca's aphasia underwent the treatments in hourly sessions, 3 days per week for 6 weeks, in a cross-over design. The informativeness of connected speech, speech accuracy of trained and non-trained sentences, motor-speech agility, and mood was assessed before and after the treatments. The results show that the three treatments improved speech accuracy in trained sentences, but that the combination of rhythm and pitch elicited the strongest generalization effect both to non-trained stimuli and connected speech. No significant change was measured in motor-speech agility or mood measures with either treatment. The results emphasize the beneficial effect of both rhythm and pitch in the efficacy of original MIT on connected speech, an outcome of primary clinical importance in aphasia therapy.
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Affiliation(s)
- Anna Zumbansen
- Faculty of Medicine, School of Speech Pathology and Audiology, Université de Montréal, Montreal, QC, Canada
- CRBLM, Centre for Research on Brain, Language and Music, McGill University, Montreal, QC, Canada
- BRAMS, International Laboratory for Research on Brain, Music, and Sound, Université de Montréal, Montreal, QC, Canada
| | - Isabelle Peretz
- CRBLM, Centre for Research on Brain, Language and Music, McGill University, Montreal, QC, Canada
- BRAMS, International Laboratory for Research on Brain, Music, and Sound, Université de Montréal, Montreal, QC, Canada
- Faculty of Arts and Science, Department of Psychology, Université de Montréal, Montreal, QC, Canada
| | - Sylvie Hébert
- Faculty of Medicine, School of Speech Pathology and Audiology, Université de Montréal, Montreal, QC, Canada
- CRBLM, Centre for Research on Brain, Language and Music, McGill University, Montreal, QC, Canada
- BRAMS, International Laboratory for Research on Brain, Music, and Sound, Université de Montréal, Montreal, QC, Canada
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