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Sihvonen AJ, Leo V, Ripollés P, Lehtovaara T, Ylönen A, Rajanaro P, Laitinen S, Forsblom A, Saunavaara J, Autti T, Laine M, Rodríguez-Fornells A, Tervaniemi M, Soinila S, Särkämö T. Vocal music enhances memory and language recovery after stroke: pooled results from two RCTs. Ann Clin Transl Neurol 2020; 7:2272-2287. [PMID: 33022148 PMCID: PMC7664275 DOI: 10.1002/acn3.51217] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Revised: 08/27/2020] [Accepted: 09/18/2020] [Indexed: 12/13/2022] Open
Abstract
Objective Previous studies suggest that daily music listening can aid stroke recovery, but little is known about the stimulus‐dependent and neural mechanisms driving this effect. Building on neuroimaging evidence that vocal music engages extensive and bilateral networks in the brain, we sought to determine if it would be more effective for enhancing cognitive and language recovery and neuroplasticity than instrumental music or speech after stroke. Methods Using data pooled from two single‐blind randomized controlled trials in stroke patients (N = 83), we compared the effects of daily listening to self‐selected vocal music, instrumental music, and audiobooks during the first 3 poststroke months. Outcome measures comprised neuropsychological tests of verbal memory (primary outcome), language, and attention and a mood questionnaire performed at acute, 3‐month, and 6‐month stages and structural and functional MRI at acute and 6‐month stages. Results Listening to vocal music enhanced verbal memory recovery more than instrumental music or audiobooks and language recovery more than audiobooks, especially in aphasic patients. Voxel‐based morphometry and resting‐state and task‐based fMRI results showed that vocal music listening selectively increased gray matter volume in left temporal areas and functional connectivity in the default mode network. Interpretation Vocal music listening is an effective and easily applicable tool to support cognitive recovery after stroke as well as to enhance early language recovery in aphasia. The rehabilitative effects of vocal music are driven by both structural and functional plasticity changes in temporoparietal networks crucial for emotional processing, language, and memory.
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Affiliation(s)
- Aleksi J Sihvonen
- Cognitive Brain Research Unit, Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland.,Department of Neurosciences, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Vera Leo
- Cognitive Brain Research Unit, Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Pablo Ripollés
- Department of Psychology, New York University, New York, New York
| | | | - Aki Ylönen
- Private Music Therapy Practitioner, Turku, Finland
| | | | - Sari Laitinen
- Private Music Therapy Practitioner, Helsinki, Finland
| | | | - Jani Saunavaara
- Department of Medical Physics, Turku University Hospital, Turku, Finland
| | - Taina Autti
- Department of Radiology, HUS Medical Imaging Center, Helsinki University Central Hospital, University of Helsinki, Helsinki, Finland
| | - Matti Laine
- Department of Psychology, Åbo Akademi University, Turku, Finland
| | - Antoni Rodríguez-Fornells
- Cognition and Brain Plasticity Group, Bellvitge Biomedical Research Institute, L'Hospitalet de Llobregat, Barcelona, Spain.,Department of Cognition, Development and Education Psychology, University of Barcelona, Barcelona, Spain.,Institució Catalana de Recerca i Estudis Avançats, Barcelona, Spain
| | - Mari Tervaniemi
- Cognitive Brain Research Unit, Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland.,CICERO Learning, University of Helsinki, Helsinki, Finland
| | - Seppo Soinila
- Division of Clinical Neurosciences, Department of Neurology, Turku University Hospital and University of Turku, Turku, Finland
| | - Teppo Särkämö
- Cognitive Brain Research Unit, Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
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