The role of music in cognitive rehabilitation (CR) has been the last domain to come into full focus in neurologic music therapy. Often, the least recognized and most pervasive deficits following stroke and other neurological injuries are cognitive in nature. According to Gordon and Hibbard, cognitive treatment must occur in layers, beginning with more basic skills and progressing to more complex ones. Attentional processes occur in a hierarchical manner. Music is also built of elements in a similar manner, so it is fitting for music to facilitate cognitive improvement (Gordon).
The participants in a study to see if music could really improve post-stroke attention in four patients found positive trends in neuropsychological scores as well as self-reported measures of cognitive functioning. Additionally, these trends progressed at a similar rate, indicating the effectiveness of the protocol itself.
One of the more interesting but lesser understood examples of music therapy’s post-stroke efficacy involves cases of visual neglect. In a study of three stroke patients with visual neglect in half of their field of vision, all of them could “identify colored shapes and red lights in their depleted side of vision much more accurately while they were listening to their preferred music, compared with listening to music they did not like or silence” (Anon).
The increasing use of music therapy in stroke rehabilitation is the direct result of advances made in brain imaging technology, which have led to an improved understanding of brain functionality and music’s role in it. While great strides have been made, it is not unrealistic to expect continuing leaps in technology as researchers from various disciplines seek to study the living human brain. The anecdotal and experiential successes of music therapy in stroke rehabilitation have given way to burgeoning research that aims to replicate outcomes, understand the neuroscience behind them, and create standard treatment protocols.
List of Visuals
- A CT scan slice of the brain showing a right-hemispheric ischemic stroke (left side of image).
Wikipedia, the Free Encyclopedia
- A framework for stroke rehabilitation.
Agency for Healthcare Research and Quality, U.S. Department of Health and Human Services
- The second of a two-part profile of the Berklee School of Music's Music Therapy program.
- A picture depicting the different areas of the brain relevant to music processing.
- A reproduction of a lithograph plate from Gray's Anatomy depicting the superior temporal gyrus in green.
Wikipedia, the Free Encyclopedia
- The Aphasia Tones sing Under the Boardwalk at their June 2nd, 2010 concert at California State University East Bay (CSUEB). This 19+ member choir is comprised of individuals who have aphasia and are part of the Aphasia Treatment Group directed by Ellen Bernstein-Ellis at CSUEB in Hayward, CA.
Harvey Alter, president and founder of the International Aphasia Movement, spoke regarding his first-hand experience on music's power to heal at the Institute for Music and Neurologic Function's 2008 Music Has Power Awards Benefit.
- The swallowing mechanisms in the mouth and neck hindered by dysphagia.
National Institute on Deafness and Other Communication Disorders, National Institutes of Health
- Know Stroke: Know the Signs. Act in Time. National Institute of Neurological Disorders and Stroke, National Institutes of Health. Web. Accessed 7 Mar. 2011. http://stroke.nih.gov.
- "News in Health: Strike Out Stroke – Quick Action Can Keep Damage at Bay." National Institutes of Health, May 2010. Web. Accessed 7 Mar. 2011. http://newsinhealth.nih.gov/issue/May2010/feature2.
- "Stroke: Frequently Asked Questions." WomensHealth.gov.Office on Women’s Health. 28 Jan. 2011. Web. Accessed 7 Mar. 2011. http://www.womenshealth.gov/faq/stroke.cfm.
- "Stroke: Hope Through Research." National Institute of Neurological Disorders and Stroke (NINDS). National Institutes of Health. 3 Mar. 2011. Web. Accessed 7 Mar. 2011. http://www.ninds.nih.gov/disorders/stroke/detail_stroke.htm.
- Taylor, Thomas N., Patricia H. Davis, James C. Torner, Julia Holmes, Jay W. Meyer, and Mark F. Jacobson.
"Lifetime Cost of Stroke in the United States." Stroke 27.1 (1996): 1459-1466.Web. Accessed from the American Heart Association on 7 Mar. 2011. http://stroke.ahajournals.org/cgi/content/full/27/9/1459.
- “Frequently Asked Questions About Music Therapy.” American Music Therapy Association (AMTA). Web. Accessed 7. Mar. 2011. http://www.musictherapy.org/faqs.html.
- “Complementary and Alternative Therapies for Cancer Patients: Music Therapy.” University of California, San Diego Medical Center (UCSD). Web. Accessed 7 Mar. 2011. http://cancer.ucsd.edu/Outreach/PublicEducation/CAMs/music.asp.
- Thaut, Michael H. “Neurologic Music Therapy in Cognitive Rehabilitation.” Music Perception 27.4 (2010): 281-285.
- Hodges, Donald A. “Implications of Music and Brain Research.” Music Educators Journal 87.2 ( 2000): 17-22.
- Sarkamo, Teppo, Mari Tervaniemi, Sari Laitinen, Anita Forsblom, et al. “Music Listening Enhances Cognitive Recovery and Mood After Middle Cerebral Artery Stroke.” Brain 131.3 (2008): 866-876.
- Overy, Katie, and Istvan Molnar-Szakacs. “Being Together in Time: Musical Experience and the Mirror Neuron System.” Music Perception 26.5 (2009): 489-504.
- King, Betsey. “Language and Speech: Distinguishing Between Aphasia, Apraxia, and Dysarthia in Music Therapy Research and Practice.” Music Therapy Perspectives 25.1 (2007): 13-18.
- Kim, Mihn and Concetta M. Tomaino. “Protocol Evaluation for Effective Music Therapy for Persons with Nonfluent Aphasia.” Topics in Stroke Rehabilitation 15.6 (2008): 555-569.
- Wilson, Sarah J., Kate Parsons, and David C. Reutens. “Preserved Singing in Aphasia: A Case Study of the Efficacy of Melodic Intonation Therapy.” Music Perception 24.1 (2006): 23-35.
- Maess, Burkhard, Stefan Koelsch, Thomas C. Gunter, Thomas C., and Angela D. Friederici.
“Music Syntax Is Processed in Broca’s Area: An MEG Study.” Nature Neuroscience 4.5 (2001): 540-545.
- Schlaug, Gottfried, Sarah Marchina, and Andrea Norton. “From Singing to Speaking: Why Singing May Lead to Recovery of Expressive Language Function in Patients with Broca’s Aphasia.” Music Perception 25.4 (2008): 315-323.
- Hobson, Marly Rychener. “The Collaboration of Music Therapy and Speech-Language Pathology in the Treatment of Neurogenic Communication Disorders: Part I-Diagnosis, Therapist Roles, and Rationale for Music.” Music Therapy Perspectives 24.2 (2006): 58-65.
- Tamplin, Jeanette. “A Music Therapy Treatment Protocol for Acquired Dysarthria.” Music Therapy Perspectives 26.1 (2008): 23-29.
- Yoo, Jeehyun. “The Role of Therapeutic Instrumental Music Performance in Hemiparetic Arm Rehabilitation.” Music Therapy Perspectives 27.1 (2009): 16-24.
- Schneider, Sabine, Thomas Munte, Antoni Rodriguez-Fornells, Michael Sailer, and Eckart Altenmuller. “Music-Supported Training Is More Efficient Than Funcational Motor Training for Recovery of Fine Motor Skills in Stroke Patients.” Music Perception 27.4 (2010): 271-280.
- Hayden, Rebecca, Alicia Ann Clair, Gary, Johnson, and David Otto. “The Effect of Rhythmic Auditory Stimulation (RAS) on Physical Therapy Outcomes for Patients in Gait Training Following Stroke: A Feasibility Study.” The International Journal of Neuroscience 119.12 (2009): 2183-2195.
- Schauer, Michael and Karl-Heinz Mauritz. “Musical Motor Feedback (MMF) in Walking Hemiparetic Stroke Patients: Randomized Trials of Gate Improvement.” Clinical Rehabilitation 17.7 (2003): 713-722.
- Altenmuller, Eckhart, J. Marco-Pallares, Thomas Munte, and Sabine Schenider. “Neural Reorganization Underlies Improvement in Stroke-Induced Motor Dysfunction by Music-Supported Therapy.” Annals of the New York Academy of Sciences 1169.1 (2009): 395-405.
- Kim, Soo Ji.
“Music Therapy Protocol Development to Enhance Swallowing Training for Stroke Patients with Dysphagia.” Journal of Music Therapy 47.2 (2010): 102-119.
- Sarkamo, Teppo, Elina Pihko, Sari Laitinen, Anita Forsblom, et al.“Music and Speech Listening Enhance the Recovery of Early Sensory Processing After Stroke.” Journal of Cognitive Neuroscience 22.12 (2010): 2716.
- Gordon, Wayne A. and Mary R. Hibbard. “Critical Issues in Cognitive Remediation.” Neuropsychology 6.4 (1992): 361-371.
- Anonymous. “Imperial College London; Listening to Pleasant Music Could Help Restore Vision in Stroke Patients, Suggests Study.” Leisure & Travel Week April 11, 2009: 70.