Archive for category Music/Music therapy

[Abstract] The Value of Exercise Rehabilitation Program Accompanied by Experiential Music for Recovery of Cognitive and Motor Skills in Stroke Patients

Abstract

Background

The aim of this study was to systematically assess the effects of exercise rehabilitation program accompanied by experiential music for clinical recovery.

Methods

This was a prospective randomized study with 65 stroke survivor patients. All cases underwent a neuropsychological assessment first as a prescreening test, during the admission at the Rehabilitation center (baseline), and 6 months poststroke. All patients received standard treatment for stroke in terms of medical care and rehabilitation. Additionally, all patients were separated into 2 Groups: a music Group (daily listening to experiential/traditional music), and a control Group (CG) with no experiential/traditional music therapy (standard care only). Computed tomography perfusion and full neurological examination including GCS were assessment. As Recovery was defined the improvement of cognitive and motor skills of the limb in the affected site, with an increase of muscle strength at least by 1/5 and with emotional progress.

Results

Statistically significant differences were found between the Group CG and the rest of the patients in respect of Lesion size (P = .001) and CBF in affected area (P = .001). Μultivariate analysis revealed that only Group and Lesion size were independent predictors for Recovery (odd ratio [OR][95%confidence interval]) .11(.001-.133) and .798(.668-.954) respectively.

Conclusion

The findings of this study suggest that the music-based exercise program has a positive effect on mood profile in stroke patients and Recovery rate is higher when exercise rehabilitation program was accompanied by an enriched sound environment with experiential music.

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[WEB] Effect of Rhythm of Music Therapy on Gait in Patients with Stroke: Several Questions

Recently, we read with great interest the paper entitled “Effect of rhythm of music therapy on gait in patients with stroke” published in Journal of Stroke and Cerebrovascular Diseases. Wang et al. reported that, music therapy to ischemic stroke patients can improve their gait, walking ability, lower limb motor function, balance ability and treatment satisfaction. 1 This study is a valuable and interesting article but we have several queries about this article.

  • 1.In the exclusion criteria, patients who had or were inclined to have cerebral hemorrhage were excluded. But in the “general data” of “results”, it seems a little confused and paradoxical that the control group and study group have included patients with cerebral hemorrhage. Is this a clerical error or an experimental design error?
  • 2.The patients in each group were ranged in age from 40 to 80 approximately. As we know, they had different faculty to distinguish and comprehend sounds due to their age difference. That is, the younger patients may perform better than older ones, so would the study be more accurate in dividing groups according to their age?
  • 3.Are you sure that the serial number is wrong of “Walking ability”, “Lower extremity motor function”, “Balance ability” and “Degree of treatment satisfaction” in “outcome measures”? What’s more, it seems there are some spelling mistakes in the last paragraph of discussion, such as “improve their walking ability, lower their extremity motor function, balance their ability”.
  • 4.George et al. reported that the recovery rate is higher when exercise rehabilitation program was accompanied by an enriched sound environment with experiential music after 6 months of treatment 2. For improvement of lower limb motor function, it seems insufficient to prove significant differences about 4 weeks in this research. So, long-term period of treatment and further prospective comparative studies should also be taken into consideration.

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[WEB] Mozart’s Music Reduces Epilepsy More Than Haydn’s

Scientists tested the impact of listening to Mozart and Haydn on epileptic patients and found Mozart’s music more effective for treating epilepsy.

By Sharon Kelly

Mozart composer - featured image

Listening to classical music has a wide range of health benefits including lowering blood pressure, reducing stress and improving the quality of sleep – but is some music more healing than others? Researchers at the Hospital St Anne and CEITEC Masaryk University in the Czech Republic tested the impact of listening to Mozart and Haydn on epileptic patients and found that listening to Mozart was more effective than Haydn’s in treating epilepsy. Their research was presented on 19 June 2021 at the 7th Congress of the European Academy of Neurology.

The concept that listening to Mozart’s music may have beneficial side-effects on mental health started with several ‘Mozart Effect’ findings in the 1990s.

The researchers tested the validity of the ‘Mozart Effect’ on 18 patients with epilepsy and found that listening to Mozart’s Sonata For Two Pianos in D major K. 488 reduced epileptiform discharges (EDs) – the electrical brain waves associated with epilepsy and which can cause seizures.

Mozart’s sonata reduced epileptic discharges

Professor Ivan Rektor, who led the study, said, “We have confirmed that Mozart’s Sonata reduced epileptic discharges that were measured directly in the brain. The study was carried out on patients with electrodes implanted in their brains who were due to undergo a neurosurgery. The electrodes were there to localize the place which was to be surgically removed.”

The scientists also wanted to establish whether listening to this particular Mozart piece was more beneficial than others for patients with epilepsy and chose the first movement of Haydn’s Symphony No. 94 to compare results. They noted, “We selected Haydn’s Symphony because it was composed in the same era and roughly the same style as Mozart’s. None of our patients had any musical training, so they didn’t really care whether they listened to Mozart or Haydn. We selected these two compositions because we wanted to test various acoustic parameters of the music, and we needed compositions that would be different in this respect.”

“Listening to Mozart led to a 32% decrease in EDs”

Professor Ivan Rektor said, “To our surprise, there were significant differences between the effects of listening to Mozart’s K448 and Haydn’s No. 94. Listening to Mozart led to a 32% decrease in EDs but listening to Haydn’s No. 94 caused a 45% increase.”

The study confirmed that the healing effect of music depends mainly on its acoustic properties, including rhythm, melody, tempo and harmony and that listening to Mozart’s sonata was more beneficial for patients with epilepsy. The scientists were also surprised to discover that the music affected women’s and men’s brains differently. They explained, “This is something we hadn’t expected at all. We found out that while Mozart’s composition reduced epileptic activity in both women and men, listening to Haydn’s composition reduced epileptic discharges only in women. In men, the epileptic activity increased.”

A follow-up study, using Magnetic Resonance Imaging, confirmed that certain parts of the brain were affected differently in men and women.

Epilepsy is a common neurological disorder affecting nearly one in one hundred people worldwide. Mostly it’s treated by drugs but they do not work for about 30 percent of patients.

The researchers hope that in future music could be used as an alternative, non-invasive treatment for epileptic patients.

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[Abstract] Music-based techniques and related devices in neurorehabilitation: a scoping review

ABSTRACT

Introduction:

The music as a powerful, and versatile stimulus for the brain, is at the date sometimes used in neurorehabilitation and proposed as a promising complementary strategy provided in combination with other therapy in individuals with neurological disorders. Different techniques and devices have been developed in the field of the music-based neurorehabilitation.

Areas covered:

This scoping review analyzes the current scientific literature concerning the different techniques and devices used in the music-supported neurorehabilitation, also focusing on the devices used in music-based therapies in patients with neurological disorders: 46 studies met the inclusion criteria and were included.

Expert opinion:

Included studies, highlight the potentiality and the versatility of the music-based therapy in the rehabilitation of neurological disorders. The variety of existing techniques allow to applied the music-based therapy in different situations and conditions. Moreover, the wide range of used devices that ranging from the simple musical instruments to the more advanced technologies, allows to develop customized exercises based on the needs of the patient. This review may be considered as a starting point to better design future RCTs that would investigate the effectiveness of music therapy on neurological disorders.

Article highlights

  • The use of specific techniques based on music, has been shown to induce brain adaptation which involves auditory, sensory and motor circuits, in both childhood and adulthood
  • The Neurologic Music Therapy (NMT) is placed as the therapeutic application of the music to recovery cognitive, sensory and motor disorders in patients with neurological diseases
  • Studies shown a wide variability in terms of techniques and used devices for administering music therapy that limits the possibility to find strong scientific evidences about the best possible approach.

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[ARTICLE] Neurophysiological Changes Induced by Music-Supported Therapy for Recovering Upper Extremity Function after Stroke: A Case Series – Full Text

Abstract

Music-supported therapy (MST) follows the best practice principles of stroke rehabilitation and has been proven to instigate meaningful enhancements in motor recovery post-stroke. The existing literature has established that the efficacy and specificity of MST relies on the reinforcement of auditory-motor functional connectivity in related brain networks. However, to date, no study has attempted to evaluate the underlying cortical network nodes that are key to the efficacy of MST post-stroke. In this case series, we evaluated changes in connectivity within the auditory-motor network and changes in upper extremity function following a 3-week intensive piano training in two stroke survivors presenting different levels of motor impairment. Connectivity was assessed pre- and post-training in the α- and the β-bands within the auditory-motor network using magnetoencephalography while participants were passively listening to a standardized melody. Changes in manual dexterity, grip strength, movement coordination, and use of the upper extremity were also documented in both stroke survivors. After training, an increase in the clinical measures was accompanied by enhancements in connectivity between the auditory and motor network nodes for both the α- and the β-bands, especially in the affected hemisphere. These neurophysiological changes associated with the positive effects of post-stroke MST on motor outcomes delineate a path for a larger scale clinical trial.

1. Introduction

Stroke is a leading cause of disability that can result in a contralesional upper extremity paresis [1,2], including impaired gross and fine motor functions, changes in muscle tone, and reduced range of motion [3,4]. Current rehabilitation approaches often yield modest to moderate motor improvements [5,6,7], with residual upper extremity impairments becoming permanent and leading to activity restrictions [8] and reduced quality of life [2,9]. Longitudinal studies have shown that 46% to 66% of stroke survivors do not regain functional independence in the upper extremity 6 months post-stroke [3,4,10,11]. Best practice principles in stroke rehabilitation indicate that interventions should be individually tailored, meaningful, task specific, variable, and should involve sufficient repetition and challenge to promote recovery [12,13,14,15]. Previous studies including the ones from our laboratory [16,17], indicate that music-supported therapy (MST) can not only meet but extend beyond these imperatives to yield improvements in motor skills, cognitive functions [18,19,20,21,22,23,24,25,26,27], and stress reduction [28].

The efficacy and specificity of MST are hypothesized to be mediated by the auditory-motor network, which is required to play music as well as to support recovery and/or compensate for stroke-related dysfunction [29,30]. Pascual-Leone’s work clearly demonstrates that training with a musical instrument such as piano can instigate neural plasticity by inducing swift unmasking of existing synapses and the formation of newer ones [31]. In expert and novice musicians, MST-induced auditory-motor coupling engages a network of distributed brain regions that includes the auditory and primary motor cortices (M1s), the dorsal and ventral parts of the premotor area (PMd and PMv), the inferior frontal gyrus (IFG), and the supplementary motor area (SMA) [29,32]. In stroke survivors, MST has been shown to increase motor cortex excitability in the affected hemisphere and to be associated with partial recovery of motor functions of the paretic hand [17,18,33]. Recent systematic reviews and meta-analyses [18,19,34] have also highlighted the beneficial effects of MST on upper extremity recovery in chronic stroke survivors. In the context of this study, we sought to clarify the neurophysiological mechanisms that underlie the beneficial effects of MST when used as a tool for rehabilitation post-stroke [18,19].

Neuroimaging techniques have been used to evaluate the neurophysiological effects associated with MST in stroke survivors [33,35,36,37] during passive listening [36,37] or silent tapping of musical instruments [33]. Using functional magnetic resonance imaging (fMRI), Rojo et al. [37] reported greater activation in motor areas contralateral to the affected upper limb during passive music listening after MST. They also observed bilateral enhanced cortical excitability as indexed by a larger amplitude of motor evoked potentials (MEP) that were evoked with transcranial magnetic stimulation (TMS). Amengual et al. [35] also reported MEPs’ enhancement following MST, although it was restricted to the lesioned hemisphere. Using magnetoencephalography (MEG), Fujioka et al. [36] observed event-related desynchronization (ERD) (i.e., power decrease) in the β-band (15–35 Hz) in auditory and sensorimotor cortices after MST, while stroke participants were passively listening to a metronome. The focus on neurophysiological effects in the α- and β-bands is due to their remarkable signal strength in humans, and their well-studied association with cognitive vigilance [38,39] and motor performance [30], respectively. A critical electroencephalography (EEG) study by Altenmuller et al. [33] also evaluated ERD and intracortical connectivity changes in the α- and β-bands in stroke participants actively playing a muted-drum or a muted-piano instrument. The authors reported greater ERD in the β-band during silent playing after MST, and no differences in the α-band. They also observed increased β-band intra- and interhemispheric coherence between the frontal and parietal regions when stroke participants played the muted electronic drum sets using either the affected or unaffected arms after MST. Here too, no pre/post MST changes in coherence were observed by the authors in the α-band. The authors interpreted these effects as reflecting increased auditory-motor coupling in stroke survivors following MST. From the current state of literature, gaps in knowledge exist regarding the extent of changes in the functional connectivity between the auditory-motor network nodes after MST. Moreover, the literature fails to explain as to how MST-induced functional connectivity changes might differ in stroke survivors not presenting the same level of motor impairment at baseline.

MST studies involving stroke participants have reported treatment effects in pre-determined regions of interest (ROIs) of the auditory-motor network, such as in M1 and the auditory cortex (AC). However, because stroke causes changes in functional brain organization, ROIs based on standard coordinates or atlases of brain anatomy may not be accurate in individuals with brain lesions within these areas [40,41,42,43]. We therefore sought to determine how the neurophysiological effects of MST are related to clinical outcomes, using brain ROIs selected based on functional localizers in the motor and sensory regions in chronic stroke participants. We anticipated that MST would induce enhanced functional coupling between multiple nodes of the auditory-motor network following an intensive, 3-week piano training intervention in stroke survivors. Furthermore, previous data from our laboratory showed that stroke survivors who had greater functional status prior to MST experienced the largest gains in manual dexterity and functional use of their upper extremity following MST [17]. In the present study, we therefore hypothesized that baseline motor performance would be predictive of changes in functional connectivity in the auditory-motor network following MST. We anticipate observing larger post-MST enhancements in auditory-motor functional connectivity in stroke survivors with better baseline functional capability as compared to stroke survivors with poorer baseline capability.[…]

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An external file that holds a picture, illustration, etc.
Object name is brainsci-11-00666-g002.jpg
Regions of interests of the auditory-motor network created by Brainstorm. M1 and AC ROIs were defined from individual functional data pre- and post-MST; SMA, PMd, and PMv were selected from a previously published study [58]; IFG was selected from the Broadmann area maps’ atlas [59] (P1: Participant 1, P2: Participant 2, M1: primary motor cortex, S1: somatosensory cortex, AC: auditory cortex, IFG: inferior frontal gyrus, pre-MST: before music-supported therapy, post-MST: after music-supported therapy, SMA: supplementary motor area: PMv: premotor ventral area, PMd: premotor dorsal area).

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[WEB] Noted Ability of Mozart’s Music to Reduce Seizures Explained?

Listening to Mozart has a notable impact on seizure reduction in patients with epilepsy —  and now researchers believe they know why, new research suggests.

Investigators found that the acoustic characteristics of Mozart’s Sonata for Two Pianos in D Major (K448) suppresses brain activity in patients with epilepsy while a piece by the 18th century classical composer Franz Joseph Haydn did not have this effect.

Listening to this Mozart sonata and perhaps other musical pieces may eventually become a treatment for preventing epileptic seizures, said study investigator Ivan Rektor, MD, CSc, Epilepsy Centre at the Hospital St Anne and professor at the Central European Institute of Technology, Masaryk University, Brno, Czech Republic.

“This research into the impact of listening to music could lead to the development of a music-related type of palliative neurostimulation therapy,” Rektor told Medscape Medical News.

The findings were presented at the virtual Congress of the European Academy of Neurology (EAN) 2021 and published online in the European Journal of Neurology.

Clinically Controversial?

Epilepsy affects 6 million people in Europe. Furthermore, estimates show that about 15 million Europeans have had at least one seizure at some time in their lives. In addition, about 30% of patients with epilepsy are not adequately treated with antiseizure medications.

Researchers have been studying the impact of Mozart’s music on brain-wave activity since the 1990s. Various studies report a reduction in epileptiform discharges in patients with epileptic seizures, coma, and refractory nonconvulsive status.

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[Abstract] The effect of listening to SMT music made using musical expectancy violations on brain concentration and activation – Full Text PDF

Abstract

This study investigated the effect of listening to self-music therapy training (SMT) music, which was specially developed using musical expectancy violations, on improving brain concentration and activation. It was performed with a sample of 12 adults. Electroencephalograms (EEG) were obtained and analyzed after allowing the participants to listen to SMT music. An EEG device with eight channels was used to measure the brain waves. The changes in the EEGs were recorded when listening to SMT music in three states (stable, basic, and stimulated) after attaching the electrodes to the prefrontal cortex (Fp1 and Fp2), and the frontal (F3 and F4), temporal (T3 and T4), and parietal lobes (P3 and P4) according to the International 10/20 system. The EEG data were analyzed to determine the m-β wave appearance rate and absolute total power (ATP) for the three conditions, and a t-test was performed. The results showed that the rate of m-β wave appearance was higher in the stimulated and basic states than in the stable state (Fp1, Fp2, F4, T3, T4, P3, and P4) and higher in the stimulated state than in the basic state (Fp1, Fp2, T3, T4, and P4). The ATP was lower in the basic state than in the stable state (Fp2, F3, F4, and T3), but the ATP in the stimulated state was higher than in the basic or stable state in all areas excluding the left and right parietal lobes (Fp1, Fp2, F3, F4, T3, and T4). These results demonstrated that listening to SMT music by normal adults could increase brain concentration and activation.

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[ARTICLE] The State of Music Therapy Studies in the Past 20 Years: A Bibliometric Analysis – Full Text

Figure 6. Network map of co-citation journals engaged in music therapy from 2000 to 2019. Journal of Music Therapy, Arts in Psychotherapy, Nordic Journal of Music Therapy, Music Therapy Perspectives, Cochrane Database of Systematic Reviews. In this map, the node represents a journal, and the link represents the co-citation frequency between two journals. A larger node represents more publications in the journal. A thicker purple circle represents greater influence in this field.

Purpose: Music therapy is increasingly being used to address physical, emotional, cognitive, and social needs of individuals. However, publications on the global trends of music therapy using bibliometric analysis are rare. The study aimed to use the CiteSpace software to provide global scientific research about music therapy from 2000 to 2019.

Methods: Publications between 2000 and 2019 related to music therapy were searched from the Web of Science (WoS) database. The CiteSpace V software was used to perform co-citation analysis about authors, and visualize the collaborations between countries or regions into a network map. Linear regression was applied to analyze the overall publication trend.

Results: In this study, a total of 1,004 studies met the inclusion criteria. These works were written by 2,531 authors from 1,219 institutions. The results revealed that music therapy publications had significant growth over time because the linear regression results revealed that the percentages had a notable increase from 2000 to 2019 (t = 14.621, P < 0.001). The United States had the largest number of published studies (362 publications), along with the following outputs: citations on WoS (5,752), citations per study (15.89), and a high H-index value (37). The three keywords “efficacy,” “health,” and “older adults,” emphasized the research trends in terms of the strongest citation bursts.

Conclusions: The overall trend in music therapy is positive. The findings provide useful information for music therapy researchers to identify new directions related to collaborators, popular issues, and research frontiers. The development prospects of music therapy could be expected, and future scholars could pay attention to the clinical significance of music therapy to improve the quality of life of people.

Introduction

Music therapy is defined as the evidence-based use of music interventions to achieve the goals of clients with the help of music therapists who have completed a music therapy program (Association, 2018). In the United States, music therapists must complete 1,200 h of clinical training and pass the certification exam by the Certification Board for Music Therapists (Devlin et al., 2019). Music therapists use evidence-based music interventions to address the mental, physical, or emotional needs of an individual (Gooding and Langston, 2019). Also, music therapy is used as a solo standard treatment, as well as co-treatment with other disciplines, to address the needs in cognition, language, social integration, and psychological health and family support of an individual (Bronson et al., 2018). Additionally, music therapy has been used to improve various diseases in different research areas, such as rehabilitation, public health, clinical care, and psychology (Devlin et al., 2019). With neurorehabilitation, music therapy has been applied to increase motor activities in people with Parkinson’s disease and other movement disorders (Bernatzky et al., 2004Devlin et al., 2019). However, limited reviews about music therapy have utilized universal data and conducted massive retrospective studies using bibliometric techniques. Thus, this study demonstrates music therapy with a broad view and an in-depth analysis of the knowledge structure using bibliometric analysis of articles and publications.

Bibliometrics turns the major quantitative analytical tool that is used in conducting in-depth analyses of publications (Durieux and Gevenois, 2010Gonzalez-Serrano et al., 2020). There are three types of bibliometric indices: (a) the quantity index is used to determine the number of relevant publications, (b) the quality index is employed to explore the characteristics of a scientific topic in terms of citations, and (c) the structural index is used to show the relationships among publications (Durieux and Gevenois, 2010Gonzalez-Serrano et al., 2020). In this study, the three types of bibliometric indices will be applied to conduct an in-depth analysis of publications in this frontier.

While research about music therapy is extensively available worldwide, relatively limited studies use bibliometric methods to analyze the global research about this topic. The aim of this study is to use the CiteSpace software to perform a bibliometric analysis of music therapy research from 2000 to 2019. CiteSpace V is visual analytic software, which is often utilized to perform bibliometric analyses (Falagas et al., 2008Ellegaard and Wallin, 2015). It is also a tool applied to detect trends in global scientific research. In this study, the global music therapy research includes publication outputs, distribution and collaborations between authors/countries or regions/institutions, intense issues, hot articles, common keywords, productive authors, and connections among such authors in the field. This study also provides helpful information for researchers in their endeavor to identify gaps in the existing literature.[…]

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[MUSIC] 5 Hours Mozart Brain Power Music – YouTube

Focus, Concentration, Improve, Recharge, Reading, Studying Music

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[Abstract] The Effectiveness of Music Therapy on Hand Function in Patients With Stroke: A Systematic Review of Randomized Controlled Trials

Abstract

Objective: This study aims to evaluate the efficacy of music-supported therapy for stroke patients’ hand function. 

Methods: The databases used included Cumulative Index to Nursing and Allied Health Literature (CINAHL), MEDLINE, PubMed, Embase, Music Index, and Google Scholar. Studies published between January 2010 and August 2020 were included. The searching key terms included “music-supported therapy,” “music therapy,” “hand function,” “hand dysfunction,” “stroke,” “ischemic,” and “hemorrhagic.” Randomized controlled trials or controlled trials involving adults who have hand function problems caused by stroke are included in this study. The methodological quality and risk of bias of the included studies were rated by two independent assessors under the guidance of Cochrane collaboration’s risk of bias tool. 

Results: Twelve studies that met the inclusion criteria were included in this study. Totally, the data included 598 stroke patients (345 male, 253 female) with recruited time from 1.7 months to 3 years, and the mean age of the participants were 61.09 years old. Based on the Cochrane risk of bias tool, study quality ranged from three to seven out of seven points. Compared with the control group, outcomes including hand strength, range of joint motion, dexterity of hands, arm function, and quality of life were significantly superior with music-supported therapy. Five studies reported improved dexterity of hands, and one study reported the improvement of range of motion and strength of patients’ hands, which supported the therapy has positive effects on patients’ hand function and improving their quality of life after the therapy. The therapy ranged over a period of 4-8 weeks, with an average duration of 30 min/session and an average of three times per week. 

Conclusion: Based on the results, music-supported therapy could be a useful treatment for improving hand function and activities of daily living in patients with stroke, especially for patients within 6 months after stroke. However, the low certainty of evidence downgrades our confidence to practice in hospital. More and more randomized controlled trials and larger sample sizes are required for a deeper review.

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