The Power of Music: Transforming Minds and Healing through Neurological Therapy

The effect of music on the brain is different from the mind because music has a measurable effect on the brain’s neural structure. In fact, even as an infant, the human brain is able to experience music. Indeed, infants’ developing brains may experience music and language as a single proto-musical/linguistic hybrid before they learn to differentiate exactly each form of audio. Music has strong connections to multiple brain systems, including systems involved in language, motor control, and social cognition.

According to multiple research based on neurological disorders, music training can increase communication and movement in patients. In this research, we are able to see four different ways in which music-based therapy can help people with neurological disorders.

Aphasia and Melodic Intonation Therapy

Aphasia is a language disorder caused by damage to the brain. In this research, they focus on aphasia to strokes that lead to destructive human communication. Long strokes in the left frontal, temporal regions of the brain can lead to persistent non-fluent aphasia in which an individual’s difficulty communicating orally and writing a word. Standard speech therapy is helpful for many people, and the interest of individuals is growing up to recovery. However, there is an older music-based therapy that is also attracting attention. This Melodic Intonation Therapy (MIT) was invented in the early 1970s at Boston VA Hospital by Albert, Sparks, and Helm. Albert and colleagues hypothesized that this was due to intact right hemisphere circuits for the song-to-speech recovery. Melodic Intonation Therapy trains short phrases, such as I love you, using song-like pitch and rhythm patterns. Each syllable is intoned with a fixed or low pitch. The therapist models a phrase, and the patient sings it back while also tapping the phrase’s rhythm with one tap per syllable. The goal of the therapy is to increase their verbal fluency. Gottfried Schalug and colleagues are comparing MIT to control therapy called speech repetition therapy, which is a simple repetition of a word without singing or tapping. They experimented with a patient that was given 40 sessions of MIT and the other 40 sessions of speech repetition. Both patients improved with therapy, but the MIT patient showed larger improvements in the number of coherent phrases produced per minute and in the number of syllables per phrase. After therapy, the MIT patient activated more right hemisphere regions while speaking than did the other patient, who had speech repetition therapy. A music-based therapy seemed to be changing the structure of the brain. In a more recent paper, Huang, Schlaug, and colleagues used Diffusion Tensor Imaging (DTI) to examine structural changes in the brains of 11 non-fluent aphasia patients who did MIT. These patients were, on average, two years post-stroke when they started therapy. This time they were compared to a control group of non-fluent aphasia who did not get MIT. This study focused on the white matter structure just below the cortex. Local white matter structure might be related to how many axons are coming into a particular region or going out of the region. After 15 weeks of therapy, the patients showed significant gains in communication in terms of how much speech they could produce in a given amount of time. They also showed increases in local white matter structure in several regions of the brain, including the right inferior frontal gyrus and the right superior temporal gyrus. This suggests that the brain changes in this are related to the verbal improvements in the patients. It is important to note that the control group did not show significant improvements in fluency.

Parkinson’s Disease and Rhythmic Auditory Stimulation

Parkinson’s disease with prominent motor symptoms results from the death of dopamine-producing neurons in a part of the deep brain structure called the substantia nigral, which is in the midbrain. Prominent motor symptoms include shaking, rigidity, slowness of movement, and difficulty with walking and gait. Parkinson’s patients often have a kind of shuffling stride. The problem is not muscle weakness but a problem in complex motor control. Michael Thaut did research based on this phenomenon that showed music with a beat can help patients with motor disorders and coordinate walking movements. That is one of the founders of music therapy called neurologic music therapy, a research-based treatment system for patients with neurological disorders. They and his colleagues have designed a music-based gait therapy called rhythmic auditory stimulation. In rhythmic auditory stimulation therapy, patients practice walking to music with a steady beat, such as folk and jazz music. The beat tempo is initially matched to the patient’s own natural gait, then gradually increased in small increments over the course of training. In 1996 and 1997, Thaut and colleagues published research comparing rhythmic auditory stimulation to conventional physical therapy in Parkinson’s patients. These studies focused on patients with moderate gait deficits. Like the stroke studies, these studies showed that rhythm-based therapy led to greater improvements in gait. The patients did not just walk to the music; they often synchronized their movements to the beat of the music. fMRI research has shown that the perception of beat-based rhythms leads to the coactivation of auditory regions and motor planning regions of the brain, even in movements. In the meantime, it is interesting to see how public awareness has begun to grow about the positive impact of moving to music for people with Parkinson’s disease.

Music-Supported Therapy for Upper Limb Paresis

We’ve been focusing on gait and movements of the lower limbs. Research also looks at the impact of music on the upper limbs in patients with motor disorders. These are patients with strokes that affect their arm and hand on one side, leaving it weak and uncoordinated. This is called a one-sided upper limb paresis or partial paralysis. In these patients, their strokes have not affected their communication, or they are not aphasia. As humans, we are very dependent on our arms and our hands. In the brain, the human hand gets an especially large representation in sensory-motor areas of the cortex because of the fine manual motor control involved in hand movement. The researchers Eckart Altenmuller, Thomas Munte, Sabine Schneider, and colleagues have developed a novel, music-based therapy for those patients, which they call Music Supported Therapy.

The idea of the therapy is to use simple forms of music making the promote neural plasticity in the undamaged brain tissue around the lesion to help it take over some of the functions of the damaged areas. Alternmuller and colleagues designed music-supported therapy to take advantage of some of the special features of playing music. One is that the degree of fine motor control needed to play musical instruments is variable, depending on what instruments you play. A patient is trained to produce patterns on two different instruments. An electronic drum set is used to train gross motor movements. An electronic piano keyboard is used to train fine motor movements. By using electronic drum pads, the researchers can control the sounds that come out when you hit. The melodic pattern is the same in both cases, but the physical movements required are different. Altenmuller and colleagues combined behavioral and brain measurements to see what changed in the brain as a person went through the therapy. The patient was a woman who had a left subcortical stroke about two years before the therapy. She had moderate paresis of the right arm and hand. She had no prior musical training. This allowed the researchers to see if this kind of therapy would work for someone who had never played a musical instrument before. The patient was able to do music-supported therapy. She had 20 sessions over the course of a month. Both before and after therapy, she did a number of standardized tests of motor control, which had nothing to do with music. After therapy, she showed improvement in the ability to grasp, grip, and pitch with her affected hand. She was also able to tap faster with her hand and to tap more smoothly with the fingers of that hand.

Auditory-Motor Mapping Training in Autism Spectrum Disorder

We mentioned that Parkinson’s mostly affects older adults. Now, let us focus on children with autism. Autism Disorder Spectrum disorder is a developmental disorder that affects about 1 in 110 children. Up to a quarter of autistic children do not communicate with others verbally. A new form of therapy called Auditory-Motor Mapping Training aims to get nonverbal autistic children to speak. It comes from the laboratory of Gottfried Schlaug and shares some features of melodic intonation. It involves intoning words and phrases while doing simple rhythmic movements. Schlaug and colleagues did a proof of concept study where they had six nonverbal autistic children get 40 sessions of this therapy. In each session, a therapist sits across from the child with a pair of tuned drums that is between them. The drum makes different pitches. The therapist intones two-syllable set utterances, like memory or more please, while also tapping out the pitches on the drums. The child is gradually led from just listening to speech to producing speech through a series of intermediate stages. First, they just listen. After, they are encouraged to produce the speech with some support from the therapist. After that, they are encouraged to repeat what the therapist says. Finally, they get to the stage where they can speak and play by themselves. As a result of their efforts, all of the children in the study improved in a shorter time than they expected.

Conclusion

Based on different research that is discussed in the paper, we can come to the conclusion that music works as magic that affects every individual’s brain. Infant or young, adult or older, music influences everybody’s brain, which is the result of emotion, communication, movements, and language skills. In this research, we were able to see four different ways in which music-based therapy helped a lot to overcome and improve their weaknesses.

References

1. Schlaug, G., Marchina, S., & Norton, A. (2009). Evidence for plasticity in white-matter tracts of patients with chronic Broca’s aphasia undergoing intense intonation-based speech therapy. Annals of the New York Academy of Sciences, 1169, 385–394.
2. Thaut, M. H., McIntosh, G. C., & Hoemberg, V. (2015). Neurobiological foundations of neurologic music therapy: rhythmic entrainment and the motor system. Frontiers in Psychology, 5, 1185.
3. Altenmüller, E., Marco-Pallares, J., Münte, T. F., & Schneider, S. (2009). Neural reorganization underlies improvement in stroke-induced motor dysfunction by music-supported therapy. Annals of the New York Academy of Sciences, 1169, 395–405.
4. Schlaug, G., & Norton, A. (2017). From Singing to Speaking: Facilitating Recovery from Nonfluent Aphasia. Future Neurology, 2(6), 585–597.

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