Sunday, October 16, 2011

Summary: Neurologic Music Therapy in Cognitive Rehabilitation

Title: Neurologic Music Therapy in Cognitive Rehabilitation
Author: Michael H. Thaut

Reference: Music Perception: An Interdisciplinary Journal
Vol. 27, No. 4 (April 2010), pp. 281-285
Published by: University of California Press
Article DOI: 10.1525/mp.2010.27.4.281
Article Stable URL: http://www.jstor.org.myaccess.library.utoronto.ca/stable/10.1525/mp.2010.27.4.281

Neurological Music Therapy in Cognitive Rehabilitation, by researcher Michael H. Thaut, looked at the development and applications of neurologic music therapy to cognitive rehabilitation.

The Role of Music in Cognitive Rehabilitation

In the field of neurologic music therapy, the role of music in cognitive rehabilitation (CR) has been the last domain to come into full focus (Thaut, 2010). Thaut explains that the applications of music to CR were not studied well in the past in comparison to music’s role in motor therapies or speech/language rehabilitation. The article further states that over the past 50 years, very few studies have examined how music influenced cognitive functions in a therapeutic context on a theoretical basis.

Another factor that hindered the progress of this area of research is more technical oriented, in that there were limitations to cognitive brain research from a neuroscience perspective before the advent of noninvasive research tools to study an intact functioning human brain (Thaut, 2010). It was between 1985 and 1990 that brain imaging techniques began to fully develop, and they were not readily available to musical brain research. The refinement in brain-wave measurement techniques through the EEG and MEG, has produced a new basis for biomedical research in music cognition and rehabilitation.

Links Between Music and Cognitive Functions


This ongoing research has shed new light on the intriguing links between music and a variety of cognitive functions, including temporal order learning (Hitch, Burgess, Towse, and Culpin, 1996), a spatiotemporal reasoning (Sarntheim et al., 1997), a spatiotemporal reasoning (Sarntheim et al., 1997), attention (Drake, Jones, and Baruch, 2000; Large and Jones, 1999), and auditory verbal memory (e.g., Deutsch, 1982; Glassman, 1999; Kilgour, Jakobson, and Cuddy, 2000; Thaut et al.,2005; Chan et al., 1998; Ho el al., 2003).

“Efforts have been put forward to examine models how music can remediate cognitive functions” (Thaut, 2010). Thaut reports that evidence has been found for divided attention mechanisms in song between processing of lyrics and processing of music (Bonnel, Faita, Peretz, and Besson, 2001). It is reported that very important connections between music and nonmusical memory formation have been laid out by Deutsch (1982). His study shows how some of the “fundamental organizational processes for memory formation in music- based on the structural principles of phrasing, grouping, and hierarchical abstraction in musical patterns – have their parallels in temporal chunking principles of nonmusical memory processes” (Thaut, 2010).

Shared Mechanisms and Brain Systems

The Rational Scientific Mediating Model (RSMM) was developed “to provide a systematic epistemology for translational research in music and rehabilitation” (Thaut, 2005).

Memory
According to various studies, music has been shown to serve as an “effective mnemonic device to facilitate verbal learning and recall in healthy persons, patients with memory disorders, and children with learning disabilities” (e.g., Claussen and Thaut, 1997; Gfeller, 1983; Maeller, 1996; Wallace, 1994; Wolfe and Hom, 1993).

In a recent study of patients with multiple sclerosis, Thaut (2005) reports that they were able to show that word lists from Rey’s Auditory Verbal Learning Test were “significantly better learned and recalled when presented and rehearsed via song as a rhythmic-melodic template vs. the usual spoken presentation and rehearsal”.

“Recent research also has shown that musical memories may survive longer than nonmusical memories and may be functionally available and accessible for persons with neurologic memory disorders such as dementia or Alzheimer’s disease” (Baur, Uttner, Illmberger, Fesl, and Mai, 2000; Crystal, Grober, and David, 1989; Cuddy and Duffin, 2005; Halpern and O’Connor, 2000; Haslam and Cook, 2002; Samson, Dellacherie, and Platel, 2009; Son, Therrien, and Whall, 2002; Vanstone and Cuddy, 2010; Vanstone, Cuddy, Duffin, and Alexander, 2009).

Due to the nature of music as a “highly salient emotional stimulus”, as described by Thaut (2010), he suggests that “music-based memory training in dementia and Alzheimer’s disease may therefore facilitate a shift in accessing this amygdale-based neuroanatomical network” (Thaut, 2010).

(In)attention and Neglect

There has been some evidence that shows that music can be an effective training modality in the areas of neglect training. In the 1990 study of Hommel, Peres, Pollak, and Memin proposed that the “beneficial effect of musical stimulation for overcoming visual neglect as a result of right hemispheric lesions due to stroke or traumatic brain injury”. The application of music stimuli was proven to enhance visual perception in neglect states.

Executive Function and Emotional Adjustment

Thaut (2010) states that the psychological functioning of patients as part of their executive control has always been a critical aspect of treatment. Neurologic music therapy has been found to be successful in addressing the treatment of psychological issues (Kleinstauber and Gurr, 2006; Nyak, Wheeler, Shiflett, and Agostinelli, 2000). In a recent study (Thaut et al., 2009), specific techniques in neurologic music therapy were shown to improve cognitive retraining in traumatic brain injury rehabilitation. In the study conducted by Thaut and colleagues, neurologic music therapy techniques were examined in regards to its relation to musical attention training, musical executive function training, and musical memory training. Following the study, data were measured “before and after a single therapy session and compared between the music condition and a standard neuropsychology condition” (Thaut, 2010). The results indicated that “after a single intervention, memory and attention did not show any significant improvement in either condition” (Thaut, 2010). However, executive function was significantly improved.

This study concludes that a new model for linking music learning to retraining the injured brain has emerged, allowing the study and application of music “efficiently as a complex multisensory stimulus to cognitive rehabilitation” (Thaut, 2010).


Reflection


“Research has shown that music can serve as an effective mnemonic device to facilitate verbal learning and recall in healthy persons, patients with memory disorders, and children with learning disabilities”(e.g., Claussen & Thaut, 1997; Gfeller, 1983; Maeller, 1996; Wallace, 1994; Wolfe & Hom, 1993).

Music is a powerful intervention tool. Having had the opportunity to utilize music therapy in special education, I can personally attest to the importance of crafting a musical activity, based on the ability and need of the student. As an example, I devised a music exercise to teach a young student, who was diagnosed with a moderate learning disability, basic mathematic skills. The student was administered 6 thirty minute music therapy sessions per week with the end result being a student who developed the ability, through music intervention, to learn the basic fundamentals of addition and subtraction, to the amazement of his teachers.

Musical memories may be retained longer than non-musical memories. This statement yet again validates the relevance of music and memory retention. Throughout my various encounters with diverse populations in the field of music therapy, I have also seen, how senior citizens with a mid-stage dementia diagnosis, have the ability to recall scales with the correct fingering, having been absent from practical music for more than 75 years. These older students find this “rediscovery” encouraging, as at later stages in life, one is often conditioned to focus on loss rather than retention.

Overall, I have found this article to be applicable in my interest to stay abreast of the latest research and findings in the area of neurologic music therapy. Furthermore, it will be studies such as this, which will assist in propelling the image and validity of music therapy in memory intervention in society.

4 comments:

Bev Foster said...
This comment has been removed by the author.
Bev Foster said...

These results are encouraging, indeed. I’ve been aware of Thaut’s interest in the temporal relationship between music and the brain. His suggestion for music-based memory training in dementia based on the salient emotional stimulation and the carryover effect music has in the ADRD population is already happening. One of the lead programs from England is called Singing for the Brain. http://www.nhs.uk/Video/Pages/singing-for-the-brain.aspx . It is a community-based program. Thaut may be advocating for individual music-based memory training.
I was also interested in the referral to music and neglect. I had never heard of “neglect” until reading Harvard neuroscientist Lisa Genova’s fictional work Left Neglected about a woman who suffers with left neglect after a traumatic blow to her head. It did occur to me when reading that novel that music therapy might somehow play a role in treatment because of its influence on temporal-spatial reasoning.

Alicia_Ritmundi said...

Thanks for the comment Bev. I find these studies absolutely promising for the progression of Music Therapy as a valuable instrument in cognitive rehabilitation.

vabna islam said...

The very heart of your writing shilst sounding agreeable at first, did not settle very well with me personally after some time. Someplace within the paragraphs you were able to make me a believer but just for a while. I nevertheless have a problem with your leaps in assumptions and one would do well to fill in those breaks. In the event you actually can accomplish that, I will definitely end up being fascinated.

Its such as you learn my thoughts! You seem to grasp so much approximately this, such as you wrote the ebook in it or something. I think that you simply can do with some% to force the massage house a bit, however other than that this is magnificent blog. An excellent read. I will certainly be back.
executive training toronto