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Verbal and musical memory: Selectivity of auditory disorders after stroke
Annals of Physical and Rehabilitation Medicine 58S (2015) e73–e77
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ScienceDirect www.sciencedirect.com
Music and the brain (SOFMER-INSERM-CNRS) Oral communications CO22-001-e
Cognitive, emotional, and neural benefits of musical leisure activities in stroke and dementia T. Sa¨rka¨mo¨ (Dr)*, M. Tervaniemi (Prof) Cognitive Brain Research Unit, Institute of Behavioural Sciences, University of Helsinki, Helsinki, Finland *Corresponding author. E-mail address: teppo.sarkamo@helsinki.fi (T. Sa¨rka¨mo¨) Introduction The capacity of music to engage auditory, cognitive, motor, and emotional functions across cortical and subcortical brain regions and the relative preservation of music in ageing and dementia makes it a promising tool in the rehabilitation of ageingrelated neurological illnesses, such as stroke and Alzheimer’s disease. As the incidence and prevalence of these illnesses is increasing rapidly, it is important to develop music-based interventions that are enjoyable and effective in the everyday care of the patients. Methods In two single-blind RCTs, the cognitive, emotional, and neural efficacy of self- or caregiver-implemented musical leisure activities was studied in stroke patients (n = 60) and persons with dementia (PWDs, n = 89). In stroke patients, daily music listening was compared to audio book listening and standard rehabilitation. In PWDs, regular listening and singing of familiar songs were compared to standard care. Results Original results showed that music listening enhanced the recovery of memory, attention, and mood after stroke [1] and that both singing and music listening helped maintain better cognitive functioning and mood in PWDs [2]. Here, we will present recent results from voxel-based morphometry (VBM) analyses showing that the cognitive and emotional benefits of music listening after stroke are associated with structural neuroplasticity in a network of prefrontal and limbic regions [3]. We will also present new results on how different clinical and demographical factors influence the outcome of the music interventions in PWDs. Discussion Musical leisure activities can provide an effective and easily applicable to enhance cognitive and emotional well-being after stroke and in the early stage of dementia. Keywords Music; Listening; Singing; Stroke; Dementia; Alzheimer; Neuropsychology; Emotion Disclosure of interest The authors have not supplied their declaration of conflict of interest. References [1] Sa¨rka¨mo¨ T, et al. Music listening enhances cognitive recovery and mood after middle cerebral artery stroke. Brain 2008;131:866–76.
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[2] Sa¨rka¨mo¨ T, et al. Cognitive, emotional and social benefits of regular musical activities in early dementia: randomized controlled study. Gerontologist 2014;54:634–50. [3] Sa¨rka¨mo¨ T, et al. Structural changes induced by daily music listening in the recovering brain after middle cerebral artery stroke: a voxel-based morphometry study. Front Hum Neurosci 2014;8:245. http://dx.doi.org/10.1016/j.rehab.2015.07.169 CO22-004-e
Verbal and musical memory: Selectivity of auditory disorders after stroke C. Hirel a,*, Y. Le´veˆque (Dr)b, L. Fornoni a, N. Nighoghossian (Prof)c, B. Tillmann (Dr)b, A. Caclin (Dr)a a Centre de recherche en neurosciences de Lyon, Inserm U1028/CNRS UMR 5292, e´quipe dynamique ce´re´brale et sognition, Bron, France b Inserm U1028, CNRS UMR5292, centre de recherche en neurosciences de Lyon, e´quipe cognition auditive et psychoacoustique c Service de neuro-vasculaire, hoˆpital neurologique Pierre-Wertheimer, Lyon *Corresponding author. E-mail address: [email protected] (C. Hirel) Introduction Neuropsychological consequences of stroke have important social, professional, and private life impacts. Deficits affecting language processing are well documented unlike musical disorders. Yet, according to Sarkamo et al. (Neuropsychologia, 2009), the incidence of acquired amusia after stroke is 60% after a delay of one week and 42% after 3 months. The goal of this study is to compare verbal and musical auditory memory in patients with stroke history, using a short-term memory paradigm. The goal is to evaluate the interest of testing non-verbal memory in neuropsychological assessment after stroke, as it could guide the choice of reeducation methods. Material and methods Patients included in the study have been hospitalized in the stroke unit of the neurological hospital in Lyon for a stroke in the MCA (middle cerebral artery) territory. Several months after stroke, they were assessed with a test battery including cognitive evaluation, speech evaluation and audiometry. Acquired amusia was diagnosed with the MBEA (Montreal Battery of Evaluation of Amusia, Peretz et al., Ann N Y Acad Sci, 2003). The auditory musical and verbal short-term memory was tested with a paradigm involving a comparison of short word sequences or tone sequences, separated by a delay of 1000 ms. Results Performance in the auditory short-term memory task were significantly decreased for the verbal task in patients with left hemisphere lesions, and for the musical task in patients with right hemisphere lesions, in comparison with controls.
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Music and the brain (SOFMER-INSERM-CNRS) / Annals of Physical and Rehabilitation Medicine 58S (2015) e73–e77
Discussion These results suggest separated cerebral networks for speech and music, for auditory short-term memory, with a preference of the left hemisphere for speech and the right hemisphere for music. To correlate behavioral results and cerebral lesions, analyses of cerebral imaging data will be conducted using voxel based lesion symptom mapping and DTI. Keywords Amusia; Acquired; Stroke; Auditory; Language Disclosure of interest The authors have not supplied their declaration of conflict of interest. http://dx.doi.org/10.1016/j.rehab.2015.07.170 CO29-001-e
Can preferred music boost cognition in patients with disorders of consciousness? J. Luaute´ (Prof)a,*, F. Perrin b CHU de Lyon, PAM de re´e´ducation, Saint-Genis-Laval, France b ´ Equipe cognition auditive et psychoacoustique, centre de recherche en neurosciences de Lyon, CNRS UMR5292, inserm U1028, universite´ Lyon 1 *Corresponding author. E-mail address: [email protected] (J. Luaute´) a
Background In the last decade, several studies have shown the favorable influence of music on cognitive functions in normal and brain-damaged patients. Among clinical applications in neurological rehabilitation, recent works suggests the utility of musical stimulation in awakening patients to improve detection of conscious processes or boost communication abilities (for a review see [1]). However, the evidence remains low, based on single-case studies. The majority of these studies did not use quantified measures and control condition. Several controlled studies have been developed with the Auditory Cognition and Psychoacoustics (CAP) Team, Lyon Neuroscience Research Center. Material and methods The purpose of the first study was to evaluate the effect of music on the detection of cognitive markers. Event-related potentials to the patient’s first name were recorded in two conditions: when the patient’s own name was preceded by a preferred music (music condition) or by a continuous song (control condition) [2]. Thirteen patients with disorders of consciousness were included in this study. Results showed that a P300 component of the evoked potentials was more frequently detected in the music condition as compared to the control condition. In another study, the effect of a preferred song on the relational behaviour was compared to that of a continuous sound. Six patients in a minimally conscious state (MCS) were included in this study [3]. Results showed that responsiveness of MCS patients was significantly enhanced in the music condition as compared to the control condition. Discussion These results confirmed that preferred music can improve the detection of cognitive processes and communication abilities in some patients with disorders of consciousness. Autobiographical and emotional components of the preferred music could explain these beneficial effects. Keywords Music; Disorder of consciousness; Evoked potentials Disclosure of interest The authors have not supplied their declaration of conflict of interest. Re´fe´rences [1] Magee. et al. Ann NY Acad Sci 2015;1337:256–62. [2] Castro et al. Neurorehabilitation and Neural Repair [ahead of print]. [3] Verger. et al. Rev Neurol 2014;170(11):693–9. http://dx.doi.org/10.1016/j.rehab.2015.07.171
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Apollo’s Gift: Music as a driver for beneficial brain plasticity E. Altenmueller (Prof) University of Music, Drama and Media, Hannover, Germany E-mail address: [email protected] Sensory-motor skills of musicians have some specific qualities: learning begins at an early age in a playful atmosphere. Routines for stereotyped movements are rehearsed for extended periods of time with gradually increasing degrees of complexity. Via auditory feedback, the motor performance is extremely controllable by both, performer and audience. All movements are strongly linked to emotions,–pleasure or anxiety–, processed by the limbic system. These specific circumstances seem to play an important role for plastic adaptation at several levels of the central nervous system. In the lecture, I focus on the functional and anatomical changes of cortical and subcortical brain regions observed in beginner and advanced musicians. Plastic adaptations of the auditory as well as the sensory-motor system are not only reflected in functional but also in morphological changes. Auditory-sensorimotor integration is accompanied by rapid modulations of neuronal connectivity in the time range of 20 minutes. I then will focus on music-supported Therapy (MST), which has been developed during the last decade in order to improve motor functions after stroke. The rationale behind this therapy is that motor improvement occurs due to auditory feedback, central-nervous auditory-motor coupling, and/ or replacement or reinforcement of proprioceptive information by auditory cues. Behavioral data has shown positive effects of these interventions. The detailed mechanisms and the use of modern technology with auditory real-time feedback will be addressed. Disclosure of interest The authors have not supplied their declaration of conflict of interest. http://dx.doi.org/10.1016/j.rehab.2015.07.172 CO36-001-e
Cueing effects in Parkinson’s disease: Benefits and drawbacks A. Nieuwboer (Prof) KU Leuven, Leuven University, Leuven, Belgium E-mail address: [email protected] Gait and balance impairments are considered a priority area for research in Parkinson’s disease (PD) as these problems are not well-controlled by levodopa. Many studies demonstrated that providing additional sensory information to motor training can improve gait and balance in PD. The extraordinary sensitivity for sensory-motor input can be attributed to the automaticity deficit as a result of basal ganglia dysfunction in PD. Hence, movement guidance by sensory cues, music or augmented feedback has been used to promote a goal-oriented mode of motor control. Cueing is defined as temporal or spatial stimuli, which facilitate repetitive movement usually provided as visual, tactile or auditory rhythmic signals. Several systematic reviews have shown the cueing has an immediate and sustained effect on gait and reduces the severity of freezing of gait. However, not all patients respond well to cueing and this may be why studies showed heterogeneity. Several factors may explain this lack of response, of which cognitive overload and inflexibility and lack of perceptual rhythmicity are the most important. In almost all studies, cueing was delivered in a one-size fit all fashion without being adjusted to walking performance. Therefore, we conducted a study as part of the CuPiD project (FP7 EU-funded) to investigate if intelligent cueing was more effective than a conventional gait-training program. The CuPiD system was developed especially for PD and comprised of sensor-technology embedded in a smartphone, allowing online cueing and feedback when patients’ gait deviated from their reference walk. Forty PD patients participated in a six-week training program in which they
Disponible en ligne sur
ScienceDirect www.sciencedirect.com
Music and the brain (SOFMER-INSERM-CNRS) Oral communications CO22-001-e
Cognitive, emotional, and neural benefits of musical leisure activities in stroke and dementia T. Sa¨rka¨mo¨ (Dr)*, M. Tervaniemi (Prof) Cognitive Brain Research Unit, Institute of Behavioural Sciences, University of Helsinki, Helsinki, Finland *Corresponding author. E-mail address: teppo.sarkamo@helsinki.fi (T. Sa¨rka¨mo¨) Introduction The capacity of music to engage auditory, cognitive, motor, and emotional functions across cortical and subcortical brain regions and the relative preservation of music in ageing and dementia makes it a promising tool in the rehabilitation of ageingrelated neurological illnesses, such as stroke and Alzheimer’s disease. As the incidence and prevalence of these illnesses is increasing rapidly, it is important to develop music-based interventions that are enjoyable and effective in the everyday care of the patients. Methods In two single-blind RCTs, the cognitive, emotional, and neural efficacy of self- or caregiver-implemented musical leisure activities was studied in stroke patients (n = 60) and persons with dementia (PWDs, n = 89). In stroke patients, daily music listening was compared to audio book listening and standard rehabilitation. In PWDs, regular listening and singing of familiar songs were compared to standard care. Results Original results showed that music listening enhanced the recovery of memory, attention, and mood after stroke [1] and that both singing and music listening helped maintain better cognitive functioning and mood in PWDs [2]. Here, we will present recent results from voxel-based morphometry (VBM) analyses showing that the cognitive and emotional benefits of music listening after stroke are associated with structural neuroplasticity in a network of prefrontal and limbic regions [3]. We will also present new results on how different clinical and demographical factors influence the outcome of the music interventions in PWDs. Discussion Musical leisure activities can provide an effective and easily applicable to enhance cognitive and emotional well-being after stroke and in the early stage of dementia. Keywords Music; Listening; Singing; Stroke; Dementia; Alzheimer; Neuropsychology; Emotion Disclosure of interest The authors have not supplied their declaration of conflict of interest. References [1] Sa¨rka¨mo¨ T, et al. Music listening enhances cognitive recovery and mood after middle cerebral artery stroke. Brain 2008;131:866–76.
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[2] Sa¨rka¨mo¨ T, et al. Cognitive, emotional and social benefits of regular musical activities in early dementia: randomized controlled study. Gerontologist 2014;54:634–50. [3] Sa¨rka¨mo¨ T, et al. Structural changes induced by daily music listening in the recovering brain after middle cerebral artery stroke: a voxel-based morphometry study. Front Hum Neurosci 2014;8:245. http://dx.doi.org/10.1016/j.rehab.2015.07.169 CO22-004-e
Verbal and musical memory: Selectivity of auditory disorders after stroke C. Hirel a,*, Y. Le´veˆque (Dr)b, L. Fornoni a, N. Nighoghossian (Prof)c, B. Tillmann (Dr)b, A. Caclin (Dr)a a Centre de recherche en neurosciences de Lyon, Inserm U1028/CNRS UMR 5292, e´quipe dynamique ce´re´brale et sognition, Bron, France b Inserm U1028, CNRS UMR5292, centre de recherche en neurosciences de Lyon, e´quipe cognition auditive et psychoacoustique c Service de neuro-vasculaire, hoˆpital neurologique Pierre-Wertheimer, Lyon *Corresponding author. E-mail address: [email protected] (C. Hirel) Introduction Neuropsychological consequences of stroke have important social, professional, and private life impacts. Deficits affecting language processing are well documented unlike musical disorders. Yet, according to Sarkamo et al. (Neuropsychologia, 2009), the incidence of acquired amusia after stroke is 60% after a delay of one week and 42% after 3 months. The goal of this study is to compare verbal and musical auditory memory in patients with stroke history, using a short-term memory paradigm. The goal is to evaluate the interest of testing non-verbal memory in neuropsychological assessment after stroke, as it could guide the choice of reeducation methods. Material and methods Patients included in the study have been hospitalized in the stroke unit of the neurological hospital in Lyon for a stroke in the MCA (middle cerebral artery) territory. Several months after stroke, they were assessed with a test battery including cognitive evaluation, speech evaluation and audiometry. Acquired amusia was diagnosed with the MBEA (Montreal Battery of Evaluation of Amusia, Peretz et al., Ann N Y Acad Sci, 2003). The auditory musical and verbal short-term memory was tested with a paradigm involving a comparison of short word sequences or tone sequences, separated by a delay of 1000 ms. Results Performance in the auditory short-term memory task were significantly decreased for the verbal task in patients with left hemisphere lesions, and for the musical task in patients with right hemisphere lesions, in comparison with controls.
e74
Music and the brain (SOFMER-INSERM-CNRS) / Annals of Physical and Rehabilitation Medicine 58S (2015) e73–e77
Discussion These results suggest separated cerebral networks for speech and music, for auditory short-term memory, with a preference of the left hemisphere for speech and the right hemisphere for music. To correlate behavioral results and cerebral lesions, analyses of cerebral imaging data will be conducted using voxel based lesion symptom mapping and DTI. Keywords Amusia; Acquired; Stroke; Auditory; Language Disclosure of interest The authors have not supplied their declaration of conflict of interest. http://dx.doi.org/10.1016/j.rehab.2015.07.170 CO29-001-e
Can preferred music boost cognition in patients with disorders of consciousness? J. Luaute´ (Prof)a,*, F. Perrin b CHU de Lyon, PAM de re´e´ducation, Saint-Genis-Laval, France b ´ Equipe cognition auditive et psychoacoustique, centre de recherche en neurosciences de Lyon, CNRS UMR5292, inserm U1028, universite´ Lyon 1 *Corresponding author. E-mail address: [email protected] (J. Luaute´) a
Background In the last decade, several studies have shown the favorable influence of music on cognitive functions in normal and brain-damaged patients. Among clinical applications in neurological rehabilitation, recent works suggests the utility of musical stimulation in awakening patients to improve detection of conscious processes or boost communication abilities (for a review see [1]). However, the evidence remains low, based on single-case studies. The majority of these studies did not use quantified measures and control condition. Several controlled studies have been developed with the Auditory Cognition and Psychoacoustics (CAP) Team, Lyon Neuroscience Research Center. Material and methods The purpose of the first study was to evaluate the effect of music on the detection of cognitive markers. Event-related potentials to the patient’s first name were recorded in two conditions: when the patient’s own name was preceded by a preferred music (music condition) or by a continuous song (control condition) [2]. Thirteen patients with disorders of consciousness were included in this study. Results showed that a P300 component of the evoked potentials was more frequently detected in the music condition as compared to the control condition. In another study, the effect of a preferred song on the relational behaviour was compared to that of a continuous sound. Six patients in a minimally conscious state (MCS) were included in this study [3]. Results showed that responsiveness of MCS patients was significantly enhanced in the music condition as compared to the control condition. Discussion These results confirmed that preferred music can improve the detection of cognitive processes and communication abilities in some patients with disorders of consciousness. Autobiographical and emotional components of the preferred music could explain these beneficial effects. Keywords Music; Disorder of consciousness; Evoked potentials Disclosure of interest The authors have not supplied their declaration of conflict of interest. Re´fe´rences [1] Magee. et al. Ann NY Acad Sci 2015;1337:256–62. [2] Castro et al. Neurorehabilitation and Neural Repair [ahead of print]. [3] Verger. et al. Rev Neurol 2014;170(11):693–9. http://dx.doi.org/10.1016/j.rehab.2015.07.171
CO29-003-e
Apollo’s Gift: Music as a driver for beneficial brain plasticity E. Altenmueller (Prof) University of Music, Drama and Media, Hannover, Germany E-mail address: [email protected] Sensory-motor skills of musicians have some specific qualities: learning begins at an early age in a playful atmosphere. Routines for stereotyped movements are rehearsed for extended periods of time with gradually increasing degrees of complexity. Via auditory feedback, the motor performance is extremely controllable by both, performer and audience. All movements are strongly linked to emotions,–pleasure or anxiety–, processed by the limbic system. These specific circumstances seem to play an important role for plastic adaptation at several levels of the central nervous system. In the lecture, I focus on the functional and anatomical changes of cortical and subcortical brain regions observed in beginner and advanced musicians. Plastic adaptations of the auditory as well as the sensory-motor system are not only reflected in functional but also in morphological changes. Auditory-sensorimotor integration is accompanied by rapid modulations of neuronal connectivity in the time range of 20 minutes. I then will focus on music-supported Therapy (MST), which has been developed during the last decade in order to improve motor functions after stroke. The rationale behind this therapy is that motor improvement occurs due to auditory feedback, central-nervous auditory-motor coupling, and/ or replacement or reinforcement of proprioceptive information by auditory cues. Behavioral data has shown positive effects of these interventions. The detailed mechanisms and the use of modern technology with auditory real-time feedback will be addressed. Disclosure of interest The authors have not supplied their declaration of conflict of interest. http://dx.doi.org/10.1016/j.rehab.2015.07.172 CO36-001-e
Cueing effects in Parkinson’s disease: Benefits and drawbacks A. Nieuwboer (Prof) KU Leuven, Leuven University, Leuven, Belgium E-mail address: [email protected] Gait and balance impairments are considered a priority area for research in Parkinson’s disease (PD) as these problems are not well-controlled by levodopa. Many studies demonstrated that providing additional sensory information to motor training can improve gait and balance in PD. The extraordinary sensitivity for sensory-motor input can be attributed to the automaticity deficit as a result of basal ganglia dysfunction in PD. Hence, movement guidance by sensory cues, music or augmented feedback has been used to promote a goal-oriented mode of motor control. Cueing is defined as temporal or spatial stimuli, which facilitate repetitive movement usually provided as visual, tactile or auditory rhythmic signals. Several systematic reviews have shown the cueing has an immediate and sustained effect on gait and reduces the severity of freezing of gait. However, not all patients respond well to cueing and this may be why studies showed heterogeneity. Several factors may explain this lack of response, of which cognitive overload and inflexibility and lack of perceptual rhythmicity are the most important. In almost all studies, cueing was delivered in a one-size fit all fashion without being adjusted to walking performance. Therefore, we conducted a study as part of the CuPiD project (FP7 EU-funded) to investigate if intelligent cueing was more effective than a conventional gait-training program. The CuPiD system was developed especially for PD and comprised of sensor-technology embedded in a smartphone, allowing online cueing and feedback when patients’ gait deviated from their reference walk. Forty PD patients participated in a six-week training program in which they