Music-supported Therapy Induces Plasticity in the Sensorimotor Cortex in Chronic Stroke: A Single-case Study Using Multimodal Imaging (fMRI-TMS)

Journal

Brain Injury

Year

2011

Abstract

PRIMARY OBJECTIVE: Music-Supported Therapy (MST) has been developed recently in order to improve the use of the affected upper extremity after stroke. This study investigated the neuroplastic mechanisms underlying effectiveness in a patient with chronic stroke. METHODS: MST uses musical instruments, a midi piano and an electronic drum set emitting piano sounds, to retrain fine and gross movements of the paretic upper extremity. Data are presented from a patient with a chronic stroke (20 months post-stroke) with residual right-sided hemiparesis who took part in 20 MST sessions over the course of 4 weeks. RESULTS: Post-therapy, a marked improvement of movement quality, assessed by 3D movement analysis, was observed. Moreover, functional magnetic resonance imaging (fMRI) of a sequential hand movement revealed distinct therapy-related changes in the form of a reduction of excess contralateral and ipsilateral activations. This was accompanied by changes in cortical excitability evidenced by transcranial magnetic stimulation (TMS). Functional MRI in a music listening task suggests that one of the effects of MST is the task-dependent coupling of auditory and motor cortical areas. CONCLUSIONS: The MST appears to be a useful neurorehabilitation tool in patients with chronic stroke and leads to neural reorganization in the sensorimotor cortex.

Music and Health Institute Terms

Mobility; Music Listening; Music and Cognition; Music Neuroscience; Music Medicine; Physiological Measures; Receptive Music Methods; Rehabilitation Exercises; Stroke

Indexed Terms

Stroke Rehabilitation; Magnetic Resonance Imaging; Motor Activity; Neuronal Plasticity; Paresis; Recovery of Function; Stroke; Transcranial Magnetic Stimulation

Study Type

Quasi-Experimental Study; Quantitative Methods

Document Type

Article

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