Neural reorganization underlies improvement in stroke-induced motor dysfunction by music-supported therapy.
Motor impairments are common after stroke, but efficacious therapies for these dysfunctions are scarce. By extending an earlier study on the effects of music-supported therapy, behavioral indices of motor function as well as electrophysiological measures were obtained before and after a series of therapy sessions to assess whether this new treatment leads to neural reorganization and motor recovery in patients after stroke. The study group comprised 32 stroke patients in a large rehabilitation hospital; they had moderately impaired motor function and no previous musical experience. Over a period of 3 weeks, these patients received 15 sessions of music-supported therapy using a manualized step-by-step approach. For comparison 30 additional patients received standard rehabilitation procedures. Fine as well as gross motor skills were trained by using either a MIDI-piano or electronic drum pads programmed to emit piano tones. Motor functions were assessed by an extensive test battery. In addition, we studied event-related desynchronization/synchronization and coherences from all 62 patients performing self-paced movements of the index finger (MIDI-piano) and of the whole arm (drum pads). Results showed that music-supported therapy yielded significant improvement in fine as well as gross motor skills with respect to speed, precision, and smoothness of movements. Neurophysiological data showed a more pronounced event-related desynchronization before movement onset and a more pronounced coherence in the music-supported therapy group in the post-training assessment, whereas almost no differences were observed in the control group. Thus we see that music-supported therapy leads to marked improvements of motor function after stroke and that these are accompanied by electrophysiological changes indicative of a better cortical connectivity and improved activation of the motor cortex.
Altenmüller
E
E
Institute of Music Physiology and Musicians' Medicine, University of Music and Drama Hannover, Hannover, Germany.
Marco-Pallares
J
J
Münte
T F
TF
Schneider
S
S
D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009147:Music Therapy; D009473:Neuronal Plasticity / Q000502:physiology*; D011597:Psychomotor Performance / Q000502:physiology*; D012047:Rehabilitation Centers; D020521:Stroke / Q000503:physiopathology / Q000628:therapy*