title: Music-supported therapy induces plasticity in the sensorimotor cortex in chronic stroke: a single-case study using multimodal imaging (fMRI-TMS).
abstract: 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.
authors.affiliation: Department of Psicologia Bàsica, Faculty of Psychology, University of Barcelona, Passeig de la Vall d’Hebron 171, Barcelona, Spain. nuriarojofite@gmail.com
authors.forename: Nuria
authors.initials: N
authors.lastname: Rojo
authors.forename: Julian
authors.initials: J
authors.lastname: Amengual
authors.forename: Montserrat
authors.initials: M
authors.lastname: Juncadella
authors.forename: Francisco
authors.initials: F
authors.lastname: Rubio
authors.forename: Estela
authors.initials: E
authors.lastname: Camara
authors.forename: Josep
authors.initials: J
authors.lastname: Marco-Pallares
authors.forename: Sabine
authors.initials: S
authors.lastname: Schneider
authors.forename: Misericordia
authors.initials: M
authors.lastname: Veciana
authors.forename: Jordi
authors.initials: J
authors.lastname: Montero
authors.forename: Bahram
authors.initials: B
authors.lastname: Mohammadi
authors.forename: Eckart
authors.initials: E
authors.lastname: Altenmüller
authors.forename: Carles
authors.initials: C
authors.lastname: Grau
authors.forename: Thomas F
authors.initials: TF
authors.lastname: Münte
authors.forename: Antoni
authors.initials: A
authors.lastname: Rodriguez-Fornells
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D009043:Motor Activity / Q000502:physiology; D009147:Music Therapy / Q000379:methods*; D009473:Neuronal Plasticity / Q000502:physiology*; D010291:Paresis / Q000503:physiopathology / Q000534:rehabilitation*; D020127:Recovery of Function / Q000502:physiology*; D020521:Stroke / Q000503:physiopathology; D000071939:Stroke Rehabilitation; D050781:Transcranial Magnetic Stimulation / Q000379:methods*