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I have choosen this article because I love music, when I feel stress or need some motivation, I just listen to music to change my mood. So, when, I heard about this new therapy, I just get exited because our brain is amazing and using such a simple tools, we can help patients recover from their disabilities such as the capacity of communication.
But, first of all, you can listen this song and have a litte bit of motivation :)
https://www.youtube.com/watch?v=nEjLFpU2pJ4
I hope you enjoy this article.
SINGING TO SPEAKING
It's amazing to see stroke survivors who've lost the ability to speak suddenly produce accurate words when singing familiar songs. This phenomenon was first reported by Swedish physician Olaf Dalin in 1736. Dr. Dalin described a young man who had lost his ability to talk as a result of brain damage, but who surprised townsfolk by singing hymns in church.
The acquired language disorder now called “aphasia” became a subject of clinical study and a target for rehabilitation beginning in the mid-1880s. Since that time, every clinician working with aphasia has seen individuals who can produce words only when singing. Indeed, this observation prompted American neurologist Charles Mills to suggest (in 1904!) that it might help to play the piano and encourage patients with aphasia to sing well-known songs.
There appear to be psychological benefits, but singing familiar songs alone doesn’t seem to improve the speech of people with aphasia. This is probably because words that come automatically when singing are intricately linked to the melodies and are not easily separated.
The spoken word is a different matter. We know the brain has difficulty starting in the middle of highly memorized spoken passages (such as the “Pledge of Allegiance”). We need a “running start” to prime the pump of recall.
Songs themselves might be used to communicate. I had a patient who struggled to tell his son he wanted to go to a Boston Red Sox game. He finally got his point across by bursting forth with “Take Me Out to the Ball Game.” Unfortunately, there aren’t appropriate songs for every communication need, so it would be better if singing could be used to unblock residual speech abilities. This was the motivation for the aphasia treatment approach known as “Melodic Intonation Therapy,” which we began to develop in 1972.
Why Does It Work For Some People?
We know that aphasia typically results from a stroke or other damage that affects the left hemisphere of the brain, where language ability usually is located. We thought it might be because a stroke increased the use of the brain’s right hemisphere, where many aspects of music and the melody of speech are located. Using this treatment, the dominance of the damaged left hemisphere language areas might diminish while the right hemisphere became more involved.
A recent study using functional magnetic resonance imaging with individuals treated with melodic intonation therapy showed that the right hemisphere does, indeed, play a role in response to this method. Preliminary results suggest that the amount of speech recovery may be associated with how much and what part of the right hemisphere is activated. This study demonstrates the flexibility of adult brains, even those with stroke-related damage.
It is encouraging to know that with special treatment we can learn to use undamaged portions of our brains to perform “new tricks” – even one as complicated as speaking.
Trial And Error
Robert Sparks, a speech-language pathologist, Martin Albert, a behavioral neurologist, and I were working on the Aphasia Unit of the Boston VA Hospital. We saw a woman whose only purposeful speech was the combination of nonsense syllables: “nee-nee-nah-nah.”
At that time, a hospital volunteer was coming to each inpatient ward with a piano on wheels and conducting sing-along sessions with the patients. One day we observed our patient sitting beside him in her wheelchair and singing many of the words of popular songs. Though we had seen this before, this new example convinced us we had to try to develop a method that capitalized on this preserved ability to produce speech when singing.
We knew that simply singing familiar songs with this woman would not do the trick. Through trial and error, we discovered that if we melodically intoned everyday phrases such as “open the window” while helping her tap out the syllables with her unaffected hand, she could produce phrases in unison with us. Then she could intone the phrases with just a little help at the beginning. Finally, she could produce them on her own.
From this experience, we created a treatment program using melodically intoned and tapped out phrases of increasing length. Usually within a few sessions, patients’ production of nonsense syllables had disappeared and they began to communicate verbally in everyday situations. Our continued research helped identify the best candidates for this method.
Why Does It Work For Some People?
We know that aphasia typically results from a stroke or other damage that affects the left hemisphere of the brain, where language ability usually is located. We thought it might be because a stroke increased the use of the brain’s right hemisphere, where many aspects of music and the melody of speech are located. Using this treatment, the dominance of the damaged left hemisphere language areas might diminish while the right hemisphere became more involved.
A recent study using functional magnetic resonance imaging with individuals treated with melodic intonation therapy showed that the right hemisphere does, indeed, play a role in response to this method. Preliminary results suggest that the amount of speech recovery may be associated with how much and what part of the right hemisphere is activated. This study demonstrates the flexibility of adult brains, even those with stroke-related damage.
It is encouraging to know that with special treatment we can learn to use undamaged portions of our brains to perform “new tricks” – even one as complicated as speaking.
Trial And Error
Robert Sparks, a speech-language pathologist, Martin Albert, a behavioral neurologist, and I were working on the Aphasia Unit of the Boston VA Hospital. We saw a woman whose only purposeful speech was the combination of nonsense syllables: “nee-nee-nah-nah.”
At that time, a hospital volunteer was coming to each inpatient ward with a piano on wheels and conducting sing-along sessions with the patients. One day we observed our patient sitting beside him in her wheelchair and singing many of the words of popular songs. Though we had seen this before, this new example convinced us we had to try to develop a method that capitalized on this preserved ability to produce speech when singing.
We knew that simply singing familiar songs with this woman would not do the trick. Through trial and error, we discovered that if we melodically intoned everyday phrases such as “open the window” while helping her tap out the syllables with her unaffected hand, she could produce phrases in unison with us. Then she could intone the phrases with just a little help at the beginning. Finally, she could produce them on her own.
Eli this is a beautiful post about a wonderful therapy which cherishes the hope to recuperate disabilities in a lovely way. Thanks for this ending of our blog, I think it’s the best final touch.
ResponderEliminarThere are neurological structures similarities between music and language. Utilizing positron emission tomography (PET), the findings showed that both linguistic and melodic phrases produced activation in almost identical functional brain areas
As a result, a new science known as Neuromusicology appears. It studies the brain areas involved in music processing, neural and cognitive processes of musical processing, and ontogeny of musical capacity and musical skill. Comparative musicology studies the functions and uses of music, advantages and costs of music making, and universal features of musical systems and musical behaviour.
Researchers were based on this finding they found in music a possible therapy and rehabilitation for speech and may benefit in other diseases.
Regarding the Melodic Intonation Therapy (MIT), as Elisa has mentioned, the patients that would benefit from MIT typically suffer from non-fluent aphasia or Broca’s aphasia. Some individuals with apraxia of speech have also benefited from MIT. As the name suggests, the damage to the brain in this category is mostly in the Broca’s area and thus speech production is affected. Sparks and associates found that adult patients meeting the following criteria achieved positive results with MIT: good auditory comprehension; facility for self correction; markedly limited verbal output; reasonably good attention span and good emotional stability.
On the other hand, researchers have also noted that for MIT to be effective the patient must not exhibit any “bi-lateral brain damage”. However, Melodic Intonation Therapy is not appropriate for patients suffering from receptive aphasia or brain damage affecting the patient’s ability to read and comprehend language.
The main goal is to help the patient speak in a comprehendible manner. MIT may also be an effective treatment for speech impairments caused by other disorders such as Down syndrome, but this is in research.
“Music’s the medicine of the mind” John A. Logan
ANDREA GARCÍA GÓMEZ
Hi Eli!!!
ResponderEliminarSimply brilliant! I never had thought that with music people with cerebral damage could recover lost functions like speech. I must say I’m impressed, I think it’s a very intelligent idea and it makes sense.
It distinguishes humans from other living beings by being able to talk even have developed different languages. Therefore a person who loses the speech has a great disability because is conditioned to isolation and will be more vulnerable to mood disorders as they cannot express their feelings, one of the best ways we have to overcome the problems of everyday life. So it’s incredible that something so simple like music can be so helpful.
Therefore, I repeat, this is a very great idea and I hope that progress will continue until the music therapy gets people fully recovery speech.
Nothing is impossible with a bit of creativity and hope!
Marta Córdoba
Thank you for your comments. I´m glad you find this article interesting. As Andrea said, this therapy also has its limitations, such as the receptive aphasia or a brain damage that affects the patient ability to read. Besides, patients will also need to accomplish the criteria for rehab. However, at least Broca´s aphasia could be resolved and some patients could be helped; Moreover, I´m sure that if investigations keeps on, they could find more amazing and simple techniques such as this.
ResponderEliminarCommunication is essential for any human being since we are part of a society and people need to express their thoughts or feeling. Hence, this therapy is very simple but it will help more than we think. As Marta said, it may prevent isolation or mood disorders; which are more prevalent on elderly people. So there are just benefits from this.
Finally, this therapy may be useful for other diseases such as autism or Down syndrome. That´s why I will not be tired of saying that our brain is incredible and there are plenty of things that are there for discovering.