1. Music-Supported Therapy induces plasticity in the sensorimotor cortex in chronic stroke: A single-case study using multimodal imaging (fMRI-TMS)
- Author
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Eckart Altenmüller, Nuria Rojo, Thomas F. Münte, Montserrat Juncadella, B. Mohammadi, Antoni Rodríguez-Fornells, Sabine Schneider, Francisco Rubio, Julian Amengual, Jordi Montero, Estela Camara, Misericordia Veciana, Carles Grau, and Josep Marco-Pallarés
- Subjects
Adult ,medicine.medical_specialty ,medicine.medical_treatment ,Neuroscience (miscellaneous) ,Motor Activity ,Neurologic music therapy ,Physical medicine and rehabilitation ,Neuroimaging ,Neuroplasticity ,Developmental and Educational Psychology ,medicine ,Humans ,Music Therapy ,Stroke ,Neurorehabilitation ,Neuronal Plasticity ,medicine.diagnostic_test ,Stroke Rehabilitation ,Recovery of Function ,medicine.disease ,Magnetic Resonance Imaging ,Transcranial Magnetic Stimulation ,Paresis ,Transcranial magnetic stimulation ,Hemiparesis ,Female ,Neurology (clinical) ,medicine.symptom ,Psychology ,Functional magnetic resonance imaging ,human activities - 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 poststroke) 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.
- Published
- 2011
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