Music practice enhances motor recovery after stroke.
We were fortunate to contribute to a study driven by Dr. Shashank Ghai in Dr. Anouk Lamontagne’s group at McGill that shows the neurophysiological effects of piano practice and how they enhance motor recovery after stroke.
The report is published in open access in the latest issue of the journal Brain Sciences.
The study followed two stroke patients over 3 weeks - a relatively short period during which they practiced simple piano playing exercices.
We used MEG time-resolved imaging to track changes in the patients brain waves before and after their training program.
Music-supported therapy (MST) is indeed often used in stroke rehabilitation to enhance motor recovery. Both patients motor skills improved after 3 weeks.
Our data show that the functional gains induced by MST were related to increased brain connectivity between the motor & auditory cortices, with a particular emphasis over the brain hemisphere where the stroke lesion was located.
The effects were strong in the alpha & beta frequency bands of human brain rhythms [8-35Hz].
Power spectrum density plots for both participants, pre- and post-MST. (P1: Participant 1, P2: Participant 2, L: left, R: right, Pre: pre-training; Post: post-training, M1: primary motor cortex, AC: auditory cortex, SMA: supplementary motor area: PMv: premotor ventral area, PMd: premotor dorsal area, IFG: inferior frontal gyrus).
Overall, the data encourages larger-scale clinical trials to optimize clinical interventions by better targeting specific neurophysiological signals and enhance functional recovery.
Intracortical coherence in the β-band in Participant 1 and Participant 2 with percentage connectivity changes before and after MST. The error bars (i.e., orange line) represent the standard error of the mean in the overall connectivity. (M1: primary motor cortex, AC: auditory cortex, SMA: supplementary motor area: PMv: premotor ventral area, PMd: premotor dorsal area, IFG: inferior frontal gyrus, P1: Participant 1, P2: Participant 2).
"Neurophysiological Changes Induced by Music-Supported Therapy for Recovering Upper Extremity Function after Stroke: A Case Series"
Ghai, S.; Maso, F.D.; Ogourtsova, T.; Porxas, A.-X.; Villeneuve, M.; Penhune, V.; Boudrias, M.-H.; Baillet, S.; Lamontagne, A.
Music-supported therapy (MST) follows the best practice principles of stroke rehabilitation and has been proven to instigate meaningful enhancements in motor recovery post-stroke. The existing literature has established that the efficacy and specificity of MST relies on the reinforcement of auditory-motor functional connectivity in related brain networks. However, to date, no study has attempted to evaluate the underlying cortical network nodes that are key to the efficacy of MST post-stroke. In this case series, we evaluated changes in connectivity within the auditory-motor network and changes in upper extremity function following a 3-week intensive piano training in two stroke survivors presenting different levels of motor impairment. Connectivity was assessed pre- and post-training in the α- and the β-bands within the auditory-motor network using magnetoencephalography while participants were passively listening to a standardized melody. Changes in manual dexterity, grip strength, movement coordination, and use of the upper extremity were also documented in both stroke survivors. After training, an increase in the clinical measures was accompanied by enhancements in connectivity between the auditory and motor network nodes for both the α- and the β-bands, especially in the affected hemisphere. These neurophysiological changes associated with the positive effects of post-stroke MST on motor outcomes delineate a path for a larger scale clinical trial.