A new study by researchers in Finland found that listening to music soon after a stroke appeared to improve patients' recovery.
The study is the work of Dr Teppo Sarkamo, a psychologist at the Cognitive Brain Research Unit, Department of Psychology, at the University of Helsinki and at the Helsinki Brain Research Centre, and colleagues, and is to be published today, Wednesday 20th February, in the journal Brain.
Sarkamo and colleagues found stroke patients had a more positive mood and improved recovery of verbal memory and attention focus if they listened to music for about two hours a day, compared to counterparts who listened to audio books or nothing at all.
The researchers said this was the first time such an effect had been observed in humans and has important implications for clinical practice. As Sarkamo explained:
"As a result of our findings, we suggest that everyday music listening during early stroke recovery offers a valuable addition to the patients' care, especially if other active forms of rehabilitation are not yet feasible at this stage, by providing an individually targeted, easy-to-conduct and inexpensive means to facilitate cognitive and emotional recovery."
The researchers carried out a single-blind, randomized controlled trial with 60 patients who had experienced a stroke in the middle cerebral artery (MCA) of the left or right hemisphere of the brain. The trial lasted from March 2004 to May 2006, and the patients were enlisted as soon after they were admitted to hospital as possible. 54 of the patients completed the trial.
Sarkamo explained that it was important for the patients to start the trial as early as possible in the acute post-stroke stage, because:
"The brain can undergo dramatic changes during the first weeks and months of recovery and we know these changes can be enhanced by stimulation from the environment."
For most patients, their stroke had left them experiencing problems with movement and cognitive problems, for instance with memory and attention.
The researchers randomly assigned the patients to one of three groups: a music group, a language group, and a control group.
For two months the patients in the music and language groups listened every day either to music or audio books. The music listeners chose their own music to listen to, including pop, jazz, folk and classical. The control group were given no listening materials.
All three groups also underwent the standard stroke rehabilitation programmes, and the researchers monitored and assessed their progress for up to six months after their stroke.
The results showed that:
- Comparing their ability in the first week after the stroke with three months later, verbal memory in the music listeners improved by 60 per cent.
- This contrasted with 18 per cent in the audio book listeners (language group) and 29 per cent in the non-listeners (control group).
- Focused attention tests showed 17 per cent improvement in the music group and no improvement in the other two groups.
- These differences remained essentially the same after six months.
- The music group experienced less depressed and confused mood than the patients in the control group.
Commenting on their findings, Sarkamo said:
"The differences in cognitive recovery can be directly attributed to the effect of listening to music."
"Furthermore, the fact that most of the music (63 percent) also contained lyrics would suggest that it is the musical component (or the combination of music and voice) that plays a crucial role in the patients' improved recovery," he added.
The researchers were keen to point out that these are novel findings in a single small study. They show promise, but need to be confirmed by further studies, and especially if we are to understand the underlying mechanisms of the brain.
They also emphasized that since their study examined group effects, it does not mean it will have the same result in individual cases, and patients should not read into this that music will be the only thing that will help them recover from a stroke. They should consider this only as one optional addition to a range of active rehabilitative treatments, for instance speech therapy and neuropsychological rehabilitation.
However, speculating on their findings, the researchers suggested three neural processes as potential explanations for how music might help people recover from strokes:
-- Enhancing arousal and alertness, attention, and mood, by stimulating the dopaminergic mesocorticolimbic system. This system is involved in the processing of pleasure, reward, arousal, motivation and memory.
-- Directly stimulating damaged areas of the brain to promote recovery.
-- Stimulating other processes that help the brain mend itself after neural networks have been damaged (plasticity).
The researchers mentioned that previous studies had shown that after a stroke, in the first few weeks of recovery, patients tend to spend about 75 per cent of their time in their rooms, inactive and unstimulated, without interaction. This period is crucial for maximising brain plasticity and an ideal window of opportunity for rehabilitation.
"Our research shows for the first time that listening to music during this crucial period can enhance cognitive recovery and prevent negative mood, and it has the advantage that it is cheap and easy to organise", concluded Sarkamo.
Click here for journal Brain.
Sources: University of Helsinki press statement, Reuters.
Written by: Catharine Paddock, PhD