Improving left spatial neglect through music scale playing

Abstract

The study assessed whether the auditory reference provided by a music scale could improve spatial exploration of a standard musical instrument keyboard in right-brain-damaged patients with left spatial neglect. As performing music scales involves the production of predictable successive pitches, the expectation of the subsequent note may facilitate patients to explore a larger extension of space in the left affected side, during the production of music scales from right to left. Eleven right-brain-damaged stroke patients with left spatial neglect, 12 patients without neglect, and 12 age-matched healthy participants played descending scales on a music keyboard. In a counterbalanced design, the participants' exploratory performance was assessed while producing scales in three feedback conditions: With congruent sound, no-sound, or random sound feedback provided by the keyboard. The number of keys played and the timing of key press were recorded. Spatial exploration by patients with left neglect was superior with congruent sound feedback, compared to both Silence and Random sound conditions. Both the congruent and incongruent sound conditions were associated with a greater deceleration in all groups. The frame provided by the music scale improves exploration of the left side of space, contralateral to the right hemisphere, damaged in patients with left neglect. Performing a scale with congruent sounds may trigger at some extent preserved auditory and spatial multisensory representations of successive sounds, thus influencing the time course of space scanning, and ultimately resulting in a more extensive spatial exploration. These findings offer new perspectives also for the rehabilitation of the disorder.

Effectiveness of music-based interventions on motricity or cognitive functioning in neurological populations: a systematic review

“…Besides motricity, music-based interventions have also been investigated for effects on cognitive functions. Some examples are symptoms of spatial (41), unilateral (42)(43)(44) and visual neglect (45,46), memory in Alzheimer subjects (47), verbal memory and learning in Alzheimer subjects (48,49) and MS subjects (50,51). These studies showed improvements in the cognitive outcomes measured.…”

Musical Neglect Training for Chronic Persistent Unilateral Visual Neglect Post-stroke

“…Bodak et al (22) examined the effectiveness of MNT using musical instruments, chime bars, which were aligned horizontally extending into the neglect visual field. Bernardi et al (23) used playing a music scale on the keyboard with decreasing range into the neglect field. Both studies tried to exercise perceptual-attentional and motor-intentional deficits by asking subjects to complete musical patterns whose lengths was increasingly extended into the visual neglect field.…”

Contributos da música na reabilitação da pessoa após acidente vascular cerebral

“…Dando enfoque às intervenções que constituem os programas de reabilitação estudados nos artigos primários supracitados, verifica-se que a estimulação auditiva e rítmica foi a mais utilizada [17,18,21,23,26], seguindo-se da terapia com suporte musical [16,18,19,27], a terapia de entonação melódica [21] e a musicoterapia [25]. Nas duas revisões foram incluídos estudos primários com intervenção da musicoterapia, terapia de entonação melódica, terapia com suporte musical e estimulação auditiva rítmica.…”

“…O intervalo de tempo de implementação dos programas variou entre 8 e 18 semanas, com sessões entre 2 e 3 vezes por semana, em que cada uma poderia durar entre 20 minutos e 1 hora. Os resultados obtidos não são todos consensuais, no entanto são descritos ganhos nas habilidades motoras, cognitivas, melhorias na comunicação e no desempenho das Atividades de Vida Diárias (AVDs) [16,19,20,27].…”