Melodic Intonation Therapy on Non-fluent Aphasia After Stroke: A Systematic Review and Analysis on Clinical Trials

Abstract

Melodic intonation therapy (MIT) is a melodic musical training method that could be combined with language rehabilitation. However, some of the existing literature focuses on theoretical mechanism research, while others only focus on clinical behavioral evidence. Few clinical experimental studies can combine the two for behavioral and mechanism analysis. This review aimed at systematizing recent results from studies that have delved explicitly into the MIT effect on non-fluent aphasia by their study design properties, summarizing the findings, and identifying knowledge gaps for future work. MIT clinical trials and case studies were retrieved and teased out the results to explore the validity and relevance of these results. These studies focused on MIT intervention for patients with non-fluent aphasia in stroke recovery period. After retrieving 128 MIT-related articles, 39 valid RCT studies and case reports were provided for analysis. Our summary shows that behavioral measurements at MIT are excessive and provide insufficient evidence of MRI imaging structure. This proves that MIT still needs many MRI studies to determine its clinical evidence and intervention targets. The strengthening of large-scale clinical evidence of imaging observations will result in the clear neural circuit prompts and prediction models proposed for the MIT treatment and its prognosis.

Potential Benefits of Music Therapy on Stroke Rehabilitation

“…The results demonstrate the beneficial effect of MIT on language rehabilitation. However, further MRI studies have been recommended that can help determine the clinical evidence and intervention targets of MIT and help provide clear neural circuit prompts and predict models used for MIT intervention [ 86 ]. Lim et al demonstrate that neurologic music therapy and speech language therapy are both effective treatments for poststroke aphasic patients during the chronic stage, and the former is effective in the subacute stage of stroke [ 87 ].…”

Effect of an extension speech training program based on Chinese idioms in patients with post-stroke non-fluent aphasia: A randomized controlled trial

“…Chinese idioms are harmonious, with level and oblique deployment and a strong sense of rhythm [ 21 , 22 ]. This rhythm of idioms can be used to prepare for the rapid start of pronunciation by adjusting the speed of pronunciation more clearly similar to Melodic Intonation Therapy [ 23 ]. Moreover, the structure of idioms is fixed, and the corresponding collocations are neat.…”

Neurologic Music Therapy in Geriatric Rehabilitation: A Systematic Review

“…Other studies show that music therapy can effectively improve dysphagia, which is a serious problem in the post-stroke elderly [ 103 , 104 ]. Melodic intonation therapy in both SP and PD therapy is gaining increasing interest among therapists and researchers [ 21 , 105 , 106 ]. Unfortunately, strong evidence for its effectiveness is still lacking.…”

“…Unfortunately, strong evidence for its effectiveness is still lacking. Researchers point out, among other things, the problems of providing the intervention to people who have not received adequate specialized training (musicians/music therapists), the lack of appropriate assessment tools and under-sampling in clinical trials [ 106 ]. Therefore, it can be concluded that research in this area should continue with the inclusion of techniques focusing on the speech/language area as well.…”