Post-stroke enriched auditory environment induces structural connectome plasticity: secondary analysis from a randomized controlled trial

Abstract

Post-stroke neuroplasticity and cognitive recovery can be enhanced by multimodal stimulation via environmental enrichment. In this vein, recent studies have shown that enriched sound environment (i.e., listening to music) during the subacute post-stroke stage improves cognitive outcomes compared to standard care. The beneficial effects of post-stroke music listening are further pronounced when listening to music containing singing, which enhances language recovery coupled with structural and functional connectivity changes within the language network. However, outside the language network, virtually nothing is known about the effects of enriched sound environment on the structural connectome of the recovering post-stroke brain. Here, we report secondary outcomes from a single-blind randomized controlled trial (NCT01749709) in patients with ischaemic or haemorrhagic stroke (N = 38) who were randomly assigned to listen to vocal music, instrumental music, or audiobooks during the first 3 post-stroke months. Utilizing the longitudinal diffusion-weighted MRI data of the trial, the present study aimed to determine whether the music listening interventions induce changes on structural white matter connectome compared to the control audiobook intervention. Both vocal and instrumental music groups increased quantitative anisotropy longitudinally in multiple left dorsal and ventral tracts as well as in the corpus callosum, and also in the right hemisphere compared to the audiobook group. Audiobook group did not show increased structural connectivity changes compared to both vocal and instrumental music groups. This study shows that listening to music, either vocal or instrumental promotes wide-spread structural connectivity changes in the post-stroke brain, providing a fertile ground for functional restoration.

Enriched Environments in Stroke Units: Defining Characteristics and Limitations

“…Some studies have established the enrichment of the environment exclusively through various musical interventions: The music therapist provided the patients with a portable MP3 player, headphones, and a collection of listening material individually selected to match the music or literature preferences of the patient as closely as possible. ( Sihvonen et al, 2022 , p. 1815) …”

“…The music therapist provided the patients with a portable MP3 player, headphones, and a collection of listening material individually selected to match the music or literature preferences of the patient as closely as possible. (Sihvonen et al, 2022(Sihvonen et al, , p. 1815 The third group of studies personalized the environment using home-based equipment:…”

Neural oscillations after acute large artery atherosclerotic cerebral infarction during resting state and sleep spindles

“…The continuous increase in MsA indicates the sustained high expression of the AN on language function rehabilitation. Listening to music may promote language recovery after stroke (Sihvonen et al, 2022), which stems from the compensatory reorganisation of the sensorimotor network (Wang et al, 2014). Interestingly, we found the presence of paracentral lobule, which was part of the sensorimotor network, in Ms source localisation brain regions in the LAACI group.…”

Overnight olfactory enrichment using an odorant diffuser improves memory and modifies the uncinate fasciculus in older adults

“…For example, mean diffusivity of white matter in older adults increased when dancing was used as a form of environmental enrichment ( Rektorova et al, 2020 ). Sensory enrichment provided by listening to music increased quantitative anisotropy longitudinally in the left uncinate fasciculus compared to the group that listened to audiobooks ( Sihvonen et al, 2022 ). Widespread increases in mean diffusivity in the white matter tracts in the frontal lobes bilaterally, internal and external capsules, and partial right parietal lobe also occurred after a wellness/cognitive enhancement program in older adults ( Stephen et al, 2020 ).…”