Preserved Singing in Aphasia

Wilson, Sarah J.; Parsons, Kate; Reutens, David C.

doi:10.1525/mp.2006.24.1.23

Cited by 57 publications

(18 citation statements)

References 46 publications

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“…In transversal studies, the rhythmic component of intoned-speech production appears to be responsible for on-line facilitation of patients’ speech accuracy (Laughlin et al, 1979; Boucher et al, 2001; Stahl et al, 2011). Longitudinal studies have used variations of MIT where only a limited set of sentences (10 to 15) is repeatedly trained (i.e., palliative variations of MIT, see Zumbansen et al, 2014) and examined if participants improved their speech accuracy in normally spoken sentences trained either with intoned speech (i.e., with rhythm and pitch), with rhythmic speech (i.e., without musical pitch) or non-trained (Wilson et al, 2006; Stahl et al, 2013). Significant improvement was obtained for trained sentences compared to non-trained items and pitch did not add any beneficial effect over rhythm on speech accuracy immediately post-treatment.…”

Section: Introductionmentioning

confidence: 99%

The Combination of Rhythm and Pitch Can Account for the Beneficial Effect of Melodic Intonation Therapy on Connected Speech Improvements in Brocaâ€™s Aphasia

Zumbansen

Peretz

Hébert

2014

Front. Hum. Neurosci.

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Melodic intonation therapy (MIT) is a structured protocol for language rehabilitation in people with Broca’s aphasia. The main particularity of MIT is the use of intoned speech, a technique in which the clinician stylizes the prosody of short sentences using simple pitch and rhythm patterns. In the original MIT protocol, patients must repeat diverse sentences in order to espouse this way of speaking, with the goal of improving their natural, connected speech. MIT has long been regarded as a promising treatment but its mechanisms are still debated. Recent work showed that rhythm plays a key role in variations of MIT, leading to consider the use of pitch as relatively unnecessary in MIT. Our study primarily aimed to assess the relative contribution of rhythm and pitch in MIT’s generalization effect to non-trained stimuli and to connected speech. We compared a melodic therapy (with pitch and rhythm) to a rhythmic therapy (with rhythm only) and to a normally spoken therapy (without melodic elements). Three participants with chronic post-stroke Broca’s aphasia underwent the treatments in hourly sessions, 3 days per week for 6 weeks, in a cross-over design. The informativeness of connected speech, speech accuracy of trained and non-trained sentences, motor-speech agility, and mood was assessed before and after the treatments. The results show that the three treatments improved speech accuracy in trained sentences, but that the combination of rhythm and pitch elicited the strongest generalization effect both to non-trained stimuli and connected speech. No significant change was measured in motor-speech agility or mood measures with either treatment. The results emphasize the beneficial effect of both rhythm and pitch in the efficacy of original MIT on connected speech, an outcome of primary clinical importance in aphasia therapy.

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Section: Introductionmentioning

confidence: 99%

The Combination of Rhythm and Pitch Can Account for the Beneficial Effect of Melodic Intonation Therapy on Connected Speech Improvements in Brocaâ€™s Aphasia

Zumbansen

Peretz

Hébert

2014

Front. Hum. Neurosci.

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“…When considered in conjunction with putative neuroplasticity mechanisms, this raises a number of hypotheses, including (1) that MIT would be more effective in individuals with previous singing experience who have already developed a specialized singing network or (2) that through regular singing practice, MIT could promote the development of a more “expert” singing network that would occupy left-hemisphere perilesional regions. The first hypothesis is indirectly supported in the existing literature, given that Wilson et al (2006) found that MIT was more effective than rhythmic speech in their case study of a trained musician, while Stahl et al (2013) did not find an advantage of singing over rhythmic speech in a group of non-musicians. Additional studies are needed to disentangle the relationship between music and language in aphasia and in MIT relative to expertise.…”

Section: Shared or Specific Features Of Music And Languagementioning

confidence: 84%

“…If observation, imitation, and synchronization of singing or intoned speech are interacting with a neural perception–action integration system, they might be expected to impact motor aspects of speech most strongly (Fadiga et al, 2002; Wilson et al, 2004). Indeed, some of the benefits of MIT are perhaps attributable to improvements in speech articulation (Sparks and Holland, 1976; Wilson et al, 2006) that subsequently lead to improvements in language output. Racette et al (2006) compared word production and intelligibility in individuals with aphasia when singing and speaking both alone and with an auditory model.…”

Section: Observation Imitation Integration and The Mirror Neuron Smentioning

confidence: 99%

“…It may be that the slower articulation of singing benefits some patients, while being less helpful for others (Racette et al, 2006). In another example of a possible effect of melody, Wilson et al (2006) found a long-term benefit for the production of rehearsed phrases that had a melodic and rhythmic component over those with only a rhythmic component in a musically-trained individual with aphasia. They proposed that the melodic component may have promoted separate representation in memory, leading to superior phrase encoding and retrieval.…”

Section: Shared or Specific Features Of Music And Languagementioning

confidence: 99%

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Neurobiological, Cognitive, and Emotional Mechanisms in Melodic Intonation Therapy

Merrett

Peretz

Wilson

2014

Front. Hum. Neurosci.

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Singing has been used in language rehabilitation for decades, yet controversy remains over its effectiveness and mechanisms of action. Melodic Intonation Therapy (MIT) is the most well-known singing-based therapy; however, speculation surrounds when and how it might improve outcomes in aphasia and other language disorders. While positive treatment effects have been variously attributed to different MIT components, including melody, rhythm, hand-tapping, and the choral nature of the singing, there is uncertainty about the components that are truly necessary and beneficial. Moreover, the mechanisms by which the components operate are not well understood. Within the literature to date, proposed mechanisms can be broadly grouped into four categories: (1) neuroplastic reorganization of language function, (2) activation of the mirror neuron system and multimodal integration, (3) utilization of shared or specific features of music and language, and (4) motivation and mood. In this paper, we review available evidence for each mechanism and propose that these mechanisms are not mutually exclusive, but rather represent different levels of explanation, reflecting the neurobiological, cognitive, and emotional effects of MIT. Thus, instead of competing, each of these mechanisms may contribute to language rehabilitation, with a better understanding of their relative roles and interactions allowing the design of protocols that maximize the effectiveness of singing therapy for aphasia.

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“…A study by Belin et al (1996) used positive emission tomography (PET) to demonstrate that MIT reactivates Broca's area in the left hemisphere in nonfluent aphasics. In yet another study, Wilson, Parsons and Reutens (2006) found that MIT was also effective for a patient with severe Broca's aphasia. The patient was a former musician with expressive aphasia.…”

Section: Poetry Therapy and Music Therapymentioning

confidence: 98%