Vocal music enhances memory and language recovery after stroke: pooled results from two RCTs

Abstract

Objective: Previous studies suggest that daily music listening can aid stroke recovery, but little is known about the stimulus-dependent and neural mechanisms driving this effect. Building on neuroimaging evidence that vocal music engages extensive and bilateral networks in the brain, we sought to determine if it would be more effective for enhancing cognitive and language recovery and neuroplasticity than instrumental music or speech after stroke. Methods: Using data pooled from two single-blind randomized controlled trials in stroke patients (N = 83), we compared the effects of daily listening to self-selected vocal music, instrumental music, and audiobooks during the first 3 poststroke months. Outcome measures comprised neuropsychological tests of verbal memory (primary outcome), language, and attention and a mood questionnaire performed at acute, 3-month, and 6-month stages and structural and functional MRI at acute and 6-month stages. Results: Listening to vocal music enhanced verbal memory recovery more than instrumental music or audiobooks and language recovery more than audiobooks, especially in aphasic patients. Voxelbased morphometry and resting-state and task-based fMRI results showed that vocal music listening selectively increased gray matter volume in left temporal areas and functional connectivity in the default mode network. Interpretation: Vocal music listening is an effective and easily applicable tool to support cognitive recovery after stroke as well as to enhance early language recovery in aphasia. The rehabilitative effects of vocal music are driven by both structural and functional plasticity changes in temporoparietal networks crucial for emotional processing, language, and memory.

Rock ’n’ Roll but not Sex or Drugs: Music is negatively correlated to depressive symptoms during the COVID-19 pandemic via reward-related mechanisms

“…Furthermore, as previous studies indicate that some types of musical activities are more beneficial to wellbeing than others 78,79 , future research should focus on highlighting the particular musical activities that are associated with better mental health. Nevertheless, since we did not find consistent relationships with reduction in anxiety or depression associated with other activities besides food-related ones, we infer that perhaps music should be encouraged as a potential coping strategy, particularly given its relative accessibility and low cost.…”

Psychological and Physiological Signatures of Music Listening in Different Listening Environments—An Exploratory Study

“…In parallel, Wilkins and others showed that the default mode network (especially precuneus) was more connected when listening to preferred music than when listening to music with less emotional meaning [ 29 ]. The health benefits of favorite music listening were originally shown by Särkämö and others who reported faster emotional and cognitive recovery in acute stroke patients who were instructed to listen to their favorite music, when compared with audio book listening or a passive control group [ 30 ] (for replication and upgrade, see [ 31 ]).…”

Clinical and Neural Predictors of Treatment Response to Music Listening Intervention after Stroke

“…These include active interventions that utilize instrument playing or musical rhythm to rehabilitate deficits in motor control of movements (hemiparesis) [ 13 ] and singing-based methods to rehabilitate deficits in speech production (aphasia) [ 14 ] as well as receptive interventions that utilize music listening. In three randomized controlled trials (RCTs), daily music listening during the first three post-stroke months has been reported to enhance the recovery of verbal memory, attention, and language skills compared to a control intervention (audiobook listening) or standard care [ 15 , 16 , 17 ]. Using structural and functional magnetic resonance imaging (s/fMRI), these positive behavioural effects have been coupled with structural neuroplasticity in prefrontal, temporal, and limbic brain regions and white matter tracts [ 17 , 18 , 19 ], as well as with increased functional activation or connectivity in motor cortical, temporal, and parietal regions [ 17 , 19 ].…”

“…In three randomized controlled trials (RCTs), daily music listening during the first three post-stroke months has been reported to enhance the recovery of verbal memory, attention, and language skills compared to a control intervention (audiobook listening) or standard care [ 15 , 16 , 17 ]. Using structural and functional magnetic resonance imaging (s/fMRI), these positive behavioural effects have been coupled with structural neuroplasticity in prefrontal, temporal, and limbic brain regions and white matter tracts [ 17 , 18 , 19 ], as well as with increased functional activation or connectivity in motor cortical, temporal, and parietal regions [ 17 , 19 ].…”

“…The present study sought to identify which clinical, demographic, and musical factors and music-evoked functional activation patterns and networks were the best treatment response predictors of a post-stroke music listening intervention. To do so, we assessed a subsample of 31 stroke patients from our latest RCT who received a music listening intervention [ 17 , 19 ] and used regression models with subacute (baseline) post-stroke stage clinical, demographic, and musical information as well as music listening induced task-based functional MRI (fMRI) activity and network-level functional connectivity to predict favorable language and verbal memory outcomes after the music intervention. At the brain level, we hypothesized that greater neural responsiveness to music at the early post-stroke stage, indicated by stronger activity or connectivity in language- and auditory-related regions in the music task, would be associated with favorable treatment outcomes.…”