Abstract
Aphasia is a complex disorder, frequent after stroke (with an incidence of 38%), with a detailed pathophysiological characterization. Effective approaches are crucial for devising an efficient rehabilitative strategy, in order to address the everyday life and professional disability. Several rehabilitative procedures are based on psycholinguistic, cognitive, psychosocial or pragmatic approaches, including amongst those with a neurobehavioral approach the Melodic Intonation Therapy (MIT). Van Eeckhout’s adaptation of MIT to French language (Melodic-Rhythmic Therapy: MRT) has implemented the training strategy by adding a rhythmic structure reproducing French prosody. The purpose of this study was to adapt MRT rehabilitation procedures to Italian language and to verify its efficacy in a group of six chronic patients (five males) with severe non-fluent aphasia and without specific aphasic treatments during the previous 9 months. The patients were treated 4 days a week for 16 weeks, with sessions of 30–40 min. They were assessed 6 months after the end of the treatment (follow-up). The patients showed a significant improvement at the Aachener Aphasie Test (AAT) in different fields of spontaneous speech, with superimposable results at the follow-up. Albeit preliminary, these findings support the use of MRT in the rehabilitation after stroke. Specifically, MRT seems to benefit from its stronger structure than the available stimulation-facilitation procedures and allows a better quantification of the rehabilitation efficacy.
Highlights
A frequent event after stroke is aphasia, which is multifaceted because of the brain structural and functional processes dedicated to, or involved in language (Mesulam, 1990; Bachman and Albert, 1991; Bookheimer, 2002; Démonet et al, 2005; Jung-Beeman, 2005)
Aphasia is a complex disorder (Huber et al, 1997; McNeil and Pratt, 2001); detailed pathophysiological characterization and proper approaches are mandatory for an efficient rehabilitative strategy to be devised and the disability in everyday life and profession to be compensated for Black-Schaffer and Osberg (1990), Holland et al (1996), Paolucci et al (1997), Robey (1998) and Tilling et al (2001)
The emerging research field of music and neuroscience has evidenced that the sound envelope processing (Kotz and Schwartze, 2010; Patel, 2011; Peelle and Davis, 2012) and the synchronization and entrainment to a pulse, may help to stimulate brain networks for human communication (Fujii and Wan, 2014)
Summary
A frequent event after stroke is aphasia (with an incidence of 38% of cases; Pedersen et al, 1997; Engelter et al, 2006), which is multifaceted because of the brain structural and functional processes dedicated to, or involved in language (Mesulam, 1990; Bachman and Albert, 1991; Bookheimer, 2002; Démonet et al, 2005; Jung-Beeman, 2005). Linguistic and non-linguistic processes (e.g., attention, memory, sensory or motor subroutines) are functionally related and their damage results in language impairment at varying levels of complexity. The fluent form is generally characterized by the impairment to grasp the meaning of spoken words, while the ease of producing connected speech is not affected so critically. Sentences do not hang together and irrelevant words intrude sometimes to the point of jargon, in severe cases. Reading and writing are often severely impaired (Stringer and Green, 1996)
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