Abstract
Music is a highly complex and versatile stimulus for the brain that engages many temporal, frontal, parietal, cerebellar, and subcortical areas involved in auditory, cognitive, emotional, and motor processing. Regular musical activities have been shown to effectively enhance the structure and function of many brain areas, making music a potential tool also in neurological rehabilitation. In our previous randomized controlled study, we found that listening to music on a daily basis can improve cognitive recovery and improve mood after an acute middle cerebral artery stroke. Extending this study, a voxel-based morphometry (VBM) analysis utilizing cost function masking was performed on the acute and 6-month post-stroke stage structural magnetic resonance imaging data of the patients (n = 49) who either listened to their favorite music [music group (MG), n = 16] or verbal material [audio book group (ABG), n = 18] or did not receive any listening material [control group (CG), n = 15] during the 6-month recovery period. Although all groups showed significant gray matter volume (GMV) increases from the acute to the 6-month stage, there was a specific network of frontal areas [left and right superior frontal gyrus (SFG), right medial SFG] and limbic areas [left ventral/subgenual anterior cingulate cortex (SACC) and right ventral striatum (VS)] in patients with left hemisphere damage in which the GMV increases were larger in the MG than in the ABG and in the CG. Moreover, the GM reorganization in the frontal areas correlated with enhanced recovery of verbal memory, focused attention, and language skills, whereas the GM reorganization in the SACC correlated with reduced negative mood. This study adds on previous results, showing that music listening after stroke not only enhances behavioral recovery, but also induces fine-grained neuroanatomical changes in the recovering brain.
Highlights
During the past 10 years, advanced magnetic resonance imaging (MRI) analysis methods, such as voxel-based morphometry (VBM) and diffusion tensor imaging (DTI), have provided novel information about the dynamics of the structural neuroplastic changes underlying spontaneous recovery and rehabilitation after stroke
In LHD patients, significant Group × Time interactions in gray matter volume (GMV) were found for the music group (MG) > audio book group (ABG) and control group (CG) contrast in five different clusters: three in frontal areas [left and right superior frontal gyrus (SFG) and right medial SFG] and two in limbic areas [left ventral/subgenual anterior cingulate cortex (SACC) and right ventral striatum (VS) / globus pallidum)
The novel key finding of the present VBM study was that regular music listening during the 6-month post-stroke stage can lead to structural reorganization in the recovering brain
Summary
During the past 10 years, advanced magnetic resonance imaging (MRI) analysis methods, such as voxel-based morphometry (VBM) and diffusion tensor imaging (DTI), have provided novel information about the dynamics of the structural neuroplastic changes underlying spontaneous recovery and rehabilitation after stroke. Intensive motor rehabilitation using constraint-induced movement therapy (CIMT) has been shown to increase GMV in frontal and parietal sensory–motor areas and in the hippocampus (Gauthier et al, 2008) and intensive aphasia rehabilitation using constraint-induced language therapy (CILT) or melodic intonation therapy (MIT) has been observed to enhance the integrity of the WM tracks connecting frontal and temporal regions (arcuate fasciculus) in the left (Breier et al, 2011) and right (Schlaug et al, 2009) hemispheres, respectively All in all, these findings suggest that both behavioral recovery and active rehabilitation after stroke are closely linked to fine-grained neuroanatomical changes in the recovering brain. These findings indicate that auditory enrichment can be beneficial for the brain and suggest that it could potentially contribute to better cognitive and neural recovery after stroke
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