This Rehab Science Spotlight summarizes a study that suggests positive changes in a small TBI sample following a music based intervention.
CITATION:
Vik, B. M. D., Skeie, G. O., & Specht, K. (2019). Neuroplastic effects in patients with traumatic brain injury after music-supported therapy. Frontiers in human neuroscience, 13. doi: 10.3389/fnhum.2019.00177
SUMMARY:
The authors of this study claim they have shown that learning to play the piano may generate neuroplasticity in patients with cognitive deficits following mTBI. They assert that because playing a musical instrument is a complex operation and activates many different regions of the brain, it could be a key factor in improving cognitive functioning, and result in improved well-being and social behavior. A focus of the study was to examine if the intervention of learning to play piano positively impacted the participants to the extent that they were able to return to work.
All seven of their participants were at least two months post injury, and had not fully returned to work or school. All participants had also received rehabilitation treatment prior to the study without any reported improvement of their difficulties and they reported continued difficulty with attention, concentration, fatigue, memory and social behavior. They utilized between-group and longitudinal within-subjects designs and all participants were assessed pre and post intervention. The authors administered neuropsychological tests, the Mini Mental Status Test (MMS), the California Verbal Learning Test (CVLT-2), the Stroop Word/Color test and semi-structured interviews, and included neuroimaging with functional and structural MRI. The intervention was a training curriculum that included two 30 minute, one on one piano lessons each week for 8 weeks, with instructions to practice at home for at least 15 minutes a day. The curriculum involved learning to play melodies with each hand separately at first, then playing with both hands together. At each lesson there was repetition of the previous lesson’s objectives in order to facilitate neuroplasticity. The authors collected both qualitative and quantitative results. They found increased neural connectivity in the participant group, mostly located in the orbito-frontal and prefrontal cortices, which was demonstrated in both resting-state and task fMRI. The participants also had improvement in their CVLT-2 scores post intervention.
The authors consider many factors contributing to their outcomes. They reviewed the role of dopamine in learning to play an instrument and its possible impact on the neural changes observed. They discovered that brain areas showing signs of recovery were all related to attention, cognitive control, and social cognition, as well as being areas that receive dopaminergic connections. Six out of the seven participants were able to return to work, with reportedly improved cognitive performance, well-being and ability to engage socially. Limitations of the study included small sample size and lack of control group.
I chose this article because I am interested in learning about alternative interventions that can be utilized with the brain injured population. Despite the study’s limitations, it presents information that supports the notion that learning to play a musical instrument can be good for the brain, whether a person’s brain is recovering from injury or still developing.
THIS MONTH’S REHABILITATION SCIENCE SPOTLIGHT was provided by Molly Keith, M.A., M.S., Fifth Year Psychology Trainee, Neuropsychology Concentration, Nova Southeastern University