Music Therapy Enhances Executive Functions and Prefrontal Structural Neuroplasticity after Traumatic Brain Injury: Evidence from a Randomized Controlled Trial.

Autor: Siponkoski ST; Department of Psychology and Logopedics, Cognitive Brain Research Unit, University of Helsinki, Helsinki, Finland., Martínez-Molina N; Department of Psychology and Logopedics, Cognitive Brain Research Unit, University of Helsinki, Helsinki, Finland., Kuusela L; HUS Medical Imaging Center, Department of Radiology, Helsinki Central University Hospital and University of Helsinki, Helsinki, Finland.; Department of Physics, University of Helsinki, Helsinki, Finland., Laitinen S; Espoo Hospital, Espoo, Finland., Holma M; Musiikkiterapiaosuuskunta InstruMental (Music Therapy Cooperative InstruMental), Helsinki, Finland., Ahlfors M; Private music therapy entrepreneur, Finland., Jordan-Kilkki P; Dialogic Partner Oy, Espoo, Finland., Ala-Kauhaluoma K; Ludus Oy Tutkimus- ja kuntoutuspalvelut (Assessment and Intervention Services), Helsinki, Finland., Melkas S; Department of Neurology and Brain Injury Outpatient Clinic, Helsinki University Central Hospital, Helsinki, Finland., Pekkola J; HUS Medical Imaging Center, Department of Radiology, Helsinki Central University Hospital and University of Helsinki, Helsinki, Finland., Rodriguez-Fornells A; Cognition and Brain Plasticity Group, Bellvitge Biomedical Research Institute, L'Hospitalet de Llobregat, Barcelona, Spain.; Department of Cognition, Development and Educational Psychology, University of Barcelona, Barcelona, Spain.; Catalan Institution for Research and Advanced Studies, Barcelona, Spain., Laine M; Department of Psychology, Åbo Akademi University, Turku, Finland., Ylinen A; Department of Neurology and Brain Injury Outpatient Clinic, Helsinki University Central Hospital, Helsinki, Finland.; Tampere University Hospital, Tampere, Finland., Rantanen P; Kanta-Häme Central Hospital, Hämeenlinna, Finland., Koskinen S; Department of Psychology and Logopedics, University of Helsinki, Helsinki, Finland., Lipsanen J; Department of Psychology and Logopedics, University of Helsinki, Helsinki, Finland., Särkämö T; Department of Psychology and Logopedics, Cognitive Brain Research Unit, University of Helsinki, Helsinki, Finland.
Jazyk: angličtina
Zdroj: Journal of neurotrauma [J Neurotrauma] 2020 Feb 15; Vol. 37 (4), pp. 618-634. Date of Electronic Publication: 2019 Dec 05.
DOI: 10.1089/neu.2019.6413
Abstrakt: Traumatic brain injury (TBI) causes lifelong cognitive deficits, particularly impairments of executive functioning (EF). Musical training and music-based rehabilitation have been shown to enhance cognitive functioning and neuroplasticity, but the potential rehabilitative effects of music in TBI are still largely unknown. The aim of the present crossover randomized controlled trial (RCT) was to determine the clinical efficacy of music therapy on cognitive functioning in TBI and to explore its neural basis. Using an AB/BA design, 40 patients with moderate or severe TBI were randomized to receive a 3-month neurological music therapy intervention either during the first (AB, n  = 20) or second (BA, n  = 20) half of a 6-month follow-up period. Neuropsychological and motor testing and magnetic resonance imaging (MRI) were performed at baseline and at the 3-month and 6-month stage. Thirty-nine subjects who participated in baseline measurement were included in an intention-to-treat analysis using multiple imputation. Results showed that general EF (as indicated by the Frontal Assessment Battery [FAB]) and set shifting improved more in the AB group than in the BA group over the first 3-month period and the effect on general EF was maintained in the 6-month follow-up. Voxel-based morphometry (VBM) analysis of the structural MRI data indicated that gray matter volume (GMV) in the right inferior frontal gyrus (IFG) increased significantly in both groups during the intervention versus control period, which also correlated with cognitive improvement in set shifting. These findings suggest that neurological music therapy enhances EF and induces fine-grained neuroanatomical changes in prefrontal areas.
Databáze: MEDLINE