Rhythm and Brain: Music in the Cognitive, Emotional, Motor, and Neural Rehabilitation of Traumatic Brain Injury

  • Särkämö, Teppo (Project manager)
  • Siponkoski, Sini-Tuuli (PI)
  • Tervaniemi, Mari (Participant)
  • Koskinen, Sanna (Participant)
  • Ala-Kauhaluoma, Katja (Participant)
  • Rantanen, Pekka (Participant)
  • Sarajuuri, Jaana (Participant)
  • Melkas, Susanna (Participant)
  • Ylinen, Aarne (Participant)
  • Lotvonen, Veera (Participant)
  • Pekkola, Johanna, HUS Medical Imaging Centre, Helsinki University Central Hospital (Participant)
  • Kuusela, Linda (Participant)
  • Peltonen, Juha (Participant)
  • Sairanen, Viljami, HUS Medical Imaging Centre, Helsinki University Central Hospital (Participant)
  • Laitinen, Sari (Participant)
  • Holma, Milla (Participant)
  • Ahlfors, Mirja (Participant)
  • Ala-Ruona, Esa (Participant)
  • Jordan-Kilkki, Päivi (Participant)
  • Rodriguez-Fornells, Antoni (Participant)
  • Martinez Molina, Noelia (Participant)
  • Ripollés, Pablo (Participant)
  • Zasler, Nathan (Participant)

Project Details

Description

BACKGROUND AND AIMS: Traumatic brain injury (TBI) is one of the leading causes of serious, life-long disability. Especially the cognitive, emotional, and motors deficits caused by TBI often impair everyday psychosocial functioning, quality of life (QoL) and ability to work dramatically, thereby bringing about enormous suffering and burden to the patients and their families as well as substantial social and economic costs to the society. Early rehabilitation is highly important for restoring lost skills and functioning, but often very difficult given the severity and extent of the TBI symptoms and the high strain that the available rehabilitation methods put on the patients. Music therapy is a highly motivating, versatile, and applicable form of TBI rehabilitation, but currently there is little scientific evidence for its efficacy or mechanisms in the TBI population. The purpose of the present project was to determine the long-term effect of neurological music therapy on motor, cognitive, emotional, and social recovery after TBI and to study the neural mechanisms that underlie behavioural recovery and the efficacy of music.

METHODS: The study was a single-blind, cross-over randomized controlled trial (RCT) involving 40 patients with a moderate / severe TBI who were followed for 18 months. Using an AB/BA design, the patients received neurological music therapy intervention (20 session, 2 x week) in addition to standard care either during the first (AB group) or second (BA group) 3-month period of the study. The intervention utilized structured cognitive-motor training with drums and creative musical expression (music playing, song writing) with piano and Figure Notes. The progression of the recovery was assessed from baseline to 3-month and 6-month stages using neuropsychological and motor tests; questionnaires about mood and quality of life (QoL); and modern structural and functional magnetic resonance imaging (MRI) methods, including voxel-based morphometry (VBM), diffusion tensor imaging (DTI) and functional MRI (fMRI) measured at rest and during a rhythmic task. Questionnaires were also performed at the 18-month stage.

IMPLEMENTATION: The project was a joint collaborative effort between the Cognitive Brain Research Unit (CBRU) of University of Helsinki, Validia Rehabilitation Helsinki, the Brain Injury Outpatient Clinic of Helsinki-Uusimaa Hospital District, the Department of Music of University of Jyväskylä, and the Bellvitge Biomedical Research Institute of the University of Barcelona. The project was carried out during 2014-2018 by an experienced multidisciplinary research team comprising experts in the fields of neuropsychology, neurology, radiology, cognitive neuroscience, music therapy, and physical therapy.

RESULTS: At the moment, the results from the neuropsychological test, motor test, and VBM data are analysed and submitted for publication and the results from the questionnaire, DTI, and fMRI data are currently being analysed and are in preparation for publication. The neuropsychological results showed that general executive functioning improved more in the AB group than in the BA group over the 3-month and 6-month periods. Both groups also showed an improvement in set shifting and vigilance performance during the intervention period compared to the control period. VBM results further showed that grey matter volume (GMV) in the right inferior frontal gyrus (IFG) increased significantly in both groups during the intervention vs. control period, which also correlated with cognitive improvement in set shifting.

CONCLUSIONS: Currently, the study provides the first evidence that neurological music therapy is effective in the rehabilitation of executive functioning and in inducing fine-grained structural neuroplasticity changes in prefrontal areas. The potential benefits of the intervention on subjective well-being (mood and QoL questionnaires) and on structural and functional connectivity of brain regions (DTI and fMRI data) are currently being explored.
StatusFinished
Effective start/end date01/01/201431/12/2018

Fields of Science

  • 515 Psychology
  • 3124 Neurology and psychiatry
  • 3112 Neurosciences
  • 6131 Theatre, dance, music, other performing arts
  • 316 Nursing

Equipment

Cognitive Brain Research Unit

Teija Kujala (Manager) & Mari Tervaniemi (Manager)

Facility/equipment: Equipment

Research Output

Music therapy enhances executive functions and prefrontal structural neuroplasticity after traumatic brain injury: Evidence from a randomized controlled trial

Siponkoski, S-T., Martinez Molina, N., Kuusela, L., Laitinen, S., Holma, M., Ahlfors, M., Jordan-Kilkki, P., Ala-Kauhaluoma, K., Melkas, S., Pekkola, J., Rodriguez-Fornells, A., Laine, M., Ylinen, A., Rantanen, P., Koskinen, S., Lipsanen, J. & Särkämö, T., 15 Feb 2020, In : Journal of Neurotrauma. 37, 4, p. 618-634 17 p.

Research output: Contribution to journalArticleScientificpeer-review

Golden oldies and silver brains: Deficits, preservation, learning, and rehabilitation effects of music in ageing-related neurological disorders

Sarkamo, T. & Sihvonen, A. J., Dec 2018, In : Cortex. 109, p. 104-123 20 p.

Research output: Contribution to journalReview ArticleScientificpeer-review

Open Access
File

Music-based interventions in neurological rehabilitation

Sihvonen, A. J., Särkämö, T., Leo, V., Tervaniemi, M., Altenmueller, E. & Soinila, S., Aug 2017, In : Lancet Neurology. 16, 8, p. 648-660 13 p.

Research output: Contribution to journalReview ArticleScientificpeer-review

Open Access
File

Activities

  • 2 Academic visit at UH
  • 1 Supervisor or co-supervisor of doctoral thesis
  • 1 Supervision of other thesis (Master's, Licentiate)

Noelia Martinez-Molina

Teppo Särkämö (Host)

2018 → …

Activity: Hosting a visitor typesAcademic visit at UH

Jennifer Grau

Teppo Särkämö (Host)

30 Nov 201527 Feb 2016

Activity: Hosting a visitor typesAcademic visit at UH

Co-Supervisor, Doctoral Thesis, Sini-Tuuli Siponkoski (University of Helsinki)

Teppo Särkämö (Supervisor)

2013 → …

Activity: Examination typesSupervisor or co-supervisor of doctoral thesis

Prizes

Cortex Prize

Särkämö, Teppo (Recipient), 15 Sep 2017

Prize: Prizes and awards