TY - JOUR
T1 - Music therapy enhances executive functions and prefrontal structural neuroplasticity after traumatic brain injury
T2 - Evidence from a randomized controlled trial
AU - Siponkoski, Sini-Tuuli
AU - Martinez Molina, Noelia
AU - Kuusela, Linda
AU - Laitinen, Sari
AU - Holma, Milla
AU - Ahlfors, Mirja
AU - Jordan-Kilkki, Päivi
AU - Ala-Kauhaluoma, Katja
AU - Melkas, Susanna
AU - Pekkola, Johanna
AU - Rodriguez-Fornells, Antoni
AU - Laine, Matti
AU - Ylinen, Aarne
AU - Rantanen, Pekka
AU - Koskinen, Sanna
AU - Lipsanen, Jari
AU - Särkämö, Teppo
PY - 2020/2/15
Y1 - 2020/2/15
N2 - 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
AB - 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
KW - 515 Psychology
KW - 6162 Cognitive science
KW - 6131 Theatre, dance, music, other performing arts
KW - 3124 Neurology and psychiatry
KW - 3112 Neurosciences
U2 - 10.1089/neu.2019.6413
DO - 10.1089/neu.2019.6413
M3 - Article
SN - 0897-7151
VL - 37
SP - 618
EP - 634
JO - Journal of Neurotrauma
JF - Journal of Neurotrauma
IS - 4
ER -