Singing 'Rewires' Damaged Brain

Subject: Singing 'Rewires' Damaged Brain
From: bobad
Date: 21 Feb 10 - 07:49 AM

Singing 'rewires' damaged brain
By Victoria Gill
Science reporter, BBC News, San Diego

Teaching stroke patients to sing "rewires" their brains, helping them recover their speech, say scientists.

By singing, patients use a different area of the brain from the area involved in speech.

If a person's "speech centre" is damaged by a stroke, they can learn to use their "singing centre" instead.

Researchers presented these findings at the annual meeting of the American Association for the Advancement of Science (AAAS) in San Diego.

An ongoing clinical trial, they said, has shown how the brain responds to this "melodic intonation therapy".

Gottfried Schlaug, a neurology professor at Beth Israel Deaconess Medical Center and Harvard Medical School in Boston, US, led the trial.

The therapy is already established as a medical technique. Researchers first used it when it was discovered that stroke patients with brain damage that left them unable to speak were still able to sing.

Professor Schlaug explained that his was the first study to combine this therapy with brain imaging - "to show what is actually going on in the brain" as patients learn to sing their words.

Making connections

Most of the connections between brain areas that control movement and those that control hearing are on the left side of the brain.

"But there's a sort of corresponding hole on the right side," said Professor Schlaug.

"For some reason, it's not as endowed with these connections, so the left side is used much more in speech.

"If you damage the left side, the right side has trouble [fulfilling that role]."

But as patients learn to put their words to melodies, the crucial connections form on the right side of their brains.

Previous brain imaging studies have shown that this "singing centre" is overdeveloped in the brains of professional singers.

During the therapy sessions, patients are taught to put their words to simple melodies.

Professor Schlaug said that after a single session, a stroke patients who was are not able to form any intelligible words learned to say the phrase "I am thirsty" by combining each syllable with the note of a melody.

The patients are also encouraged to tap out each syllable with their hands. Professor Schlaug said that this seemed to act as an "internal pace-maker" which made the therapy even more effective.

"Music might be an alternative medium to engage parts of the brain that are otherwise not engaged," he said.

Brain sounds

Dr Aniruddh Patel from the Neurosciences Institute in San Diego, said the study was an example of the "explosion in research into music and the brain" over the last decade.

"People sometimes ask where in the brain music is processed and the answer is everywhere above the neck," said Dr Patel.

"Music engages huge swathes of the brain - it's not just lighting up a spot in the auditory cortex."

Dr Nina Kraus, a neuroscientist from Northwestern University in Chicago, also studies the effects of music on the brain.

In her research, she records the brain's response to music using electrodes on the scalp.

This work has enabled her to "play back" electrical activity from brain cells as they pick up sounds.

"Neurons work with electricity - so if you record the electricity from the brain you can play that back through speakers and hear how the brain deals with sounds," she explained.

Dr Kraus has also discovered that musical training seems to enhance the ability to perform other tasks, such as reading.

She said that the insights into how the brain responds to music provided evidence that musical training was an important part of children's education.

Subject: RE: Singing 'Rewires' Damaged Brain
From: Richard Bridge
Date: 21 Feb 10 - 07:58 AM

At most folk festivals you will find some for whom the process seems to have been the obverse.

Subject: RE: Singing 'Rewires' Damaged Brain
From: Steve Parkes
Date: 21 Feb 10 - 07:58 AM

It's long been known that stammerers can usually sing without problems. Different brain pathways, ny bro the nurse tells me. I find it much easier to sing in, say, French or German than to speak, particularly with the accent.

Subject: RE: Singing 'Rewires' Damaged Brain
From: maeve
Date: 21 Feb 10 - 07:58 AM

Thanks for posting this interesting article. This may be one reason I could still sing when chronic migraines had shut off my speaking ability.

maeve

Subject: RE: Singing 'Rewires' Damaged Brain
From: Rumncoke
Date: 21 Feb 10 - 02:24 PM

My mother in law used to work with stroke patients who were having speach problems - and noted that almost all of them were men, and that they could usually swear most wonderfully in their frustration at the lack of ordinary words.

She wondered if the imbalance of the sexes was because it is a lot more difficult to shut up a woman, or if the families were enjoying the quietness too much....

Anne Croucher

Subject: RE: Singing 'Rewires' Damaged Brain
From: michaelr
Date: 21 Feb 10 - 06:41 PM

Please link this to the Jean Ritchie stroke thread.

Subject: RE: Singing 'Rewires' Damaged Brain
From: Charley Noble
Date: 21 Feb 10 - 08:43 PM

This is intriguing, that the songs we learn go to "singing centre" of the brain. Obviously the habitual users of the RUSSB (Blue Books) are not making use of this resource and do not have this protection in the event of a stroke; they should take note.

That being said I'm happy to learn that my ever increasing inventory of arcane songs has some useful personal function for my survival. Lord knows it's hasn't a lucrative one.

Charley Noble

Subject: RE: Singing 'Rewires' Damaged Brain
From: JennieG
Date: 21 Feb 10 - 10:00 PM

Too true, Charlie....

I had also heard of the stammering/singing link.

Cheers
JennieG

Subject: RE: Singing 'Rewires' Damaged Brain
From: Beer
Date: 21 Feb 10 - 10:24 PM

Very close friend of mine has a terrible stammering problem. But you would never know it when we have the opportunity to sing together.
Great find Bobad.
Beer (adrien)

Subject: Singing 'rewires' damaged brain
From: mauvepink
Date: 22 Feb 10 - 04:03 AM

Singing 'rewires' damaged brain in stroke survivors

Take a look at this article. Sounds full of promise. However, if my experiences of people who have had a stroke and the NHS are anything to go by, there will be lots of missed opportunities. I was trained that for a stroke survivor to have the best chance of recovering speech, when it has been affected by the stroke, is the most urgent intervention of a speech therapist. Sadly there seems a shortage of speech therapists generally so delays inevtiably affect potential recoveries.

What would be interesting, if the approach in the article was taken up, would be to see who would do the therapy: speech therapists, music teachers, or a combination of both?

Your thoughts?

mp

Subject: RE: Singing 'rewires' damaged brain
From: Dave the Gnome
Date: 22 Feb 10 - 04:08 AM

Many years ago a good friend, now departed due to another condition sadly, was given this advice by a therapist after he had a stroke. He started to go to folk clubs and became realy involved in singing shanties - Did him a lot of good. This was in the Manchester area so I guess there are people already on the case around here. I don't know how widespread it is though.

Cheers

Dave

Subject: RE: Singing 'Rewires' Damaged Brain
From: Sandra in Sydney
Date: 22 Feb 10 - 05:14 AM

I've known 2 good singers who stuttered badly. I've also known a singer who was paid for helping a brain-damaged woman to sing, as part of her Hospital treatment

There's been a thread about the singing/stuttering pathways in the past.

sandra

Subject: RE: Singing 'rewires' damaged brain
From: Dave the Gnome
Date: 22 Feb 10 - 06:06 AM

I think there are two threads on this subject - Can a mudelf please combine?

Ta

D.

---

Done. -Joe-

Subject: RE: Singing 'rewires' damaged brain
From: GUEST
Date: 22 Feb 10 - 07:42 AM

most urgent intervention of a speech therapist

When Patricia Neal had a brain haemorrhage, Roald Dahl was told the best therapy was just to get people to talk to her - constantly. After paying huge sums to professional nurses to do this in California, he upped-sticks and took his near zero bank account to a quiet village in the UK. He got family & in-laws who marshalled the village (mostly housewives) to just spend an 2 hours per person with her and they just talked. And probably had some really odd conversations! She had scrambled word association to start with. He had to work to pay to live.

She even got back to acting in the end.

It is the talking that does it. I am sure he had professional advice along with it, but think how a baby learns - by immitation.

We had a docu-drama on British TV showing the story, but I have heard him (& her) talk about it.

Subject: RE: Singing 'Rewires' Damaged Brain
From: GUEST,Mr Red
Date: 22 Feb 10 - 07:44 AM

duplicate thread

Subject: RE: Singing 'Rewires' Damaged Brain
From: Hawker
Date: 22 Feb 10 - 07:52 AM

Having had a mini stroke a number of years ago, I am certain that both singing and determinedly learning to read music and play played a BIG part in my recovery.
Cheers, Lucy

Subject: RE: Singing 'rewires' damaged brain
From: mauvepink
Date: 22 Feb 10 - 10:40 AM

My apologies for the twinned thread. I'll withdraw off this one as I had no idea at the time I started this

mp

Subject: RE: Singing 'Rewires' Damaged Brain
From: Cats
Date: 22 Feb 10 - 12:59 PM

Taffy Thomas used stories to help him speak again after his stroke, the repetition being the same process as singing, and I know of quite a few folkies who have used song to get their speech back, some in welsh. It is not new but it is timely and always a good idea to flag it up from time to time

Subject: RE: Singing 'Rewires' Damaged Brain
From: Vic Smith
Date: 22 Feb 10 - 01:15 PM

After his major stroke, my dad could no longer speak, but if I sang his favourite songs to him, he was able to join in.

Subject: RE: Singing 'Rewires' Damaged Brain
From: Pulseroom
Date: 22 Feb 10 - 03:54 PM

I would recommend reading: The Musical Mind: The Cognitive Psychology of Music, the same auther also wrote a later version: Exploring the Musical Mind: Cognition, Emotion, Ability, Function

Fantastic really.

Subject: RE: Singing 'Rewires' Damaged Brain
From: Dharmabum
Date: 22 Feb 10 - 07:36 PM

This past Sept,my 30 year old daughter,Shalisa, was admitted to the Thomas Jefferson hospital in Philadelphia, with double vision,slurred speech,headaches,short term memory loss & dementia.
After a 10 day stay,which included numerous tests,scans and a biopsy of her brain,we were handed the diagnoses of terminal cancer.
Numbness,best describes the emotions we initially had to deal with.
Followed closely by devastation.
Ironically,my daughter was probably in the best emotional state at the time,as she had no memory of the diagnoses that the doc's had given her.
The next six hours was most likely the hardest I'd ever spent as a father.
Then,we got the call from the hospital.
They were uncertain of the cancer diagnoses,could we please bring her back to the hospital.

After an additional 5 day hospital stay & another battery of tests, we were given the diagnoses of something very rare & barely pronounceable,called,Metachromatic Leukodystrophy.

Not great,& no known cure,but not cancer.
And a slightly better prognoses in adults than in children.

At our last meeting with the neurology team at Thomas Jefferson ,we were told that they were again not 100% certain with the diagnoses,but her insurance would not cover further testing.
The best diagnoses they would commit to was a form of Leukodystrophy that had caused a demylinization (exposed nerves) in a large part of her brain.
This was late Oct.

We've since started seeing the neurology staff at the University Hospital in Philadelphia,& new testing has begun. (Hopefully,insurance will cover what needs to be done)

Shalisa is doing relatively well at this time.
Physically,she's dealing with a fair amount of fatigue & a bit of unsteadiness.
The headaches,double/blurred vision have almost completely subsided,& her speech is once again normal.
The most prominent & lingering symptom is her short term memory loss.
On a good day,Shalisa cannot retain any information for more than 5 minutes.

My daughter & I have played music together for many years.
She,as a young girl,showed a natural ability for guitar,pennywhistle,flute,keyboards.
I'm happy to say that she's retained most of her personality & quite a bit of her musical ability throughout this ordeal.
Though,some days it may be only be a 5 minute session,we're still playing together,and I have confidence we'll continue doing so for many years to come.

I've been told that recovering from brain injury is not so much about getting back to "normal",as much as it's about achieving a "new" normal.
Whatever that new state may be,I'm sure that our music,combined with all the other forms of rehabilitation we've undertaken,will be a very signifigant part in achieving that goal.
We're all very hopeful and positive about Shalis's recovery.

Please excuse the long winded post.
I've been hauling this around in my head for the past couple of months,& just needed to shake it outta there.

    Ron.

Subject: RE: Singing 'Rewires' Damaged Brain
From: Sandra in Sydney
Date: 23 Feb 10 - 05:41 AM

Ron - that's a lot to carry around.

The bit that hits me is that tests stopped because insurance wouldn't cover them.

Good luck & best wishes for your daughter's treatment & ongoing health & music!

sandra (who lives with a different health system)

Subject: RE: Singing 'Rewires' Damaged Brain
From: sciencegeek
Date: 23 Feb 10 - 06:47 AM

Saw Jerry Epstein this weekend and while he still has issues, it was wonderful to hear him singing again.

Music does more than just soothe the savage breast... :)

Subject: RE: Singing 'Rewires' Damaged Brain
From: Dharmabum
Date: 23 Feb 10 - 07:59 AM

Thank you Sandra.

"The bit that hits me is that tests stopped because insurance wouldn't cover them."

Unfortunately,that's what happens when large corporations control the healthcare system.
People will suffer at the hands of proffit.

Honestly though,at this point,I've got no time or energy to spare for negativity towards anything.
We'll pick ourselves up,dust ourselves off & keep going.

Shalisa's got an incredible network of family & friends supporting her.
( As I'm writing,I can hear her singing in the next room)

Ron.

Subject: RE: Singing 'Rewires' Damaged Brain
From: M.Ted
Date: 23 Feb 10 - 10:38 AM

Good thoughts from me, too, Ron. I've been there, too, and in Philly, at that, so I know a couple things that might be helpful, like how to get that medical stuff covered, short term and long, even if insurance won't cover it. I'm sending you a PM--

Subject: RE: Singing 'Rewires' Damaged Brain
From: JohnB
Date: 23 Feb 10 - 10:56 AM

I have a friend in Toronto, who has a stroke a couple of years ago.
He was bad for about a week and then made basically a full recovery.
I remember him telling me many months later that he had short term memory loss, in that he lost recently learned songs and tunes (he plays concertina). Fortunately the old stuff stuck around.
JohnB.

Subject: RE: Singing 'Rewires' Damaged Brain
From: Dharmabum
Date: 23 Feb 10 - 11:56 AM

Anything before August is still there in her memory.
A little rusty,but there.

I'm convinced that for the time being,whatever information she's presently recieving,is being stored in her brain,we just have to discover how to access it.

Having lived with MS now for the past 26 years,I'm fully convinced that the human body has the capability to re route nerve signals.

Music has been a great rehabilitative tool for me,as I'm sure it will be for her.

We've also got Shalisa doing as many mind stimulating exercises as possible.
One avenue I'd like to research is smell or "ollifactory"sp? therapy.
I don't know if there's been any research done on it,but I know I've experienced certain smells triggering certain memories.

M.Ted,thanks,we're always open to suggestions.
We've jumped through a fair amount of thr appropriate "hoops" so far,& it looks like we're starting to get a handle on the insurance thing.
But as they say,the wheels of progress do move slowly.

Ron.

Subject: RE: Singing 'Rewires' Damaged Brain
From: wysiwyg
Date: 23 Feb 10 - 12:36 PM

Ron,

Well that explains why YOU have been on our minds (in our prayers) of late.

First reaction: Not SHALISA!

Second reaction: She has the perfect dad for this though.

PM for current contact info?

Love ya,

~Susan & Greg

Subject: RE: Singing 'Rewires' Damaged Brain
From: GUEST,Stringsinger
Date: 23 Feb 10 - 01:04 PM

You know, Alzheimer's patients can sing songs they learned many years ago.
The memory part of singing is physiological. You learn from voicing the words aloud
through muscle memory of the lips, teeth, tongue and other aspects of vocal production.
Have you noticed that you can remember songs that you learned long ago easier than those just learned recently?

I believe that music is a healing therapeutic agent and have seen it do wonders for people in need of help or not. It's revelatory to see people in nursing homes who enter not speaking to anyone suddenly get up and sing a song they learned years ago. This is an agent that
helps bring them back into a social community.

Subject: RE: Singing 'Rewires' Damaged Brain
From: Desert Dancer
Date: 16 Jan 12 - 11:27 AM

Singing Therapy Helps Stroke Patients Speak Again

by Richard Knox
National Public Radio, Dec. 26, 2010

Debra Meyerson was hiking near Lake Tahoe 15 months ago when a stroke destroyed part of the left side of her brain, leaving her literally speechless. It happens to more than 150,000 Americans a year.

But now Meyerson is learning to talk again through an approach that trains the undamaged right side of her brain to "speak." Specifically, it's a region that controls singing.

For more than 100 years, it's been known that people who can't speak after injury to the speech centers on the left side of the brain can sing.

In the 1970s, Boston researchers started to use a sort of "singing therapy" to help stroke survivors speak again.

However, it never caught on much – perhaps because a lot of therapists, not to mention patients, weren't comfortable singing what they wanted to say. And back then, the science wasn't advanced enough to show the actual changes in the brain that result from the therapy.

That's changing fast.

Congresswoman Gabrielle Giffords, who has had a version of "singing therapy," astounded everyone by her ability to speak again – albeit so far in single words and short phrases. Nearly a year ago, a would-be assassin's bullet tore through the speech center in Giffords' left brain.

Singing Sessions

Less visibly, an NIH-funded study at the Beth Israel Deaconess Medical Center in Boston may be the first rigorous trial of singing therapy. They call it melodic intonation therapy. Post-stroke patients are assigned to a form of conventional speech therapy or to singing therapy. They undergo 90 minutes of treatment a day for 15 weeks.

Debra Meyerson, 54, is a volunteer in that study. Her aphasia is a cruel twist of fate. Meyerson is an expert in gender and race relations who was a dynamic and popular speaker before her stroke. After a year of conventional speech therapy, she couldn't speak more than a word or two.

When NPR sat in on one of her therapy sessions recently, Meyerson still struggled to speak even the simplest phrases. But she's beginning to talk again.

"If you go to a restaurant and the server asks if you'd like something before your main dish, you might choose something like this," therapist Andrea Norton says, showing Meyerson a picture of a salad. Then Norton sings the word "salad," intoning the syllables on a minor third – the tune every child knows from the taunt "nyah-nyah! nyah-nyah!"

Norton slows everything down. That's critical because the right side of Meyerson's brain – the singing part that's being retrained to "speak" – is good at melody and pitch, but it's not as fast as the left-sided language center, called Broca's area.

It's also not as good at the rhythmic components of speech. That's why Norton taps Meyerson's left hand (controlled by the right brain). The tapping entrains the rhythms of speech and engages the motor nerves needed to produce speech in Meyerson's mouth and throat.

Then she shifts to a different phase – bridging the gap between singing and speaking. First Norton has Meyerson sing the phrase "Would you pour me a glass, please?" Next the therapist says it with exaggerated diction that's in between singing and normal speech.

Then, gratifyingly, Norton speaks the sentence. "Would you pour me a glass, please?" she says. "Nice!" Norton says.

Watching this laborious process, you might not appreciate the remarkable thing that's going on inside the brains of patients like Meyerson. The Harvard team has evidence that melodic intonation therapy actually remolds the brain.

Growing Nerves

One of the clearest examples is Laurel Fontaine, a 16-year-old sophomore at North Attleborough High School in southeastern Massachusetts. A little more than four years ago, when Laurel was 11, she suffered a devastating stroke – unusual in a child, but not as rare as you might think.

Laurel's stroke destroyed 80 percent of the left side of her brain. One of her doctors says it's the biggest stroke he's ever seen.

"My doctor told me I'm not going to talk, I'm not going to walk, I'm not going to, like, do anything...press buttons...ever," she says.

After a year of conventional speech therapy, Laurel could speak only a word or two at a time. Then her mother persuaded the Beth Israel Deaconess researchers to let Laurel enroll in their research project.

The singing therapy lasted only about four months, but it's had permanent effects. Though Laurel still struggles sometimes to find the words she wants, she doesn't have to sing them out loud.

"I'm singing in my head and talking out loud without singing," she says between classes. "I do it, like, really quick."

Laurel offered the researchers a big bonus – an identical twin sister named Heather. So the researchers could use MRI scans to compare the girls' brains. They focused on a structure on the right side that's important for singing.

Before Laurel began melodic intonation therapy, that structure was smaller in her brain compared to Heather's. That's probably because she hadn't been doing anything with her voice for a whole year.

But during therapy, scans showed that nerve fibers in Laurel's right-sided singing center actually grew – they clearly multiplied and thickened. With therapy, those nerve bundled got bigger than the corresponding region in Heather's brain.

Dr. Gottfried Schlaug, who heads the study, says that's exactly what he was looking for.

"It is the perfect confirmation," he says. "Basically, the hardware of the system really changed to support this increased vocal output."

And Laurel continues to improve. It's possible, Schlaug says, that when Laurel is in her 20s, someone who didn't know any better would never suspect she ever had a massive stroke that left her unable to speak.

The Age Factor

But how much of her remarkable recovery is because Laurel was so young when her brain was injured? Schlaug says her youth was definitely a factor.

"However, we know that patients even in their 80s can show plastic changes to their brain, can show adaptations," he says. It just may take longer. And, as with learning a foreign language at a later age, an older brain may never get to the same level.

From his work with older patients Schlaug says a surprising amount of recovery is possible. He also reports good results working with autistic children and people with Parkinson's disease who have trouble speaking.

Schlaug thinks singing therapy can be enhanced by simultaneously stimulating the brain with painless, low-voltage electricity – and one day, possibly, by drugs.

For now, it takes an incredible amount of willpower. Meyerson can testify to that.

"Recovery is long and hard," Meyerson told Laurel Fontaine recently when therapist Andrea Norton brought them together.

"Well, it's hard at first," Laurel told the older woman. "But you can get used to it. I'm getting better all the time. Don't get frustrated."

"Yes...yes...thank you!" Meyerson replied, clearly moved by Laurel's example.

Clearly Laurel's a star and Deb Meyerson has a long way to go. But she's determined to get there. By next Labor Day — the second anniversary of her stroke — Meyerson wants to start public speaking again, this time as an advocate for better stroke care.