Brain Advance Access originally published online on February 20, 2008
Brain 2008 131(3):866-876; doi:10.1093/brain/awn013
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Music listening enhances cognitive recovery and mood after middle cerebral artery stroke
1Cognitive Brain Research Unit, Department of Psychology, University of Helsinki, and Helsinki Brain Research Centre, Helsinki, 2Department of Music, University of Jyväskylä, Jyväskylä, 3Department of Neurology and 4Department of Radiology, Helsinki University Central Hospital, Helsinki, 5Department of Psychology, Åbo Akademi University, Turku, Finland and 6Department of Psychology, University of Montreal, Montreal, Canada
Correspondence to: Teppo Särkämö, MA, Cognitive Brain Research Unit, Department of Psychology, PO Box 9 (Siltavuorenpenger 20 C), FIN-00014 University of Helsinki, Finland E-mail: teppo.sarkamo{at}helsinki.fi
We know from animal studies that a stimulating and enriched environment can enhance recovery after stroke, but little is known about the effects of an enriched sound environment on recovery from neural damage in humans. In humans, music listening activates a wide-spread bilateral network of brain regions related to attention, semantic processing, memory, motor functions, and emotional processing. Music exposure also enhances emotional and cognitive functioning in healthy subjects and in various clinical patient groups. The potential role of music in neurological rehabilitation, however, has not been systematically investigated. This single-blind, randomized, and controlled trial was designed to determine whether everyday music listening can facilitate the recovery of cognitive functions and mood after stroke. In the acute recovery phase, 60 patients with a left or right hemisphere middle cerebral artery (MCA) stroke were randomly assigned to a music group, a language group, or a control group. During the following two months, the music and language groups listened daily to self-selected music or audio books, respectively, while the control group received no listening material. In addition, all patients received standard medical care and rehabilitation. All patients underwent an extensive neuropsychological assessment, which included a wide range of cognitive tests as well as mood and quality of life questionnaires, one week (baseline), 3 months, and 6 months after the stroke. Fifty-four patients completed the study. Results showed that recovery in the domains of verbal memory and focused attention improved significantly more in the music group than in the language and control groups. The music group also experienced less depressed and confused mood than the control group. These findings demonstrate for the first time that music listening during the early post-stroke stage can enhance cognitive recovery and prevent negative mood. The neural mechanisms potentially underlying these effects are discussed.
Key Words: stroke; rehabilitation; music; cognition; emotions
Abbreviations: FLAIR, fluid-attenuated inversion recovery; MCA, middle cerebral artery; MRI, magnetic resonance imaging; QOL, quality of life; RT, reaction time
Received September 18, 2007. Revised January 9, 2008. Accepted January 14, 2008.
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