Sensorimotor Plasticity after Music-Supported Therapy in Chronic Stroke Patients Revealed by Transcranial Magnetic Stimulation

Amengual, Julià L.; Rojo, Nuria; Heras, Misericordia Veciana de las; Marco-Pallarés, Josep; Grau-Sánchez, Jennifer; Schneider, Sabine; Vaquero, Lucía; Juncadella, Montserrat; Montero, Jordi; Mohammadi, Bahram; Rubio, Francisco; Rueda, Nohora; Duarte, Esther; Grau, Cai; Altenmüller, Eckart; Münte, Thomas F.; Rodrı́guez-Fornells, Antoni

doi:10.1371/journal.pone.0061883

Cited by 78 publications

(79 citation statements)

References 45 publications

(69 reference statements)

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“…Jamali S 26. and Amengual J.L 27. in their experiment used healthy subjects as a comparator, and their conclusions supported the use of music-supported therapy for chronic stroke patients.…”

Section: Discussionmentioning

confidence: 70%

Improvement in Stroke-induced Motor Dysfunction by Music-supported Therapy: A Systematic Review and Meta-analysis

Zhang

Ren

et al. 2016

Sci Rep

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To conduct a meta-analysis of clinical trials that examined the effect of music-supported therapy on stroke-induced motor dysfunction, comprehensive literature searches of PubMed, Embase and the Cochrane Library from their inception to April 2016 were performed. A total of 10 studies (13 analyses, 358 subjects) were included; all had acceptable quality according to PEDro scale score. The baseline differences between the two groups were confirmed to be comparable. Compared with the control group, the standardized mean difference of 9-Hole Peg Test was 0.28 (−0.01, 0.57), 0.64 (0.31, 0.97) in Box and Block Test, 0.47 (0.08, 0.87) in Arm Paresis Score and 0.35 (−0.04, 0.75) in Action Research Arm Test for upper-limb motor function, 0.11 (−0.24, 0.46) in Berg Balance Scale score, 0.09 (−0.36, 0.54) in Fugl-Meyer Assessment score, 0.30 (−0.15, 0.74) in Wolf Motor Function Test, 0.30 (−0.15, 0.74) in Wolf Motor Function time, 0.65 (0.14, 1.16) in Stride length and 0.62 (0.01, 1.24) in Gait Velocity for total motor function, and 1.75 (0.94, 2.56) in Frontal Assessment Battery score for executive function. There was evidence of a positive effect of music-supported therapy, supporting its use for the treatment of stroke-induced motor dysfunction. This study was registered at PRESPERO (CRD42016037106).

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Section: Discussionmentioning

confidence: 70%

Improvement in Stroke-induced Motor Dysfunction by Music-supported Therapy: A Systematic Review and Meta-analysis

Zhang

Ren

et al. 2016

Sci Rep

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“…In this grid there were two perpendicular axes where the x -axis is horizontal and the y -axis is vertical (two-dimensional, Cartesian coordinate system). Stimulation sites were defined following x and y axes and becoming coordinates ( x, y ) in the grid (Amengual et al, 2013). …”

Section: Methodsmentioning

confidence: 99%

“…Gains in motor function were accompanied by changes in motor cortex excitability (evaluated using motor mapping TMS) with an expansion of the cortical representation of the hand and by activation changes in fMRI (Rojo et al, 2011; Rodríguez-Fornells et al, 2012). In addition, Amengual et al (2013) have reported evidence from a group of chronic patients that have been treated with MST. Patients improved their motor function as well as an increase of the excitability of the motor system was encountered.…”

Section: Introductionmentioning

confidence: 99%

Plasticity in the sensorimotor cortex induced by Music-supported therapy in stroke patients: a TMS study

Grau-Sánchez¹,

Amengual²,

Rojo³

et al. 2013

Front. Hum. Neurosci.

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Playing a musical instrument demands the engagement of different neural systems. Recent studies about the musician's brain and musical training highlight that this activity requires the close interaction between motor and somatosensory systems. Moreover, neuroplastic changes have been reported in motor-related areas after short and long-term musical training. Because of its capacity to promote neuroplastic changes, music has been used in the context of stroke neurorehabilitation. The majority of patients suffering from a stroke have motor impairments, preventing them to live independently. Thus, there is an increasing demand for effective restorative interventions for neurological deficits. Music-supported Therapy (MST) has been recently developed to restore motor deficits. We report data of a selected sample of stroke patients who have been enrolled in a MST program (1 month intense music learning). Prior to and after the therapy, patients were evaluated with different behavioral motor tests. Transcranial Magnetic Stimulation (TMS) was applied to evaluate changes in the sensorimotor representations underlying the motor gains observed. Several parameters of excitability of the motor cortex were assessed as well as the cortical somatotopic representation of a muscle in the affected hand. Our results revealed that participants obtained significant motor improvements in the paretic hand and those changes were accompanied by changes in the excitability of the motor cortex. Thus, MST leads to neuroplastic changes in the motor cortex of stroke patients which may explain its efficacy.

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“…Superior motor control in daily activities is achieved with MST, as compared to conventional physical therapy (Schneider et al, 2007). Gains in motor skills by MST are related to increased ipsilesional MI excitability (Amengual et al, 2013; Grau-Sanchez et al, 2013), and the reinforcement of functional connectivity between auditory and premotor regions (Rodriguez-Fornells et al, 2012). Although mechanisms rendering the motor system sensitive to auditory priming and timing of stimulation still need to be elucidated, there is evidence suggesting that the time structure of music, namely the rhythm, is the essential element relating music specifically to motor behavior.…”

Section: Sensory-based Strategies To Enhance Post-stroke Motor Recmentioning

confidence: 99%

The sensory side of post-stroke motor rehabilitation

Bolognini

Russo

Edwards

2016

RNN

135

115

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Contemporary strategies to promote motor recovery following stroke focus on repetitive voluntary movements. Although successful movement relies on efficient sensorimotor integration, functional outcomes often bias motor therapy toward motor-related impairments such as weakness, spasticity and synergies; sensory therapy and reintegration is implied, but seldom targeted. However, the planning and execution of voluntary movement requires that the brain extracts sensory information regarding body position and predicts future positions, by integrating a variety of sensory inputs with ongoing and planned motor activity. Neurological patients who have lost one or more of their senses may show profoundly affected motor functions, even if muscle strength remains unaffected. Following stroke, motor recovery can be dictated by the degree of sensory disruption. Consequently, a thorough account of sensory function might be both prognostic and prescriptive in neurorehabilitation. This review outlines the key sensory components of human voluntary movement, describes how sensory disruption can influence prognosis and expected outcomes in stroke patients, reports on current sensory-based approaches in post-stroke motor rehabilitation, and makes recommendations for optimizing rehabilitation programs based on sensory stimulation.

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Sensorimotor Plasticity after Music-Supported Therapy in Chronic Stroke Patients Revealed by Transcranial Magnetic Stimulation

Cited by 78 publications

References 45 publications

Improvement in Stroke-induced Motor Dysfunction by Music-supported Therapy: A Systematic Review and Meta-analysis

Improvement in Stroke-induced Motor Dysfunction by Music-supported Therapy: A Systematic Review and Meta-analysis

Plasticity in the sensorimotor cortex induced by Music-supported therapy in stroke patients: a TMS study

The sensory side of post-stroke motor rehabilitation

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