Adaptation of Melodic Intonation Therapy to Greek: A Clinical Study in Broca’s Aphasia With Brain Perfusion SPECT Validation

Abstract

Melodic intonation therapy (MIT) is one of the most well-known treatment methods which is based on pitch and rhythm and was developed to increase verbal output in adults with non-fluent aphasia. Although MIT has been adapted to several languages, in Greece it is almost unknown. The aim of the proposed study is twofold: (1) to translate and adapt the MIT to the Greek language, and (2) to conduct an experimental study in order to examine the effect of MIT on Greek patients with Broca’s aphasia. To this aim, a 64-year-old, right-handed male who had a 6-year primary school education level, no musical abilities and poor performance on the recognition of prosody attended the MIT intervention program almost two and a half years after the event of suffering an ischemic stroke. The MIT intervention was administered three times per week for a 12-week period, in which each session lasted from 30 to 40 min. The patient underwent three assessments all using both the Boston Diagnostic Aphasia Examination–Short Form (BDAE-SF) and brain perfusion single-photon emission computed tomography (SPECT); (1) before the MIT, (2) immediately after, and (3) 3 months after the completion of MIT. The results from the BDAE-SF revealed an impressive improvement on both trained and prepositional speech production, immediately after the completion of the MIT, and a stable improved performance 3 months after MIT. The SPECT scan revealed reactivation of the perilesional areas of the left hemisphere, and considerably improved perfusion of the frontal lobe, the anterior temporal lobe, and the upper part of the parietal lobe of the right hemisphere. The improvement persisted and even expanded 3 months after MIT. Therefore, MIT is a promising intervention program and its positive effects last for at least 3 months after the completion of the intervention.

Melodic Intonation Therapy in Post-Stroke Non-Fluent Aphasia and Its Effects on Brain Plasticity

“…According to the design, six records were a series of cases [ 21 , 22 , 23 , 24 , 25 , 26 , 27 ] and five were studies with a unique case [ 18 , 19 , 28 , 29 , 30 ]. Two articles compared MIT with another therapy [ 31 , 32 ] and another two studies with a group of untreated participants [ 27 , 33 ].…”

“…Magnetoencephalography was used in another study to examine cerebral activity during an action-naming task [ 23 ]. Finally, Single-Photon Emission Computed Tomography (SPECT) was used in three studies to observe neuronal reorganization after MIT [ 28 ], language activation with simple repetition and MIT [ 25 ], and brain activity during rest, ordinary repetition, and MIT [ 19 ].…”

“…Finally, several articles reported an involvement of both hemispheres [ 19 , 21 , 25 , 28 , 34 ]. In the cases that used SPECT to measure regional cerebral blood flow, an increase in perfusion was observed, mainly in the fronto-temporal regions in the left and also right hemisphere [ 19 , 25 , 28 ].…”

“…Finally, several articles reported an involvement of both hemispheres [ 19 , 21 , 25 , 28 , 34 ]. In the cases that used SPECT to measure regional cerebral blood flow, an increase in perfusion was observed, mainly in the fronto-temporal regions in the left and also right hemisphere [ 19 , 25 , 28 ]. Merrett et al [ 34 ] evidenced a deactivation of the peri-lesional areas in the left hemisphere concerning an activation of right frontal and bilateral auditory regions.…”

Melodic Intonation Therapy on Non-fluent Aphasia After Stroke: A Systematic Review and Analysis on Clinical Trials

“…In the case reports retrieved in this paper, the evaluation criteria of early studies were generally international scales, mostly subjective scoring methods, and language recovery competence was based on scoring in different dimensions. In the recent 10 years of research, some medical imaging evidence of changes in brain structure at MIT to aphasia patients is easier to find in case reports (Schlaug et al, 2009;Al-Janabi et al, 2014;Tabei et al, 2016;Martzoukou et al, 2021).…”