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

Abstract

Melodic Intonation Therapy (MIT) is one of the most well-known therapies for the rehabilitation of speech in patients with non-fluent aphasia and which is thought to promote right-hemisphere involvement in language processing. This review focuses on the study of language lateralization and/or neuroplastic reorganization with neuroimaging and/or neurophysiological techniques in non-fluent aphasic patients post-stroke during or after MIT. A systematic search was carried out according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) in databases (PubMed, Scopus, EMBASE, Dialnet, Web of Science, Cochrane) with the keywords melodic intonation therapy, neuroimaging, functional magnetic resonance, and positron emission tomography and the boolean operators AND and OR. Articles including patients of all ages and either sex with any type of aphasia post-stroke and in any language, which studied language lateralization and/or neuroplastic reorganization after or during MIT were included. Articles which did not achieve the objectives, revisions and conferences were excluded. Different results were obtained from the 16 studies included in the review: predominantly greater activation of the right hemisphere but also of the left hemisphere or both. MIT is an effective therapy to rehabilitate non-fluent aphasic patients post-stroke. It involves different neurobiological mechanisms and depends on multiple individual factors. Studies with larger samples are necessary.

The neural correlates of Spanish whistle language: An exploratory EEG study

“…for executive functions and speech comprehension. In patients with left-hemispheric stroke, the right inferior frontal lobe was observed to be important for the recovery of sentence comprehension [29,30,56].…”

“…Perilesional and contralateral areas of the left-biased language network can support at least partial recovery in non-fluent aphasics. Melodic intonation therapy (MIT), as an evidencebased therapy, promotes right hemispheric involvement through intonation and rhythmic musical elements to improve expressive language in a patient with non-fluent Broca's aphasia, which has been shown for tonal and atonal languages [29,30,55]. The understanding of mechanisms involved in language recovery and the efficiency of less asymmetrical processing of whistle languages, therefore, appear interesting for the development of an innovative therapy approach [31].…”

“…Research into linguistic rehabilitation for this prevalent cognitive syndrome is of great importance due to the conditions' considerable physical, psychological and economic consequences [27,28]. Melodic intonation therapy (MIT) is a formalised impairment-based approach that promotes right hemisphere involvement through intonation to improve expressive language in patients with non-fluent Broca's aphasia [29,30]. Hence, the unexplained mechanisms involved in language recovery and the whistle languages' capability for symmetrical processing might be promising research areas for the future development of individualised and innovative therapies [31].…”

Melodische Intonationstherapie – MIT

“…Betroffenen mit globaler oder Wernicke-Aphasie wurde diese Therapieform nicht empfohlen. Spätere Studien zeigen neben Verbesserung der Nachsprechleistung auch jene der funktionalen Kommunikationsfähigkeiten auf [5][6][7]. Zudem wurden mit einer modifizierten Methode auch Personen(gruppen) mit globaler Aphasie und/oder flüssigen Aphasieformen und eingeschränktem Sprachverständnis erfolgreich behandelt [8].…”