Music therapy with disorders of consciousness: current evidence and emergent evidence‐based practice

Abstract

Patients with prolonged disorders of consciousness (PDOC) stemming from acquired brain injury present one of the most challenging clinical populations in neurological rehabilitation. Because of the complex clinical presentation of PDOC patients, treatment teams are confronted with many medicolegal, ethical, philosophical, moral, and religious issues in day-to-day care. Accurate diagnosis is of central concern, relying on creative approaches from skilled clinical professionals using combined behavioral and neurophysiological measures. This paper presents the latest evidence for using music as a diagnostic tool with PDOC, including recent developments in music therapy interventions and measurement. We outline standardized clinical protocols and behavioral measures to produce diagnostic outcomes and examine recent research illustrating a range of benefits of music-based methods at behavioral, cardiorespiratory, and cortical levels using video, electrocardiography, and electroencephalography methods. These latest developments are discussed in the context of evidence-based practice in rehabilitation with clinical populations.

Personally relevant stimuli during assessment of patients with disorders of consciousness

“…For example, it was shown that performance on items of the CRS-R improved after the preferred music condition compared with a neutral sound condition (without rhythm or notes) (11). This is in line with indications of possible long-term benefits (12). Furthermore, spontaneous signs of consciousness (e.g.…”

Intervenciones musicoterapéuticas para la activación del sistema reticular

“…Existe evidencia sobre la efectividad del tratamiento musicoterapéutico con resultados positivos, a través del aumento de estados de relajación y la reducción de la agitación psicomotora, utilizando diferentes técnicas que tienen en cuenta el efecto en la reducción de la activación de estructuras como el hipotálamo, la glándula pituitaria y adrenal, conocidas como el eje HPA (Crawford, Hogan & Silverman, 2013;Magee & O'Kelly, 2014) así como también la disminución de cortisol y b-Endorfinas luego de la implementación de la técnica de imaginería guiada con música (McKinney, Antoni, Kumar, Tims & Mc Cabe, 1997). Para el logro de dichas mejorías, el musicoterapeuta debe establecer en primer lugar contacto con el paciente.…”

Editorial: Music and Disorders of Consciousness: Emerging Research, Practice and Theory

“…Case studies suggest music may have diagnostic value to distinguish between vegetative and minimally conscious states, as well as prognostic potential (Okumura et al, 2014). Clinical music protocols for therapeutic intervention have been developed and music-based diagnostic measures have been standardized (Magee and O'Kelly, 2015). …”