Abstract Title: Musicians and music making as a model for the study of brain plasticity. Abstract Source: Prog Brain Res. 2015 ;217:37-55. Epub 2015 Feb 11. PMID: 25725909 Abstract Author(s): Gottfried Schlaug Article Affiliation: Gottfried Schlaug Abstract: Playing a musical instrument is an intense, multisensory, and motor experience that usually commences at an early age and requires the acquisition and maintenance of a range of sensory and motor skills over the course of a musician's lifetime. Thus, musicians offer an excellent human model for studying behavioral-cognitive as well as brain effects of acquiring, practicing, and maintaining these specialized skills. Research has shown that repeatedly practicing the association of motor actions with specific sound and visual patterns (musical notation), while receiving continuous multisensory feedback will strengthen connections between auditory and motor regions (e.g., arcuate fasciculus) as well as multimodal integration regions. Plasticity in this network may explain some of the sensorimotor and cognitive enhancements that have been associated with music training. Furthermore, the plasticity of this system as a result of long term and intense interventions suggest the potential for music making activities (e.g., forms of singing) as an intervention for neurological and developmental disorders to learn and relearn associations between auditory and motor functions such as vocal motor functions. Article Published Date : Dec 31, 2014

Abstract Title: Rehabilitation of aphasia: application of melodic-rhythmic therapy to Italian language. Abstract Source: Front Hum Neurosci. 2015 ;9:520. Epub 2015 Sep 24. PMID: 26441615 Abstract Author(s): Maria Daniela Cortese, Francesco Riganello, Francesco Arcuri, Luigina Maria Pignataro, Iolanda Buglione Article Affiliation: Maria Daniela Cortese Abstract: Aphasia is a complex disorder, frequent after stroke (with an incidence of 38%), with a detailed pathophysiological characterization. Effective approaches are crucial for devising an efficient rehabilitative strategy, in order to address the everyday life and professional disability. Several rehabilitative procedures are based on psycholinguistic, cognitive, psychosocial or pragmatic approaches, including amongst those with a neurobehavioral approach the Melodic Intonation Therapy (MIT). Van Eeckhout's adaptation of MIT to French language (Melodic-Rhythmic Therapy: MRT) has implemented the training strategy by adding a rhythmic structure reproducing French prosody. The purpose of this study was to adapt MRT rehabilitation procedures to Italian language and to verify its efficacy in a group of six chronic patients (five males) with severe non-fluent aphasia and without specific aphasic treatments during the previous 9 months. The patients were treated 4 days a week for 16 weeks, with sessions of 30-40 min. They were assessed 6 months after the end of the treatment (follow-up). The patients showed a significant improvement at the Aachener Aphasie Test (AAT) in different fields of spontaneous speech, with superimposable results at the follow-up. Albeit preliminary, these findings support the use of MRT in the rehabilitation after stroke. Specifically, MRT seems to benefit from its stronger structure than the available stimulation-facilitation procedures and allows a better quantification of the rehabilitation efficacy. Article Published Date : Dec 31, 2014

Abstract Title: Apollo's gift: new aspects of neurologic music therapy. Abstract Source: Prog Brain Res. 2015 ;217:237-52. Epub 2015 Feb 11. PMID: 25725918 Abstract Author(s): Eckart Altenmüller, Gottfried Schlaug Article Affiliation: Eckart Altenmüller Abstract: Music listening and music making activities are powerful tools to engage multisensory and motor networks, induce changes within these networks, and foster links between distant, but functionally related brain regions with continued and life-long musical practice. These multimodal effects of music together with music's ability to tap into the emotion and reward system in the brain can be used to facilitate and enhance therapeutic approaches geared toward rehabilitating and restoring neurological dysfunctions and impairments of an acquired or congenital brain disorder. In this article, we review plastic changes in functional networks and structural components of the brain in response to short- and long-term music listening and music making activities. The specific influence of music on the developing brain is emphasized and possible transfer effects on emotional and cognitive processes are discussed. Furthermore, we present data on the potential of using musical tools and activities to support and facilitate neurorehabilitation. We will focus on interventions such as melodic intonation therapy and music-supported motor rehabilitation to showcase the effects of neurologic music therapies and discuss their underlying neural mechanisms. Article Published Date : Dec 31, 2014

Abstract Title: Intensive therapy induces contralateral white matter changes in chronic stroke patients with Broca's aphasia. Abstract Source: Brain Lang. 2014 Sep ;136:1-7. Epub 2014 Jul 18. PMID: 25041868 Abstract Author(s): Catherine Y Wan, Xin Zheng, Sarah Marchina, Andrea Norton, Gottfried Schlaug Article Affiliation: Catherine Y Wan Abstract: Using a pre-post design, eleven chronic stroke patients with large left hemisphere lesions and nonfluent aphasia underwent diffusion tensor imaging and language testing before and after receiving 15 weeks of an intensive intonation-based speech therapy. This treated patient group was compared to an untreated patient group (n=9) scanned twice over a similar time period. Our results showed that the treated group, but not the untreated group, had reductions in fractional anisotropy in the white matter underlying the right inferior frontal gyrus (IFG, pars opercularis and pars triangularis), the right posterior superior temporal gyrus, and the right posterior cingulum. Furthermore, we found that greater improvements in speech production were associated with greater reductions in FA in the right IFG (pars opercularis). Thus, our findings showed that an intensive rehabilitation program for patients with nonfluent aphasia led to structural changes in the right hemisphere, which correlated with improvements in speech production. Article Published Date : Aug 31, 2014

Abstract Title: Insight into the neurophysiological processes of melodically intoned language with functional MRI. Abstract Source: Brain Behav. 2014 Sep ;4(5):615-25. Epub 2014 Jul 3. PMID: 25328839 Abstract Author(s): Carolina P Méndez Orellana, Mieke E van de Sandt-Koenderman, Emi Saliasi, Ineke van der Meulen, Simone Klip, Aad van der Lugt, Marion Smits Article Affiliation: Carolina P Méndez Orellana Abstract: BACKGROUND: Melodic Intonation Therapy (MIT) uses the melodic elements of speech to improve language production in severe nonfluent aphasia. A crucial element of MIT is the melodically intoned auditory input: the patient listens to the therapist singing a target utterance. Such input of melodically intoned language facilitates production, whereas auditory input of spoken language does not. METHODS: Using a sparse sampling fMRI sequence, we examined the differential auditory processing of spoken and melodically intoned language. Nineteen right-handed healthy volunteers performed an auditory lexical decision task in an event related design consisting of spoken and melodically intoned meaningful and meaningless items. The control conditions consisted of neutral utterances, either melodically intoned or spoken. RESULTS: Irrespective of whether the items were normally spoken or melodically intoned, meaningful items showed greater activation in the supramarginal gyrus and inferior parietal lobule, predominantly in the left hemisphere. Melodically intoned language activated both temporal lobes rather symmetrically, as well as the right frontal lobe cortices, indicating that these regions are engaged in the acoustic complexity of melodically intoned stimuli. Compared to spoken language, melodically intoned language activated sensory motor regions and articulatory language networks in the left hemisphere, but only when meaningful language was used. DISCUSSION: Our results suggest that the facilitatory effect of MIT may - in part - depend on an auditory input which combines melody and meaning. CONCLUSION: Combined melody and meaning provide a sound basis for the further investigation of melodic language processing in aphasic patients, and eventually the neurophysiological processes underlying MIT. Article Published Date : Aug 31, 2014

Abstract Title: The Efficacy and Timing of Melodic Intonation Therapy in Subacute Aphasia. Abstract Source: Neurorehabil Neural Repair. 2014 Jan 20 ;28(6):536-544. Epub 2014 Jan 20. PMID: 24449708 Abstract Author(s): Ineke van der Meulen, W Mieke E van de Sandt-Koenderman, Majanka H Heijenbrok-Kal, Evy G Visch-Brink, Gerard M Ribbers Article Affiliation: Ineke van der Meulen Abstract: Background. Little is known about the efficacy of language production treatment in subacute severe nonfluent aphasia. Although Melodic Intonation Therapy (MIT) is a language production treatment for this disorder, until now MIT effect studies have focused on chronic aphasia. Purpose. This study examines whether language production treatment with MIT is effective in subacute severe nonfluent aphasia. Methods. A multicenter, randomized controlled trial was conducted in a waiting-list control design: patients were randomly allocated to the experimental group (MIT) or the control group (control intervention followed by delayed MIT). In both groups, therapy started at 2 to 3 months poststroke and was given intensively (5 h/wk) during 6 weeks. In a second therapy period, the control group received 6 weeks of intensive MIT. The experimental group resumed their regular treatment. Assessment was done at baseline (T1), after the first intervention period (T2), and after the second intervention period (T3). Efficacy was evaluated at T2. The impact of delaying MIT on therapy outcome was also examined. Results. A total of 27 participants were included: n = 16 in the experimental group and n = 11 in the control group. A significant effect in favor of MIT on language repetition was observed for trained items, with mixed results for untrained items. After MIT there was a significant improvement in verbal communication but not after the control intervention. Finally, delaying MIT was related to less improvement in the repetition of trained material. Conclusions. In these patients with subacute severe nonfluent aphasia, language production treatment with MIT was effective. Earlier treatment may lead to greater improvement. Article Published Date : Jan 19, 2014

Abstract Title: The Combination of Rhythm and Pitch Can Account for the Beneficial Effect of Melodic Intonation Therapy on Connected Speech Improvements in Broca's Aphasia. Abstract Source: Front Hum Neurosci. 2014 ;8:592. Epub 2014 Aug 11. PMID: 25157222 Abstract Author(s): Anna Zumbansen, Isabelle Peretz, Sylvie Hébert Article Affiliation: Anna Zumbansen Abstract: Melodic intonation therapy (MIT) is a structured protocol for language rehabilitation in people with Broca's aphasia. The main particularity of MIT is the use of intoned speech, a technique in which the clinician stylizes the prosody of short sentences using simple pitch and rhythm patterns. In the original MIT protocol, patients must repeat diverse sentences in order to espouse this way of speaking, with the goal of improving their natural, connected speech. MIT has long been regarded as a promising treatment but its mechanisms are still debated. Recent work showed that rhythm plays a key role in variations of MIT, leading to consider the use of pitch as relatively unnecessary in MIT. Our study primarily aimed to assess the relative contribution of rhythm and pitch in MIT's generalization effect to non-trained stimuli and to connected speech. We compared a melodic therapy (with pitch and rhythm) to a rhythmic therapy (with rhythm only) and to a normally spoken therapy (without melodic elements). Three participants with chronic post-stroke Broca's aphasia underwent the treatments in hourly sessions, 3 days per week for 6 weeks, in a cross-over design. The informativeness of connected speech, speech accuracy of trained and non-trained sentences, motor-speech agility, and mood was assessed before and after the treatments. The results show that the three treatments improved speech accuracy in trained sentences, but that the combination of rhythm and pitch elicited the strongest generalization effect both to non-trained stimuli and connected speech. No significant change was measured in motor-speech agility or mood measures with either treatment. The results emphasize the beneficial effect of both rhythm and pitch in the efficacy of original MIT on connected speech, an outcome of primary clinical importance in aphasia therapy. Article Published Date : Dec 31, 2013

Abstract Title: Augmenting melodic intonation therapy with non-invasive brain stimulation to treat impaired left-hemisphere function: two case studies. Abstract Source: Front Psychol. 2014 ;5:37. Epub 2014 Feb 4. PMID: 24550864 Abstract Author(s): Shahd Al-Janabi, Lyndsey A Nickels, Paul F Sowman, Hana Burianová, Dawn L Merrett, William F Thompson Article Affiliation: Shahd Al-Janabi Abstract: The purpose of this study was to investigate whether or not the right hemisphere can be engaged using Melodic Intonation Therapy (MIT) and excitatory repetitive transcranial magnetic stimulation (rTMS) to improve language function in people with aphasia. The two participants in this study (GOE and AMC) have chronic non-fluent aphasia. A functional Magnetic Resonance Imaging (fMRI) task was used to localize the right Broca's homolog area in the inferior frontal gyrus for rTMS coil placement. The treatment protocol included an rTMS phase, which consisted of 3 treatment sessions that used an excitatory stimulation method known as intermittent theta burst stimulation, and a sham-rTMS phase, which consisted of 3 treatment sessions that used a sham coil. Each treatment session was followed by 40 min of MIT. A linguistic battery was administered after each session. Our findings show that one participant, GOE, improved in verbal fluency and the repetition of phrases when treated with MIT in combination with TMS. However, AMC showed no evidence of behavioral benefit from this brief treatment trial. Post-treatment neural activity changes were observed for both participants in the left Broca's area and right Broca's homolog. These case studies indicate that a combination of MIT and rTMS applied to the right Broca's homolog has the potential to improve speech and language outcomes for at least some people with post-stroke aphasia. Article Published Date : Dec 31, 2013

Abstract Title: Melodic intonation therapy: back to basics for future research. Abstract Source: Front Neurol. 2014 ;5:7. Epub 2014 Jan 28. PMID: 24478754 Abstract Author(s): Anna Zumbansen, Isabelle Peretz, Sylvie Hébert Article Affiliation: Anna Zumbansen Abstract: We present a critical review of the literature on melodic intonation therapy (MIT), one of the most formalized treatments used by speech-language therapist in Broca's aphasia. We suggest basic clarifications to enhance the scientific support of this promising treatment. First, therapeutic protocols using singing as a speech facilitation technique are not necessarily MIT. The goal of MIT is to restore propositional speech. The rationale is that patients can learn a new way to speak through singing by using language-capable regions of the right cerebral hemisphere. Eventually, patients are supposed to use this way of speaking permanently but not to sing overtly. We argue that many treatment programs covered in systematic reviews on MIT's efficacy do not match MIT's therapeutic goal and rationale. Critically, we identified two main variations of MIT: the French thérapie mélodique et rythmée (TMR) that trains patients to use singing overtly as a facilitation technique in case of speech struggle and palliative versions of MIT that help patients with the most severe expressive deficits produce a limited set of useful, readymade phrases. Second, we distinguish between the immediate effect of singing on speech production and the long-term effect of the entire program on language recovery. Many results in the MIT literature can be explained by this temporal perspective. Finally, we propose that MIT can be viewed as a treatment of apraxia of speech more than aphasia. This issue should be explored in future experimental studies. Article Published Date : Dec 31, 2013

Abstract Title: Neurobiological, cognitive, and emotional mechanisms in melodic intonation therapy. Abstract Source: Front Hum Neurosci. 2014 ;8:401. Epub 2014 Jun 2. PMID: 24917811 Abstract Author(s): Dawn L Merrett, Isabelle Peretz, Sarah J Wilson Article Affiliation: Dawn L Merrett Abstract: Singing has been used in language rehabilitation for decades, yet controversy remains over its effectiveness and mechanisms of action. Melodic Intonation Therapy (MIT) is the most well-known singing-based therapy; however, speculation surrounds when and how it might improve outcomes in aphasia and other language disorders. While positive treatment effects have been variously attributed to different MIT components, including melody, rhythm, hand-tapping, and the choral nature of the singing, there is uncertainty about the components that are truly necessary and beneficial. Moreover, the mechanisms by which the components operate are not well understood. Within the literature to date, proposed mechanisms can be broadly grouped into four categories: (1) neuroplastic reorganization of language function, (2) activation of the mirror neuron system and multimodal integration, (3) utilization of shared or specific features of music and language, and (4) motivation and mood. In this paper, we review available evidence for each mechanism and propose that these mechanisms are not mutually exclusive, but rather represent different levels of explanation, reflecting the neurobiological, cognitive, and emotional effects of MIT. Thus, instead of competing, each of these mechanisms may contribute to language rehabilitation, with a better understanding of their relative roles and interactions allowing the design of protocols that maximize the effectiveness of singing therapy for aphasia. Article Published Date : Dec 31, 2013

Abstract Title: The therapeutic effect of neurologic music therapy and speech language therapy in post-stroke aphasic patients. Abstract Source: Ann Rehabil Med. 2013 Aug ;37(4):556-62. Epub 2013 Aug 26. PMID: 24020037 Abstract Author(s): Kil-Byung Lim, Yong-Kyun Kim, Hong-Jae Lee, Jeehyun Yoo, Ji Youn Hwang, Jeong-Ah Kim, Sung-Kyun Kim Article Affiliation: Kil-Byung Lim Abstract: OBJECTIVE: To investigate the therapeutic effect of neurologic music therapy (NMT) and speech language therapy (SLT) through improvement of the aphasia quotient (AQ) in post-stroke aphasic patients. METHODS: Twenty-one post-stroke, nonfluent aphasia patients who had ischemic/hemorrhagic stroke on radiologic evaluation were divided into the NMT and SLT groups. They received NMT and SLT for 1 month. Language function was assessed by Korean version-Western Aphasia Battery before and after therapy. NMT consisted of therapeutic singing and melodic intonation therapy, and SLT consisted of language-oriented therapy. RESULTS: Significant improvements were revealed in AQ, repetition, and naming after therapy in the NMT group and improvements in repetition in the SLT group of chronic stroke patients (p<0.05). There were significant improvements in language ability in the NMT group of subacute stroke patients. However, there was no significant improvement in the SLT group of subacute stroke patients. CONCLUSION: We concluded that the two therapies are effective treatments in the chronic stage of stroke and NMT is effective in subacute post-stroke aphasic patients. Article Published Date : Jul 31, 2013

Abstract Title: The effects of modified melodic intonation therapy on nonfluent aphasia: a pilot study. Abstract Source: J Speech Lang Hear Res. 2012 Oct ;55(5):1463-71. Epub 2012 Mar 12. PMID: 22411278 Abstract Author(s): Dwyer Conklyn, Eric Novak, Adrienne Boissy, Francois Bethoux, Kamal Chemali Article Affiliation: Dwyer Conklyn Abstract: OBJECTIVE: Positive results have been reported with melodic intonation therapy (MIT) in nonfluent aphasia patients with damage to their left-brain speech processes, using the patient's intact ability to sing to promote functional language. This pilot study sought to determine the immediate effects of introducing modified melodic intonation therapy (MMIT), a modification of MIT, as an early intervention in stroke patients presenting with Broca's aphasia. METHOD: After a randomized controlled single-blind design, 30 acute stroke survivors with nonfluent aphasia were randomly assigned to receive MIT treatment or no treatment. A pre/post test, based on the responsive and repetition subsections of the Western Aphasia Battery, was developed for this study. RESULTS: After 1 session, a significant within-subject change was observed for the treatment group's adjusted total score ( p = .02), and a significant difference between groups was found for adjusted total score ( p = .02) favoring the treatment group. The treatment group also showed a significant change in their responsive subsection scores ( p = .01) when their pre-tests from Visit 1 to Visit 2 were compared, whereas the control group showed no change, suggesting a possible carry-over effect of MIT treatment. CONCLUSION: This study provides preliminary data supporting the possible benefits of utilizing MMIT treatment early in the recovery of nonfluent aphasia patients. Article Published Date : Sep 30, 2012

Abstract Title: [Music therapy for dementia and higher cognitive dysfunction: a review]. Abstract Source: Brain Nerve. 2011 Dec ;63(12):1370-7. PMID: 22147456 Abstract Author(s): Masayuki Satoh Article Affiliation: Masayuki Satoh Abstract: Music is known to affect the human mind and body. Music therapy utilizes the effects of music for medical purposes. The history of music therapy is quite long, but only limited evidence supports its usefulness in the treatment of higher cognitive dysfunction. As for dementia, some studies conclude that music therapy is effective for preventing cognitive deterioration and the occurrence of behavioral and psychological symptoms of dementia (BPSD). In patients receiving music therapy for the treatment of higher cognitive dysfunction, aphasia was reported as the most common symptom. Many studies have been conducted to determine whether singing can improve aphasic symptoms: singing familiar and/or unfamiliar songs did not show any positive effect on aphasia. Melodic intonation therapy (MIT) is a method that utilizes melody and rhythm to improve speech output. MIT is a method that is known to have positive effects on aphasic patients. Some studies of music therapy for patients with unilateral spatial neglect; apraxia; hemiparesis; and walking disturbances, including parkinsonian gait, are available in the literature. Studies showed that the symptoms of unilateral spatial neglect and hemiparesis significantly improved when musical instruments were played for several months as a part of the music therapy. Here, I describe my study in which mental singing showed a positive effect on parkinsonian gait. Music is interesting, and every patient can go through training without any pain. Future studies need to be conducted to establish evidence of the positive effects of music therapy on neurological and neuropsychological symptoms. Article Published Date : Nov 30, 2011

Abstract Title: Non-invasive brain stimulation enhances the effects of melodic intonation therapy. Abstract Source: Front Psychol. 2011 ;2:230. Epub 2011 Sep 26. PMID: 21980313 Abstract Author(s): Bradley W Vines, Andrea C Norton, Gottfried Schlaug Article Affiliation: Bradley W Vines Abstract: Research has suggested that a fronto-temporal network in the right hemisphere may be responsible for mediating melodic intonation therapy's (MIT) positive effects on speech recovery. We investigated the potential for a non-invasive brain stimulation technique, transcranial direct current stimulation (tDCS), to augment the benefits of MIT in patients with non-fluent aphasia by modulating neural activity in the brain during treatment with MIT. The polarity of the current applied to the scalp determines the effects of tDCS on the underlying tissue: anodal-tDCS increases excitability, whereas cathodal tDCS decreases excitability. We applied anodal-tDCS to the posterior inferior frontal gyrus of the right hemisphere, an area that has been shown both to contribute to singing through the mapping of sounds to articulatory actions and to serve as a key region in the process of recovery from aphasia, particularly in patients with large left hemisphere lesions. The stimulation was applied while patients were treated with MIT by a trained therapist. Six patients with moderate to severe non-fluent aphasia underwent three consecutive days of anodal-tDCS + MIT, and an equivalent series of sham-tDCS + MIT. The two treatment series were separated by 1 week, and the order in which the treatments were administered was randomized. Compared to the effects of sham-tDCS + MIT, anodal-tDCS + MIT led to significant improvements in fluency of speech. These results support the hypothesis that, as the brain seeks to reorganize and compensate for damage to left hemisphere language centers, combining anodal-tDCS with MIT may further recovery from post-stroke aphasia by enhancing activity in a right hemisphere sensorimotor network for articulation. Article Published Date : Dec 31, 2010

Abstract Title: From singing to speaking: facilitating recovery from nonfluent aphasia. Abstract Source: Future Neurol. 2010 Sep ;5(5):657-665. PMID: 21088709 Abstract Author(s): Gottfried Schlaug, Andrea Norton, Sarah Marchina, Lauryn Zipse, Catherine Y Wan Article Affiliation: Gottfried Schlaug Abstract: It has been reported for more than 100 years that patients with severe nonfluent aphasia are better at singing lyrics than they are at speaking the same words. This observation led to the development of melodic intonation therapy (MIT). However, the efficacy of this therapy has yet to be substantiated in a randomized controlled trial. Furthermore, its underlying neural mechanisms remain unclear. The two unique components of MIT are the intonation of words and simple phrases using a melodic contour that follows the prosody of speech and the rhythmic tapping of the left hand that accompanies the production of each syllable and serves as a catalyst for fluency. Research has shown that both components are capable of engaging fronto-temporal regions in the right hemisphere, thereby making MIT particularly well suited for patients with large left hemisphere lesions who also suffer from nonfluent aphasia. Recovery from aphasia can happen in two ways: either through the recruitment of perilesional brain regions in the affected hemisphere, with variable recruitment of right-hemispheric regions if the lesion is small, or through the recruitment of homologous language and speech-motor regions in the unaffected hemisphere if the lesion of the affected hemisphere is extensive. Treatment-associated neural changes in patients undergoing MIT indicate that the unique engagement of right-hemispheric structures (e.g., the superior temporal lobe, primary sensorimotor, premotor and inferior frontal gyrus regions) and changes in the connections across these brain regions may be responsible for its therapeutic effect. Article Published Date : Aug 31, 2010

Abstract Title: Changes in maps of language activity activation following melodic intonation therapy using magnetoencephalography: two case studies. Abstract Source: J Clin Exp Neuropsychol. 2010 Mar ;32(3):309-14. Epub 2009 Aug 5. PMID: 19657914 Abstract Author(s): Joshua I Breier, Shannon Randle, Lynn M Maher, Andrew C Papanicolaou Article Affiliation: Joshua I Breier Abstract: Two patients with chronic expressive aphasia underwent two blocks of melodic intonation therapy (MIT) each. Maps of language-specific neurophysiological activity were obtained prior to and after each MIT block during a covert action naming task using magnetoencephalography. Both patients exhibited increased left hemisphere activation after MIT. The patient who responded positively to therapy exhibited decreasing activation within areas of the right hemisphere homotopic to left hemisphere language areas compared to baseline after both blocks of MIT. In contrast, the patient who did not show improvement after therapy exhibited increasing activation in these areas of the right hemisphere after therapy. Results are consistent with hypotheses that melodic intonation therapy acts through promotion of left hemisphere activation. Article Published Date : Feb 28, 2010

Abstract Title: Evidence for plasticity in white-matter tracts of patients with chronic Broca's aphasia undergoing intense intonation-based speech therapy. Abstract Source: Ann N Y Acad Sci. 2009 Jul ;1169:385-94. PMID: 19673813 Abstract Author(s): Gottfried Schlaug, Sarah Marchina, Andrea Norton Article Affiliation: Gottfried Schlaug Abstract: Recovery from aphasia can be achieved through recruitment of either perilesional brain regions in the affected hemisphere or homologous language regions in the nonlesional hemisphere. For patients with large left-hemisphere lesions, recovery through the right hemisphere may be the only possible path. The right-hemisphere regions most likely to play a role in this recovery process are the superior temporal lobe (important for auditory feedback control), premotor regions/posterior inferior frontal gyrus (important for planning and sequencing of motor actions and for auditory-motor mapping), and the primary motor cortex (important for execution of vocal motor actions). These regions are connected reciprocally via a major fiber tract called the arcuate fasciculus (AF), however, this tract is not as well developed in the right hemisphere as it is in the dominant left. We tested whether an intonation-based speech therapy (i.e., melodic intonation therapy [MIT]), which is typically administered in an intense fashion with 75-80 daily therapy sessions, would lead to changes in white-matter tracts, particularly the AF. Using diffusion tensor imaging (DTI), we found a significant increase in the number of AF fibers and AF volume comparing post- with pretreatment assessments in six patients that could not be attributed to scan-to-scan variability. This suggests that intense, long-term MIT leads to remodeling of the right AF and may provide an explanation for the sustained therapy effects that were seen in these six patients. Article Published Date : Jun 30, 2009

Abstract Title: Melodic intonation therapy: shared insights on how it is done and why it might help. Abstract Source: Ann N Y Acad Sci. 2009 Jul ;1169:431-6. PMID: 19673819 Abstract Author(s): Andrea Norton, Lauryn Zipse, Sarah Marchina, Gottfried Schlaug Article Affiliation: Andrea Norton Abstract: For more than 100 years, clinicians have noted that patients with nonfluent aphasia are capable of singing words that they cannot speak. Thus, the use of melody and rhythm has long been recommended for improving aphasic patients' fluency, but it was not until 1973 that a music-based treatment [Melodic Intonation Therapy (MIT)] was developed. Our ongoing investigation of MIT's efficacy has provided valuable insight into this therapy's effect on language recovery. Here we share those observations, our additions to the protocol that aim to enhance MIT's benefit, and the rationale that supports them. Article Published Date : Jun 30, 2009

Abstract Title: From Singing to Speaking: Why Singing May Lead to Recovery of Expressive Language Function in Patients with Broca's Aphasia. Abstract Source: Music Percept. 2008 Apr 1 ;25(4):315-323. PMID: 21197418 Abstract Author(s): Gottfried Schlaug, Sarah Marchina, Andrea Norton Article Affiliation: Gottfried Schlaug Abstract: It has been reported that patients with severely nonfluent aphasia are better at singing lyrics than speaking the same words. This observation inspired the development of Melodic Intonation Therapy (MIT), a treatment whose effects have been shown, but whose efficacy is unproven and neural correlates remain unidentified. Because of its potential to engage/unmask language-capable regions in the unaffected right hemisphere, MIT is particularly well suited for patients with large left-hemisphere lesions. Using two patients with similar impairments and stroke size/location, we show the effects of MIT and a control intervention. Both interventions' post-treatment outcomes revealed significant improvement in propositional speech that generalized to unpracticed words and phrases; however, the MIT-treated patient's gains surpassed those of the control-treated patient. Treatment-associated imaging changes indicate that MIT's unique engagement of the right hemisphere, both through singing and tapping with the left hand to prime the sensorimotor and premotor cortices for articulation, accounts for its effect over nonintoned speech therapy. Article Published Date : Mar 31, 2008

Abstract Title: [Can music therapy for patients with neurological disorders?]. Abstract Source: Tidsskr Nor Laegeforen. 2004 Dec 16 ;124(24):3229-30. PMID: 15608775 Abstract Author(s): Audun Myskja Article Affiliation: Audun Myskja Abstract: Recent developments in brain research and in the field of music therapy have led to the development of music-based methods specifically aimed at relieving symptoms of Parkinson's disease and other neurologic disorders. Rhythmic auditory stimulation uses external rhythmic auditory cues from song, music or metronome to aid patients improving their walking functioning and has been shown to be effective both within sessions and as a result of training over time. Melodic intonation therapy and related vocal techniques can improve expressive dysphasia and aid rehabilitation of neurologic disorders, particularly Parkinson's disease, stroke and developmental disorders. Article Published Date : Dec 15, 2004