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Improved Neural Processing Efficiency in a Chronic Aphasia Patient Following Melodic Intonation Therapy: A Neuropsychological and Functional MRI Study.

ABSTRACT: Melodic intonation therapy (MIT) is a treatment program for the rehabilitation of aphasic patients with speech production disorders. We report a case of severe chronic non-fluent aphasia unresponsive to several years of conventional therapy that showed a marked improvement following intensive 9-day training on the Japanese version of MIT (MIT-J). The purpose of this study was to verify the efficacy of MIT-J by functional assessment and examine associated changes in neural processing by functional magnetic resonance imaging. MIT improved language output and auditory comprehension, and decreased the response time for picture naming. Following MIT-J, an area of the right hemisphere was less activated on correct naming trials than compared with before training but similarly activated on incorrect trials. These results suggest that the aphasic symptoms of our patient were improved by increased neural processing efficiency and a concomitant decrease in cognitive load.

SUBMITTER: Tabei KI

PROVIDER: S-EPMC5027199 | biostudies-literature | 2016

REPOSITORIES: biostudies-literature

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Improved Neural Processing Efficiency in a Chronic Aphasia Patient Following Melodic Intonation Therapy: A Neuropsychological and Functional MRI Study.

Tabei Ken-Ichi KI Satoh Masayuki M Nakano Chizuru C Ito Ai A Shimoji Yasuo Y Kida Hirotaka H Sakuma Hajime H Tomimoto Hidekazu H

Frontiers in neurology 20160919

Melodic intonation therapy (MIT) is a treatment program for the rehabilitation of aphasic patients with speech production disorders. We report a case of severe chronic non-fluent aphasia unresponsive to several years of conventional therapy that showed a marked improvement following intensive 9-day training on the Japanese version of MIT (MIT-J). The purpose of this study was to verify the efficacy of MIT-J by functional assessment and examine associated changes in neural processing by functiona ...[more]

PMID: 27698650

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Project description:Melodic intonation therapy (MIT) positively impacts the speech function of patients suffering from aphasia and strokes. Fixed-pitch melodies and phrases formulated in MIT provide the key to the target language to open the language pathway. This randomized controlled trial compared the effects of music therapy-based MIT and speech therapy on patients with non-fluent aphasia. The former is more effective in the recovery of language function in patients with aphasia. Forty-two participants were enrolled in the study, and 40 patients were registered. The participants were randomly assigned to two groups: the intervention group (n = 20; 16 males, 4 females; 52.90 ± 9.08 years), which received MIT, and the control group (n = 20; 15 males, 5 females; 54.05 ± 10.81 years), which received speech therapy. The intervention group received MIT treatment for 30 min/day, five times a week for 8 weeks, and the control group received identical sessions of speech therapy for 30 min/day, five times a week for 8 weeks. Each participant of the group was assessed by a Boston Diagnostic Aphasia Examination (BDAE) at the baseline (t1, before the start of the experiment), and after 8 weeks (t2, the experiment was finished). The Hamilton Anxiety Scale (HAMA) and Hamilton Depression Scale (HAMD) were also measured on the time points. The best medical care of the two groups is the same. Two-way ANOVA analysis of variance was used only for data detection. In the spontaneous speech (information), the listening comprehension (right or wrong, word recognition, and sequential order) and repetitions of the intervention group were significantly higher than the control group in terms of the cumulative effect of time and the difference between groups after 8 weeks. The intervention group has a significant time effect in fluency, but the results after 8 weeks were not significantly different from those in the control group. In terms of naming, the intervention group was much better than the control group in spontaneous naming. Regarding object naming, reaction naming, and sentence completing, the intervention group showed a strong time accumulation effect. Still, the results after 8 weeks were not significantly different from those in the control group. These results indicate that, compared with speech therapy, MIT based on music therapy is a more effective musical activity and is effective and valuable for the recovery of speech function in patients with non-fluent aphasia. As a more professional non-traumatic treatment method, MIT conducted by qualified music therapists requires deeper cooperation between doctors and music therapists to improve rehabilitating patients with aphasia. The Ethics Committee of the China Rehabilitation Research Center approved this study (Approval No. 2020-013-1 on April 1, 2020) and was registered with the Chinese Clinical Trial Registry (Registration number: Clinical Trials ChiCTR2000037871) on September 3, 2020.

Project description:The behavioural and neural processes underpinning different word classes, particularly nouns and verbs, have been a long-standing area of interest in psycholinguistic, neuropsychology and aphasiology research. This topic has theoretical implications concerning the organisation of the language system, as well as clinical consequences related to the management of patients with language deficits. Research findings, however, have diverged widely, which might, in part, reflect methodological differences, particularly related to controlling the psycholinguistic variations between nouns and verbs. The first aim of this study, therefore, was to develop a set of neuropsychological tests that assessed single-word production and comprehension with a matched set of nouns and verbs. Secondly, the behavioural profiles and neural correlates of noun and verb processing were explored, based on these novel tests, in a relatively large cohort of 48 patients with chronic post-stroke aphasia. A data-driven approach, principal component analysis (PCA), was also used to determine how noun and verb production and comprehension were related to the patients' underlying fundamental language domains. The results revealed no performance differences between noun and verb production and comprehension once matched on multiple psycholinguistic features including, most critically, imageability. Interestingly, the noun-verb differences found in previous studies were replicated in this study once un-matched materials were used. Lesion-symptom mapping revealed overlapping neural correlates of noun and verb processing along left temporal and parietal regions. These findings support the view that the neural representation of noun and verb processing at single-word level are jointly-supported by distributed cortical regions. The PCA generated five fundamental language and cognitive components of aphasia: phonological production, phonological recognition, semantics, fluency, and executive function. Consistent with the behavioural analyses and lesion-symptom mapping results, both noun and verb processing loaded on common underlying language domains: phonological production and semantics. The neural correlates of these five principal components aligned with existing models of language and the regions implicated by other techniques such as functional neuroimaging and neuro-stimulation.

Dataset Information

Improved Neural Processing Efficiency in a Chronic Aphasia Patient Following Melodic Intonation Therapy: A Neuropsychological and Functional MRI Study.

Publications

Improved Neural Processing Efficiency in a Chronic Aphasia Patient Following Melodic Intonation Therapy: A Neuropsychological and Functional MRI Study.

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