The title above is not an abstract statement or a philosophical question. Hence, what follows is not a speculative or metaphysical piece. It is an evaluation of the concrete, experimental data on the merits of music therapy in the treatment of brain injury, particularly one due to a stroke. A stroke or a cerebrovascular accident (CVA) is a sudden event, much like a heart attack, due to either an obstruction in the blood flow or hemorrhage in a specific region of the brain. Various rehabilitative modalities are often required to help victims regain function. Although not a mainstay of post-stroke care, there is a robust, albeit small, body of scientific papers supporting the use of music therapy as an adjunct intervention in certain neurological illnesses.
Dr. Michael Thaut of Colorado State University in Fort Collins has conducted pioneering research in this field for close to two decades now. In 2002 he demonstrated that a metronome like beat presented to stroke patients with right arm weakness improved both the speed and accuracy of tasks performed by the affected hand as compared to when the same exercise was attempted in the absence of any auditory cues. Five years later, in a larger study he and his colleagues showed a similar improvement in gait after CVA when training was done with rhythmic sounds versus without any sonic prompting. Thaut also reported that singing a series of words rather than repeating them without music improved retention of material and reduced errors in patients with cognitive compromise due to multiple sclerosis, another disorder of the nervous system.
Drs Teppo Särkämö and David Soto, of the University of Helsinki and Imperial College London respectively, presented equally intriguing results in 2012. Patients with visual disturbances due to stroke had greater improvement in their vision while they listened to their preferred music vs. when they listened to non-preferred music or nothing at all. Specialized medical imaging techniques, called functional magnetic resonance imaging (fMRI), showed an increase in activity in the area of the brain that is involved in language production as well. To determine the long-term benefits of musical exposure, Särkämö and Soto randomly divided sixty patients with large strokes affecting similar areas of the brain into three groups. One listened to music of their choice for a minimum of 1 hour per day for two months, the second group did the same with books on tape and the third group was not offered any listening material. All sixty received standard of care rehabilitation services otherwise. Assessed with the use of standardized testing, at one week, three months and six months the music group had significantly greater improvement in memory, mood and attention, and significantly less confusion compared to the other two groups. All these stroke studies, although fascinating, utilize passive exposure to music and rhythm. What about active music playing? How does that impact recovery from a CVA? Can actually playing music, especially the spontaneous performance of it, lead to greater improvement in brain function than just mere passive enjoyment of it? The Case of Louis Smith