Monday, October 27, 2014

Music Therapy For Aphasia

Let's talk with Oliver Sacks about aphasia—a condition in which there is an impairment of speech and speech comprehension—and note that music is being used as therapy for aphasia patients. Can you explain this and tell us how promising the therapy is? Are there other areas in which music has therapeutic value?

Aphasia is a terribly frustrating and isolating condition. Some people experience temporary aphasia (say, following a stroke or brain injury), but others are left with it for months or years. Yet many people with expressive aphasia, unable to utter a sentence, may be able to sing. I often greet such patients by singing “Happy Birthday” to them, whether it is their birthday or not. Everyone knows the words and melody of this song, and often aphasic people can join in. In 1973, Martin Albert and his colleagues in Boston described a form of music therapy they called “melodic intonation therapy.” Patients were taught to sing or intone short phrases—for example, “How are you today?” Then the musical elements of this were removed slowly until (in some cases) the patient regained the power to speak a little without the aid of intonation. One sixty-seven-year-old man, aphasic for eighteen months—he could only produce meaningless grunts and had received three months of speech therapy without effect—started to produce words two days after beginning melodic intonation therapy; in two weeks, he had an effective vocabulary of a hundred words, and at six weeks, he could carry on “short, meaningful conversations.”

This is a very specific use of music therapy, but there are many others. People with Alzheimer’s or other dementias will often respond to music even when they are able to respond to little else. Music, especially familiar music from one’s early years, can help to orient and organize such people.

Music works because it engages so many parts of the brain. Rhythm, actual or imagined, activates areas of the motor cortex, crucial in synchronizing and energizing movement—whether for athletes or people with movement disorders like Parkinson’s disease or Tourette’s syndrome. In Musicophilia, I described a man who has incessant seizures, which only stop when he plays music, though this is a highly individual thing, for some people with epilepsy may find that music of a particular sort can actually trigger seizures. By and large, though, there are few, if any, bad side effects of music, and music can often work where no medications can.

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