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Music helps stroke victims – new study

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London: Patients who have lost part of their visual awareness following a stroke can show an improved ability to see when they are listening to music they like, according to a new study published today in the journal Proceedings of the National Academy of Sciences.

Every year, an estimated 150,000 people in the UK have a stroke. Up to 60% of stroke patients have impaired visual awareness of the outside world as a result, where they have trouble interacting with certain objects in the visual world.

This impaired visual awareness, known as ‘visual neglect’, is due to the damage that a stroke causes in brain areas that are critical for the integration of vision, attention and action. Visual neglect causes the patient to lose awareness of objects in the opposite side of space compared to the site of their brain injury.

If the stroke occurs in the right hemisphere of the brain, these patients tend to lose awareness of visual information in the left side of space. This occurs even though the area of the brain associated with sight is not damaged.

The researchers behind the study, from Imperial College London, the University of Birmingham and other institutions, suggest that listening to their favourite music may help stroke patients with impaired visual awareness to regain their ability to see.

The new study looked at three patients who had lost awareness of half of their field of vision as a result of a stroke. The patients completed tasks under three conditions: while listening to their preferred music, while listening to music they did not like and in silence. All three patients could identify coloured shapes and red lights in their depleted side of vision much more accurately while they were listening to their preferred music, compared with listening to music they did not like or silence.

For example, in one task, patients were asked to press a button when they could see a red light appear. One patient could point out the light in 65% of cases while he was listening to music he liked, but could only recognise the light in 15% of cases when there was no music or music he did not like being played.

The researchers believe that the improvement in visual awareness seen in these patients could be as a result of patients experiencing positive emotions when listening to music that they like. The team suggest that when a patient experiences positive emotions this may result in more efficient signalling in the brain. This may then improve the patient’s awareness by giving the brain more resources to process stimuli.

The team also used functional MRI scans to look at the way the brain functioned while the patients performed different tasks. They found that listening to pleasant music as the patients performed the visual tasks activated the brain in areas linked to positive emotional responses to stimuli. When the brain was activated in this way, the activation in emotion brain regions was coupled with the improvement of the patients’ awareness of the visual world.

Dr David Soto, the lead author of the study from the Division of Neurosciences and Mental Health at Imperial College London, said: “Visual neglect can be a very distressing condition for stroke patients. It has a big effect on their day-to-day lives. For example, in extreme cases, patients with visual neglect may eat only the food on the right side of their plate, or shave only half of their face, thus failing to react to certain objects in the environment”.

“We wanted to see if music would improve visual awareness in these patients by influencing the individual’s emotional state. Our results are very promising, although we would like to look at a much larger group of patients with visual neglect and with other neuropsychological impairments. Our findings suggest that we should think more carefully about the individual emotional factors in patients with visual neglect and in other neurological patients following a stroke. Music appears to improve awareness because of its positive emotional effect on the patient, so similar beneficial effects may also be gained by making the patient happy in other ways. This is something we are keen to investigate further,” added Dr Soto.

This research was funded by the British Academy, Biotechnology and Biological Sciences Research Council, Economic and Social Research Council, Medical Research Council and Stroke Association.

1. About Imperial College London

Consistently rated amongst the world’s best universities, Imperial College London is a science-based institution with a reputation for excellence in teaching and research that attracts 13,000 students and 6,000 staff of the highest international quality.

Innovative research at the College explores the interface between science, medicine, engineering and business, delivering practical solutions that improve quality of life and the environment – underpinned by a dynamic enterprise culture.

Since its foundation in 1907, Imperial’s contributions to society have included the discovery of penicillin, the development of holography and the foundations of fibre optics. This commitment to the application of research for the benefit of all continues today, with current focuses including interdisciplinary collaborations to improve health in the UK and globally, tackle climate change and develop clean and sustainable sources of energy.

Website: www.imperial.ac.uk

Music therapy improves schizophrenia

London: Music therapy for psychiatric in-patients with schizophrenia can improve some of the symptoms of the disorder, according to a new study by researchers at Imperial College London and therapists at the Central and North West London Mental Health Trust.

The preliminary research, published today in the British Journal of Psychiatry, is the first time music therapy for people with acute schizophrenia has been evaluated.

For this small study, 81 in-patients at four hospitals in central and inner London were randomised to receive music therapy or standard care alone. Those people receiving music therapy had between 8 and 12 sessions, once a week, for up to 45 minutes.

During the sessions patients were given access to a range of musical instruments and encouraged to use them to express themselves. Initially the therapist listened carefully to the patient’s music and accompanied them closely, seeking to follow their emotional state in musical terms. The therapist then offered opportunities to extend or vary the nature of the musical interaction.

The researchers measured symptoms of schizophrenia and found that improvements were greater among those people receiving music therapy than among those receiving standard care alone. Referral for music therapy was associated with reductions in general symptoms, such as depression and anxiety, and the negative symptoms of schizophrenia, such as emotional withdrawal. However, the authors caution that because this was a small study, it is possible that other factors, such as severity of illness, may have influenced the study’s findings.

Dr Mike Crawford, from the Department of Psychological Medicine at Imperial College London and lead author of the study, said: “We have known for some time that psychological treatments can help people with schizophrenia, but these have only been used when people are fairly stable. This study shows that music therapy provides a way of working with people when they are acutely unwell.

“At such times patients may find it difficult to express themselves using words, but through the skill of the therapist it may be possible to help people interact through music in a way that is constructive, creative and enjoyable,” he added.

The researchers believe that the study provides sufficient evidence to justify a larger explanatory randomised trial of music therapy for people with schizophrenia, designed to explore the effects and cost-effectiveness of this kind of therapy.

Dr Crawford explained: “In-patient treatment is the form of care that people with schizophrenia are least satisfied with. Music therapy may provide a means of enhancing the effectiveness of in-patient treatment by reducing some of the symptoms of schizophrenia that respond least well to drug treatment.”

-ends-

1. “An exploratory randomised controlled trial of music therapy
for inpatients with schizophrenia” British Journal of Psychiatry, 1 November 2006

Nakul Talwar(1), Mike J Crawford* (2), Anna Maratos (1), Ula Nur, Orri McDermott (1), Simon Proctor (3)
(1) Central and North West London Mental Health NHS Trust
(2) Department of Psychological Medicine, Imperial College London
(3) East London and the City NHS Mental Health Trust
* Corresponding author

2. Consistently rated in the top three UK university
institutions, Imperial College London is a world leading science-based university whose reputation for excellence in teaching and research attracts students (11,000) and staff (6,000) of the highest international quality. Innovative research at the College explores the interface between science, medicine, engineering and management and delivers practical solutions that enhance the quality of life and the environment – underpinned by a dynamic enterprise culture. Website:
www.imperial.ac.uk

Art Therapy

This therapy combines a number of arts – music, dance, movement and painting – to help those with self-expression problems. It can be helpful to those with mental or physical conditions such alcoholism, drug addiction, and depression.