Gabby Giffords response to music therapy: Fine-tunning the brain clock via rhythm

Very interesting story and video regarding speech and language therapy progress for Congresswoman Gabby Giffords.

The use of music therapy is consistent with rhythm-based intervention programs.  One of this class of interventions mentioned in the article is melodic intonation therapy (MIT).  MIT is one of a class of rhythm-based therapies that have demostrated significant progress not only for brain-injury related aphasia, but other clinical disorders.  The Brain Clock blog has made many posts regarding the importance of brain rhythm or timing, with the master internal brain clock possibly being the underlying cognitive/brain mechanism that may be being "fine tuned" by these therapies.

A recent white paper that reviewed the efficacy of 23 different rhythm-based therapies can be found here. I recently blogged about one of these neurotechnologies, namely Interactive Metronome, at the IM-Home web page blog.  My post can be found here.  In a post to be released any day, I touch on the above white paper that concluded:

"After a review of four different types of rhythm-based timing treatments, of which IM was just one, we concluded that:

“we believe that collectively the preponderance of positive outcomes (across the 23 listed studies) indicates that rhythm-based mental-timing treatments have merit for clinical use and warrant increased clinical use and research attention…positive treatment outcomes were reported for all four forms of rhythm-based treatment.  Positive outcomes were also observed for normal subjects and, more importantly, across a variety of clinical disorders (e.g., aphasia, apraxia, coordination/movement disorders, TBI, CP, Parkinson's disease, stroke/CVA, Down's syndrome, ADHD)….One notable observation of interest is that 15 of the 23 studies (the RAS, AOS-RRT and SMT treatment studies) all employed some form of auditory-based metronome to pace or cue the subjects targeted rhtymic behavior.  In all other studies, rhythm-pacing used some form of manual tapping or beat sound (e.g., drum).  We conclude that the use of external metronome-based rhythm tools (tapping to a beat, metronome-based rhythmic pacing, rhythmic-cuing via timed pulses/beats) is a central tool to improving temporal processing and mental-timing.” 

Gabby Giffords brain clock interactive metronome aphasia ABC news stroke rhythm therapies music therapy

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The brain clock (mental timing) and clinical disorders

The human brain clock is intimately involved in wide array of human cognitive and motor behaviors.  At this blog a number of clincal disorders have been associated with some degree of disturbance or damage to brain mechanisms related to mental timing.  This informaiton is scattered across a variety of posts.  I decided to pull it all together (as of today's date) in this post.

Mental timing (brain clock) has been implicated via research reported at this blog in:

ADHD and attention

Autismhttp://www.brainclock.net/search/label/autism

Various speech and language disorders

• Aphasia
• Apraxia
• Speech and language

Tourette's syndrome

Cerbral palsy

Central auditory processing disorders (CAPD)

Reading disabilities/dyslexia (click here, here and here)

Various dopaminegeric-based disorders

• Huntington's 
• Schizophrenia
• Parkinson's

Gate disorders

Stroke related dysfunction

A more detailed reference list of timing-related dysfunctions/disorder (e.g., aging related disorders--Alzheimer's, dementia; ADHD, motor coordination/timing disorders--gait, stroke,swallowing;  speech and language disorders--aphasia/stroke/apraxia/speech; TBI) can be found in special white paper regarding the efficacy of various rhythm-based interventions.

Research bytes: Interactive Metronome (brain-clock based) efficacy study with stroke patients

If you check out my conflict of interest statement at this blog, it should be no secret that the reason I started this blog is because I became involved in an academic intervention that utilized the Interactive Metronome neurotechnology. The results were very positive and I set out on a mission to determine why it worked across such diverse domains as academics, stroke rehab, ADHD, golf, etc. ("What's happening under the hood" - see PPT slideshow section of blog).

Today I found a report in the American Journal of Occupational Therapy that demonstrated the effectiveness of the IM (brain-clock based IMHO) method in two stroke victims. Yes, this is a clinical n=2 study...but is consistent with other mental timing intervention studies. Of particular interest is the authors discussion of the efficacy of the intervention without the need for large-scale technology and apparatus. Sometimes simple/elegant is better.

Below is the abstract. Click here to read the complete article. Click here to see all prior blog posts that make some mention of the IM method, or non-IM research that is related.

As noted above, I do have a conflict of interest as I am on the IM Scientific Advisory Board. You should be able to enlarge the image by clicking on it. If not, go to the article link.


- iPost using BlogPress from my Kevin McGrew's iPad

mental timing IQ Brain Clock brain clock temporal processing metronome mental time-keeping brain timing educational psychology school psychology special education neuropsychology neuroscience neurology brain rhythm rhythm processing rhythm perception Interactive Metronome stroke stroke rehabilitation stroke intervention stroke treatment

Research bytes 8-18-2010: IQ brain clock and sex/handedness differences and impact on aphasis

Sidiropoulos, K., Ackermann, H., Wannke, M., & Hertrich, I. (2010). Temporal processing capabilities in repetition conduction aphasia. Brain and Cognition, 73(3), 194-202.

This study investigates the temporal resolution capacities of the central-auditory system in a subject (NP) suffering from repetition conduction aphasia. More specifically, the patient was asked to detect brief gaps between two stretches of broadband noise (gap detection task) and to evaluate the duration of two biphasic (WN-3) continuous noise elements, starting with white noise (WN) followed by 3 kHz bandpass-filtered noise (duration discrimination task). During the gap detection task, the two portions of each stimulus were either identical (“intra-channel condition”) or differed (“inter-channel condition”) in the spectral characteristics of the leading and trailing acoustic segments. NP did not exhibit any deficits in the intra-channel condition of the gap detection task, indicating intact auditory temporal resolution across intervals of 1–3 ms. By contrast, the inter-channel condition yielded increased threshold values. Based upon the “multiple-looks” model of central-auditory processing, this profile points at a defective integration window operating across a few tens of milliseconds – a temporal range associated with critical features of the acoustic speech signal such as voice onset time and formant transitions. Additionally, NP was found impaired during a duration discrimination task addressing longer integration windows (ca. 150 ms). Concerning speech, this latter time domain approximately corresponds to the duration of stationary segmental units such as fricatives and long vowels. On the basis of our results we suggest, that the patient’s auditory timing deficits in non-speech tasks may account, at least partially, for his impairments in speech processing.

Article Outline

1. Introduction
2. Materials and methods

2.1. Case history
2.2. Intra-channel gap detection task
2.3. Inter-channel gap detection task
2.4. Duration discrimination task

3. Results

3.1. Intra-channel gap detection task
3.2. Inter-channel gap detection
3.3. Duration discrimination task

4. Discussion
Acknowledgements
References

Rammsayer, T. & Troche, S. (2010, in press) Sex differences in the processing of temporal information in the sub-second range.  Personality and Individual Differences

Processing of temporal information in the sub-second range appears to be controlled by an automatic timing system. The present study examined sex-related differences in this temporal domain. For this purpose, 132 male and 144 female participants ranging in age from 18 to 39 years completed five different psychophysical timing tasks. Reliably better timing performance in males compared to females could be shown for temporal discrimination of empty intervals and rhythm perception. Males’ better performance on temporal discrimination of filled intervals and temporal-order judgment just failed to reach the 5%-level of statistical significance. No indication of a sex-related difference was found for temporal generalisation. Findings are consistent with the notion of a slightly more efficient automatic timing system in males compared to females. Furthermore, with tasks requiring temporal integration across a series of sensory events, a more holistic processing strategy applied by males may also contribute to their performance advantage.

Article Outline

1. Introduction
2. Method

2.1. Participants
2.2. Intelligence test
2.3. Psychophysical timing tasks

2.3.1. Duration discrimination
2.3.2. Temporal-discrimination tasks
2.3.3. Temporal-generalisation task
2.3.4. Temporal-order judgment (TOJ)
2.3.5. Rhythm perception

3. Results
4. Discussion
Acknowledgements
References

Westfall, J., Jasper, J. & Zelmanova (2010) Differences in time perception as a function of strength of handedness.  Personality and Individual Differences, 49, 629–633

Research has established that objective measures of time rarely have a perfect correlation with subjective judgments of time. Given that proper time perception appears to depend upon access to right-hemisphere processing (e.g., Harrington, Haaland, & Knight, 1998), the present paper investigates the link between strength of handedness and subjective time judgments. In two distinctive time- associated decision-making tasks, results indicated that mixed-handers (individuals who use their non-dominant hand for at least a few activities), perceived time differently than strong-handers (individuals who use one hand predominantly). These findings signify a link between strength of handedness and different levels of interhemispheric communication, consistent with previous handedness literature, and suggest that researchers studying time perception or problems involving the perception of time should incorporate measures of handedness strength.
Article Outline

1. Introduction

1.1. Strength of handedness and interhemispheric communication

2. Method

2.1. Subjective time perception task
2.2. Delay discounting task
2.3. Edinburgh Handedness Inventory (EHI)

3. Results

3.1. Subjective time perception task
3.2. Delay discounting task

4. Discussion
Acknowledgements
References

Technorati Tags: Psychology, school psychology, educational psychology, cognitive psychology, neuropsychology, neurosciences, neurotechnology, neurology, brain, brain function, cognitive abilities, intelligence, IQ brain clock, brain timing, mental timekeeping, brain rhythms, rhythm perception, brain synchrony, brain synchronization, neural synchrony, neural synchronization, brain clock, brain injury, stroke rehabilitation, gender differences

More research supports brain rhythm training benefits for stroke patients.

Research review suggests positive benefits of brain rhythm training (rhythmic auditory stimulation-RAS)/music for stroke rehab. clients.  This is consistent with a prior special report posted at the IQ Brain clock---The efficacy of rhythm-based (mental timing) treatments with subjects with a variety of clinical disorders:  A brief review of theoretical, diagnostic, and treatment research (McGrew & Vega, 2009).

Technorati Tags: Psychology, school psychology, educational psychology, cognitive psychology, neuropsychology, neurosciences, neurotechnology, neurology, brain, brain function, cognitive abilities, intelligence, IQ brain clock, brain timing, mental timekeeping, brain rhythms, rhythm perception, brain synchrony, brain synchronization, neural synchrony, neural synchronization, brain clock, brain injury, stroke rehabilitation, RAS, music therapy

Brain Clock Research Bytes #3: Timing-based interventions improve gait (Parkinsons), stroke rehab, and golf

I've found a number of new (or recent) studies supporting the importance of the brain clock in a variety of areas. Below are the brief bytes....check out articles for detailed information.

Yet another study (Hausdorff et al., 2007) dealing with Parkinson's (a clinical disordery that appears to involve a dysfunctional internal timing-click here for prior posts), this time the use of the RAS (rapid auditory stimulation) therapy to improve gait functioning.

• Abstract: Patients with Parkinson’s disease (PD) walk with a shortened stride length and high stride-to-stride variability, a measure associated with fall risk. Rhythmic auditory stimulation (RAS) improves stride length but the effects on stride-to-stride variability, a marker of fall risk, are unknown. The effects of RAS on stride time variability, swing time variability and spatial-temporal measures were examined during 100-m walks with the RAS beat set to 100 and 110% of each subject’s usual cadence in 29 patients with idiopathic PD and 26 healthy age-matched controls. Carryover effects were also evaluated. During usual walking, variability was significantly higher (worse) in the patients with PD compared with the controls (P < 0.01). For the patients with PD, RAS at 100% improved gait speed, stride length and swing time (P < 0.02) but did not significantly affect variability. With RAS at 110%, reductions in variability were also observed (P < 0.03) and these effects persisted 2 and 15 min later. In the control subjects, the positive effects of RAS were not observed. For example, RAS increased stride time variability at 100 and 110%. These results demonstrate that RAS enables more automatic movement and reduces stride-to-stride variability in patients with PD. Further, these improvements are not simply a by-product of changes in speed or stride length. After walking with RAS, there also appears to be a carryover effect that supports the possibility of motor plasticity in the networks controlling rhythmicity in PD and the potential for using RAS as an intervention to improve mobility and reduce fall risk.

The original Libkuman et al. (2002) study (well designed IMHO) demonstrating the positive effects of the brain-clock based Groove treament (based on the Interactive Metronome technology) on improved golf performance. [see conflict of interest disclosure post]

• Abstract: In this experiment, the authors investigated the influence of training in timing on performance accuracy in golf. During pre- and posttesting, 40 participants hit golf balls with 4 different clubs in a golf course simulator. The dependent measure was the distance in feet that the ball ended from the target. Between the pre- and posttest, participants in the experimental condition received 10 hr of timing training with an instrument that was designed to train participants to tap their hands and feet in synchrony with target sounds. The participants in the control condition read literature about how to improve their golf swing. The results indicated that the participants in the experimental condition significantl improved their accuracy relative to the participants in the control condition, who did not show any improvement. We concluded that training in timing leads to improvement in accuracy, and that our results have implications for training in golf as well as other complex motor activities.

And yet another positive RAS stroke study by the Thaut et al. (2007) research group

• Abstract: Objectives: The effectiveness of 2 different types of gait trainingi n stroke rehabilitation, rhythmic auditory stimulation (RAS) versus neurodevelopmental therapy (NDT)/Bobath-based training, was compared in 2 groups of hemiparetic stroke patients over a 3-week period of daily training (RAS group, n = 43; NDT/Bobath group =35). Methods.Mean entry date into the study was 21.3 days poststroke for the RAS group and 22.3 days for the control group. Patients entered the study as soon as they were able to complete 5 stride cycles with handheld assistance. Patients were closely equated by age, gender,and lesion site. Motor function in both groups was preassessed by the Barthel Index and the Fugl-Meyer Scales. Results. Pre- to posttest measures showed a significant improvement in the RAS group for velocity (P = .006), stride length (P = .0001), cadence (P = .0001) and symmetry (P = .0049) over the NDT/Bobath group. Effect sizes for RAS over NDT/Bobath training were 13.1 m/min for velocity, 0.18 m for stride length, and 19 steps/min for cadence. Conclusions. The data show that after 3 weeks of gait training, RAS is an effective therapeutic method to enhance gait training in hemiparetic stroke rehabilitation. Gains were significantly higher for RAS compared to NDT/Bobath training.
  

Time Doc Byte # 3 - Brain clock importance and clinical groups

Here is my third Time Doc Byte. Categories - "importance" of the human brain clock and mental time-keeping; relevance to clinical groups/populations

This time the quotes come from a chapter from Meck (2003); Introduction to edited book - Functional and Neural Mechanisms of Interval Timing - yep, I've got the book and am hoping I can get through the technical and deep material - the book is listed as a "recommended book" on the right side of this blog).

Underline or italic emphasis added by blogmaster.

• The term interval timing is used to describe the temporal discrimination processes involved in the estimation and reproduction of relatively short during the seconds-to-minutes range that form the fabric of our everyday existence and unite our mental representations of actions and rhythmical structures.

• Human learning and memory is highly sensitive to temporal factors, and oscillator-based models have been proposed for the coding of serial order in memory...In addition, deficits in learning, memory, set shifting, and interval timing have been observed in a variety of patient populations with damage to the basal ganglia, including Parkinson's disease and Huntington's disease patients, as well as other cortical and subcortical brain structures affected by Alzheimer's disease, injury, and stroke.

• ...understanding temporal integration by the brain will be among the premier topics to unite systems, cellular, computational, and cognitive neuroscience over the next decade.

• It is interesting to note that some researchers have argued that a primary function of the internal clock is to allow for the efficient transfer of information from one stage of information processing to another at regularly spaced intervals.
  

Technorati Tags: psychology, educational psychology, neuropsychology, neuroscience, interval timing, brain clock, mental time keeping, Parkinsons, Huntingtons, Alzheimers, stroke, brain injury, temporal processing, Time Doc Byte

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Stroke patients and metronome training

I just ran across an article (actually based on an email tip via the mental timing grapevine) for a 2002 article by Thaut et al. in Neuropsychologia that supports the use of synchronized metronome tapping (SMT) methods to improve motor coordination in patients with strokes.

In the article, the authors goal was to "investigate the effect of rhythm on the control of paretic arm movements in stroke patients." The basis for this intervention was prior research that had suggested that:

• "a rhythmic model of rehabilitative motor training, has shown significant improvements in gait function of stroke patients. In this model, rhythm functions as a sensory cue to induce temporal stability and enhance the temporal organization of motor control in the nervous system by translating the temporal structure of movement patterns into temporally isomorphic auditory rhythmic patterns to entrain the movement in question. Similar models have been successfully used in high-performance motor skill learning in sports and music."

In a sample of 21 hemispheric stroke patients, the researchers found that:

• "the observed changes in timing and trajectory control strongly suggest that the structured time information in auditory rhythm added significant kinematic stability to the patient’s paretic arm reaching motions. These changes were not present during the non-rhythmic condition...Our data suggest, therefore, that auditory rhythm may offer an essential component of enhanced sensorimotor control to make hemiparetic arm training more effective."

The results of this study provide indirect support for the use of the Interactive Metronome SMT-based program in stroke patients with motor control impairment. (click here for other IM-related prior posts on this blog). Of course, all of this makes sense in the context of the extant research literature on temporal processing and the IQ Brain Clock (click here to enter the wonderful world of the IQ Brain Clock EWOK)

Click here for IM-related conflict of interest statement.

Technorati Tags: psychology, educational psychology, rehabilitation, strokes, motor function, metronome, Interactive Metronome, rhythmicity, neuroscience, neuropsychology, stroke rehab, speech and language

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My Stroke Insight book

Thanks to Neurofuture for the tip re: a book (My Stroke Insight) that captures the personal journey of a neuroanatomist with suffered an AVM stroke, and how she regained many capabilities via innovative and traditional rehab methods. The following description was lifted from the link above:

Jill Taylor was a 37-year-old Harvard-trained brain scientist when a blood vessel exploded in her brain. Through the eyes of a curious scientist, she watched her mind deteriorate whereby she could not walk, talk, read, write, or recall any of her life. Because of her understanding of the brain, her respect for the cells in her body, and an amazing mother, Jill completely recovered. In My Stroke of Insight, she shares her recommendations for recovery and the insight she gained into the unique functions of the two halves of her brain. When she lost the skills of her left brain, her consciousness shifted away from normal reality where she felt "at one with the universe." Taylor helps others not only rebuild their brains from trauma, but helps those of us with normal brains better understand how we can consciously influence the neural circuitry underlying what we think, how we feel and how we react to life’s circumstances.

Technorati Tags: psychology, educational psychology, school psychology, neuropsychology, neuroscience, stroke, brain injury, rehabilitation

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"Brain cleaner" for brain injuries

Interesting article at the Science Blog about a new "brain cleaner" for use in treating brain injuries.

Technorati Tags: psychology, educational psychology, school psychology, neuropsychology, neuroscience, brain, brain injury, glutamate

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Motor imagery and neurotechnologies

The Positive Technology Journal has two posts re: articles reporting on new uses of neurotechnology. One is "Motor imagery and EEG-based control of spellling devices and neuroprotheses." The second is "Motor imagery practice in gait rehabilitation of chronic post-stroke hemiparesis." Check out this valuable blog site.

Technorati Tags: psychology, neuroscience, neuropsychology, neurotechnology, motor, motor imagery, spelling, neuroprotheses, brain, strokes, stroke rehabilitation, rehabilitation, hemiparesis, spelling

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