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The effect of music therapy on language recovery in patients with aphasia after stroke: a systematic review and meta-analysis

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Abstract

Objective

The aim of this meta-analysis was to evaluate the evidence on the effectiveness of music therapy in the recovery of language function in post-stroke aphasia, compared with conventional therapy or no therapy.

Methods

We searched studies that explored the effect of music therapy on language function in post-stroke aphasia and published in PubMed, Embase, the Cochrane Library, Web of Science, CINAHL, ProQuest Digital Dissertations, and ClinicalTrials.gov from inception to March 2021. Six reviewers independently screened out eligible studies, extracted data, and evaluated the methodological quality. Results were pooled using mean difference (MD) with 95% confidence interval (CI). Heterogeneity was assessed by the chi-square test and I2 statistic.

Results

Six studies were included in this meta-analysis involving 115 patients. The methodological quality of these studies ranged from poor to excellent. There was significant mean difference in functional communication for post-stroke aphasia by 1.45 (95% CI: 0.24, 2.65; P = 0.02, from poor to excellent evidence), in repetition by 6.49 (95% CI: 0.97, 12.00; P = 0.02, from acceptable to excellent evidence), and in naming by 11.44 (95% CI: 1.63, 21.26; P = 0.02, from acceptable to excellent evidence). But there was no significant difference in comprehension for post-stroke aphasia by 7.21 (95% CI: − 10.88, 25.29; P = 0.43, from acceptable to excellent evidence).

Conclusions

Music therapy can improve functional communication, repetition, and naming in patients with post-stroke aphasia, but did not significantly improve comprehension.

Trial registration

CRD42021251526

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References

  1. Berthier ML (2005) Poststroke aphasia: epidemiology, pathophysiology and treatment. Drugs Aging 22(2):163–182. https://doi.org/10.2165/00002512-200522020-00006

    Article  CAS  PubMed  Google Scholar 

  2. Fridriksson J, Rorden C, Elm J, Sen S, George MS, Bonilha L (2018) Transcranial direct current stimulation vs sham stimulation to treat aphasia after stroke: a randomized clinical trial. JAMA Neurol 75(12):1470–1476. https://doi.org/10.1001/jamaneurol.2018.2287

    Article  PubMed  PubMed Central  Google Scholar 

  3. Godecke E, Armstrong E, Rai T, Ciccone N, Rose ML, Middleton S, Whitworth A, Holland A, Ellery F, Hankey GJ, Cadilhac DA, Bernhardt J, VERSE Collaborative Group (2021) A randomized control trial of intensive aphasia therapy after acute stroke: the Very Early Rehabilitation for SpEech (VERSE) study. Int J Stroke 16(5)556-572https://doi.org/10.1177/1747493020961926

  4. Fama ME, Turkeltaub PE (2014) Treatment of poststroke aphasia: current practice and new directions. Semin Neurol 34(5):504–513. https://doi.org/10.1055/s-0034-1396004

    Article  PubMed  Google Scholar 

  5. Lendrem W, Lincoln NB (1985) Spontaneous recovery of language in patients with aphasia between 4 and 34 weeks after stroke. J Neurol Neurosurg Psychiatry 48(8):743–748. https://doi.org/10.1136/jnnp.48.8.743

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  6. Brady MC, Kelly H, Godwin J, Enderby P, Campbell P (2016) Speech and language therapy for aphasia following stroke. Cochrane Database Syst Rev 2016(6):CD000425. https://doi.org/10.1002/14651858.CD000425.pub4

  7. Lazar RM, Minzer B, Antoniello D, Festa JR, Krakauer JW, Marshall RS (2010) Improvement in aphasia scores after stroke is well predicted by initial severity. Stroke 41(7):1485–1488. https://doi.org/10.1161/STROKEAHA.109.577338

    Article  PubMed  PubMed Central  Google Scholar 

  8. Code C (2003) The quantity of life for people with chronic aphasia. Neuropsychol Rehabil 13(3):379-390https://doi.org/10.1080/09602010244000255

  9. Jones F, Riazi A (2011) Self-efficacy and self-management after stroke: a systematic review. Disabil Rehabil 33(10):797–810. https://doi.org/10.3109/09638288.2010.511415

    Article  PubMed  Google Scholar 

  10. Engelter ST, Gostynski M, Papa S, Frei M, Born C, Ajdacic-Gross V, Gutzwiller F, Lyrer PA (2006) Epidemiology of aphasia attributable to first ischemic stroke: incidence, severity, fluency, etiology, and thrombolysis. Stroke 37(6):1379–1384. https://doi.org/10.1161/01.STR.0000221815.64093.8c

    Article  PubMed  Google Scholar 

  11. Magee WL, Clark I, Tamplin J, Bradt J (2017) Music interventions for acquired brain injury. Cochrane Database Syst Rev 1(1):D6787. https://doi.org/10.1002/14651858.CD006787.pub3

  12. Aalbers S, Fusar-Poli L, Freeman RE, Spreen M, Ket JC, Vink AC, Maratos A, Crawford M, Chen XJ, Gold C (2017) Music therapy for depression. Cochrane Database Syst Rev 11(11):D4517. https://doi.org/10.1002/14651858.CD004517.pub3

  13. Särkämö T, Tervaniemi M, Laitinen S, Forsblom A, Soinila S, Mikkonen M, Autti T, Silvennoinen HM, Erkkilä J, Laine M, Peretz I, Hietanen M (2008) Music listening enhances cognitive recovery and mood after middle cerebral artery stroke. Brain 131(Pt 3):866–76. https://doi.org/10.1093/brain/awn013

  14. Kim SJ, Koh I (2005) The effects of music on pain perception of stroke patients during upper extremity joint exercises. J Music Ther 42(1):81–92. https://doi.org/10.1093/jmt/42.1.81

  15. Tarrant M, Carter M, Dean SG, Taylor R, Warren FC, Spencer A, Adamson J, Landa P, Code C, Backhouse A, Lamont RA, Calitri R (2021) Singing for people with aphasia (SPA): results of a pilot feasibility randomised controlled trial of a group singing intervention investigating acceptability and feasibility. BMJ Open 11(1):e040544. https://doi.org/10.1136/bmjopen-2020-040544

    Article  PubMed  PubMed Central  Google Scholar 

  16. Sihvonen AJ, Leo V, Ripollés P, Lehtovaara T, Ylönen A, Rajanaro P, Laitinen S, Forsblom A, Saunavaara J, Autti T, Laine M, Rodríguez-Fornells A, Tervaniemi M, Soinila S, Särkämö T (2020) Vocal music enhances memory and language recovery after stroke: pooled results from two RCTs. Ann Clin Transl Neurol 7(11):2272–2287. https://doi.org/10.1002/acn3.51217

    Article  PubMed  PubMed Central  Google Scholar 

  17. Leonardi S, Cacciola A, De Luca R, Aragona B, Andronaco V, Milardi D, Bramanti P, Calabrò RS (2018) The role of music therapy in rehabilitation: improving aphasia and beyond. Int J Neurosci 128(1):90–99. https://doi.org/10.1080/00207454.2017.1353981

    Article  PubMed  Google Scholar 

  18. Shi ER, Zhang Q (2020) A domain-general perspective on the role of the basal ganglia in language and music: benefits of music therapy for the treatment of aphasia. Brain Lang 206:104811. https://doi.org/10.1016/j.bandl.2020.104811

    Article  PubMed  Google Scholar 

  19. Särkämö T, Sihvonen AJ (2018) Golden oldies and silver brains: deficits, preservation, learning, and rehabilitation effects of music in ageing-related neurological disorders. Cortex 109:104–123. https://doi.org/10.1016/j.cortex.2018.08.034

    Article  PubMed  Google Scholar 

  20. Moher D, Shamseer L, Clarke M, Ghersi D, Liberati A, Petticrew M, Shekelle P, Stewart LA, PRISMA-P Group (2015) Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015 statement. Syst Rev 4(1)1https://doi.org/10.1186/2046-4053-4-1

  21. Bhogal SK, Teasell RW, Foley NC, Speechley MR (2005) The PEDro scale provides a more comprehensive measure of methodological quality than the Jadad scale in stroke rehabilitation literature. J Clin Epidemiol 58(7):668–673. https://doi.org/10.1016/j.jclinepi.2005.01.002

    Article  PubMed  Google Scholar 

  22. Foley NC, Teasell RW, Bhogal SK, Speechley MR (2003) Stroke rehabilitation evidence-based review: methodology. Top Stroke Rehabil 10(1):1–7

    Article  Google Scholar 

  23. Higgins JP, Altman DG, Gøtzsche PC, Jüni P, Moher D, Oxman AD, Savovic J, Schulz KF, Weeks L, Sterne JA, Cochrane Bias Methods Group, Cochrane Statistical Methods Group (2011) The Cochrane Collaboration’s tool for assessing risk of bias in randomised trials. BMJ 343:d5928https://doi.org/10.1136/bmj.d5928

  24. Yang FG, Wang NY, Lin C, Chiang T, Lin C, Lai Y (2019) Change of neuronal pathways in Chinese speakers with non-fluent aphasia after therapy. LINGUA 218(SI):3–13. https://doi.org/10.1016/j.lingua.2018.01.005

  25. Haro-Martínez AM, Lubrini G, Madero-Jarabo R, Díez-Tejedor E, Fuentes B (2019) Melodic intonation therapy in post-stroke nonfluent aphasia: a randomized pilot trial. Clin Rehabil 33(1):44–53. https://doi.org/10.1177/0269215518791004

    Article  PubMed  Google Scholar 

  26. Van Der Meulen I, Van De Sandt-Koenderman MW, Heijenbrok MH, Visch-Brink E, Ribbers GM (2016) Melodic intonation therapy in chronic aphasia: evidence from a pilot randomized controlled trial. Front Hum Neurosci 10:533. https://doi.org/10.3389/fnhum.2016.00533

    Article  Google Scholar 

  27. van der Meulen I, van de Sandt-Koenderman WM, Heijenbrok-Kal MH, Visch-Brink EG, Ribbers GM (2014) the efficacy and timing of melodic intonation therapy in subacute aphasia. Neurorehabil Neural Repair 28(6):536–544. https://doi.org/10.1177/1545968313517753

    Article  PubMed  Google Scholar 

  28. Lim KB, Kim YK, Lee HJ, Yoo J, Hwang JY, Kim JA, Kim SK (2013) The therapeutic effect of neurologic music therapy and speech language therapy in post-stroke aphasic patients. Ann Rehabil Med 37(4):556–562. https://doi.org/10.5535/arm.2013.37.4.556

    Article  PubMed  PubMed Central  Google Scholar 

  29. Conklyn D, Novak E, Boissy A, Bethoux F, Chemali K (2012) The effects of modified melodic intonation therapy on nonfluent aphasia: a pilot study. J Speech Lang Hear Res 55(5):1463–1471. https://doi.org/10.1044/1092-4388(2012/11-0105)

    Article  PubMed  Google Scholar 

  30. Yang Y, Fang YY, Gao J, Geng GL (2019) Effects of five-element music on language recovery in patients with poststroke aphasia: a systematic review and meta-analysis. J Altern Complement Med 25(10):993–1004. https://doi.org/10.1089/acm.2018.0479

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Graduate School of Hebei Medical University, Shijiazhuang, 050000, China

    Qingqing Liu, Yu Yin, Yue Zhao, Yafei Tan & Jing Yu

  2. Department of Gastrointestinal Surgery, the Second Hospital of Hebei Medical University, Shijiazhuang, 050000, China

    Weibo Li

  3. Rehabilitation Department, Hebei General Hospital, Shijiazhuang, 050000, China

    Yu Yin, Zhenbiao Zhao & Yuhui Yang

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  1. Qingqing Liu
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  2. Weibo Li
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Contributions

Qingqing Liu and Yu Yin initiated the study; Weibo Li and Zhenbiao Zhao contributed to the study design; Qingqing Liu, Yu Yin, Zhenbiao Zhao, and Yuhui Yang carried out the search and selection study; Yue Zhao and Yafei Tan performed data extraction; Yue Zhao and Yuhui Yang evaluated the quality of the study; Qingqing Liu and Jing Yu assessed the risk of bias; Qingqing Liu, Weibo Li, Yu Yin, and Zhenbiao Zhao contributed to statistical analysis. All authors contributed to interpreting the results. Qingqing Liu and Yu Yin wrote the first draft of the manuscript. Other authors contributed to the revision of the draft. All authors agreed with the final manuscript.

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Correspondence to Yu Yin.

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Liu, Q., Li, W., Yin, Y. et al. The effect of music therapy on language recovery in patients with aphasia after stroke: a systematic review and meta-analysis. Neurol Sci 43, 863–872 (2022). https://doi.org/10.1007/s10072-021-05743-9

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  • DOI: https://doi.org/10.1007/s10072-021-05743-9

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