Buard Isabelle, Dewispelaere William B, Thaut Michael, Kluger Benzi M
Department of Neurology, University of Colorado Denver, Denver, CO, United States.
Medical School Program, University of Colorado Denver, Denver, CO, United States.
Front Neurosci. 2019 Feb 19;13:105. doi: 10.3389/fnins.2019.00105. eCollection 2019.
Neurologic Music Therapy (NMT) is a novel impairment-focused behavioral intervention system whose techniques are based on the clinical neuroscience of music perception, cognition, and production. Auditory Stimulation (RAS) is one of the NMT techniques, which aims to develop and maintain a physiological rhythmic motor activity through rhythmic auditory cues. In a series of breakthrough studies beginning in the mid-nineties, we discovered that RAS durably improves gait velocity, stride length, and cadence in Parkinson's disease (PD). No study to date reports the neurophysiological evidence of auditory-motor frequency entrainment after a NMT intervention in the Parkinson's community. We hypothesized that NMT-related motor improvements in PD are due to entrainment-related coupling between auditory and motor activity resulting from an increased functional communication between the auditory and the motor cortices. Spectral analysis in the primary motor and auditory cortices during a cued finger tapping task showed a simultaneous increase in evoked power in the beta-range along with an increased functional connectivity after a course of NMT in a small sample of three older adults with PD. This case study provides preliminary evidence that NMT-based motor rehabilitation may enhance cortical activation in the auditory and motor areas in a synergic manner. With a lack of both control subjects and control conditions, this neuroimaging case-proof of concept series of visible changes suggests potential mechanisms and offers further education on the clinical applications of musical interventions for motor impairments.
神经音乐疗法（NMT）是一种新型的以损伤为重点的行为干预系统，其技术基于音乐感知、认知和产生的临床神经科学。节律性听觉刺激（RAS）是NMT技术之一，旨在通过节律性听觉线索来发展和维持生理性节律性运动活动。在始于九十年代中期的一系列突破性研究中，我们发现RAS能持久改善帕金森病（PD）患者的步态速度、步幅和步频。迄今为止，尚无研究报道帕金森病群体在接受NMT干预后听觉-运动频率同步的神经生理学证据。我们推测，PD患者中与NMT相关的运动改善是由于听觉和运动皮层之间功能交流增加，导致听觉和运动活动之间与同步相关的耦合。在一项针对三名老年PD患者的小样本研究中，在提示性手指敲击任务期间对初级运动皮层和听觉皮层进行频谱分析，结果显示，经过一个疗程的NMT后，β波段的诱发功率同时增加，功能连接性也增强。该案例研究提供了初步证据，表明基于NMT的运动康复可能以协同方式增强听觉和运动区域的皮层激活。由于缺乏对照受试者和对照条件，这个可见变化的神经影像学概念验证案例系列提示了潜在机制，并为运动障碍的音乐干预临床应用提供了进一步的知识。
