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01.21.2025

Harnessing the power of music for neurorehabilitation: Evidence-based approaches

Music has long been recognized for its ability to evoke emotion and enhance cognitive function, but in recent decades, researchers have increasingly focused on its potential therapeutic role in neurorehabilitation. Music therapy is now an established tool in the treatment of neurologic disorders, from stroke to Parkinson disease, due to its ability to engage and synchronize brain regions involved in motor control, cognition, and emotional regulation. Numerous studies have demonstrated that music-based interventions can improve recovery outcomes in patients with neurologic impairments by stimulating neuroplasticity, enhancing motor skills, and supporting emotional well-being.

For neurologists, understanding the mechanisms and evidence behind music therapy can provide valuable insights into how this non-invasive treatment may be integrated into clinical practice to support neurologic recovery.

Music and motor recovery: rhythmic auditory stimulation

One of the most well-documented uses of music in neurorehabilitation is rhythmic auditory stimulation, which uses the rhythmic properties of music to improve motor function, particularly in patients recovering from stroke or living with Parkinson disease.

  • Key Study: Rhythmic auditory stimulation in stroke rehabilitation. In a pivotal study by Thaut and colleagues, researchers examined the effects of rhythmic auditory stimulation on gait in post-stroke patients (Thaut et al 1997). Participants were divided into two groups: one received conventional physical therapy, and the other underwent rhythmic auditory stimulation-based gait training. The study found that the group exposed to rhythmic auditory stimulation showed significant improvements in stride length, gait velocity, and overall motor coordination compared to the control group. These findings demonstrated that the brain’s motor systems can synchronize with external rhythmic cues, improving locomotion in patients with neurologic impairments.
  • Key Study: Rhythmic auditory stimulation in Parkinson disease. In Parkinson disease, rhythmic auditory stimulation has also shown efficacy in improving gait. Research by McIntosh and colleagues revealed that rhythmic auditory stimulation can help patients with Parkinson disease improve walking speed, step length, and cadence (McIntosh et al 1997). Rhythmic auditory cues help bypass the defective basal ganglia circuitry involved in Parkinson disease, providing an external stimulus to initiate and maintain movement. This has profound implications for enhancing patients’ mobility and independence.

Language and communication: melodic intonation therapy

Melodic intonation therapy has proven to be an effective intervention for patients with aphasia, particularly following a stroke. Melodic intonation therapy leverages the brain’s preserved ability to process melody and rhythm, which are often housed in the right hemisphere, to compensate for damage to the language-dominant left hemisphere.

  • Key Studies: melodic intonation therapy in nonfluent aphasia. A study by Schlaug and colleagues demonstrated the efficacy of melodic intonation therapy in treating non-fluent aphasia (Schlaug et al 2008). The researchers conducted an imaging study using fMRI to observe brain changes in patients undergoing melodic intonation therapy. They found that after intensive therapy, there was increased activation in right-hemisphere regions associated with language and motor planning. Patients exhibited significant improvements in their ability to produce speech, suggesting that music can facilitate neuroplasticity in brain areas adjacent to damaged regions, thereby enhancing speech recovery.
  • In another study, van der Meulen and colleagues compared melodic intonation therapy with traditional speech therapy in aphasia patients (van der Meulen et al 2014). Those who received melodic intonation therapy showed better outcomes in verbal communication and were more likely to regain fluency, further supporting the role of melodic elements in restoring language function in patients with speech impairments due to stroke or brain injury.

Cognitive rehabilitation and emotional well-being

Beyond motor and language recovery, music has been found to enhance cognitive function and emotional well-being in patients with neurologic impairments. Music engages the hippocampus and prefrontal cortex, key areas for memory and executive function, making it a valuable tool in treating patients with cognitive deficits following stroke or traumatic brain injury.

  • Key Study: listening to music after stroke. In a study by Särkämö and colleagues, stroke patients were divided into three groups: one listened to music daily, another to audiobooks, and a third received standard care without auditory stimuli (Särkämö et al 2008). The group that listened to music exhibited significantly better recovery in verbal memory, focused attention, and mood compared to the other two groups. The researchers suggested that listening to music could enhance cognitive rehabilitation by stimulating neural networks involved in attention, memory, and emotional processing.
  • Music’s role in emotional regulation. Music’s capacity to engage the limbic system and regulate mood is also critical in neurorehabilitation. Patients recovering from stroke, traumatic brain injury, or neurodegenerative diseases often experience anxiety, depression, and emotional instability, which can impede rehabilitation progress. Music therapy has been shown to reduce stress, alleviate depression, and improve patients' emotional resilience, which in turn supports engagement in rehabilitation programs and enhances overall recovery outcomes.

Neurodegenerative diseases: music in Parkinson disease and dementia

Music therapy has shown particular promise in treating patients with Parkinson disease and dementia. In addition to improving motor function, music has cognitive and emotional benefits that can improve the quality of life for patients with neurodegenerative diseases.

  • Key Study: music therapy in Parkinson disease. A study by Pacchetti and colleagues investigated the effects of music therapy on motor and emotional functions in patients with Parkinson disease (Pacchetti et al 2000). The study demonstrated that patients who participated in music therapy sessions had significant improvements in motor symptoms (such as tremor and bradykinesia) and reported enhanced emotional well-being. Music therapy allowed patients to synchronize movements with rhythmic cues, thereby improving motor coordination while also offering emotional expression and relief from depression and anxiety.
  • Key study: music and dementia. In dementia care, music therapy has been shown to improve cognitive function, reduce agitation, and enhance quality of life. A study by Simmons-Stern and colleagues found that patients with Alzheimer disease who were exposed to familiar music exhibited better autobiographical memory recall and reduced anxiety (Simmons-Stern et al 2010). Music helps engage memory circuits that remain intact during the early stages of dementia, providing a unique means of stimulating cognition and emotional well-being.

Conclusion: integrating music into neurorehabilitation

Music therapy is emerging as a powerful tool in neurorehabilitation, supported by a growing body of research. Studies demonstrate that music, through mechanisms such as rhythmic synchronization, melodic processing, and emotional engagement, can enhance neuroplasticity, improve motor function, facilitate language recovery, and support cognitive rehabilitation. For neurologists, incorporating music-based therapies into treatment plans offers a noninvasive, patient-centered approach to improving outcomes in patients with stroke, traumatic brain injury, Parkinson disease, and other neurologic conditions.

As research continues to expand, music therapy is likely to play an increasingly important role in the rehabilitation landscape, offering new avenues for treatment and recovery in neurologic care.

References cited:

McIntosh GC, Brown SH, Rice RR, Thaut MH. Rhythmic auditory-motor facilitation of gait patterns in patients with Parkinson's disease. J Neurol Neurosurg Psychiatry 1997;62(1):22-6. PMID: 9010395 PMID 9010395

Pacchetti C, Mancini F, Aglieri R, Fundarò C, Martignoni E, Nappi G. Active music therapy in Parkinson's disease: an integrative method for motor and emotional rehabilitation. Psychosom Med 2000;62(3):386-93. PMID 10845352

Särkämö T, Tervaniemi M, Laitinen S, et al. Music listening enhances cognitive recovery and mood after middle cerebral artery stroke. Brain 2008;131(Pt 3):866-76. PMID 18287122

Schlaug G, Norton A, Marchina S, Zipse L, Wan CY. From singing to speaking: facilitating recovery from nonfluent aphasia. Future Neurol 2010;5(5):657-65. PMID 21088709

Simmons-Stern NR, Budson AE, Ally BA. Music as a memory enhancer in patients with Alzheimer's disease. Neuropsychologia 2010;48(10):3164-7. PMID 20452365

Thaut MH, McIntosh GC, Rice RR. Rhythmic facilitation of gait training in hemiparetic stroke rehabilitation. J Neurol Sci 1997;151(2):207-12. PMID 9349677

van der Meulen I, van de Sandt-Koenderman WM, Heijenbrok-Kal MH, Visch-Brink EG, Ribbers GM. The efficacy and timing of melodic intonation therapy in subacute aphasia. Neurorehabil Neural Repair 2014;28(6):536-44. PMID 24449708


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