Music aids stroke recovery

Researchers claim “listening to music in the early weeks after a stroke could help patients recover from brain damage”, reported the Daily Mail on a study.

The Daily Telegraph said that the stroke patients were divided into three groups. One group listened to pop, classical, jazz or folk music for a couple of hours a day while the other two listened to audio books or did not listen to anything. It was found that the music group had a better verbal memory, were more focused and were happier than those in the other two groups.

The results show that all three groups improved with time. Although an appropriate technique was used to randomly allocate the patients to their groups, there were differences between the music and control groups at the beginning of the study that could account for the small differences in improvements. For example, the music group were younger, started treatment earlier, and had fewer strokes in the temporal region of the brain. It is not clear from this study how much benefit music therapy has.

In the meantime, those who enjoy listening to music should continue to do so, and those who feel it may benefit them in other ways will obviously find no harm in it.

Where did the story come from?

Dr Teppo Sarkamo from the Department of Psychology at the University of Helsinki in Finland is the main author of the study. The project was supported by the Academy of Finland and other foundations from Finland. The study was published in the peer-reviewed medical journal: Brain.

What kind of scientific study was this?

In this randomised controlled trial, 60 stroke patients were recruited between March 2004 and May 2006 from the Helsinki Hospital neurology department.

The researchers recruited only those who had had a particular type of stroke, (ischaemic middle cerebral artery stroke), were able to cooperate and, prior to the stroke, had had no neurological or psychiatric illness.

The patients were randomly allocated to one of three groups; those who were given a portable CD player with their favourite music (the music group), those who were given cassette players with narrated books chosen by the patients (the language group), and a group that had neither books nor music (the control group). The study was single blinded, meaning that the researchers assessing the patients’ cognitive function were unaware of the groups to which the patients had been allocated.

The patients in the music and narrated book groups were told to listen for at least an hour a day, whether at the hospital or at home, and asked to keep a diary detailing how long they had listened. Clinical and neuropsychological assessments were carried out at the start of the study (within one week from stroke) and at three and six months after the stroke. Standard tests of verbal memory, short-term memory, language, spatial cognition, music cognition and attention were used. The patients also completed a Quality Of Life (QOL) questionnaire and a specific Finnish Profile Of Mood States (POMS) questionnaire that asked 38 questions about aspects of mood such as tension, depression, irritability, vigour, fatigue, confusion, inertia and forgetfulness.

What were the results of the study?

There were some minor chance differences between the groups at the start of the study, although none of these was statistically significant. For example, the music group were slightly younger than the control group, were more likely to have listened to music or the radio prior to their stroke, had begun treatment about two days sooner than the control group, and were less likely to have had strokes in the temporal lobe region of the brain. The music group also scored worse (45 out of 124) in a test of verbal memory than the control group (50 out of 124). Fifty-four patients completed
the study.

Not surprisingly, the music group listened to more music than the control or language groups. Of the 10 cognitive measures reported, two showed statistically significant differences between the groups. At three months, the music groups’ verbal memory improved by about 25 points on a 124-point scale compared to an improvement of about 15 points in the control group and about 10 points in the language group. The other cognitive measure, focused attention (assessed by a series of questions at three months), improved by about 12 points on a scale of 90 compared to the control or language groups who showed little change.

All groups improved by a similar amount in music cognition. The groups did not show significant differences in change in mood from the start of the study, and differences were only found when the researchers looked at mood scores at three months. At this time, the music group showed significantly lower depression scores than the control group, but no differences on the other seven aspects of mood.

What interpretations did the researchers draw from these results?

The researchers claim that their findings demonstrate for the first time “that music listening during the early post-stroke stage can enhance cognitive recovery and prevent negative mood”.

What does the NHS Knowledge Service make of this study?

This study has investigated the effect of listening to music during recovery from stroke and has provided some early evidence that the therapy may be useful. However, confident conclusions are prevented by the small size of the study and doubts about similarities between the groups at the start of the study. It is possible that the music groups younger age or different type of stroke account for the results.

Larger studies are needed before listening to music therapy can be regarded as therapeutic for stroke and prescribed as such.