Monday, January 15, 2018

Sound Heals

The sound of healing: Study says sound-stimulation could help Alzheimer's patients

A new therapy could be music to the ears of hundreds of thousands of Canadians suffering from Alzheimer's disease.
Study of Alzheimer’s Patients Finds Low Frequency Sound Stimulation Improves Cognition
A recent study found that sitting down patients in a chair with built-in speakers and subjecting them to sound stimulation at 40 hertz had "promising" results in terms of increasing their cognition, clarity and alertness.


The research, which was undertaken by researchers from the University of Toronto, Wilfrid Laurier University and the Baycrest Centre hospital in Toronto, studied the effects on 18 participants with different stages of the disease (six mild, six moderate and six severe) after six sessions of treatment.

They also received a second round of treatment through visual stimulation on DVDs, also across six sessions.

Researchers then tested the participants on their mental, emotional and behavioural states.

They found that the 40 Hz stimulation had the strongest impact on patients with mild or moderate Alzheimer's disease.

While the study's sample size is small, Lee Bartel, one of the authors of the study says the findings are encouraging.

"I was absolutely delighted and elated because … you go from theory, and this study had not been done before," said Bartel, associate director of the Music and Health Research Collaboratory at the University of Toronto.

Bartel said the study saw some of the participants with mild Alzheimer's return to being "normal again," and those in moderate condition see their symptoms be downgraded to mild.

"They became more engaged with their present space and the people around them," said Bartel.

"They seemed to be more alert and more interested in life and the goings on, and, in fact there was evidence of some memory from two or three days before ," he added.

Amy Clements-Cortes, another one of the authors and senior music therapist at Baycrest, was also hopeful about the study's findings.

"(There was) increased clarity and cognition, as well as increased alertness to the surroundings, and we also saw that it prompted spontaneous discussion, storytelling and reminiscence," said Clements-Cortes.

Bartel said he came up with the premise of the study after seeing research from the 1990s that Alzheimer sufferers have a lower frequency pattern at which neurons interact in the central nervous system. In healthy people, the pattern, or gamma frequency, generally hovers around 40 Hz.

Bartel compared it to the need for wireless telephones to function at the same frequency in order to communicate.

"Parts of the brain appear to need to be at the same communication frequency, and that frequency is about 40 Hz," said Bartel.

"So when you have a deterioration of that -- when you have too little of it -- the two parts of the brain that want to talk to each other, like the thalamus and the hippocampus, the short-term memory to the long-term memory, they can't talk to each other, they won't communicate, so you won't have a long-term memory."

Bartel said the sound-stimulation treatment at 40 Hz leads to an "increased" frequency, which allows "parts of the brain to talk to each other again."

"So in a sense it is like sitting on the subwoofer of your sound system," explained Bartel.

"So you are getting both the sound and the feeling of the vibration, which in turn is communicated through the cells of the body."

Bartel said the body's cells proceed to relay the frequency to the sensory-motor and auditory cortices to "reregulate" the brain.

Despite the treatment being relatively non-invasive, there are some risks, according to the authors.

Bartel said the magnets in the chair's built-in speakers could pose problems for people with pacemakers. The vibrations could also be dangerous for people with blood clots or strokes. The authors also don't recommend the treatment for pregnant women.

"There are very minimal risks -- it is only sound," said Bartel.

While Bartel admits the treatment is likely not the "cure for Alzheimer's," he and Clements-Cortes said it could be a "relatively inexpensive" way for people to treat themselves at home.

Bartel said the chair they used at Baycrest cost $10,000, but there are devices on the market or new ones that are "much less expensive."

"What we have is potentially a means where a person at home can use a vibratory-therapy device and with the right soundtrack -- that we can find a way to make -- people could treat themselves, and perhaps it could delay the speed of development, or it could, even in some cases, offer a reversal of a mild sort," said Bartel.

"In the broader scale, even if we could halt the rapidity or the decline that would already be a great achievement, and I think that is completely realistic."

Bartel hopes the study's results spur more research in the area.

The University of Toronto is also hosting a showcase for the study, and other breakthroughs that combine music and science, at an event on May 3.


With a report from CTV's medical specialist Avis Favaro and producer Elizabeth St. Philip.

Short-Term Effects of Rhythmic Sensory Stimulation in Alzheimer's Disease: An Exploratory Pilot Study.

Abstract

This study assessed the effect of stimulating the somatosensory system of Alzheimer's disease (AD) patients at three stages of their illness with 40 Hz sound. In this AB cross-over study design, 18 participants (6 mild, 6 moderate, 6 severe) each participated in 13 sessions: one intake and 12 treatment. Treatment A consisted of 40 Hz sound stimulation and Treatment B consisted of visual stimulation using DVDs, each provided twice a week over 6 weeks for a total of 6 times per treatment. Outcome measures included: St. Louis University Mental Status Test (SLUMS), Observed Emotion Rating Scale, and behavioral observation by the researcher. Data were submitted to regression analysis for the series of 6 SLUMS scores in treatment A and 6 scores in B with comparison by group. The slopes for the full sample and subgroups in the 40 Hz treatment were all significant beyond alpha = 0.05, while those for the DVD were not. A thematic analysis of qualitative observations supported the statistical findings. 40 Hz treatment appeared to have the strongest impact on persons with mild and moderate AD. Results are promising in terms of a potential new treatment for persons with AD, and further research is needed.

Study of Alzheimer’s Patients Finds Low Frequency Sound Stimulation Improves Cognition

UTSoundsevent

Prof. Lee Bartel will show how musical vibrations can help return damaged brains to normal function. “Our research shows that the rhythmic part of music stimulates the brain in ways that contribute to powerful healing results,” Bartel said. “Through music we have seen improvements in Alzheimer’s and in fibromyalgia, where patients have decreased pain in as early as three weeks.”

“Sounds of Science: Music, Technology, Medicine” happens live from 4:30 to 5:30 p.m. (explore science fair demonstrations in lobby); and 5:30 to 7 p.m. as a main-stage performance. Tickets are free, but people should register online here.

Results of a new study published in the Journal of Alzheimer’s Disease by a team of researchers at the University of Toronto, Wilfrid Laurier University in Waterloo, Ontario, and the Baycrest Centre in Toronto, Canada, reports the investigators’ assessment of the effect of stimulating the somatosensory systems of Alzheimer’s disease (AD) patients with 40Hz sound (think sub-woofer bass) at three stages of their illness’s degenerative progression.


The report, “Rhythmic Sensory Stimulation in Alzheimer’s Short-Term Effects of Disease: An Exploratory Pilot Study,“ was co-authored by Amy Clements-Cortes, Heidi Ahonen, Michael Evans, Morris Freedman, and Lee Bartel.

ClementsCortesA

Study coordinator and research team member Amy Clements-Cortes is a registered psychotherapist with the College of Registered Psychotherapists of Ontario (CRPO), an assistant professor in the University of Toronto Faculty of Music (LTA), a music therapy instructor and graduate supervisor at Wilfrid Laurier University, and senior music therapist/practice advisor at Toronto’s Baycrest Centre.

Her business, Notes By Amy, is dedicated to providing professional services to people to enhance well-being, personal growth, and development — a mission that embraces the fields of music therapy, music education, and health and wellness.

The Rhythmic Sensory Stimulation and Alzheimer’s disease project is led by the University of Toronto Music and Health Research Collaboratory (MaHRC) in collaboration with the Baycrest Centre and the Conrad Institute for Music Therapy Research at Wilfrid Laurier University.

FreedmanM

⇧ Principal investigator is Dr. Morris Freedman, head of neurology and medical director of the Ross Memory Clinic at Baycrest, and a professor in the University of Toronto Department of Medicine.

⇩ Principal co-investigator Heidi Ahonen, Ph.D., a Wilfrid Laurier University professor of music therapy and director of the Manfred and Penny Conrad Institute for Music Therapy 
Research (CIMTR); an accredited music therapist by the Canadian Music Therapy Association, who is a member of the Group Analytic Society in London, England; the American Group Psychotherapy Association (AGPA); the Canadian Group Psychotherapy Association (CGPA); and the International Association of Group Psychotherapy (IAGP). She is a member of the Music Medicine Collaboration Low Frequency Sound Research web forum that connects researchers and clinicians who are researching therapeutic use and effects of low frequencies.
AhonenH

BartelL

↑Principal co-investigator Lee Bartel, Ph.D., is associate dean of research and acting director of MaHRC, a professor of music education and music and health, and a member of the Collaborative Program in Neuroscience who has taught a graduate course on Music and Brain.

Clements-Cortes says the specific aim of the research, which has received research ethics board approval, was to perform a pilot study evaluating the effects of 40 Hz Rhythmic Sensory Stimulation (RSS) in Alzheimer’s disease (AD) with the intent of informing the parameters of a larger proof-of-concept study followed by a clinical trial.

The purpose of this exploratory study was to test 40-Hz sensory stimulation as a means of improving alertness, clarity, and short-term memory in Alzheimer’s patients.

In this A-B crossover study model, 18 participants (six mild, six moderate, six severe Alzheimer’s patients) participated in 13 sessions — one intake and 12 involving one or another of two treatments. Treatment A consisted of 40Hz sound stimulation, while Treatment B consisted of visual stimulation using DVDs, each provided twice a week over six weeks for a total of six times per treatment. Each participant received six sessions of visual stimulation and six sessions of 40Hz treatment.

Subjects were randomized into one of two groups within the crossover study design. Group one received six sessions of visual stimulation followed by six sessions of 40 Hz treatment, while group two received six sessions of 40 Hz treatment followed by six sessions of visual stimulation, with a “wash-out period” of a minimum of two days between the category crossover.

Outcome evaluations were done using the St. Louis University Mental Status Test (SLUMS), the Observed Emotion Rating Scale, and behavioral observation by the researchers.

Data from the tests were submitted to regression analysis for the series of six SLUMS scores in treatment A and six scores in B with comparison by group. The researchers determined that the 40Hz frequency sound treatment appeared to have the strongest impact on people with mild and moderate Alzheimer’s disease, reporting that slopes for the full sample and subgroups in the 40Hz treatment were all significant beyond alpha=0.05, while those for the DVD treatment were not, and that a thematic analysis of qualitative observations supported the statistical findings.

The investigators conclude that results are promising in terms of sound stimulation being a potential new treatment for persons with Alzheimer’s, although they say further research is needed.

From 4:30 to 7 p.m. on May 3, the Faculty of Music at the University of Toronto will host a free event — Sounds of Science: Music, Technology, Medicine — demonstrating how music helps heal certain medical conditions. The performance at the University’s MacMillan Theatre will showcase the science behind the music with the latest discoveries in music medicine, technology, therapy, and clinical applications of the healing power of music.

Alzheimer's patients' brains boosted by belting out Sound of Music

Four-month study finds mental performance of people with dementia improves after singing classic hits from musicals.
Julie Andrews in The Sound Of Music

Belting out classic numbers from hit musicals can boost the brain function of people with Alzheimer's disease, according to researchers who worked with elderly residents at a US care home. 

Over a four-month study, the mental performance of patients who took part in regular group singing sessions improved compared with others who just listened.

In the sessions, patients were led through familiar songs from The Sound of Music, Oklahoma, The Wizard of Oz and Pinocchio.

The sessions appeared to have the most striking effect on people with moderate to severe dementia, with patients scoring higher on cognitive and drawing tests, and also on a satisfaction-with-life questionnaire at the end of the study.

Jane Flinn, a neuroscientist at George Mason University in Virginia, said care homes that did not hold group singing sessions should consider them, because they were cheap, entertaining and beneficial for patients with Alzheimer's.


A neuroscientist explains: the need for ‘empathetic citizens’ - podcast
"Even when people are in the fairly advanced stages of dementia, when it is so advanced they are in a secure ward, singing sessions were still helpful. The message is: don't give up on these people. You need to be doing things that engage them, and singing is cheap, easy and engaging," she said.

Flinn's colleague Linda Maguire worked with the residents of a care home on the US east coast. Some of the residents with moderate dementia were assigned to an assisted living group. Others, who had more severe Alzheimer's and were kept on a secure ward at the home, formed a second group. Both groups took part in three 50-minute group sessions a week for four months, but only half in each group joined in with the singing. The rest turned up, but only to listen.

Maguire chose most of the songs to be familiar to the patients, and included classics such as The Sound of Music, When You Wish Upon a Star and Somewhere Over the Rainbow.

Scores on cognitive tests given before and after the four months of singing classes showed that mental ability improved among the singers. Those who joined in the singing also fared better at another task that involved drawing the hands on a clock face to show a particular time. The study was described at the Society for Neuroscience meeting in San Diego.

Though memory loss and a decline in brain function are hallmarks of dementia, patients often demonstrate a striking ability to remember the lyrics and melodies of songs from their past. "A lot of people have grown up singing songs and for a long time the memories are still there," said Flinn. "When they start singing it can revive those memories."

But the singing sessions seemed to activate a raft of brain areas. Listening sparked activity in the temporal lobe on the right-hand side of the brain, while watching someone lead a class activated the visual areas. Singing and speaking led to more activity in the left-hand side, Flinn said.

The findings are backed up by other work in the area. In September, researchers at Helsinki University looked at the impact of a 10-week singing course on patients with dementia. Compared with their usual care, singing and listening to music improved mood, orientation, and certain types of memory. To a lesser extent, their attention and general cognitive skills also improved.

The UK Alzheimer's Society holds regular group singing sessions nationwide.


"There is much anecdotal evidence that the groups have real benefits for people with dementia," a spokesperson said. "Even when many memories are hard to retrieve, music can sometimes still be recalled, if only for a short while. The sessions help people with dementia communicate, improving their mood and leaving them feeling good about themselves."

No comments: