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Ebook Handbook of neurologic music therapy: Part 2

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Ebook Handbook of neurologic music therapy: Part 2

Chapter 12Musical Speech stimulation (MUSTIM)Corene p. Thaut12.1 DefinitionMusical speech stimulation (MUS LIM) is a neurologic music therapy (NM I )

Ebook Handbook of neurologic music therapy: Part 2 technique lor non-fluent aphasia, that utilizes musical materials such as songs, rhymes, chants, and musical phrases to simulate prosodic speech gest

ures and trigger automatic speech ( I haul, 2005). In many patients with aphasia, non-propositional reflexive speech is unaffected, and overlearned mu Ebook Handbook of neurologic music therapy: Part 2

sical phrases or songs can he used lo stimulate spontaneous speech output. MUSTIM is an appropriate technique to select for patients who do not meet t

Ebook Handbook of neurologic music therapy: Part 2

he criteria to be good candidates for melodic intonation therapy (MIT), due to decreased cognition or to dementia-related primary progressive aphasia.

Chapter 12Musical Speech stimulation (MUSTIM)Corene p. Thaut12.1 DefinitionMusical speech stimulation (MUS LIM) is a neurologic music therapy (NM I )

Ebook Handbook of neurologic music therapy: Part 2o increase their spontaneous output of propositional Speech.12 2 Target populationsPatients who have experienced a left hemisphere stroke or brain inj

ury frequently suffer from some level of non-fluent aphasia which results in disrupted spontaneous expression of speech. Although many of these patien Ebook Handbook of neurologic music therapy: Part 2

ts never recover speech despite intensive treatment, it has been observed that many patients with non-fluent expressive aphasia retain the ability to

Ebook Handbook of neurologic music therapy: Part 2

sing familiar melodies and words (Yamadori Ct al., 1977). MUSTIM is an NMT intervention designed for people with some form of non-fluent aphasia who s

Chapter 12Musical Speech stimulation (MUSTIM)Corene p. Thaut12.1 DefinitionMusical speech stimulation (MUS LIM) is a neurologic music therapy (NM I )

Ebook Handbook of neurologic music therapy: Part 2es for MUSTIM have some type of non-fluent aphasia, such as Brocas or primary progressive aphasia, accompanied by difficulty with cognition. Candidate

s arc also typically unable to follow the complexity of Mi r with good functional carryover. This may be due to a stroke, or to diffuse traumatic brai Ebook Handbook of neurologic music therapy: Part 2

n injury, or related to Alzheimer’s disease or dementia. Other suitable candidates for MƯST1M are patients with Brocas aphasia who have progressed wit

Ebook Handbook of neurologic music therapy: Part 2

h MIT and are beginning to increase their functional use of language outside of the sentences practiced in MIT sessions. In this case, MƯSTIM can be a

Chapter 12Musical Speech stimulation (MUSTIM)Corene p. Thaut12.1 DefinitionMusical speech stimulation (MUS LIM) is a neurologic music therapy (NM I )

Ebook Handbook of neurologic music therapy: Part 2mmaryNumerous studies support the use of singing and intoning to trigger non-propositional speech in people who present with non-fluent aphasia (Basso

el al., 1979; Cadalbert et al., 1994; Lucia, 1987; Yamadori el al., 1977). Straube et al. (2008) found that singing helped word phrase production in Ebook Handbook of neurologic music therapy: Part 2

some patients with severe expressive aphasia, probably due to the association of melody and text in long-term memory. In a case study conducted by Yam

Ebook Handbook of neurologic music therapy: Part 2

aguchi et al. (2012), the results suggested that singing can be an effective treatment for severe non-fluent aphasia in rehabilitation therapy even wh

Chapter 12Musical Speech stimulation (MUSTIM)Corene p. Thaut12.1 DefinitionMusical speech stimulation (MUS LIM) is a neurologic music therapy (NM I )

Ebook Handbook of neurologic music therapy: Part 2differences between neural activation patterns in musical and non-musical speech tasks (Brown et al., 2006; Patel, 2003, 2005; Stewart, 2001). Brown e

t al. (2006) directly compared brain activation patterns during improvised melodic and linguistic phrases. Ihe two tasks revealed activation in nearly Ebook Handbook of neurologic music therapy: Part 2

identical functional brain areas, with some differences seen in lateralization tendencies, with the language task favoring the left hemisphere. Brown

Ebook Handbook of neurologic music therapy: Part 2

and colleagues further described parallel systems for music and language when generating complex sound structures (phonology), but distinctly differe

Chapter 12Musical Speech stimulation (MUSTIM)Corene p. Thaut12.1 DefinitionMusical speech stimulation (MUS LIM) is a neurologic music therapy (NM I )

Ebook Handbook of neurologic music therapy: Part 2rmonic priming tasks in music. Although the participants in the study performed poorly on both priming tasks, it was concluded that further research c

omparing the relationship between performance on the musical and non-musical priming task and the severity and variation of the deficits among aphasic Ebook Handbook of neurologic music therapy: Part 2

-patients is needed.12.4Therapeutic mechanismsI he results of a study by Ozdemir el al. (2006) suggested a bi-hemispheric network for vocal production

Ebook Handbook of neurologic music therapy: Part 2

during both singing and intoned speech, with additional right- lateralized activation of the superior temporal gyrus, inferior central operculum, and

Chapter 12Musical Speech stimulation (MUSTIM)Corene p. Thaut12.1 DefinitionMusical speech stimulation (MUS LIM) is a neurologic music therapy (NM I )

Ebook Handbook of neurologic music therapy: Part 2 hemisphere lesions arc able to sing the text of a song even though they are unable to speak the same words.12.5Clinical protocolsMƯSTIM can be implem

ented at many different levels of complexity depending on the goal and the level of functioning of the patient. Ihese may include filling in words or Ebook Handbook of neurologic music therapy: Part 2

phrases to familiar songs, filling in words to common phrases put to music, or practicing phrases that can be completed with many different responses.

Ebook Handbook of neurologic music therapy: Part 2

The simplest application of MƯSTIM is through the use of a familiar song, in which the therapist sings a phrase, leaving out words at the end of the p

Chapter 12Musical Speech stimulation (MUSTIM)Corene p. Thaut12.1 DefinitionMusical speech stimulation (MUS LIM) is a neurologic music therapy (NM I )

Ebook Handbook of neurologic music therapy: Part 2h the therapist singing the first musical phrase and the148 MUSICAL SPEECH STIMULATION (MUSTlM)patient singing the second musical phrase, and then pro

gress to having the patient initiate the first phrase and the therapist singing the second phrase. The final step would be to have the patient sing th Ebook Handbook of neurologic music therapy: Part 2

e entire song with or without musical accompaniment, and without assistance from the therapist. The goals in this example of MƯSTIM could be (1) to ma

Ebook Handbook of neurologic music therapy: Part 2

intain as much verba) output as possible for as long as possible with a patient with dementia, or (2) to encourage any spontaneous output during the e

Chapter 12Musical Speech stimulation (MUSTIM)Corene p. Thaut12.1 DefinitionMusical speech stimulation (MUS LIM) is a neurologic music therapy (NM I )

Ebook Handbook of neurologic music therapy: Part 2rned sentences with obvious completions, in order to help the patient to get started with a sentence with the intention that they will independently c

omplete it. I he melodies used should mimic the natural prosody and inflection of the sentence (e.g. a question may be presented through an upward arp Ebook Handbook of neurologic music therapy: Part 2

eggio or a scale). Examples of sentences might include "How are you (today)?”. “My name is (lolin)”, or “Thankyou very (mudi)” (see Figure 12.1). The

Ebook Handbook of neurologic music therapy: Part 2

goal in presenting MUSTIM through familiar phrases is to work toward the patient’s independent automatic completion of familiar sentences when musical

Chapter 12Musical Speech stimulation (MUSTIM)Corene p. Thaut12.1 DefinitionMusical speech stimulation (MUS LIM) is a neurologic music therapy (NM I )

Ebook Handbook of neurologic music therapy: Part 2ences that have many different possible endings. I he sentence is presented through a melody in order to get the patient started, and they have the op

portunity to respond in several different ways. A typical example might be "I would like to (go outside)” (see Figure 12.2). Ihis level of MU ST IM al Ebook Handbook of neurologic music therapy: Part 2

lows the patient to choose from many different responses, and involves the initiation of propositional speech.jhj J |J J J 111 would like to go out-si

Ebook Handbook of neurologic music therapy: Part 2

de.Fig. 12.2A variation on the previous MƯSTIM application would be to ask the patient a question to which there are two different musical responses—f

Chapter 12Musical Speech stimulation (MUSTIM)Corene p. Thaut12.1 DefinitionMusical speech stimulation (MUS LIM) is a neurologic music therapy (NM I )

Ebook Handbook of neurologic music therapy: Part 2initiate and distinguish between the two answers. '1 he question asked by the therapist might be “Do you want something to eat?” to which the patient

could respond “I want something to eat” or “I don't want something to eat” (see Figure 12.3).Jll.ljlj. I1 don’t want_.Fig. 12.3CORENE p. THAUT 149In s Ebook Handbook of neurologic music therapy: Part 2

ummary, MUSTIM is a technique designed specifically for expressive non-fluent aphasia in order to stimulate spontaneous non-propositional speech, or a

Ebook Handbook of neurologic music therapy: Part 2

s a compensatory strategy to help higher-functioning aphasia patients to initiate intentional propositional speech. MƯSTIM can be implemented at vario

Chapter 12Musical Speech stimulation (MUSTIM)Corene p. Thaut12.1 DefinitionMusical speech stimulation (MUS LIM) is a neurologic music therapy (NM I )

Ebook Handbook of neurologic music therapy: Part 2habilitation on language skills in aphasic patients. Archives of Neurology, 36,190 96.

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