neurotrauma Research team It was a dark and rainy night Rhythmic Acoustic Stimulation Why is music particularly beneficial in physical rehabilitation AuditoryMotor Coupling Priming of the ID: 911663
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Slide1
A tailored music therapy and real-time bio-feedback mobile phone app to promote motor rehabilitation following
neurotrauma
Slide2Research team
Slide3It was a dark and rainy night…
Slide4Slide5Slide6Rhythmic Acoustic Stimulation
Why is music particularly beneficial in physical rehabilitation?*
Auditory-Motor Coupling
Priming of the Auditory-Motor Pathway
Cuing of the Movement PeriodStepwise Limit Cycle Entrainment
*Thaut
MH. Rhythm, Music, and the Brain: Scientific Foundations and Clinical Applications. Routledge; 2005.
Slide7IT’S FUN!!
Slide8Can we make it better?
Missing feedback
Provides the receiver with a knowledge of result (KR), vital for motor learning*
Missing automation and measurement.
What do you we have to play with??
Magill
, R. A. (2001). Augmented feedback in motor skill acquisition. In G.
Tenenbaum & R.C.
Eklund
(Eds.),
Handbook of Sport Psychology
(pp. 86–114). New York: Wiley.
Mobile
Technology
Wireless
Sensors
Low level access to personal music
A New Mobile
Feedback Instrument
Slide9GotRhythm
AppRuns on
iOS mobile devicesSupports multiple wireless sensors
Provides real-time feedback
Accesses personal iTunes music and adjusts tempoMeasures motor-music synchrony (eg
. foot or finger tapping to the beat)Records high-resolution session data for offline analysis.
Slide10Patient Monitoring
Slide11Towards an Ecosystem
Adherence
Social
Support
Analytics
Research
Clinical
Practice
$ Savings
Slide12Music entrainment and brain plasticity
Slide13The ability of the brain to change, structurally and functionally, with experience
Modification of synaptic strength Long-term potentiation / long-term depression
Underlies learning and memory across the lifespan
Aid in recovery of function following injury
Plasticity
Slide14Motor evoked potential (MEP)
We can use transcranial magnetic stimulation (TMS) to measure plasticity
in
humans
Slide15TMS to measure synaptic
plasticity
Slide16MEP reflects
transynaptic
output from pyramidal cells
A change in synaptic strength (within the cortical network activated by the stimulus) will be reflected in the MEP amplitude
Change in MEP amplitude can be used as a measure of synaptic plasticity
Hallett 2007,
Neuron
TMS to measure synaptic
plasticity
Slide17Motor training induces synaptic plasticity in the primary motor cortex (M1)
Controls the muscles of the body
Responsible for the execution of motor
plans
M1 plays an important role in motor learning
Slide18TMS to the cortical representation of the thumb
Measure the
direction of the evoked movement
Classen
et al. 1998
Journal of Neurophysiology
Motor training induces synaptic plasticity in the primary motor cortex (M1)
Slide19Classen
et al. 1998
Journal of Neurophysiology
Motor training induces synaptic plasticity in the primary motor cortex (M1)
Slide20Classen
et al. 1998
Journal of Neurophysiology
Motor training induces synaptic plasticity in the primary motor cortex (M1)
Slide21Classen
et al. 1998
Journal of Neurophysiology
Motor training induces synaptic plasticity in the primary motor cortex (M1)
Slide22A network of neural
areas regularly
implicated in processing of
musical rhythmBasal ganglia
Cerebellum Parietal cortexPrefrontal cortexPremotor cortex and supplementary motor area
Rhythm in the brain
Slide23A network of neural
areas regularly
implicated in processing of
musical rhythmBasal ganglia -
motor control, action selection, and learningCerebellum - coordination and fine-tuning of movement by integrating sensory and motor information
Parietal cortexPrefrontal cortexPremotor cortex and supplementary motor area - planning
, voluntary control, and execution of movementS
trongly interconnected with the basal ganglia and cerebellum
All
interconnected
with
M1 and influence M1 output
Rhythm in the brain
Slide24MEP reflects
transynaptic
output from pyramidal cells
A change in synaptic strength (within the cortical network activated by the stimulus) will be reflected in the MEP amplitude
Change in MEP amplitude can be used as a measure of synaptic plasticity
Hallett 2007,
Neuron
TMS to measure synaptic plasticity associated with training using
GotRhythm
Slide25GotRythm testing
Slide26Adherence to the
GotRhthym App will exceed 90% amongst participant drawn from a general population
General adult population
Acoustic feedback
Acoustic feedback with music
No feedback with music
Slide27Training with
GotRhythm will induce greater and longer lasting changes in functional neuroplasticity compared to control motor training tasks
Typical adult
Acoustic feedback with music
Control motor training
Baseline
30 minutes
10 minutes
Slide28Training with
GotRhythm will induce changes in functional neuroplasticity compared to control motor training tasks amongst neurologically impaired adults
Neurologically impaired population
Usual
treatment + Acoustic feedback with music
Usual treatment + control motor training
Baseline
Post-test
Fugl
-Meyer Assessment of Motor Recovery
Fugl
-Meyer Assessment of Motor Recovery
Slide29http://
www.populationhealthlinks.com/community-health.html
Slide30References
Chen, J. L., Penhune, V. B., & Zatorre
, R. J. (2008). Listening to Musical Rhythms Recruits Motor Regions of the Brain. Cerebral Cortex
, 18(12), 2844–2854.
De Bruin, N., Doan, J., & Turnbull, G. (2010). Walking with Music Is a Safe and Viable Tool for Gait Training in Parkinson's Disease: The Effect of a 13-Week Feasibility Study on Single and Dual Task Walking. Parkinson's Disease
, 10, 1–9.Grahn, J., & Brett, M. (2007). Rhythm and Beat Perception in Motor Areas of the Brain.
Journal of Cognitive Neuroscience, 19(5), 893–906.Hausdorff
, J. M., Lowenthal, J., Herman, T., Gruendlinger, L., Peretz, C., & Giladi, N. (2007). Rhythmic Auditory Stimulation Modulates Gait Variability in Parkinson's Disease.
European Journal of Neuroscience
,
26
(8), 2369–2375.
Hove
, M. J., Suzuki, K.,
Uchitomi
, H.,
Orimo
, S., & Miyake, Y. (2012).
Interactive Rhythmic Auditory Stimulation Reinstates Natural 1/f Timing in Gait of Parkinson's Patients.
PLoS
ONE
,
7
(3), e32600.
Lim, H. A., Miller, K., & Fabian, C. (2011).
The Effects of Therapeutic Instrumental Music Performance on Endurance Level, Self-Perceived Fatigue Level, and Self- Perceived Exertion of Inpatients in Physical Rehabilitation.
Journal of Music Therapy, 48(2), 124–148.Thaut, M. H., & Abiru, M. (2010). Rhythmic Auditory Stimulation in Rehabilitation of Movement Disorders: A Review Of Current Research. Music Perception, 27(4), 263–269. Thaut, M. H. (2005). Rhythm, Music, and the Brain: Scientific Foundations and Clinical Applications (Vol. 7). Routledge.