Singing for Speech! Restoring Stroke Victims' Voices--In-Depth Doctor's Interview
Helmi Lutsep, MD, Professor and Vice Chair, Department of Neurology, at Oregon Health and Science University, talks about musical therapy for stroke survivors.
Is it ever too late to recover from a stroke?
Dr. Lutsep: It is one of the things that has really changed about strokes. We do not think it is ever too late to recover from stroke anymore. We have conducted trials with people who had their stroke 17 years ago and they still showed improvement. So, I think that the brain has more capacity for plasticity than we previously thought.
We just came from a music group and a lot of it was camaraderie. Is that a big part of the music therapy?
Dr. Lutsep: We do not know exactly how music therapy works. There are all kinds of theories; it is probably helpful for language recovery, but I think that the support that people get from each other is a huge part of it. Especially since they do not necessarily meet other people just like them if they are younger patients. Support groups may not have as many young patients in them; therefore, I think it is a fantastic social outlet.
Is this something new or has it been around?
Dr. Lutsep: We have known for hundreds of years that people can sing when they can’t talk after a stroke. It is remarkable sometimes. For example, you ask somebody who is mute to sing happy birthday and suddenly they can produce words. We know this, but I think what we have not known is how to tap that. Now, there is more interest in actually using music to try to create some changes in the brain and allow people to speak better.
Why can music do that when other things cannot?
Dr. Lutsep: We think that one of the ways it works is that music is represented more in the right side of the brain and language more on the left side of the brain. So, if we can tap that area, maybe we can allow language to rewire itself. In many people, there is actual spread to the right hemisphere to allow people to talk better.
You see scans where images light up on certain parts of the brain; can you see lights in certain parts of the brain that didn't have it?
Dr. Lutsep: Yes. We use techniques like functional MRI imaging. It will show that in a person who has had a stroke, affecting the left side of the brain where language usually sits, that the areas can expand further in the left side, but also to the other side of the brain to the right hemisphere. We think that, with music, it might actually help do that since music lives on the right side as well.
What's the most extreme case you have seen music help?
Dr. Lutsep: I would say the most extreme are the cases in which the patient really cannot say anything. Then the therapist, or someone, starts singing with them and they start to be able to produce words for the first time. It really gives them hope and gives their families hope that they may be able to talk again.
Do you see people going from being desperate to having hope?
Dr. Lutsep: Yes. I would say they do have hope. I should be clear that it doesn't mean that they can talk from then on; it is still a huge process and takes a lot of work to be able to talk as well as sing.
Are you phil's doctor?
Dr. Lutsep: Yes I am.
How have you seen music change him?
Dr. Lutsep: One, he is able to communicate better. I don't know how much is from music and how much is from time and using language. However, Phil is also becoming more social, more of a leader, and more interactive. So it has been great.
Do you have any numbers from studies?
Dr. Lutsep: No, in fact the first real study of music is ongoing right now. So people have been using it for therapy, but without really having the hard data it's hard to know how many people it might help.
Is there a certain type of stroke, where this wouldn't help?
Dr. Lutsep: Well, we are aiming at people who have a particularly hard time producing words. Some people where the language is affected, they also can't understand language and that's harder because it’s harder to be able to guide people when they don't really understand what is being asked of them. So, it will help primarily those people who have a hard time producing words.
END OF INTERVIEW
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