The healing power of music for stroke survivors

Julie Stillman was 55 when a blood vessel in her brain suddenly burst. The hemorrhagic stroke left her unable to compose a simple sentence – a major blow for a woman who has made a career out of book publishing.

It also deprived her of the ability to speak properly. But not the ability to sing.

Now 69, Stillman is one of dozens of stroke and brain injury survivors raising their voices in joy with the Aphasia Choir of Vermont. There are a handful of such choirs around the world, giving stroke survivors and people with dementia or other brain damage the chance to tap into one of the few means of communication they have left.

“Hearing that clarity and volume is like magic,” said Stillman’s husband, Jeff Nagle, whose last fluent conversation with his wife was 14 years ago on the phone, an hour before find it on the floor of their house. “It’s amazing to see this happen.”

About a third of people who survive a stroke have aphasia, a speech disorder that makes it difficult to speak or understand language due to brain damage. But scientists have long known that even when people with certain types of aphasia lose the ability to speak, they are often able to sing, a phenomenon attributed to different regions of the brain responsible for producing music and language.

Studies of this phenomenon and how music affects the brain have led to the development of a variety of music-assisted therapies, such as melodic intonation therapy, which trains stroke survivors to communicate from rhythmically to build stronger connections between brain regions. Other therapies focus on listening to music or learning musical instruments, such as the keyboard or drums.

A growing body of research shows that these types of therapies can play an important role in the recovery of stroke survivors.

As early as 2008, researchers published work in the journal Brain that showed that simply listening to music for an hour every day improved memory and attention, as well as mood, during the early stages of recovery after a stroke. A follow-up to this study in 2014 revealed how and why: Listening to music stimulated structural changes in areas of the brain responsible for verbal memory, language skills and focusing attention. Digging deeper, investigators were able to show that vocal music was superior to instrumental music or listening to audiobooks in stimulating brain changes that led to memory and language recovery.

Karen McFeeters Leary, the speech pathologist who founded the Vermont Aphasia Choir, knew stroke survivors could sing because of her studies in speech therapy.

“When we were evaluating people with strokes or speech impairments, we were always checking their ability to sing,” said Leary, who is also a singer and songwriter.

Stillman and Nagle were among the first to join when Leary launched the choir in 2014, with just 11 stroke survivors and their spouses and caregivers. Since then, the group has more than doubled in size. She recruits through stroke support groups and the University of Vermont, which offers a speech therapy program and outpatient clinic.

To his surprise, the choir quickly turned into something much bigger than an opportunity for people to express themselves through song. He helped establish a community for people who had become socially isolated due to their condition. “They lose friendships, sometimes spouses,” Leary said. “It’s very lonely.”

But through the choir, they find other people who understand what they’re going through. “The shared experience is the big thing,” she said. “I’ve seen very, very depressed individuals absolutely come together and thrive.”

“The choir has been a wonderful support group in a different way than we had in speech therapy,” Nagle said. “We made a lot of friends.”

And through those friendships, they expanded Stillman’s ability to return to some of his old hobbies, like a love of boating. Another choir member introduced them to an adapted kayaking group in which stroke survivors and others with physical disabilities use special equipment that allows them to paddle with one arm. They are now active participants in both groups, enjoying a social life they never thought they would see again.

Nagle also believes his wife’s language skills improve during choir season, which lasts from March to June, when it culminates in a free public concert.

Researchers like Pablo Ripollés say it’s possible that daily musical engagement makes a difference. As assistant professor of psychology and associate director of the Music and Audio Research Laboratory at New York University in New York, Ripollés was part of a group of researchers who identified how listening to music alters brain structure in stroke survivors.

Scientists know that providing a rich environment can stimulate the brain and promote healing after a stroke, Ripollés said. His research has focused on using music to provide this enrichment, particularly during the early stages of recovery when people are limited in what they can do.

“There’s one thing you can do for these patients, even when they’re in bed,” he said. “Maybe they can’t move very well, but you can provide them with an enriched environment by having them listen to music.”

The benefits of music therapy can vary, and the extent of brain damage caused by a stroke affects its ability to recover. “We have good evidence that music therapy works in people who have not suffered catastrophic brain damage,” Ripollés said. “Maybe a major problem, but not catastrophic.”

More research is needed to see if music therapy can be more effective than traditional speech therapies, he said. But in the meantime, stroke survivors can listen to their favorite music or join a choir, if there’s one in their area.

“It’s something you can do on your own and for free,” Ripollés said. “It’s not going to hurt you, and it might do you some good.”

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