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A clinical study is evaluating whether a specific type of rehabilitation therapy – called neurological music therapy – can help people with Parkinson’s disease recover their fine motor skills, such as those required for writing, self-care and manipulation of objects. thin objects.
The trial (NCT03049033) is ongoing at the University of Colorado and aims to enroll 100 patients with Parkinson’s disease between the ages of 45 and 85. More information on registration is available here.
The study is led by Isabelle Buard, PhD, assistant research professor at the University of Colorado School of Medicine at Aurora, and is funded by the National Institutes of Health.
Neurological music therapy uses specific combinations of rhythm and movement to restore natural electrical activity in the brain, used by nerve cells (neurons) to communicate with each other. This electrical activity can be measured as brain waves (oscillations) with different frequencies. In the brains of patients with Parkinson’s disease, those operating in the beta frequency are more likely to be affected.
“In Parkinson’s disease, beta frequencies are most likely to be altered,” Buard said in a university press release. “The idea of the study is to use external rhythms that specifically target these frequencies by driving them to a different level, modulating them to restore some sort of homeostasis. [equilibrium] in brain activity.
In addition to the gross motor symptoms – those that affect general movements of the whole body – that characterize Parkinson’s disease, patients are also impaired in fine motor skills. The loss of fine motor skills contributes to the patient’s disability, feelings of social isolation and reduced quality of life.
Previous studies have shown that neurological music therapy alleviates several gross motor impairments and improves gait and balance. However, it is unknown whether it can also improve fine motor function.
“The idea is that if you’re doing internally generated movements, you’re relying on motor neural loops that are impaired in Parkinson’s disease, so you have problems making movements, or they’re slow and uncoordinated,” Buard said.
“When your movement is driven by external rhythms, then the movement seems to be easier to execute. I look at the networks that are mobilized during internal or external movements and try to tease out which different aspect is significant in terms of mobilization brain networks,” Buard said.
Another neurological music therapy technique that shows promise, but has not been studied for effectiveness in Parkinson’s disease, is a kind of therapeutic instrumental musical performance, such as when patients can improvise on the piano.
“We don’t really know why or how, but there’s a big component of emotional contentment that comes with producing music. It seems to improve the quality of life for some people,” Buard said. “A lot of people feel very uncomfortable improvising at first, but in the end they really like it.”
Data collected throughout the study includes finger dexterity measured via the grooved perforated plate test (GPT), commonly used as a test of fine motor performance. The GPT test consists of 25 holes with randomly positioned slots that must be rotated to certain positions to be correct.
The team will also assess quality of life and signs of anxiety and depression.
Information gathered from this trial could inform future research aimed at designing better treatments and rehabilitation interventions for patients with Parkinson’s disease and other neurological conditions, Buard said. It can also shed light on the neural processes tapped into by the music.
Buard hopes the study can help establish music as a standard and relevant practice to help improve fine motor skills.
“Right now, if you have fine motor difficulties due to Parkinson’s disease, your medications aren’t helping you,” Buard said. “The drugs help with walking and balance, and some drugs help with tremors. But fine motor skills aren’t really well managed by drug therapy. It’s really a symptomatic approach, so if we find that it is effective for Parkinson’s disease, we will do a larger clinical trial so that music therapy can be further endorsed as one of the clinical therapies for fine motor skills.