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A clinical study is evaluating whether a specific type of rehabilitative therapy – called neurological music therapy – can help people with Parkinson’s disease recover fine motor skills, such as those required for writing, self-care, and manipulation. ‘thin objects.
The trial (NCT03049033) is ongoing at the University of Colorado and aims to enroll 100 Parkinson’s disease patients aged 45 to 85. More information on registration is available here.
The study is led by Isabelle Buard, PhD, an assistant research professor at the University of Colorado, Aurora School of Medicine, 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, which is 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 that function at 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 press release from the University. “The idea of the study is to use external rhythms that specifically target these frequencies by training them at a different level, modulating them to restore a kind of homeostasis. [equilibrium] in brain activity.
Along with the gross motor symptoms – those that affect general movements of the whole body – that characterize Parkinson’s disease, patients are also impaired in their fine motor skills. The loss of fine motor skills contributes to the patient’s disability, a feeling of social isolation and a reduced quality of life.
Previous studies have shown that neurological music therapy relieves several gross motor impairments and improves gait and balance. However, it is not known if this can improve fine motor skills as well.
“The idea is that if you do internally generated movements, you are relying on motor neural loops that are impaired in Parkinson’s disease, so you have problems making movements, or they are slow and uncoordinated.” , said Buard.
“When your movement is driven by external rhythms, then the movement seems to be easier to perform. I look at the networks that are mobilized in an internal movement versus an external movement and I try to unravel what different aspect is significant in terms of mobilizing the brain networks, ”said Buard.
Another technique of neurological music therapy that shows promise, but the effectiveness of which has not been studied 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 is a big component of emotional contentment that comes with producing music. It seems to increase the quality of life for some people, ”said Buard. “A lot of people feel very uncomfortable improvising at first, but at the end of it they like it a lot. “
Data collected throughout the study includes finger dexterity measured via the Grooved Perforated Panel (GPT) test, commonly used as a fine motor performance test. The GPT test consists of 25 holes with randomly positioned slits that must be rotated in certain positions to be correct.
The team will also assess quality of life and signs of anxiety and depression.
The information gathered from this trial could inform future research to design 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 exploited by 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 from Parkinson’s disease, your medications aren’t helping you,” Buard said. “Medications help with gait and balance, and some medications help relieve tremors. But fine motor skills aren’t really well managed by drug therapy. It really is a symptomatic approach, so if we find it to be 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.