Bengaluru: Neuropsychologists at the National Institute of Mental Health and Neurosciences’ Music Cognition Lab have been exploring the role of music-based techniques in neuro-rehabilitation, particularly for stroke, in the past few years. With at least 10 patients a month, the experts say these interventions have played a key role in helping stroke patients regain their cognitive abilities.Dr Shantala Hegde, professor and consultant neuropsychologist at Nimhans, along with PhD students Preeti Kodancha and Shreyas Krishnakumar have been working with the stroke patients. Dr Shantala emphasised that they rely on evidence-based, neuroscience-driven tools. The music used is universal rather than culture-specific and can be as simple as a metronome, basic rhythmic counting such as “1-2-3-4,” structured rhythm phrases, or rhythmic syllables and simple phrases to support speech. The aim is to train intact brain regions to compensate for damaged ones.She gave the example of VS, a 42-year-old human resources executive from Bengaluru who had a premorbid history of systemic lupus erythematosus (chronic multisystem autoimmune disease) and congestive heart failure. At the age of 37, about six months after her second spontaneous abortion associated with assisted reproductive treatment, she suffered a left middle cerebral artery ischaemic stroke. Following prolonged hospitalisation, she was unable to walk or speak and showed features suggestive of post-stroke depression.Nearly three years later, in April 2024, VS presented at Nimhans with persistent cognitive and communication difficulties. A detailed neuropsychological assessment revealed deficits in expressive and written language, verbal fluency, working memory, response inhibition, verbal learning, arithmetic abilities, and logical sequencing of ideas. At this stage, psychologists, along with other therapeutic interventions, introduced music-based rehabilitation strategies. Neurologic music therapy techniques were used to enhance engagement and support recovery of speech, motor coordination, and cognitive skills. With these interventions and other targeted therapies, VS showed notable improvements in expressive speech, basic arithmetic, work engagement, and independence in daily activities. “Music is one of the highest forms of cognitive function, though it is often viewed merely as something cultural or recreational. In neuropsychological rehabilitation, I use music very differently. I break it down into its fundamental components and use those building blocks to enhance core cognitive functions including attention, memory, planning, decision-making, and response inhibition,” Dr Shantala said.She illustrated this approach with another case — that of a 27-year-old medical representative who suffered a stroke. While he could understand spoken language in multiple languages, he was unable to speak, read, or write. Numbers posed a particular challenge. Therapy for him focused on using rhythm to retrain speech and numerical skills. Gradually, his speech became smoother. Complex medication names were practised using rhythmic cues, while numerical skills were rebuilt using finger movements and rhythmic patterns. Over time, he regained the ability to count into thousands, write phone numbers, calculate money, and communicate medication dosages. Box Personalised recovery plans Across the city, clinicians in different settings are using music to support patients with traumatic brain injuries. “Patients are identified through multidisciplinary assessments involving neurologists, psychologists, and rehabilitation specialists, and the therapy is integrated into personalised recovery plans rather than used as a standalone intervention,” said Neha Cadabam, senior psychologist and executive director, Cadabams Hospitals.Dr Johnson Pradeep R, associate professor, department of psychiatry, St John’s Hospital, said he uses a particular type of calm music even in his practice. “Along with regular interventions, we often use music for patients to relax, particularly for those with post-traumatic stress disorder (PTSD),” he said.
