A theoretical and clinical account of music and aphasia

DL Merrett, A Zumbansen, I Peretz - Aphasiology, 2019 - Taylor & Francis
Aphasiology, 2019Taylor & Francis
For many researchers and clinicians working in the field of aphasia, as well as for those in
music, the first thought that springs to mind on the topic of “Music and Aphasia” is the clinical
use of music for aphasia rehabilitation after stroke, particularly Melodic Intonation Therapy
(MIT). Indeed, MIT is the most well-known music intervention for aphasia and a popular
topic, both in the general media and amongst researchers, with an increasing number of
research teams attempting to provide evidence regarding MIT efficacy and mechanisms …
For many researchers and clinicians working in the field of aphasia, as well as for those in music, the first thought that springs to mind on the topic of “Music and Aphasia” is the clinical use of music for aphasia rehabilitation after stroke, particularly Melodic Intonation Therapy (MIT). Indeed, MIT is the most well-known music intervention for aphasia and a popular topic, both in the general media and amongst researchers, with an increasing number of research teams attempting to provide evidence regarding MIT efficacy and mechanisms. However, as evident in this special issue, the topic of “Music and Aphasia” is much broader than MIT and includes theoretical presumptions and clinical implications that extend far beyond a single therapeutic approach. The relationship between music and language has been debated in the literature for decades, with some prominent theories focusing on similarities and transfer between music and language and potential shared processing (for eg, Patel, 2003, 2008, 2014) and others focusing on domain specificity and dissociations between music and language (Peretz, 2009; Peretz & Coltheart, 2003; Peretz, Vuvan, Lagrois, & Armony, 2015). Within the aphasia rehabilitation literature, this has promoted a degree of ambiguity, such that both the shared processing and the dissociations between music and language have been touted as reasons to use music in aphasia rehabilitation. For example, it has been suggested that intact singing in individuals with non-fluent aphasia provides an indirect route or a scaffold for expressive language function, using mechanisms such as music’s right-hemisphere dominance or rhythm (for further discussion, see Merrett, Peretz, & Wilson, 2014; Schlaug, Marchina, & Norton, 2008; Zumbansen, Peretz, & Hébert, 2014). However, it has yet to be fully explained how cognitive systems for music and language that are dissociable in the face of brain injury or congenital abnormalities could at the same time be sufficiently linked to enable music networks to support language function. Regardless of the position taken in these debates, it is clear that further research is needed to clarify the links between music and language and their role in understanding aphasia and music-based aphasia therapies. Beyond the overarching theoretical relationship between music and language, the existence of associations between music and specific speech and language impairments has been identified in papers in this special issue. For instance, Belfi, Kasdan, and Tranel (in press) investigated the relationship between anomia and music by comparing lexical retrieval deficits for musical melodies and instruments and their neuroanatomic
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