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Training-induced cognitive and neural changes in musicians: implications for healthy aging

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Abstract

Mounting evidence supports training-induced brain changes from extended musical practice that can translate into cognitive and neural reserve in advanced age with potential to reduce cognitive decline. We will review current evidence supporting structural and functional changes from music training in the neural networks common to music, skilled movements, and auditory processing. The literature comparing professional and amateur musicians with nonmusicians will be considered in terms of innate and training-induced changes with potential to enhance cognitive and neural functions. The impact of instrumental musical practice on general cognition will be discussed with respect to neural network changes stimulated by task-specific cognitive enrichment. There will be a primary focus on how the timing of musical engagement and the years of musical activity influence cognitive and neural reserve. This theoretical framework will be considered in the context of modifiable lifestyle factors that delay expression of brain pathology. Models of environmental enrichment that can enhance neuroplasticity through multisensory stimulation are critical for development of compensatory neural networks that allow for adaptation of age-related cognitive declines.

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Purpose: Participating in a group-singing program may be beneficial to healthy aging through engaging in active music-making activities and breathing exercises. The purpose of this study was to assess the feasibility, acceptability, and impact of a 12-week group singing program on cognitive function, lung health and quality of life (QoL) of older adults. Materials and methods: A pre and post-test quasi-experimental design evaluated the impact of a group-singing program on older adult health. The intervention consisted of pre-singing exercises, song-singing and learning, and socialization. Classes were 75 min/week for 12 weeks. Inclusion criteria were age ≥60, no self-reported diagnosis of dementia, and able to hear conversations within 2 feet. Participants were recruited from 3 senior living communities. Outcome measures included cognition, lung function, QoL, and program feasibility and acceptability. A paired t-test with 2-sided alpha level at 0.05 was used to test the null hypotheses. Results: We enrolled 49 participants (mean age 83.6). Forty-two (86%) completed the posttests and exit survey. At the 12th week there was significant improvement in phonological (p < 0.0001) and animal (p = 0.0004) semantic Verbal Fluency Tests, immediate Word Recall Test (p < 0.0001), Maximum Inspiratory Pressure (p = 0.0001), Maximum Expiratory Pressure (p < 0.0001), and in-session oxygen saturation (p = 0.03). Program satisfaction was rated, on average, 9 on a 10-point scale. Conclusion: A group-singing program with deep breathing training and song-learning may promote memory, language, speech information processing, executive function, and respiratory muscle strength in older adults. The program was feasible and well-accepted. A clinical trial with a larger sample is indicated.
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More than 1.5 million people suffer a stroke in Europe per year and more than 70% of stroke survivors experience limited functional recovery of their upper limb, resulting in diminished quality of life. Therefore, interventions to address upper-limb impairment are a priority for stroke survivors and clinicians. While a significant body of evidence supports the use of conventional treatments, such as intensive motor training or constraint-induced movement therapy, the limited and heterogeneous improvements they allow are, for most patients, usually not sufficient to return to full autonomy. Various innovative neurorehabilitation strategies are emerging in order to enhance beneficial plasticity and improve motor recovery. Among them, robotic technologies, brain-computer interfaces, or noninvasive brain stimulation (NIBS) are showing encouraging results. These innovative interventions, such as NIBS, will only provide maximized effects, if the field moves away from the “one-fits all” approach toward a “patient-tailored” approach. After summarizing the most commonly used rehabilitation approaches, we will focus on NIBS and highlight the factors that limit its widespread use in clinical settings. Subsequently, we will propose potential biomarkers that might help to stratify stroke patients in order to identify the individualized optimal therapy. We will discuss future methodological developments, which could open new avenues for poststroke rehabilitation, toward more patient-tailored precision medicine approaches and pathophysiologically motivated strategies.
Article
Introduction The strong link between early-life education and subsequent reduced risk of dementia suggests that education in later life could enhance cognitive function and may reduce age-related cognitive decline and protect against dementia. Methods Episodic memory, working memory, executive function, and language processing performances were assessed annually over 4 years in 359 healthy older adults who attended university for a minimum of 12 months (intervention) and were compared against 100 healthy adult controls. Results Multiple group latent growth curve modeling revealed a significant improvement in language processing capacity over time in the intervention group. No changes were detected for episodic memory, working memory, or executive function. Discussion These results suggest that complex mental stimulation resulting from late-life further education results in improved crystallized knowledge but no changes to fluid cognitive functions.
Article
It is entangled connections and intensive functional interactions between cortex and subcortical structures that enable our brain to perform delicate movement, and poses plasticity to recover from stroke. However, it is still unclear how cortical structures and functions change in well-recovered patients from subcortical infarctions in motor pathway. In order to reveal neuroplasticity underlying well-recovered stroke patients, both structural (gray matter volume, GMV) and functional reorganizations (cerebral blood flow, CBF and resting-state functional connectivity, rsFC) were investigated by using multi-modal MRI. Our results showed that well-recovered stroke patients exhibited significantly increased GMV in contralesional supplementary motor area (SMA), increased CBFs in contralesional superior frontal gyrus (SFG) and supramarginal gyrus (SMG) irrespective of GMV correction. Furthermore, our results showed increased rsFC between contralesional middle temporal gyrus (MTG) and SMG. Negative correlations between CBF increases and behavior test scores were also observed, suggesting neural mechanism underlying clinical improvement. Our results suggested that neuroplasticity after chronic stroke showed in both structural and functional levels, and correlation between CBF change and clinical test suggested possible biomarker for stroke recovery.
Article
Background and purpose: In many neurologic diagnoses, significant interindividual variability exists in the outcomes of rehabilitation. One factor that may impact response to rehabilitation interventions is genetic variation. Genetic variation refers to the presence of differences in the DNA sequence among individuals in a population. Genetic polymorphisms are variations that occur relatively commonly and, while not disease-causing, can impact the function of biological systems. The purpose of this article is to describe genetic polymorphisms that may impact neuroplasticity, motor learning, and recovery after stroke. Summary of key points: Genetic polymorphisms for brain-derived neurotrophic factor (BDNF), dopamine, and apolipoprotein E have been shown to impact neuroplasticity and motor learning. Rehabilitation interventions that rely on the molecular and cellular pathways of these factors may be impacted by the presence of the polymorphism. For example, it has been hypothesized that individuals with the BDNF polymorphism may show a decreased response to neuroplasticity-based interventions, decreased rate of learning, and overall less recovery after stroke. However, research to date has been limited and additional work is needed to fully understand the role of genetic variation in learning and recovery. Recommendations for clinical practice: Genetic polymorphisms should be considered as possible predictors or covariates in studies that investigate neuroplasticity, motor learning, or motor recovery after stroke. Future predictive models of stroke recovery will likely include a combination of genetic factors and other traditional factors (eg, age, lesion type, corticospinal tract integrity) to determine an individual's expected response to a specific rehabilitation intervention.
Article
Objectives: Cognitive decline happens to everyone when aging, but to some more than others. Studies with children, adults, and professional musicians suggest that making music could be associated with better cognitive functioning. In older adults however, this association is less well investigated, which is therefore the aim of this study. Methods: In this cross-sectional study data from 1101 participants aged 64 and older from the Longitudinal Aging Study Amsterdam were used. Multivariable linear regression analyses were performed to test the association between making music and cognitive functioning and time spent making music and cognitive functioning. ANCOVA analyses were performed to differentiate between participants who made no music, only sang, only played an instrument or both sang and played an instrument in terms of cognitive functioning. Results: Making music was significantly positively associated with letter fluency, learning and attention/short-term memory. Time spent making music yielded no significant results. The ANCOVA analyses showed higher scores for participants who only played an instrument compared to participants who made no music on learning, working memory and processing speed. For processing speed the instrument only group also had a higher score than participants who only sang. Discussion: Making music at least once every two weeks and especially playing a musical instrument, is associated with better attention, episodic memory and executive functions. The results suggest that making music might be a potential protective factor for cognitive decline; however, to support this notion a longitudinal study design is needed.
Article
The ability to understand speech in the presence of competing sound sources is an important neuroscience question in terms of how the nervous system solves this computational problem. It is also a critical clinical problem that disproportionally affects the elderly, children with language-related learning disorders, and those with hearing loss. Recent evidence that musicians have an advantage on this multifaceted skill has led to the suggestion that musical training might be used to improve or delay the decline of speech-in-noise (SIN) function. However, enhancements have not been universally reported, nor have the relative contributions of different bottom-up versus top-down processes, and their relation to preexisting factors been disentangled. This information that would be helpful to establish whether there is a real effect of experience, what exactly is its nature, and how future training-based interventions might target the most relevant components of cognitive processes. These questions are complicated by important differences in study design and uneven coverage of neuroimaging modality. In this review, we aim to systematize recent results from studies that have specifically looked at musician-related differences in SIN by their study design properties, to summarize the findings, and to identify knowledge gaps for future work.
Article
Background: Age-related cognitive decline is well documented across various aspects of cognitive function, including attention and processing speed, and lifestyle behaviors such as physical activity play an important role in preventing cognitive decline and maintaining or even improving cognitive function. Purpose: The purpose of this study was to evaluate the effects of an 8-week Hatha yoga intervention on attention and processing speed among older adults. Methods: Participants (n = 118; mean age, 62 ± 5.59) were randomly assigned to an 8-week Hatha yoga group or a stretching control group and completed cognitive assessments-Attention Network Task, Trail Making Test parts A and B, and Pattern Comparison Test-at baseline and after the 8-week intervention. Results: Analyses of covariance revealed significantly faster reaction times for the yoga group on the Attention Network Task's neutral, congruent, and incongruent conditions (p ≤ 0.04). The yoga intervention also improved participants' visuospatial and perceptual processing on the Trail Making Test part B (p = 0.002) and pattern comparison (p < 0.001) tests. Conclusions: These results suggest that yoga practice that includes postures, breathing, and meditative exercises lead to improved attentional and information processing abilities. Although the underlying mechanisms remain largely speculative, more systematic trials are needed to explore the extent of cognitive benefits and their neurobiological mechanisms.
Article
Using in-vivo magnetic resonance morphometry it was investigated whether the midsagittal area of the corpus callosum (CC) would differ between 30 professional musicians and 30 age-, sex- and handedness-matched controls. Our analyses revealed that the anterior half of the CC was significantly larger in musicians. This difference was due to the larger anterior CC in the subgroup of musicians who had begun musical training before the age of 7. Since anatomic studies have provided evidence for a positive correlation between midsagittal callosal size and the number of fibers crossing through the CC, these data indicate a difference in interhemispheric communication and possibly in hemispheric (a)symmetry of sensorimotor areas. Our results are also compatible with plastic changes of components of the CC during a maturation period within the first decade of human life, similar to those observed in animal studies.
Article
Dementia cases are on the rise and researchers seek innovative ways to prevent or ameliorate cognitive impairment in later life. Some research has reported that combining mental and physical exercise may benefit cognition more than either alone. This randomized pilot trial examined the feasibility and cognitive benefit for older adults (n = 30) of a single bout of neuro-exergaming (physical activity with cognitive training), using an interactive physical and cognitive exercise system (iPACES™), compared to that of exergaming or neurogaming alone. Intent-to-treat and sensitivity analyses were conducted using repeated measures ANOVA, controlling for age, sex, and education. A significant interaction effect was found for executive function (Color Trails 2), with a significant improvement in the neuro-exergaming condition. Results demonstrate feasibility for older adults to use a novel and theoretically-derived neuro-exergame, and also provide promising new evidence that neuro-exergaming can yield greater cognitive benefit than either of its component parts.
Article
Cognitive training, physical activity, and exercise have often been reported to improve cognitive performance in older adults. This paper reviews some seminal and recent studies using these approaches to improve cognition and physical functioning in healthy older adults and in patients suffering from non-neurological chronic medical conditions. Results from cognitive training studies suggest that despite performance improvement in trained tasks, transfer effects appeared very limited. Surprisingly though, computerized dual-task training has been shown to improve balance and postural control in tests of physical functioning, suggesting that broad transfer can sometimes be observed. Physical exercise intervention studies generally found significant and large improvements in physical capacity, in some cognitive domains, and in quality of life. The benefits seem to be equivalent between frail and nonfrail participants. Overall, results reviewed here support the notion that cognitive plasticity for attentional control, as induced by cognitive training or physical activity and exercise, is preserved in late adulthood. Moreover, results of studies with patients at risk of cognitive decline also suggest that cognitive training and exercise interventions are promising nonpharmaceutical tools to help improve cognition in older at-risk individuals. © 2015 New York Academy of Sciences.
Article
Musical training has emerged as a useful framework for the investigation of training-related plasticity in the human brain. Learning to play an instrument is a highly complex task that involves the interaction of several modalities and higher-order cognitive functions and that results in behavioral, structural, and functional changes on time scales ranging from days to years. While early work focused on comparison of musical experts and novices, more recently an increasing number of controlled training studies provide clear experimental evidence for training effects. Here, we review research investigating brain plasticity induced by musical training, highlight common patterns and possible underlying mechanisms of such plasticity, and integrate these studies with findings and models for mechanisms of plasticity in other domains.
Article
Cerebral cortex is an assembly of neuronal cells that are highly interconnected. The morphology as well as function of these complex and spatially distributed networks is modulated or even controlled by the glial component of the central nervous system (CNS). The ability to adapt in response to the changing environment is the most fundamental property of the nervous tissue and constitutes the basis for learning. Neural plasticity is the neurobiological basis for the ability to adapt and learn in an experience-dependent manner. At the structural level, neural plasticity could be defined in terms of dendritic and axonal arborization, spine density, synapse number and size, receptor density, and, in some brain regions, also the number of neurons. These structural constituents of neural plasticity jointly determine the complexity of neuronal networks and their activity, and contribute to recovery of function after stroke and other CNS injury (Figure 3.1).