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1.
Sci Rep ; 11(1): 15291, 2021 07 27.
Artículo en Inglés | MEDLINE | ID: mdl-34315954

RESUMEN

Although music therapy may engender clinical benefits in patients with neurodegenerative disease, the impacts of social and musical factors of such activities on socio-emotional and motor engagements are poorly understood. To address this issue, non-verbal behaviors of 97 patients with or without major cognitive impairment (CI) were assessed when listening to music or a metronome in front of a musician who was present physically (live) or virtually (video). Socio-emotional engagement was quantified as emotional facial expression production and gaze direction. Motor engagement was quantified as overall body motion and the production of rhythmic movements. In both groups, positive facial expressions were more frequent and rhythmic motor activities lasted longer with music than with a metronome, and during a live performance rather than a video performance. Relative to patients without CI, patients with CI moved less with music, expressed fewer emotions, and spent less time looking at the musician in the video condition and in the metronome condition. The relative reductions in motor and socio-emotional engagements in patients with CI might be markers of disease progression. However, the presence of a live partner induces older adults to engage emotionally and physically in musical activities emphasizing the relevance of using live performance as motivational levers during music therapy.


Asunto(s)
Emociones , Musicoterapia , Enfermedades Neurodegenerativas/psicología , Percepción Auditiva , Femenino , Humanos , Masculino
2.
J Alzheimers Dis ; 78(3): 939-949, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33104027

RESUMEN

BACKGROUND: Music-based interventions appear to be efficient approaches to improve emotional, social, and cognitive functioning of patients with neurodegenerative diseases. OBJECTIVE: Because benefits seem to increase with patient's motor involvement, we studied sensorimotor synchronization (SMS) abilities of patients with cognitive impairments (Alzheimer's disease, vascular and mixed dementia) and of patients with no evidence of cognitive impairments. More specifically, we compared the impact of a live performance by a musician to a video recording on SMS. METHODS: SMS to a metronomic or a musical stimulus was assessed while patients watched a live musician or his pre-recorded video. RESULTS: SMS to a metronome was better than to music but this effect was modulated by the social context. While SMS to a metronome was better when facing a video than a live performance, there was no impact of social context on SMS to music. No group differences of SMS were found. CONCLUSION: The decrease in SMS to a metronome in a live performance may be due to social pressure. Such a pressure might be removed in pleasant social activities, like moving with music in a group, explaining the lack of effect on SMS to music. We found no performance differences in groups, suggesting relatively spared SMS in cognitively impaired patients. By showing that it is possible to encourage patients to synchronize with others, even when facing a video, our results indicate that SMS can be used as a relevant predictor in clinical trials and open up promising therapeutic options for isolated patients.


Asunto(s)
Enfermedad de Alzheimer/fisiopatología , Demencia Vascular/fisiopatología , Música , Desempeño Psicomotor , Medio Social , Estimulación Acústica , Anciano , Anciano de 80 o más Años , Disfunción Cognitiva/fisiopatología , Demencia/fisiopatología , Femenino , Humanos , Masculino , Musicoterapia , Grabación en Video
3.
Geriatr Psychol Neuropsychiatr Vieil ; 18(2): 213-222, 2020 06 01.
Artículo en Francés | MEDLINE | ID: mdl-32554353

RESUMEN

BACKGROUND: Considering the limited efficacy of pharmacological treatments, the use of musical interventions as non-drug treatment for patients with Alzheimer's disease are strongly recommended. Musical interventions seem to improve the socio-emotional and cognitive functioning of these patients, with benefits increasing when patients are engaged at the motor level. OBJECTIVE: Our study evaluates the factors that may influence patients' socio-emotional and motor engagement during musical activities, and measures their sensorimotor synchronization (SMS) abilities. METHODS: Each participant was asked to tap with a metronomic or a musical rhythm, in the presence of a musician who performed the task with them. The presence of the musician was real (live condition) or virtual (video condition). Two tempi were tested: a slow tempo (inter-onset interval of 800 ms) and a fast tempo (inter-onset interval of 667 ms). RESULTS: Patients spontaneously produced more rhythmic movements in response to the music than to the metronome. However, the consistency and accuracy of sensorimotor synchronization were better with the metronome than with the music, and also better in video than in live condition. These effects were modulated by the tempo of the auditory sequences. CONCLUSION: These results confirm the importance of the musical context and social interactions on these different performances. By evaluating in parallel the hand sensorimotor synchronization, spontaneous motor and socio-emotional behaviors with quantitative and controlled measurements, this study validates a multimodal approach to evaluate the patients' engagement in a musical task. These initial results open up promising application prospects while providing clinicians and researchers a rigorous methodology for understanding the factors that are at the origin of the therapeutic benefits of musical activities on the behavior and well-being of patients and their caregivers.


Asunto(s)
Enfermedad de Alzheimer/rehabilitación , Trastornos del Conocimiento/rehabilitación , Trastornos Neurológicos de la Marcha/rehabilitación , Música , Comunicación no Verbal , Medio Social , Estimulación Acústica , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Masculino , Calidad de Vida , Interacción Social , Percepción del Tiempo , Grabación en Video
4.
Ann N Y Acad Sci ; 1337: 249-55, 2015 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-25773641

RESUMEN

The management of patients with Alzheimer's disease is a significant public health problem given the limited effectiveness of pharmacological therapies combined with iatrogenic effects of drug treatments in dementia. Consequently, the development of nondrug care, such as musical interventions, has become a necessity. The experimental rigor of studies in this area, however, is often lacking. It is therefore difficult to determine the impact of musical interventions on patients with dementia. As part of a series of studies, we carried out randomized controlled trials to compare the effectiveness of musical activities to other pleasant activities on various functions in patients with severe Alzheimer's disease. The data obtained in these trials are discussed in light of the methodological constraints and requirements specific to these clinical studies. Although the results demonstrate the power of music on the emotional and behavioral status of patients, they also suggest that other pleasant activities (e.g., cooking) are also effective, leaving open the question about the specific benefits of music in patients with dementia. All these findings highlight the promising potential for nonpharmacological treatments to improve the well-being of patients living in residential care and to reduce caregiver burden.


Asunto(s)
Enfermedad de Alzheimer/terapia , Demencia/terapia , Musicoterapia/métodos , Música , Enfermedad de Alzheimer/fisiopatología , Conducta , Cuidadores , Cognición , Demencia/fisiopatología , Emociones , Humanos , Ensayos Clínicos Controlados Aleatorios como Asunto , Reproducibilidad de los Resultados , Proyectos de Investigación , Resultado del Tratamiento
5.
J Alzheimers Dis ; 38(2): 359-69, 2014.
Artículo en Inglés | MEDLINE | ID: mdl-23969994

RESUMEN

Although musical interventions have recently gained popularity as a non-pharmacological treatment in dementia, there is still insufficient evidence of their effectiveness. To investigate this issue, a single-center randomized controlled trial was conducted with forty-eight patients with Alzheimer's disease or mixed dementia to compare the effects of music versus cooking interventions in the emotional, cognitive, and behavioral domain, as well as on professional caregiver distress. Each intervention lasted four weeks (two one-hour sessions a week). Multi-component evaluations (with blind assessors) were conducted before, during, and after the interventions to assess their short and long-term effects (up to four weeks post interventions). Analyses revealed that both music and cooking interventions led to positive changes in the patients' emotional state and decreased the severity of their behavioral disorders, as well as reduced caregiver distress. However, no benefit on the cognitive status of the patients was seen. While results did not demonstrate a specific benefit of music on any of the considered measures, the present study suggests the efficacy of two pleasant non-pharmacological treatments in patients with moderate to severe dementia. Our findings highlight the potential of such interventions in improving the well-being of patients living in residential care, as well as reducing caregiver distress.


Asunto(s)
Enfermedad de Alzheimer/rehabilitación , Demencia/rehabilitación , Musicoterapia/métodos , Anciano de 80 o más Años , Enfermedad de Alzheimer/complicaciones , Cognición , Demencia/complicaciones , Emociones/fisiología , Femenino , Humanos , Masculino , Escala del Estado Mental , Pruebas Neuropsicológicas , Agitación Psicomotora/etiología , Agitación Psicomotora/rehabilitación , Estadística como Asunto , Estadísticas no Paramétricas
6.
Geriatr Psychol Neuropsychiatr Vieil ; 10(2): 215-24, 2012 Jun.
Artículo en Francés | MEDLINE | ID: mdl-22713851

RESUMEN

On account of the limited effectiveness of pharmacological treatments in Alzheimer's disease (AD), there is a growing interest on nonpharmacological treatments, including musical intervention. Despite the large number of studies showing the multiple benefits of music on behavioral, emotional and cognitive disorders of patients with AD, only a few of them used a rigorous method. Finally, the specificity of musical as compared to non-musical and pleasant interventions has rarely been addressed. To investigate this issue, two randomized controlled trials were conducted contrasting the effects of musical to painting (Study 1) or cooking (Study 2) interventions on emotional state of 33 patients with AD. The patients' emotional state was assessed by analyzing professional caregivers' judgments of the patient's mood, then facial expressions and valence of the discourse from short-filmed interviews. In the first study (n=22), each intervention lasted 3 weeks (two sessions per week) and the patients' emotional state was assessed before, during and after intervention periods. After the interventions, the results showed that facial expression, discourse content and mood assessment improved (more positive than negative expressions) as compared to pre-intervention assessment. However, musical intervention was more effective and had longer effects as compared with painting. In the second study (n=11), we further examined long lasting effects of music as compared to cooking by adding evaluation of the patients' emotional state 2 and 4 weeks after the last intervention. Again, music was more effective to improve the emotional state. Music had positive effects that remained significant up to 4 weeks after the intervention, while cooking only produced short-term effect on mood. In both studies, benefits were significant in more than 80% of patients. Taken together, these findings show that music intervention has specific effects on patients' emotional well being, offering promising methods to improve the quality of life of patients with AD.


Asunto(s)
Enfermedad de Alzheimer/terapia , Musicoterapia , Afecto , Anciano , Enfermedad de Alzheimer/diagnóstico , Enfermedad de Alzheimer/psicología , Arteterapia , Culinaria , Expresión Facial , Estudios de Seguimiento , Humanos , Escala del Estado Mental , Persona de Mediana Edad , Calidad de Vida/psicología , Conducta Verbal
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