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Preservation and Efficacy of Music and Singing in Ageing, Aphasia, and Alzheimer’s Disease

Periodic Reporting for period 1 - PREMUS (Preservation and Efficacy of Music and Singing in Ageing, Aphasia, and Alzheimer’s Disease)

Reporting period: 2019-01-01 to 2020-06-30

Music is a highly complex and versatile stimulus for the brain and closely linked to the neural networks that process verbal, cognitive, motor, and emotional information. In severe ageing-related neurological disorders, such as aphasia after stroke and Alzheimer’s disease (AD) dementia, music and singing may provide a valuable alternative route to verbal and emotional expression and to memory and self-awareness, but the brain mechanisms underlying this are still poorly understood. Music-based interventions may also be beneficial in ageing and in neurological rehabilitation, but we still know little about the therapeutic potential of singing, especially group singing, to support healthy neurocognitive ageing and recovery from aphasia.

PREMUS utilizes modern behavioural and neuroimaging methods to deepen our understanding of music in the ageing, recovering, and degenerating brain. The project has three main aims: (i) explore how the neural networks that govern the processing of speech, music, and singing change during normal ageing as well as after neural damage and neurodegeneration, (ii) explain which mechanisms drive the preservation of singing ability in aphasia and of music-evoked emotions and memories in Alzheimer’s disease, and (iii) determine if choir singing can have long-term positive effects in normal ageing and in aphasia rehabilitation.

PREMUS will provide new systems-level understanding of the structural and functional relationship between singing, speech and music in the ageing brain and the therapeutic power of singing in supporting emotional, cognitive, and social well-being and brain health, both in normal ageing and in aphasia. This knowledge is important for optimizing the use of music and developing new music-based rehabilitation methods for age-related neurological disorders, which are becoming increasingly common and burdening, both at individual and societal level, in our ageing population.
PREMUS comprises of four parallel studies exploring (i) the effects of ageing and singing experience on the neural processing of singing, speech, and music (Study 1), (ii) the long-term efficacy of choir singing on neurocognitive ageing (Study 2), the preservation of singing ability and the rehabilitative efficacy of a singing intervention in aphasia (Study 3), and (iv) the preservation of music-evoked emotions and memories in different stages of Alzheimer’s disease dementia (Study 4).

During the first period (Months 1-18) of the project, the work has focused on the practical implementation of Studies 1-4, comprising the recruitment of research personnel, preparation work, recruitment of study participants, and data collection. Led by the Principal Investigator (Prof. Teppo Särkämö), the work in PREMUS is carried out by the Music, Ageing and Rehabilitation Team (MART, for more information see our web site at www.helsinki.fi/en/researchgroups/music-ageing-and-rehabilitation-team). Currently, a total of 417 participants (304 healthy adults, 85 persons with aphasia, 28 persons) have been recruited and enrolled in Studies 1-4, and data collection is now at mid-stage in Study 1, completed or at end-stage in Studies 2 and 3, and at early stage in Study 4. Data analysis is active and ongoing in Studies 2 and 3, and the first results are estimated to be published within the next 6 months.
Despite the current challenges and limitations posed by the COVID-19 pandemic, PREMUS has made great progress in the successful implementation of all the studies included in the project. The unique feature and strength of PREMUS, which goes beyond the current state of the art of the research field, is the inclusion of well-controlled experimental studies which combine modern behavioural and neuroimaging techniques and advanced analysis tools and which are implemented in cross-sectional and longitudinal studies and clinical trials involving large samples of healthy persons and persons with aphasia and Alzheimer’s disease.

Regarding the final outcome, PREMUS is expected to yield novel and important results on (i) how normal ageing and singing experience affects the perception and production of singing, speech, and music in the brain, (ii) how specific facets of music cognition (singing ability, music-evoked emotions and memories) are preserved in aphasia and Alzheimer’s disease, (iii) can regular participation in choir singing prevent or slow down neurocognitive decline in ageing, and (iv) can singing-based rehabilitation enhance recovery from aphasia. These results will have important societal implications as they can help uncovering how and why music affects wellbeing and brain functioning in normal ageing and in common age-related neurological diseases and in optimizing the use of music and developing new music-based rehabilitation tools to combat the deficits and burden caused by age-related neurological diseases.
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