Singing restores speech in aphasia after stroke

Cerebrovascular disease, or stroke, is the most common cause of aphasia, a language disorder caused by brain damage. People with aphasia have difficulty understanding or producing speech or written language. It is estimated that about 40% of people who have had a stroke have aphasia. Half of them continue to have symptoms of aphasia even a year after the initial attack.

Researchers from the University of Helsinki previously found that singing helps restore speech in patients suffering from stroke. Now they have found out the reason for the rehabilitation effect of singing. The recently completed study was published in the eNeuro journal.

According to the findings, singing restores the structural language network of the brain. The language network processes language and speech in our brain. In patients with aphasia, this network is damaged.

“For the first time, our results demonstrate that rehabilitation of patients with aphasia through singing is based on neuroplasticity, that is, the plasticity of the brain,” says Aleki Sihvonen, a researcher at the University of Helsinki.

Singing improves language network pathways

The language network includes cortical areas of the brain involved in language and speech processing, as well as white matter, which transmits information between different areas of the cortex.

According to the study, singing increases gray matter volume in language areas of the left frontal lobe and improves tract connectivity, especially in the left hemisphere language network, but also in the right hemisphere.

“These positive changes were associated with improvements in speech production in patients,” says Sihvonen.

Treatment-induced changes in white matter neuroplasticity. Connectometry results show significant tract segments with longitudinal QA increases significantly associated with the singing group compared to the control group between T1 and T2 (ΔT2–T1; left) and a correlation of longitudinal QA changes with naming improvement (right). Source: eneuro (2024). DOI: 10.1523/ENEURO.0408-23.2024

A total of 54 patients with aphasia participated in the study, of whom 28 underwent MRI scanning at the beginning and end of the study. The researchers studied the rehabilitation effects of singing using choral singing, music therapy, and home singing exercises.

Singing as a cost-effective treatment Aphasia has a wide impact on the functional abilities and quality of life of those affected and easily leads to social isolation.

Sihvonen believes that singing can be considered as a cost-effective supplement to traditional forms of rehabilitation or as a rehabilitation for mild speech disorders in cases where access to other types of rehabilitation is limited.

"Patients can also sing with their family members, and singing can be organized in medical settings as a group, cost-effective rehabilitation," says Sihvonen.