Optimizing Music-Based Interventions for Stroke Rehabilitation

项目摘要：本研究将解决激励策略的需求，以达到治疗水平 中风后上肢康复中的任务重复。为此，我们正在研究最佳策略 利用音乐来增加运动活动、改善情感并增加大脑区域的功能活动 与中风后运动恢复有关。虽然大多数基于音乐的干预措施的实证研究都利用固定的 参与者演奏指定音乐序列的音乐演奏任务、音乐的临床实践 治疗涉及即兴创作，允许即时调整音乐以反映情感、社交 以及参与者的身体需求。因此，我们设计了一项研究来表征 基于音乐的上肢康复干预中的即兴创作。在目标 1 中，我们将描述 中风后偏瘫成人音乐即兴创作的运动、情感和生理相关性。 我们假设即兴创作的增加将与运动活动的增加相关（通过测量 加速度计）和增加的影响（通过根据每种条件进行自我报告调查来衡量） 生理唤醒）。在目标 2 中，我们将使用功能磁共振成像评估音乐即兴创作的神经机制。 我们假设功能连接的增加将支持情感和运动输出的增加 核心奖励、动机和情绪相关的皮质下区域以及皮质运动和额叶区域之间的关系。 这些发现将为基于音乐的最佳干预措施奠定基础，这些干预措施利用即兴创作来 最大限度地提高运动恢复并最大限度地降低磨损率。

Project Summary: This study will address the need for motivational strategies to achieve therapeutic levels of task-repetition in upper extremity rehabilitation post-stroke. To this end, we are investigating optimal strategies for utilizing music to increase motor activity, improve affect and increase functional activity in brain areas related to motor recovery post-stroke. While most empirical studies of music-based interventions utilize fixed music-playing tasks in which participants play a specified music sequence, the clinical practice of music therapy involves improvisation, allowing the music to be adjusted in the moment to reflect the emotional, social and physical needs of participants. We have therefore designed a study to characterize the effect of improvisation within music-based interventions for upper extremity rehabilitation. In Aim 1 we will characterize the motor, affective and physiological correlates of music improvisation for adults with post-stroke hemiparesis. We hypothesize that the increased improvisation will be associated with increased motor activity (measured by accelerometry) and increased affect (measured by self-report surveys following each condition and physiological arousal). In Aim 2 we will assess the neural mechanisms of music improvisation by using fMRI. We hypothesize that increased affect and motor output will be supported by increased functional connectivity between core reward, motivation and emotion-related subcortical regions and cortical motor and frontal areas. These findings will lay the foundation for optimal musi-based interventions that capitalize on improvisation to maximize motor recovery and minimize attrition rate.