Intensive MIT Cures Aphasia, “Rewires” Brain

Intensive Melodic Intonation Therapy (MIT)results in significant gains in speech production,and functional improvements are matched by longlastingneural changes, according to research by ateam led by Gottfried Schlaug, MD, PhD, associateprofessor of neurology at Harvard Medical Schooland director of neuroimaging at Beth Israel DeaconessMedical Center in Boston.

First described in 1973 by Albert and colleagues(Albert ML, Sparks RW, Helm NA. Melodic intonationtherapy for aphasia. Arch Neurol. 1973;29:130-131), MIT trains patients to verbalize by havingthem melodically intone phrases. That is, the aphasicpatient is trained to sing and be attentive torhythms in sound. This is thought to help the brainreestablish language centers and compensate fordeficits in verbal control caused by lesions attributedto stroke or another disease entity.

Eventually, the singing in MIT becomes sprechgesang,a form of vocalizing that is part speech andpart song. From there, the patient can transition tonormal-sounding and comprehensible speech.

"It's useful but not commonly used," commentedSchlaug. He presented data during a poster sessionthe 59th Annual Meeting of the AmericanAcademy of Neurology, held in Boston from April28 to May 5, that involved 7 patients who completedMIT for aphasia in an ongoing trial. Patients received75 intensive sessions. Speech production andpicture naming were assessed before and at intervalsduring MIT, and special tests that focused onintonation tasks were devised for patients to performduring functional MRI (fMRI). Voxel-basedmorphometric measures also were assessed.

All study participants demonstrated significantimprovements in speech production measures, accordingto Schlaug and his team. fMRI data revealedthat MIT helps "rewire" the brain, establishingcompensatory language-oriented activity in theright frontotemporal area. Improvements both inbehavior and in neural changes were maintainedmany months after treatment was discontinued, accordingto Schlaug.

The citation for Schlaug and colleagues researchis: Schlaug G, Norton A, Ozdemir E, Helm-EstabrookN. Long-term neural and behavioral effects of melodicintonation therapy in patients with chronic Brocasaphasia. Neurology. 2007;68(suppl 1):A177.