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Therapy Startup Tunes Into Music as Rehab for Brain Injuries

Xconomy Boston — 

A stroke or traumatic brain injury starts a race against the clock. Neurosurgeons, emergency room doctors, and paramedics have to take action to limit the damage as quickly as possible before it spreads and devastates portions of the patient’s brain, taking functions such as speech, movement, and memory with it.

After that desperate sprint comes a grueling marathon as patients and their families are joined by different medical specialists. Physical, speech, and occupational therapists replace doctors as the goal becomes helping patients recover what was lost and rebuild their lives.

Increasingly, music is becoming one of the tools they use, and specialists like MedRhythms founder and CEO Brian Harris are the people they turn to. His Boston-based startup specializes in neurologic music therapy (NMT), a treatment method that’s gaining prominence thanks to the success stories of patients and growing scientific support.

During an appointment, an NMT-trained therapist might sing with or play music for a patient. If they’re working on language, the therapist can ask the patient to sing or hum along to a well-known tune like “Happy Birthday.” If the focus is on walking, the therapist can have the patient take steps following a song’s beat. A patient can play notes on a keyboard to work on fine motor skills.

MedRhythms’ goal is to expand the practice beyond some of the nation’s top research hospitals and rehabilitation facilities and to make it commonplace at neurologic intensive care units, rehab clinics, and community care facilities around the country.

As a business, MedRhythms is in its infancy. Harris said it’s only a few months old, and is trying to stay “small and lean” in its early days. The company works with a few clinicians and a member of the Berklee College of Music’s faculty who specializes in NMT and trains therapists. Harris also has business advisers who are helping plan MedRhythms’ future growth.

“We’ve really begun the journey to make the care more accessible to people who need it,” Harris said.

The reason NMT is thought to work is because music is believed to have a connection with language, movement, and possibly thinking and memory, Harris said. That’s not a new belief: researchers studying rehabilitation have long seen results from music therapy—for example, people with aphasia as the result of a stroke often can sing before they can speak clearly—but it has only been in the past 15 years or so that advancements in neuroimaging have shown how music changes the brain.

That’s given the field an increasingly scientific underpinning, Harris said. Researchers have linked rhythm with the region used for motor control and melody and pitch with vocal intonation. They’ve found the brain is hard-wired to process music, even for non-musicians, and those abilities can survive strokes or injuries that devastate language and motor skills.

As the body of research grew, clinicians and therapists began trying to apply it with patients. The research began drawing more attention following the 2011 shooting of former Congresswoman Gabby Giffords, who used a type of NMT known as melodic intonation therapy to help recover some language and movement abilities after being shot in the head.

The field has grown since then, and research continues to back it up and suggest new uses, Harris said.

One piece of evidence that shows the therapy’s growing acceptance is its use by some of the nation’s top rehab hospitals for people with stroke or brain injuries. Top rehabilitation hospitals such as the Rehabilitation Institute of Chicago, the Spaulding Rehabilitation Hospital in Boston, and the Craig Hospital outside Denver incorporate neurologic music therapy in their recovery programs.

Harris said MedRhythms expects significant growth in the next few months, but there is one thing that could hold the company—and the entire field—back. The insurance industry, that crucial player in all medical treatment, has to be on board. So far it’s been difficult to get companies to cover therapy sessions as part of the standard rehab process, but there are billing codes that make it possible.

But Harris is an optimist and thinks it is just a matter of time before MedRhythms therapists are working alongside physical, speech, and occupational therapists as they treat stroke victims around the country.

Research suggests the therapy has benefits for two categories of patients: people who have suffered strokes or brain injuries, and those who have degenerative neurological diseases such as Parkinson’s or Huntington’s disease.

In the case of strokes, one of the goals shared by most types of therapy is to help the brain rewire itself if there has been damage to areas that control functions such as speech and movement. Because of the brain’s plasticity, different parts can be trained to handle some of those functions adequately.

For degenerative conditions, unfortunately, NMT does not offer a cure. Researchers have yet to find a way to cure the diseases or even stop them from progressing. Harris says what NMT seems able to do is mitigate some of the debilitating side effects, such as the difficulty in walking that Parkinson’s and Huntington’s patients often develop.

But in both categories, the therapy leads to results that positively affect a patient’s quality of life. Harris believes that will be the most important factor in its adoption.

“I 100 percent believe neurologic music therapy will become mainstream, that when you say it people will understand it. When people see the drastic results that can be had, it is absolutely amazing, and the more we understand how music affects the brain, the more important it is going to be in neurorehabilitation,” Harris said.

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  • I can believe this works. I am a TBI survivor and use Mozart to reboot my brain’s system after it gets exhausted. I wonder if some types of music are more effective than others in NMT.

  • Stefan

    Thomas that’s wonderful you use Mozart for relaxation! Unfortunately listening to music isn’t a form of music therapy and it’s an important distinction. Therapeutic for you? Certainly. But you need a therapist there using the music as a tool to enhance an aspect of your functioning to be considered music therapy. It’s an important distinction for the field as some people believe just putting on music and removing the human component is as effective as hiring a music therapist to save the money. To answer your question, the “type” of music doesn’t necessarily matter in neurological music therapy because in NMT the different neurological components that are activated through the music (tempo, volume, etc.) are what facilitates the movement or speech, not the quality of the music… Although higher quality music will no doubt make the experience more pleasurable for the patient so it is a factor just not the important factor. For relaxation however, there are aspects of music that will help enhance relaxation (drones, soft timbre, reverb, etc.) and in general it’s obvious that say acoustic folk music would in general be more relaxing then metal. But because within genres there is so much variability it’s impossible to say Beethoven (or classical) is more relaxing than say The Beatles because each have stimulating songs and relaxing pieces. Preferred music tends to have more favorable outcomes for all individuals so use whatever works for you! Sorry for my longwindedness… I tend to get carried away when talking about music therapy :)

  • Stefan

    Wonderful article! Great work Mr. Harris I wish you nothing but the best! Quick little nitpicky tidbit just for clarification purposes: technically when working on gait it’s not simply a matter of putting on music and having the patient walk to the beat. It’s a much more involved process that doesn’t need to be gotten into here but the clarification is that the beat/metronome is what facilitates the movement subconsciously not the patient follows the beat. How the beat is presented is incredibly important as well and there shouldn’t be too much excess music surrounding the beat as it can confuse the neurological mechanism involved. I only mention this so people reading this don’t think “I’ll put on some music and have someone walk to it” and think it will be nearly as effective as a true NMT process.