Category Archives: Singing

Deep Brain Stimulation (DBS), Music, Parkinson's, prodromal, Research, Singing , , , , , , , Leave a comment

Me and My PD – 14 Sept 2024

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It’s been said that if you’ve met one person with Parkinson’s Disease (PD), then you’ve met one person with PD.

Today I saw a news segment about a guy who plays trombone, and how he had experienced a deterioration in his ability to play in the previous year. He was diagnosed with Essential Tremors (ET), also known as familial tremors or benign tremors. The point of the story was that he had opted for Deep Brain Stimulation (DBS), during which the patient is awake (at least part of the time), and that he played trombone during the operation.

I hope his physician got the diagnosis correct. As noted earlier in this blog, et-pd-is-there-is-or-is-there-aint-a-connection, a research paper was published that established a link between ET and PD: “LINGO1 rs9652490 is associated with essential tremor and Parkinson disease.” Having had essential tremors since my teenage years, I checked my DNA analysis and discovered that I did have that specific variation on the LINGO1 gene. As I’ve often remarked about PD research, this would have been good information to know 50 years ago.

I did remark a couple of times to my Movement Disorders Specialist’s team that I regretted not having asked to play the saxophone or guitar during my own DBS operation. To their credit, they attempted to fine tune my settings, but either due to lack of practice or progression of PD symptoms, I was not able to recover the picking and strumming skills I had back in 1997. And so it goes.

These days, I try to play on my keyboard as often as I can, but any attempt to follow an instructional program, or parse out simple pieces written for instruction (e.g., Bach’s selections from the notebook for Anna Magdalena, Bela Bartok’s pieces for children), soon devolve into loose jams on simple chord progressions, or attempts to recall, remember, and play some of my own simple songs with a minimum of egregious errors.

But I have promises to keep and chores to do before I sleep, so I will just end this with a selection from 1997, when I could play a little bit (self-taught). Unlike many of my songs, this one was not influenced by Bob Dylan.

You’re A Mystery To Me

#Essentialtremors #Parkinsonsdisease #music #DBS #idiopathic

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biodiversity,, exotics, invasives, Music, native plants, nature, Parkinson's, Research, Reviews, Singing, wildflowers , , , , , , , Leave a comment

Where have all the (native) flowers gone?

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Prosser, R.S., Brain, R.A. Where have all the flowers gone? A systematic evaluation of factors driving native terrestrial plant decline in North America. Environ Sci Pollut Res (2024). https://doi.org/10.1007/s11356-024-34349-9 

Prosser and Brain have done the research and  have come up with the following conclusions:

  • Habitat alteration and non-native species are the most important drivers of the decline in native terrestrial plant diversity in North America.
  • No listed species in the U.S. or Canada faced a singular threat. In the recovery plans for all listed species, several threats were identified as contributing to their risk of extirpation or extinction.
  • Pesticides, specifically herbicides, represent a micro-scale contributor to the decline of plant biodiversity in North America relative to other drivers.

(Note: the above three points are taken verbatim from text in the article, although they are not presented as bullets in the subject article. Emphasis using bold and italics has been added).

In their conclusion, they argue that pesticides and herbicides make an easy target for litigation, even though they contribute minimally to the extirpation or extinction of native plants .

On the other hand, Paraquat is an herbicide that not only has been banned in over 50 other nation-states, and has been linked as a probable cause of Parkinson’s Disease in the book Ending Parkinson’s Disease: A Prescription For Action  and in this February 2024 article on the EarthJustice website: This Weed Killer Is Linked to Parkinson’s. Why Isn’t It Banned Yet?

I would suggest that the authors of the article on causes contributing to reduction of native plant species are failing, in their words, to see the forest by focusing on the trees. I am a native plant advocate who also has Parkinson’s Disease. I don’t know whether I have been exposed to Paraquat in the past. Just because pesticides and herbicides are not a major factor in the reduction of native species doesn’t mean I should just ignore the bigger picture of the effect of herbicides like Paraquat on the species Homo sapiens, many of whom, including myself, have displaced other native occupants of this territory, like the Apaches, the Tonkawas, and other tribal groups who are members of the same Genus and species.

This post has covered most of my main interests: scientific research, Parkinson’s Disease, and native plants. All that’s missing is some music:

The Parkinson’s Anthem (We Ain’t Givin’ Up Hope)

#nativeplants  #research #parkinsonsdisease #advocacy

Dance, Exercise, Music, Parkinson's, Research, Reviews, Singing , , , , 1 Comment

Music, music music (and exercise)

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Dial the wayback machine to 2021, where this digital commons paper from Sacred Heart University on Influence and Effect of Music on Exercise  By Kendall Stewart appeared.

… Lack of adherence to exercise and physical activity, and related programs, is correlated with absence of motivation and enjoyment. Research has proven the presence of music, during physical activity, to be a strong motivator and linked to increased enjoyment, thus increasing exercise adherence. The purpose of this essay is to compile research in order to analyze and explain how the presence of music during physical activity increases mood and affective state of mind to bring about increased adherence and motivation as well as describe how individuals feel as though they are doing less work/exercising less when listening to music while being physically active. In addition, … examine the effect that different music genres, speeds, paces, and preferences have on exercise performance, enjoyment and adherence. (emphasis added).

Among the citations are:

de Dreu MJ, van der Wilk ASD, Poppe E, Kwakkel G, van Wegen EEH. Rehabilitation,
exercise therapy and music in patients with Parkinson’s disease: A meta-analysis of the
effects of music-based movement therapy on walking ability, balance and quality of life.
Parkinsonism & Related Disorders. 2012;18(Suppl 1):S114-S119. doi:10.1016/S1353-
8020(11)70036-0

which also refers to:

Goodwin VA, Richards SH, Taylor RS, Taylor AH, Campbell JL. The effectiveness of exercise interventions for people with Parkinson’s disease: a systematic review and meta-analysis. Mov Disord. 2008 Apr 15;23(5):631-40. doi: 10.1002/mds.21922. PMID: 18181210.

Evidence supported exercise as being beneficial with regards to physical functioning, health-related quality of life, strength, balance and gait speed for people with PD. There was insufficient evidence support or refute the value of exercise in reducing falls or depression.

On the topic of music and PD, we have:

Poliakoff, E., Bek, J., Phillips, M., Young, W. R., & Rose, D. C. (2023). Vividness and Use of Imagery Related to Music and Movement in People with Parkinson’s: A Mixed-methods Survey Study. Music & Science, 6. https://doi.org/10.1177/20592043231197919

excerpts from the abstract (as always, emphasis added):

… Music is used in interventions for people with Parkinson’s, either to pace movements, or as an integral element of activities such as dance. This study explored self-reported vividness of two forms of imagery – motor imagery evoked by music and auditory (including musical) imagery – in people with Parkinson’s, and whether and how they use these types of imagery in everyday life.

Participants (N = 199) completed:

(i) vividness ratings of visual and kinesthetic music-evoked motor imagery,

(ii) vividness ratings of auditory imagery, and

(iii) ratings and open questions about their everyday use of these types of imagery.

…  <20% reported actively using music to support motor imagery in daily activities. In contrast, participants reported a broad range of contexts and uses for musical imagery (imagined music), from supporting movement (e.g., walking or exercise) to emotion regulation, and concentration.

Correlational analyses associated vividness of music- evoked motor imagery with an urge to dance and musical training, while the use of musical imagery was associated with singing ability.

A minority of participants reported not experiencing either motor or musical imagery, suggesting that interventions based on imagery may not be suitable for all.

… even participants with more severe motor symptoms reported experiencing and using both types of imagery, indicating promise for their strategic use at different stages of Parkinson’s. … musical and motor imagery have the potential to support rehabilitation strategies for Parkinson’s, either separately or in combination.

Not the “hardest” scientific evidence there is, but hey, Einstein (a guy who only has to be referred to by his surname, and we all know who were talking about) reported that he did his though experiments using visual imagery, and only later (and with much labor) worked out the math. (I believe the reference can be found in a book “The Act of Creation” by Arthur Koestler, if memory serves. As Einstein reportedly said, you can always look it up).

How to end this post on music and Parkinson’s Disease? Rather than submit one of my own YouTube videos, how about one from another person whose first name alone is sufficient to identify him:

Elvis

Dance, Drumming, Music, Research, Singing , , Leave a comment

We got the beat

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This open access article piqued my interest. I have long been aware of studies that showed that infants are basically altruistic. This is the first one I came across that shows that infant “Spontaneous Motor Tempo”  (SMT)  is something that can be measured. Here’s the link:

Infant Spontaneous Motor Tempo

From the abstract:

We present the first data documenting the SMT of infants from 5 to 37 months of age using a simple drumming task. As in late childhood and adulthood, we predicted that infant SMT would slow across the first years of life. However, we find that older infants drum more quickly than younger infants. Furthermore, studies of adults suggest larger bodies prefer slower rhythms. 

(emphasis added to quote)  … which explains why this is the first time I’ve heard about infant SMT. A couple of their research highlights:

  • SMT can be measured at 5 months old using a simple drumming task
  • Infant drumming gets faster and more regular as they get older

Kinda makes you want to read  the whole article…

or sing along to the title to this post:

We Got The Beat

Music, nature, Parkinson's, Singing , , , , , , , , Leave a comment

An early Spring, this year

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This February has seen no scenes like the one above (Feb. 15, 2021) where we saw over 6 inches of snow and sub freezing temperatures for about two weeks. Thousands of people lost power, and I don’t want to look up how many died from the pre-20th Century conditions to which they were not conditioned or prepared to deal with.

However, thanks to Global Warming, this Winter has been warm, for the most part. So we’ve seen some early blooms, one of which always persists, is the Ten-Petal Anemone. This bloom is white, but the species can vary from white through pinkish to violet. (An artist might differ with my choice of descriptive colors).

And here’s an unopened Anemone berlandieri from the violet end of the spectrum.

What are these doing in the Bob’s Brain: Living well with PD and other co-morbidities blog?

  • Bob’s brain mistakenly failed to switch to the Back to the natives: Native plants are the answer before beginning the draft, or
  • Bob’s brain has other interests in his life other than an incurable, progressive,  degenerative neurological disease,
  • or both of the above… whatever answer you choose, you won’t go wrong.

Oh well, might as well end with a song:

https://youtu.be/sxoTWy0bTXo?si=NmKkd0bLzysH8ZSO

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Dance, depression, Exercise, Music, Parkinson's, Research, Reviews, Singing , , , , , , , Leave a comment

Music, movement, and PD

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Jerry Coker, who was one of my instructors my first year in undergraduate college, and then again my last semester before graduation , had an hypothesis that for improvisation to be enjoyable, it had to be approximately 75% predictable and 25% unpredictable. Vary too far from those parameters, and you end up with something that is either too boring and predictable, or something that leaves the listener wondering what’s going on, trying to guess where the melody is.

I never advanced far enough to get his insights on swing, or the concept of where the beat is. Duke Ellington, whom I saw at a festival once, did have a short primer on swing. He began with the person who snaps his fingers or taps his feet on the downbeats (ONE-and-TWO-and….). Then he progressed to the folks who tapped their feet or snapped their fingers on the upbeat (1-AND-two-AND..). I forget where it went from there (maybe to Latin rhythm patterns), although I do remember him saying that when he greeted people, he always gave two kisses to the right, and two to the left, one for each cheek.

Love You Madly (ending)

Today’s readings all relate to music and movement –

From  Saluja A, Goyal V, Dhamija RK. Multi-Modal Rehabilitation Therapy in Parkinson’s Disease and Related Disorders. Ann Indian Acad Neurol. 2023 Jan;26(Suppl 1):S15-S25. doi: 10.4103/aian.aian_164_22. Epub 2022 Nov 21. PMID: 37092020; PMCID: PMC10114534. 

(emphasis added to the section quoted below):

Dance, Music, and Singing Therapy in Pd Rehabilitation

Dancing may improve speed of movement, balance, wellbeing, and QOL in patients with PD.[74,75] Multiple dancing interventions and their impact on symptomatology of PD patients have been assessed. In a systematic review of 38 articles that studied the role of various dancing interventions (tango, waltz/foxtrot, Sardinian folk dancing, Irish set dancing, Brazilian samba, Zumba, mixed dance forms, and home-based dance interventions), there was a moderate-to-large beneficial effect of dancing interventions in mild-to-moderate PD. Dancing sessions (once/week to daily for 30 minutes to 2 hours) significantly improved balance, total UPDRS, mobility, endurance, gait freezing, and depression among PD patients.[76]

Music and rhythmic auditory stimulation can improve gait parameters in PD.[77] BEATWALK is a smartphone-based application that initially assesses cadence in PD patients and then progressively increases musical tempo in order to reach the desired speed. A recent study found that BEATWALK significantly improved gait velocity (P < 0.01), cadence (P: 0.01), stride length (P: 0.04), and distance (P: 0.01) among 39 PD patients who could walk unaided and had no gait freezing.[78] The ParkinSong trial studied the effect of singing intervention (at weekly and monthly intervals) in PD and found significant improvements in vocal intensity (P = 0.018), maximum expiratory pressure (P = 0.032), and voice-related QOL (P = 0.043) among PD patients when compared to controls.[79] A recent systematic review and meta-analysis including 67 publications found that tango resulted in significantly improved UPDRS-III scores (Z = 2.87, P = 0.004) and TUG scores (Z = 11.25, P < 0.00001), whereas PD-specific dance resulted in improvement in PDQ-39 scores (Z = 3.77, P = 0.0002) when compared to usual care.[80]

Cox L, Youmans-Jones J. Dance Is a Healing Art. Curr Treat Options Allergy. 2023 Apr 10:1-12. doi: 10.1007/s40521-023-00332-x. Epub ahead of print. PMID: 37361639; PMCID: PMC10088655.

This article is considered an Opinion Statement rather than a “research study,”although they used the same armchair/desk jockey methods used by many reviews and meta-reviews. From the abstract (emphasis added):

The purpose of this review is to evaluate the health benefits of dance and dance therapy in various health domains. Dance interventions included movement therapy with certified therapists, common dances such as ballroom dancing, salsa, and cha-cha as well as ethnic dances, such as the Chinese Guozhuang Dance and the Native American jingle dance. The health domains included depression, cognitive function, neuromotor function, dementia, balance, neurological growth factors, and subjective well-being. The National Library of Medicine, Congress of Library, and the Internet were searched using the terms: dance, dance movement therapy, health, cognitive function, healing, neurological function, neuromotor function, and affective disorders from 1831 to January 2, 2023. Two-thousand five hundred and ninety-one articles were identified. Articles were selected if they provided information on the health benefits of dance in one or more of the above domains as compared to a “non-dance” control population. Studies included systematic reviews, randomized controlled studies, and long-term perspective studies. Most of the subjects in the studies were considered “elderly,” which was generally defined as 65 years or older. However, the benefits of DI on executive function were also demonstrated in primary school children. Overall, the studies demonstrated that DI provided benefits in several physical and psychological parameters as well as executive function as compared with regular exercise alone. Impressive findings were that dance was associated with increased brain volume and function and neurotrophic growth function. The populations studied included subjects who were “healthy” older adults and children who had dementia, cognitive dysfunction, Parkinson’s disease, or depression.

The benefits of dance for PwPs include movements and connections with others:

Jola C, Sundström M, McLeod J. Benefits of dance for Parkinson’s: The music, the moves, and the company. PLoS One. 2022 Nov 21;17(11):e0265921. doi: 10.1371/journal.pone.0265921. PMID: 36409733; PMCID: PMC9678293.

From the abstract:

Dance classes designed for people with Parkinson’s are very popular and associated not only with increasing individuals’ motor control abilities but also their mood; not least by providing a social network and the enjoyment of the music. However, quantitative evidence of the benefits is inconsistent and often lacks in power. For a better understanding of the contradictory findings between participants’ felt experiences and existing quantitative findings in response to dance classes, we employed a mixed method approach that focussed on the effects of music. Participant experience of the dance class was explored by means of semi-structured interviews and gait changes were measured in a within-subjects design through the Timed Up and Go (TUG) test before and after class, with and without music. We chose the TUG test for its ecological validity, as it is a simple test that resembles movements done in class. We hypothesised that the music and the dance class would have a facilitating effect on the TUG performance. In line with existing research, we found that before class, the gait of 26 participants was significantly improved when accompanied by a soundtrack. However, after class, music did not have a significantly facilitating effect, yet gait without music significantly improved after class compared to before.We suggest that whilst the music acts as an external stimulator for movement before the dance class, after the dance class, participants have an internalised music or rhythm that supports their motor control. Thus, externally played music is of less relevance. The importance of music was further emphasised in the qualitative data alongside social themes. A better understanding of how music and dance affects Parkinson’s symptoms and what aspects make individuals ‘feel better’ will help in the design of future interventions.

The entire article is Open Access at the link above. My own impression of the discussion of the contradictory results (from what was expected) reminded me of a quote my statistics professor was fond of repeating: It is meaningless to discuss what the data might have been if the data were something other than what they are. 

As a PwP, one explanation for the lack of significance difference in the TUG post-test could very well be fatigue. I, therefore, suggest that this could be looked into as a possible explanation for the lack of significant difference between external music v no external  music stimulus. Clearly, “Further research is needed.”

Morris ME, McConvey V, Wittwer JE, Slade SC, Blackberry I, Hackney ME, Haines S, Brown L, Collin E. Dancing for Parkinson’s Disease Online: Clinical Trial Process Evaluation. Healthcare (Basel). 2023 Feb 17;11(4):604. doi: 10.3390/healthcare11040604. PMID: 36833138; PMCID: PMC9957486.

The above citation reports on a clinical trial which was conducted with a fairly large and coordinated collaborative effort. Again, an excerpt from the abstract:

Results: Twelve people with PD, four dance instructors and two physiotherapists, participated in a 6-week online dance program. There was no attrition, nor were there any adverse events. Program fidelity was strong with few protocol variations. Classes were delivered as planned, with 100% attendance. Dancers valued skills mastery. Dance teachers found digital delivery to be engaging and practical. The safety of online testing was facilitated by careful screening and a home safety checklist. Conclusions: It is feasible to deliver online dancing to people with early PD.

As a PwP who has participated in Power for Parkinson’s online video dance Rhythm and Moves and other exercise videos, both live and asynchronously, the last line comes as no surprise.

The hour grows late, and I have medications to take before I sleep, oh so many medications to take before I sleep. To sleep, perchance to dream…

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Dance, depression, Music, Parkinson's, prodromal, Research, Singing, Sleep , , , , , Leave a comment

Prodromal symptoms, Parkinson’s Disease (PD), and that old song and dance…

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Here’s a few studies that came up in my news feed from  PubMed Central (PMC) or elsewhere for articles recently published on the topics in which I’m interested – namely, prodromal symptoms related to PD, the relationship of REM sleep disorder and depression to PD, and, of course, the use of singing and dance therapies as complementary approaches to dealing with the symptoms of PD.

Prevalence and duration of non-motor symptoms in prodromal Parkinson’s disease

The prevalence and duration of non-motor symptoms (NMS) in prodromal Parkinson’s disease (PD) has not been extensively studied. The aim of this study was to determine the prevalence and duration of prodromal NMS (pNMS) in a cohort of patients with recently diagnosed PD.

…subtracted the duration of the presence of each individual NMS reported from the duration of the earliest motor symptom. NMS whose duration preceded the duration of motor symptoms were considered a pNMS. Individual pNMS were then grouped into relevant pNMS clusters based on the NMSQuest domains. Motor subtypes were defined as tremor dominant, postural instability gait difficulty (PIGD) and indeterminate type according to the Movement Disorder Society Unified Parkinson’s Disease Rating Scale revision.

Results: Prodromal NMS were experienced by 90.3% of patients with PD. … males reporting more sexual dysfunction, forgetfulness and dream re-enactment, whereas females reported more unexplained weight change and anxiety. There was a significant association between any prodromal gastrointestinal symptoms and urinary symptoms  and the PIGD phenotype.[n.b.: phenotype includes inherent traits or characteristics that are observable]. [Emphases added].

Citation:  Durcan R, Wiblin L, Lawson RA, Khoo TK, Yarnall AJ, Duncan GW, Brooks DJ, Pavese N, Burn DJ; ICICLE-PD Study Group. Prevalence and duration of non-motor symptoms in prodromal Parkinson’s disease. Eur J Neurol. 2019 Jul;26(7):979-985. doi: 10.1111/ene.13919. Epub 2019 Mar 1. PMID: 30706593; PMCID: PMC6563450.

Associations of Sleep Disorders With Depressive Symptoms in Early and Prodromal Parkinson’s Disease

Purpose: To explore the effect of sleep disorders, including the probable rapid eye movement (REM) sleep behavior disorder (pRBD) and the daytime sleepiness, on depressive symptoms in patients with early and prodromal PD.

5-year follow-up study showed that sleep disorders, including pRBD and daytime sleepiness, were associated with the increased depressive-related score in individuals with early and prodromal PD.

Conclusion: … Sleep disorders, including pRBD and daytime sleepiness, are associated with depression at baseline and longitudinally, …  partially mediated by the autonomic dysfunction in early and prodromal PD, …  implication that sleep management is of great value for disease surveillance.

Citation: Ma J, Dou K, Liu R, Liao Y, Yuan Z, Xie A. Associations of Sleep Disorders With Depressive Symptoms in Early and Prodromal Parkinson’s Disease. Front Aging Neurosci. 2022 Jun 10;14:898149. doi: 10.3389/fnagi.2022.898149. PMID: 35754965; PMCID: PMC9226450.

Group therapeutic singing improves clinical motor scores in persons with Parkinson’s disease

Abstract
Background Previous reports suggest that group therapeutic singing (GTS) may have a positive effect on motor symptoms in persons with Parkinson’s disease (PD).

Objective To determine the effect of a single session of GTS on clinical motor symptoms.

Methods Clinical motor symptom assessment was completed immediately before and after 1 hour of GTS in 18 participants.

Results A significant decrease in average scores for gait and posture and tremor, but not speech and facial expression or bradykinesia was revealed.

Conclusion These results support the notion that GTS is a beneficial adjuvant therapy for persons with PD that warrants further research.

Citation: Stegemoller E, Forsyth E, Patel B, et al. Group therapeutic singing improves clinical motor scores in persons with Parkinson’s disease BMJ Neurology Open 2022;4:e000286. doi: 10.1136/bmjno-2022-000286