A review of dance and cognition:
We’ve got the beat… or maybe not
Research into rhythmic deficits in Parkinson’s:
Previous research has demonstrated that people with Parkinson’s disease (PD) have difficulties with the perceptual discrimination of rhythms, relative to healthy controls…. insight into how people with PD process and perceive rhythm can refine our understanding of the well known problems of temporal processing in the disease
Subjective judgments of rhythmic complexity in Parkinson’s disease
In this study, conducted over the internet,
People with PD rated all rhythms as more complex across tempi, with significant group differences in complexity ratings at 120 and 150bpm, but not at 90bpm. Our analysis found a uniform elevated baseline for complexity judgments in the PD-group, and a strong association between the two groups’ rank-ordering the rhythms for complexity. This indicates a preserved ability to discriminate between relative levels of complexity. …we speculate that Parkinson’s disease affects judgment of complexity but not judgment of likeability.
So if I understand this correctly, folks with PD find rhythms, especially faster rhythms, to be more complex than do “normal” people.
As for me, I will still prefer syncopated rhythms, especially calypso, maybe because I heard them when I was too young to remember. Military marches in 2/4 time no longer appeal to me. In fact, I believe that the march that I wrote in high school during band camp, “To The Rear March, ” had a syncopated melody, but I can’t swear to it. Guess I’ll have to dig up the old sheet music and take a look.
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Oh, the title is long, and I can’t get through it in one breath
Well, the title is a mouthful, isn’t it?
Basically, this study looked at the different effects of external Rhythmic Auditory Stimulation (RAS) on folks with Parkinson’s Disease (PD) compared with folks without PD, using different tempi and different ways to observe the ability to synchronize with the beat.
Although this blog has noted a previous study which indicated that an internal RAS (e.g., singing a song) was superior to external RAS to immprove one’s gait, I have received feedback from several caretakers that their person with PD can not sing or carry a tune, but has been able to improve gait and reduce freezing with external RAS. Thus, this study should be of interest.
Bottom line: This study showed that music was superior to a metronome stimulus in “entrainment” of the motor systems involved after the cue was removed. (look up entrainment in biomusicology on Wikipedia for a full description of what it means). In other words, once a body gets synchronized to the musical RAS, they can continue to walk at the same pace as if the music were still playing.
Of course, there is more to it than this brief report. For that, I’ve provided the link to the full article above.
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A review of non-traditional treatments for PD
Exercise is generally accepted as beneficial for the alleviation of Parkinson’s Disease (PD) symptoms. The Clinical Neurologist International has just published an open-access article that reviews the most recent research with a focus on types of exercise and their benefits for specific motor symptoms:
From the abstract:
… it is crucial to better characterize the benefits of exercise in PD. … we discuss the most recent studies analyzing the clinical effects of various modalities of exercise in PD, including physical therapy, aerobic exercise, strength and resistance training, and nontraditional forms of activity such as tai chi, dancing, aquatics, and boxing. We also provide … expert recommendations based on current evidence and highlight issues that remain unresolved (e.g. the best type of exercise, symptomatic benefits based on different modalities, optimal frequency and duration, and duration of benefit).
It appears that the authors limited their search to those studies that looked into motor symptoms of PD, and perhaps this is why their list of references doesn’t include Rehfield et al.’s 2018 article on the superiority of a dance program to repetitive physical exercise in increasing brain plasticity. Nor do they look into other approaches, such as musical training and practice, as possible ways to improve cognitive function, brain plasticity, and quality of life.
As a person with PD, I personally find that an eclectic and inclusive approach, using medications, Deep Brain Stimulation (DBS), physical exercise (including dance-related, vocal/singing and breathing exercise), diet, and social activities related to specific interests (like native plants and photography) works best for me. For others, the mix will differ.
The authors of this review reach much the same conclusion:
…evidence suggesting that any and all types of exercise can provide short-term clinical and quality of life benefits. More research is needed to help understand if exercise programs provide generalized benefits or what strategies should be used to address particular deficits. Balance, flexibility, and stretching seem to improve motor symptoms and decrease falls, contributing to an improvement in overall function. Aerobic training appears to improve cognition, cardiovascular health, gait, and reaction time. Resistance training provides the strongest benefit in strength. Nontraditional exercise programs, including tango, tai chi, cycling, aquatic therapy, and boxing are potentially beneficial options for each patient
In short: Find out what types of exercise you like to do, do what you like to do, and keep on doing it to help reduce the symptoms of PD.
(Coincidentally, most of the authors are associated with my alma mater, the University of Florida in Gainesville, FL).
Strength training can help with PD symptoms
A review of studies indicates that strength training can help with mild to moderate Parkinson’s cases. (An earlier blog post here noted that a dance training program increased grey matter volume in the brain versus repetitive strength training. So don’t exclude either from your wellness program, is my [non-medical advice).
Review of strength training in people with Parkinson’s Disease
From the abstract:
Objective: To investigate the evidence on efficacy and limits of strength training in rehabilitation of Parkinson’s disease
Method:A comprehensive search on pubmed, clinical keys database using keywords Parkinson’s disease, physical therapy, strength training ,resistance training. The studies including Randomized controlled trails and systematic reviews published since 2005 are reviewed.
Results:36 studies identified through database searching. 25 studies are excluded due to duplicates, irrelevance, based on titles, outcome diversity. 5 systemic reviews and Meta analysis, 6 RCT are included. Review and analysis of articles is going on
Conclusion : The result of this review suggests that strength training program can be effective in people with mild and moderate parkinson’s disease. It can improve functional independency with increased muscle strength, gait parameters, posture and balance, all of these positive role on participation and quality of life
Art, Dance, Medicine, Parkinson’s, Genetics, Oh My!
Arts and Medicine research – my only wish is that they would look into the possibility of physical changes in the brains of people involved, and not just on co-creating knowledge:
Next:
Dance therapy demonstrates a highly appropriate choice of intervention to stimulate plasticity processes, improve age-related deterioration, and thus contribute to successful aging. Health care professionals involved in the care of elderly individuals should whenever possible consider the feasibility of associating dance therapy as a stimulating and therapeutic activity.
Dance therapy in aging: A systematic review
“There were 2,334 studies, out of which 6 were chosen.” This review limited itself to dance as therapy for healthy aging adults, and excluded those studies that looked at Parkinson’s or Alzheimer’s people. Again, I would hope that future studies look at changes in brain activity and structure, as well as observable differences in movement, etc.
Next, an open access article reviewing genetic risks involving Parkinson’s: “This study provides evidence that alleles associated with Parkinson disease risk, in particular GBA variants, also contribute to the heterogeneity of multiple motor and nonmotor aspects. Accounting for genetic variability will be a useful factor in understanding disease course and in minimizing heterogeneity in clinical trials.”
Genetic risk of Parkinson disease and progression: An analysis of 13 longitudinal cohorts
(Will have to read it in order to see what it says, and compare it with my genome files to see what it means for me).
Kazoos are good for youse
All of the following links have to do with improving voice for PD folks, and also the use of kazoos.
I used to write for this student newspaper:
Music therapy helps tackle Parkinson’s (The Miami Hurricane July 5, 2019)
This is a fairly long honors project paper reviewing voice therapy techniques:
Not necessarily for PD, but the study used spectrographic analysis to measure the improvement in voice in addition to qualitative results.
Finger Kazoo: spectrographic acoustic modifications and vocal self-assessment
I might have already mentioned this in a previous entry, but kazoos were used:
Individual Therapeutic Singing Program for Vocal Quality and Depression in Parkinson’s Disease
Vocal warmups for the individual: Vocal warmups
Vocal warmups for the group: Anatomy of a choral warmup
I got rhythm, I got music…
Put together a slide presentation trying to synthesize some of the research on Parkinson’s Disease (PD) and the possibility of music, singing, playing musical instruments, and dance as means to counteract the progressive effects of dopaminergic neurons lost in the course of PD. Due to the length of the presentation and the limits of my computer resources, the narration seems to have gotten a little out of sync towards the end. But it is what it is, as they say: (note: added a PDF file of the presentation on 6-9-19 to make it easier to download and view)
Rhythm, Music, Singing, Dancing and the Brain
2019-06-05-Rhythm Music Singing and the brain (PDF file)
and an even smaller file with all the blue and yellow intact (6-15-2019):
And now for something completely different…
This is an article on the legal problems created by the politicization of medical issues:
Navigating Through the Haze of Cannabis and Patents
The article begins by pointing out an obvious conflict:
- The US Patent Office has permitted patenting of Cannabis related innovations since 1942.
- The Federal government has outlawed the possession, cultivation, and distribution of marijuana since 1970 with the passage of the Controlled Substances act.
An interesting timeline of the history of Marijuana (and hemp) in the United States can be found at the PBS Frontline web site:BUSTED: America’s war against marijuana
It will be interesting to see how this all plays out. At one, time, people were required to grow hemp, at another time, people were given draft deferments to grow hemp. I would be happy to see Cannabis legalized so that medical research could be conducted in a reasonable fashion. And so grandmothers don’t get arrested for carrying a small vial of CBD oil onto an airplane.
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Progressively difficult or complex dance training is superior to repetitive physical exercise
Yep, you read that correctly. This research was done using neuro-imaging and revealed that brain plasticity ( how experiences reorganize neural pathways in the brain) is increased by a program of increasingly difficult dance training. (The title of this entry was edited 04/28/2021 to make it more clear that the variable was increasing the difficulty, and not simply dance vs. exercise. ALL exercise is good, as long as not overdone, but to incorporate research findings into the program (like Power for Parkinson’s or Lew-Ortiz Pabon’s Apollo Rhythm Club do), takes some extra effort).
… Both interventions increased physical fitness to the same extent. Pronounced differences were seen in the effects on brain volumes: Dancing compared to conventional fitness activity led to larger volume increases in more brain areas, including the cingulate cortex, insula, corpus callosum and sensorimotor cortex. Only dancing was associated with an increase in plasma BDNF levels. Regarding cognition, both groups improved in attention and spatial memory, but no significant group differences emerged. The latter finding may indicate that cognitive benefits may develop later and after structural brain changes have taken place. The present results recommend our challenging dance program as an effective measure to counteract detrimental effects of aging on the brain.
On a personal note, I noticed during a year long period of reduced mobility that my Parkinson’s symptoms had progressed (or regressed, depending on how you look at it). Slurred speech was perhaps one of the more obvious or noticeable symptoms. That has now disappeared, though one has to be mindful to speak clearly and loudly in order to be understood.
Physical exercise of any kind is good, it seems. Weight resistance and other exercises can benefit from the high intensity interval approach. But move to the music, and join a dance class that increasingly challenges the brain (especially if you are classified among the elderly, even if you are Young At Heart).
bob's brain: living well with a movement disorder and other comorbidities 