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Research team

This research team has developed a mobile phone app that offers tailored music therapy and real-time biofeedback to promote motor rehabilitation following neurotrauma. The app uses rhythmic acoustic stimulation to facilitate auditory-motor coupling, priming of the auditory-motor pathway, and cuing of movement periods. It also provides missing feedback, automation, and measurement, enhancing motor learning and rehabilitation. With access to personal iTunes music and the ability to adjust tempo, the app measures motor-music synchrony and records high-resolution session data for offline analysis. The app promotes brain plasticity through music entrainment and aids in the recovery of function following injury. Using transcranial magnetic stimulation (TMS), the app can measure synaptic plasticity in the primary motor cortex and effectively induce changes in functional neuroplasticity. The app is suitable for both the general adult population and neurologically impaired adults as part of their motor rehabilitation therapy.

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Research team

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  1. A tailored music therapy and real-time bio-feedback mobile phone app to promote motor rehabilitation following neurotrauma

  2. Research team

  3. It was a dark and rainy night…

  4. Rhythmic Acoustic Stimulation • Why is music particularly beneficial in physical rehabilitation?* • Auditory-Motor Coupling • Priming of the Auditory-Motor Pathway • Cuing of the Movement Period • Stepwise Limit Cycle Entrainment • *ThautMH. Rhythm, Music, and the Brain: Scientific Foundations and Clinical Applications. Routledge; 2005.

  5. IT’S FUN!!

  6. Can we make it better? • Missing feedback • Provides the receiver with a knowledge of result (KR), vital for motor learning* • Missing automation and measurement. • What do you we have to play with?? Magill, R. A. (2001). Augmented feedback in motor skill acquisition. In G. Tenenbaum & R.C. Eklund (Eds.), Handbook of Sport Psychology (pp. 86–114). New York: Wiley. Mobile Technology Wireless Sensors Low level access to personal music A New Mobile Feedback Instrument

  7. GotRhythm App • Runs on iOS mobile devices • Supports multiple wireless sensors • Provides real-time feedback • Accesses personal iTunes music and adjusts tempo • Measures motor-music synchrony (eg. foot or finger tapping to the beat) • Records high-resolution session  data for offline analysis.

  8. Patient Monitoring

  9. Towards an Ecosystem Adherence Social Support $ Savings Clinical Practice Analytics Research

  10. Music entrainment and brain plasticity

  11. Plasticity The ability of the brain to change, structurally and functionally, with experience • Modification of synaptic strength • Long-term potentiation / long-term depression Underlies learning and memory across the lifespan Aid in recovery of function following injury

  12. We can use transcranial magnetic stimulation (TMS) to measure plasticity in humans Motor evoked potential (MEP)

  13. TMS to measure synaptic plasticity

  14. TMS to measure synaptic plasticity • MEP reflects transynaptic output from pyramidal cells • A change in synaptic strength (within the cortical network activated by the stimulus) will be reflected in the MEP amplitude • Change in MEP amplitude can be used as a measure of synaptic plasticity Hallett 2007, Neuron

  15. Motor training induces synaptic plasticity in the primary motor cortex (M1) • Controls the muscles of the body • Responsible for the execution of motor plans • M1 plays an important role in motor learning

  16. Motor training induces synaptic plasticity in the primary motor cortex (M1) TMS to the cortical representation of the thumb • Measure the direction of the evoked movement Classen et al. 1998 Journal of Neurophysiology

  17. Motor training induces synaptic plasticity in the primary motor cortex (M1) Classen et al. 1998 Journal of Neurophysiology

  18. Motor training induces synaptic plasticity in the primary motor cortex (M1) Classen et al. 1998 Journal of Neurophysiology

  19. Motor training induces synaptic plasticity in the primary motor cortex (M1) Classen et al. 1998 Journal of Neurophysiology

  20. Rhythm in the brain A network of neural areas regularly implicated in processing of musical rhythm • Basal ganglia • Cerebellum • Parietal cortex • Prefrontal cortex • Premotor cortex and supplementary motor area

  21. Rhythm in the brain A network of neural areas regularly implicated in processing of musical rhythm • Basal ganglia - motor control, action selection, and learning • Cerebellum - coordination and fine-tuning of movement by integrating sensory and motor information • Parietal cortex • Prefrontal cortex • Premotor cortex and supplementary motor area - planning, voluntary control, and execution of movement • Strongly interconnected with the basal ganglia and cerebellum All interconnectedwith M1 and influence M1 output

  22. TMS to measure synaptic plasticity associated with training using GotRhythm • MEP reflects transynaptic output from pyramidal cells • A change in synaptic strength (within the cortical network activated by the stimulus) will be reflected in the MEP amplitude • Change in MEP amplitude can be used as a measure of synaptic plasticity Hallett 2007, Neuron

  23. GotRythm testing

  24. Adherence to the GotRhthym App will exceed 90% amongst participant drawn from a general population Acoustic feedback General adult population Acoustic feedback with music No feedback with music

  25. Training with GotRhythm will induce greater and longer lasting changes in functional neuroplasticity compared to control motor training tasks Acoustic feedback with music Typical adult Control motor training Baseline 10 minutes 30 minutes

  26. Training with GotRhythm will induce changes in functional neuroplasticity compared to control motor training tasksamongst neurologically impaired adults Usual treatment + Acoustic feedback with music Neurologically impaired population Usual treatment + control motor training Post-test Baseline Fugl-Meyer Assessment of Motor Recovery Fugl-Meyer Assessment of Motor Recovery

  27. http://www.populationhealthlinks.com/community-health.html

  28. References • Chen, J. L., Penhune, V. B., & Zatorre, R. J. (2008). Listening to Musical Rhythms Recruits Motor Regions of the Brain.Cerebral Cortex, 18(12), 2844–2854. • De Bruin, N., Doan, J., & Turnbull, G. (2010). Walking with Music Is a Safe and Viable Tool for Gait Training in Parkinson's Disease: The Effect of a 13-Week Feasibility Study on Single and Dual Task Walking.Parkinson's Disease, 10, 1–9. • Grahn, J., & Brett, M. (2007). Rhythm and Beat Perception in Motor Areas of the Brain.Journal of Cognitive Neuroscience, 19(5), 893–906. • Hausdorff, J. M., Lowenthal, J., Herman, T., Gruendlinger, L., Peretz, C., & Giladi, N. (2007). Rhythmic Auditory Stimulation Modulates Gait Variability in Parkinson's Disease.European Journal of Neuroscience, 26(8), 2369–2375. • Hove, M. J., Suzuki, K., Uchitomi, H., Orimo, S., & Miyake, Y. (2012). Interactive Rhythmic Auditory Stimulation Reinstates Natural 1/f Timing in Gait of Parkinson's Patients.PLoS ONE, 7(3), e32600. • Lim, H. A., Miller, K., & Fabian, C. (2011). The Effects of Therapeutic Instrumental Music Performance on Endurance Level, Self-Perceived Fatigue Level, and Self- Perceived Exertion of Inpatients in Physical Rehabilitation.Journal of Music Therapy, 48(2), 124–148. • Thaut, M. H., & Abiru, M. (2010). Rhythmic Auditory Stimulation in Rehabilitation of Movement Disorders: A Review Of Current Research.Music Perception, 27(4), 263–269. • Thaut, M. H. (2005). Rhythm, Music, and the Brain: Scientific Foundations and Clinical Applications (Vol. 7).Routledge.

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