此篇blog或许非常零散，作为我各处学习资源的笔记的综合，用来随时查看查找。会经常更新。
Neuro basis of music processing in general
人感知音乐的神经科学基础涉及多个脑区和神经网络的复杂交互，这些脑区协同工作以支持认知、感知和运动功能。
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听觉通路：音乐感知始于对声学信息的解码。声音信号通过外耳、中耳传到内耳的耳蜗，耳蜗将声学信息转换为神经活动。耳蜗基底膜的神经元按其对不同频率声音的响应进行有序的拓扑排列（tonotopy）。
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脑干听觉核：声音信号在到达皮层之前，会在脑干的一系列听觉核（如耳蜗核、上橄榄复合体和下丘脑）中进行预处理，提取声音的基本声学特征，如声音强度、信号起始、周期性和信号位置。
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听觉皮层：人类听觉皮层位于颞上叶的后部，包括赫氏回（Heschl's gyrus）和部分颞平面（planum temporale）以及颞上回（posterior superior temporal gyrus）。主要听觉皮层对声音频率和频谱-时间调制进行精细分析，将声学特征转换为听觉感知（如将声音频率转换为音高感知）。
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非主要听觉皮层：参与建立声学环境的认知表征，包括声音对象的表示（听觉格式塔形成）、旋律轮廓分析、空间分组、声音间关系提取和声音流分离。
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听觉-运动网络：听觉皮层与运动皮层之间的连接是许多动物物种共有的神经结构特征。这些网络在节奏感知和产生、以及时间感知和运动定时中起着关键作用。
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小脑和基底神经节：小脑和基底神经节与时间处理和节拍同步有关。小脑接收来自前额叶、顶叶、颞上叶和颞叶皮层的分离投射，并通过脑干的脑桥核发送输出投射，形成一个内部“模型”，该模型包含执行特定运动或行为所需的所有动态过程。
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情感和奖赏系统：音乐感知还涉及情感和奖赏系统，如杏仁核、海马体、腹纹状体（包括伏隔核）、眶额皮层和前扣带回，这些区域在音乐引起的情感反应和奖赏体验中发挥作用。
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功能连接性：音乐感知不仅仅是局部脑区的活动，而是需要大规模认知、运动和边缘脑回路的及时协调。音乐处理诱导了神经同步的功能性组织变化，增加了区域内和区域间的振荡同步。
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音乐偏好和专业知识：音乐偏好和专业知识可以调节被动音乐聆听期间的功能脑连接性，影响默认模式网络（与内部专注思考有关的脑区网络）和其他与情感和动机相关的脑区的活动。
这些神经科学基础揭示了音乐感知是一个多维度的过程，涉及从基本声学分析到情感体验和认知整合的多个层面。
听觉-运动同步的神经基础
- 听觉系统与运动系统之间存在广泛的神经连接： 我们的听觉系统与大脑中控制运动的区域之间存在着大量的连接。这意味着，当我们听到声音时，不仅我们的听觉系统会被激活，大脑中的运动控制区域也会受到影响。
- 听觉信号可以触发肌肉活动： 早期的研究表明，声音信号和节奏音乐可以通过激活网状脊髓束来触发肌肉的活动。也就是说，听觉信息可以直接影响我们的肌肉，从而产生运动。
- 听觉系统的神经振荡与节奏同步相关： 当我们听到节奏性的声音时，我们的听觉系统会产生特定的神经振荡。这些神经振荡与声音的节奏特征密切相关。
- 下丘在听觉-运动同步中起重要作用： 下丘（inferior colliculus）是大脑中一个重要的听觉中枢，它与小脑之间存在着密切的联系。小脑在协调运动和保持平衡方面起着关键作用。因此，下丘通过与小脑的相互作用，将听觉信息转化为运动指令。
- 大脑的损伤并不会完全阻断节奏同步： 即使大脑受到损伤，比如中风或脑损伤患者，他们仍然能够通过听觉节奏来调节自己的运动。这表明，节奏同步是一种非常基础的神经机制，即使在脑损伤的情况下，仍然可以被激活。
Auditory Pathways
Cochlear nucleus
The cochlear nucleus is a part of the auditory system located in the brainstem. It is one of the first central processing centers for auditory information in the brain. Here are some key points about the cochlear nucleus:
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Location: The cochlear nucleus is situated in the lower part of the brainstem, specifically within the pons, on both sides of the brainstem.
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Function: It plays a crucial role in the early stages of auditory processing. After sound waves are converted to electrical signals in the cochlea of the inner ear, these signals are transmitted to the cochlear nucleus.
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Transmission: The cochlear nucleus is where the auditory nerve fibers synapse, transmitting sound information from the hair cells in the cochlea to the brain.
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Processing: The nucleus begins the process of sorting and organizing auditory information. It extracts basic acoustic features such as sound intensity and helps to locate the source of the sound.
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Projections: From the cochlear nucleus, auditory information is sent to higher centers in the brain, including the superior olivary complex, the medial geniculate body of the thalamus, and eventually to the primary auditory cortex.
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Structure: The cochlear nucleus is divided into several subnuclei, including the anterior ventral cochlear nucleus (AVCN), the posterior ventral cochlear nucleus (PVCN), and the dorsal cochlear nucleus (DCN). Each subnucleus has distinct functions and connections within the auditory pathway.
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Tonotopic Organization: Similar to the cochlea, the cochlear nucleus maintains a tonotopic organization, meaning that it is organized based on the frequency of the sound to which its neurons are responsive.
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Neural Pathways: The cochlear nucleus is part of both the ascending auditory pathway, which leads to the auditory cortex for sound perception, and the descending pathway, which modulates the sensitivity of the cochlea based on the brain's attention and alertness.
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Clinical Significance: Damage to the cochlear nucleus can result in hearing loss or auditory processing difficulties, although it is located deep within the brainstem and is rarely affected in isolation.
The cochlear nucleus is a critical link in the auditory pathway, translating peripheral auditory information into a form that can be further processed by the brain to create the perception of sound.
NMT的四个基本机制（underlying mechanisms）：
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Rhythmic Entrainment（节奏性同步）：
- 节奏性同步是指音乐节奏作为振荡系统，能够与大脑中的时间相关过程同步。这种同步最明显地体现在运动控制上，例如行走、手部运动等。然而，同步也发生在注意力系统、认知系统和语言系统中。由于大脑中的所有过程都是振荡的，音乐和节奏提供了一种独特的机制，通过这种机制，可以调节大脑中不同区域的时间组织。
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Augmented Auditory Feedback（增强的听觉反馈）：
- 增强的听觉反馈是指音乐干预中创建的听觉反馈，使得个体能够更好地听到自己的动作或思考过程。例如，当一个人正确地进行动作时，他们可能会听到鼓声，这种听觉反馈帮助他们继续正确的动作。这种反馈不仅可以使运动过程可听化，还可以使认知过程可听化，如注意力反应。
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Increased Functional Network Connectivity（增加的功能网络连通性）：
- 音乐感知、认知和生产创建了大脑中一个巨大的连接网络系统。音乐不仅激活了整个大脑，而且是在一个连接的功能网络中激活的。音乐基础的干预措施不可避免地会增加大脑功能网络的连通性。这种连通性的增加包括网络的转移和恢复。例如，一个受损的网络可以通过大脑的可塑性被重新训练，招募新的神经元来修复网络。
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Enhanced Motivation States（增强的动机状态）：
- 动机状态对于康复的成功至关重要。NMT通过音乐活动固有的吸引力和参与感，能够增强个体的动机状态。这种增强的动机状态有助于提高康复过程中的参与度和持续性，从而提高疗效。
这些机制共同作用，使得NMT成为一种强大的工具，可以帮助改善各种神经康复领域中的功能性结果，包括运动控制、语言和认知功能。通过这些机制，NMT能够针对个体的特定需求，设计出个性化的治疗方案。
NMT Techniques
Rhythmic Auditory Stimulation (RAS)
Definition:
-Training movements (especially gait) that are rhythmic.
Population:
Parkinson's, Stroke, TBI, Multiple Sclerosis, Orthopedic Patients
Therapeutic Mechanisms:
-Rhythmic entrainment
-Priming
-Cueing the movement
-SLICE: step-wise limit cycle entrainment
Patterned Sensory Enhancement (PSE)
Definition:
-A technique that uses the rhythmic, melodic, harmonic, and dynamic-acoustical elements of music to provide temporal, spatial, and force cues for movements which reflect functional movements of activities of daily living, or the fundamental motor patterns underlying these activities.
Population:
-Variety of neurological and orthopedic populations, children to geriatrics.
-Therapeutic Mechanisms:
Neurologic mechanisms of RAS apply to PSE.
-PSE uses highly patterned structures in music to stimulate and facilitate patterned information processing that regulates and enhances the specific spatial, force, and temporal aspects of complex movements.
-Consistent rhythmic repetition still results in the coupling of the motor system with the auditory system through rhythmic entrainment, and therefore drives the movement pattern.
-Key importance for therapist to use metronome during PSE in order to ensure that the rhythm is always driving the movements, and that the music therapist is not just responding to the client's movements.
Therapeutic Instrumental Music Performance (TIMP)
Definition:
-A neurologic music therapy technique that makes use of instrument playing to prompt functional motor movements; can improve spatial perception, endurance, timing of movements, strength, flexibility, range of motion, functional hand movements, finger dexterity, limb coordination, etc.
Population:
-TBI, Spinal cord injuries with paraplegia syndrome, Hypoxic brain damage, Ischemic or hemorrhagic strokes, Spina bifida, Ataxiate-langiectasia, Cerebral palsy, Poliomyelitis
-Damage to motor areas of the brain. Impairments in movement and posture.
-Categorize the extent of cognitive impairment based on which limbs are involved:
- Monoplegia: one limb is involved
- Hemiplegia: one upper and one lower on one side
- Paraplegia: immobolizes the lower limbs only
- Diplegia major: involves the lower limbs, with only minor involvement of the upper limbs
- Triplegia: involvement of three limbs, both lower limbs and one upper limb
Quadriplegia major: all four limbs are involved
Therapeutic Mechanisms:
-Therapeutically playing a musical instrument stimulates and trains functional non-musical movement patterns that are used in daily life in an efficient and repetitive way.
While playing instrument: sound-induced priming of motor system = auditory feedback from playing the instrument and entrainment via rhythmic cues. Creates a feedforward - feedback loop.
-Playing an instrument fulfills at least five of the core principles of motor learning: repetition, task orientation, feedback, shaping, and motivation. Assists in motor memory.
-Music = strong sensory cue that temporally structures and regulates movement patterns.
-Can create a group setting that generates feelings of accomplishment, collaboration, and enhanced motivation to work toward therapeutic goals, perhaps more so than during other types of indi
Melodic Intonation Therapy (MIT)
Definition:
-Uses melodic and rhythmic elements of intoning (singing) phrases and words to assist in speech recovery for patients with aphasia. Musical prosody should be modeled closely to the normal speech inflection patterns of the verbal utterance.
Population:
-Expressive or Broca's aphasia; Autism; Down's Syndrome; Apraxia.
-Injuries that compromise comprehension are not good candidates for MIT.
Therapuetic Mechanisms:
-Singing is characterized by syllables that are lengthened, chunked, and patterned, contributing to speech reduction in vocal output.
-Processing of music engages right hemispheric networks, thus helping to bypass damaged left hemispheric language networks.
-Rhythmic pacing and entrainment = right hemispheric networks in auditory, prefrontal, and parietal regions.
-Left hand tapping activates right hemispheric language networks as spoken language and arm gestures are controlled by the same motor control network.
Musical Speech Stimulation (MUSTIM)
Definition:
-Technique for non-fluent aphasia, that utilizes musical materials such as songs, rhymes, chants, and musical phrases to simulate prosodic speech gestures and trigger automatic speech. Good for clients not good for MIT. Good for patients who progressed with MIT and want new sentences.
Population:
-Patients who have experienced a left hemisphere stroke or brain injury.
-Designed for people with some form of non-fluent aphasia who still have the ability to produce non-propositional reflexive speech by accessing undamaged subcortical thalamic speech circuitry.
-Non-propositional speech
Overlearned, common phrases, well-known songs.
Propositional
Not overlearned, not common phrases.
-Stroke; Alzheimer's disease; Broca's aphasia; difficulty with cognition; Dementia.
-MUSTIM can be an excellent compensatory strategy for stimulating the initiation of spontaneous functional word or phrase utterances.
Therapeutic Mechanisms:
-Bi-hemispheric network for vocal production during both singing and intoned speech, with additional right-lateralized activation of the superior temporal gyrus, inferior central operculum, and inferior frontal gyrus during singing.
-Offers explanation for clients with non-fluent aphasia due to left hemisphere lesions are able to sing even if not able to speak.
Rhythmic Speech Cueing (RSC)
Defintion:
-Speech rate control via auditory rhythm is used to improve temporal characteristics such as fluency, articulatory rate, pause time, and intelligibility of speaking. Patient speaks to auditory stimulation. Presented as a metronome pulsed signal, a rhythmic pattern, or in the form of a more complex musical piece. Tempo is the most important factor for the therapeutic power of the technique. USE A METRONOME!!
-Metric cueing: match either one syllable or full word to one beat.
-Patterned cueing: reproduces a pre-structured rhythmic sentence as a given tempo. Syllables are not necessarily of equal duration.
Population:
Dysarthria = neurological motor speech impairment characterized by slow or hastened, weak, uncoordinated movements of the articulatory muscles.
Spastic or mixed dysarthria.
-Stuttering. Singing can overcome disfluency in people with stuttering.
-Parkinson's disease: speaking fast or softly.
-Festination of speech = similar to festination of gait. Smaller shuffling and accelerated steps.
-One trial supports RSC for apraxia of speech.
Therapeutic Mechanisms:
-Distinction made between treatment of dysarthria and dysfluency.
-Dysarthria: slowing down.
Rhythmic stimulus gives foundational pace.
Acoustic rhythm seems to facilitate a better motor programming in the process of speaking.
-Dysfluency:
May lead to coordination of breath and voice due to temporal regulation of speech act. Acoustic rhythm stabilizes fluency of speaking.
Oral Motor and Respiratory Exercises (OMREX)
Definition:
-Technique for addressing the improvement of articulatory control, respiratory strength, and function of the speech apparatus. Musical materials and exercises, mainly through sound vocalization and wind instrument playing, are applied to enhance articulatory control and respiratory strength and function of the speech apparatus.
Population:
-Impairments in communication are very common following various types of neurological damage: TBI, Strokes, Brain tumors, Muscular distrophy, Down Syndrome, Chronic Obstructive, Pulmonary disease (COPD), Emphysema
-Dysarthria: group of motor speech impairments that result from damage to the neurological areas that control the muscles used for speech. Speech becomes quiet, slurred, or unintelligible.
Characteristics: limited verbal intelligibility, decreased vocal intensity and range, abnormal rate of speech, poor prosody.
Tend to speak slowly, with slurred speech, and often in a monotonous, nasal voice.
Lack of coordination between breathing and speaking.
-Symptoms are also present in individual's with Huntington's Disease or Parkinson's Disease.
-Dyspraxia: a disturbance in the ability to sequence spoken language. Brain is unable to coordinate complex motor actions (such as speech) despite normal muscle strength and sensation.
Therapeutic Mechanisms:
-Role of NMT in language and speech disorders: help patient to develop spontaneous and functional speech, as well as to improve speech comprehension.
-Speech and singing use muscles for respiration and articulation, contain elements of rhythm, pitch, dynamics, tempo, and diction. Speech and singing share many neural networks.
-Music is motivating. Songs are adapted to developmental age of patient. Use characteristics of language in an enjoyable way.
-Singing provides a clear rhythmic cue from the song. Word
Vocal Intonation Therapy (VIT)
Definition:
-Use of vocal exercises to train, maintain, develop, and rehabilitate aspects of voice control due to structural, neurological, physiological, psychological, or functional abnormalities of the voice apparatus.
-Aspects of vocal control: inflection, pitch, breath control, timbre, and dynamics. Many exercises implemented in VIT are designed similarly to how a choir director would warm up choir. May include breathing exercises.
Population:
-Congenital disorders: cleft palate, Natural aging process: vocal fold elasticity, Car accident: injuries in vocal apparatus, Parkinson's disease, Thyroid disease, Psychogenic voice disorders such as anxiety states and conversion reactions can also result in voice changes. , TBI, Multiple sclerosis, Hearing impairment, Spinal cord injuries
Therapeutic Mechanisms:
-Due to shared biological structures of singing and speaking, ability to sing is as natural as speaking, with no formal training necessary. Singing can be valuable in engaging auditory-motor feedback loop in the brain more intensely than other music-making activities, such as instrumental playing.
-Singing effective tool for vocal control.
Therapeutic Singing (TS)
Definition:
-Generalized use of singing activities for a variety of therapeutic purposes. Addresses a wide spectrum of functions in a more general and undifferentiated way than the other NMT techniques with individual clients or groups of patients across all ages and diagnoses.
-Synthesize a range of specific speech, language, respiratory control, and vital capacity goal areas into an integrated therapeutic experience, thus providing follow-up exercise to other specific techniques such as OMREX, RSC, and VIT.
-Can be utilized as:
Reinforcement of therapeutic goals targeted earlier in a session.
An opportunity for assessment of the patient's translation of these individualized elements into a functional task.
A physical exercise technique that addresses needs in global vocal and respiratory strengthening and endurance.
A success-oriented technique, providing motivational input in tandem with functional enhancements to the client.
Population:
-Neurologically impaired Population:
Stroke
TBI
Parkinson's Disease
Multiple sclerosis
Guillain-Barre syndrome
-Physically impaired Population:
COPD
Surgery recovery
Trauma patients
Spinal cord injuries
-Hospice patients
-Aging adults and/or dementia populations
-Pediatric/developmental Population:
Developmentally delayed
ASD
-Children with hearing impairments
Therapeutic Mechanisms:
-Speaking and singing are natural pathways for human expression.
-Incorporate musical elements: tempo, melody, rhythm, and dynamics, and language.
-Predictability of structure can assist in improving voice prosody.
-Rhythmic components contribute to efficacy of singing in speech and language rehab.
-Shared neural networks for speaking and singing.
-Promotes strengthening and control of the muscles used for breathing, increases lung capacity.
Developmental Speech and Language Training Through Music (DSLM)
Definition:
-Specific use of developmentally appropriate musical materials and experiences to enhance speech and language development through singing, chanting, playing musical instruments, and combining music, speech, and movement. Targets children who are developing speech and language skills for the first time. Target speech production, language development, or both simultaneously. Directed toward functional use of communication.
Population:
-Utilized with a number of child populations that demonstrate speech and language delays.
-Developmental apraxia of speech
-Autism Spectrum Disorder
-Cerebral Palsy
-Intellectual Disabilities
-Specific Language Impairment
Therapeutic Mechanism:
-Music should be appealing while simultaneously targeting functional objective. TDM should be used to ensure isomorphic translation of a non-musical exercise.
-Rhythm can be useful for promoting speech production and anticipation of response. Primary facilitator of speech responses. Should be strong and clear.
Melody can be used to mimic intonation of phrases, to develop musical exercises that are engaging, and to help with response anticipation.
Music structure can further enhance the experience. Simple ABA form can allow for multiple repetitions of the "anchor" in the A section and the target response in the B section.
Symbolic Communication Training Through Music (SYCOM)
Definition:
-A technique in NMT that utilizes music performance exercises to stimulate and train appropriate communication behaviors, language pragmatics, speech gestures, and emotional expression through a non-verbal "language" system. Designed for patients with dysfunctional language or a complete lack of development of functional language.
-Exercises are designed for patients with a severe loss of expressive language (e.g. after a brain injury or stroke), or for patients with dysfunctional language or a complete lack of development of functional language. Exercises simulate and practice rules of communication through musical exercises such as structured instrumental or vocal improvisation.
-Can be structured to train structural communication behavior such as dialoguing, asking questions and creating answers, listening and responding, appropriate speech gestures, appropriate timing of initiation and responding, initiating and terminating communication, appropriate recognition of a message being communicated, and other communication structures in social interaction patterns in real time.
Population:
-SYCOM was designed specifically for patients who either have a complete loss of language related to a stroke, brain injury, or neurologic disease, or have an absence of development of functional expressive language.
-The absence of the ability to use expressive language due to severe expressive aphasia and/or cognitive impairment can leave a patient frustrated and isolated, due to lack of ability to verbally communicate with their environment. Using symbolic communication patterns through musical improvisation exercises can provide an opportunity for emotional expression and non-verbal communication of thoughts and ideas.
-In some cases, a therapist may see a patient in whom the development of functional language
Musical Sensory Orientation Training (MSOT)
Definition:
-An application of NMT that has been found particularly useful in patients with clinical conditions that affect attention, arousal, and sensory response. This uses live or recorded music to stimulate arousal and recovery of wake states and to facilitate meaningful responsiveness and orientation to time, place, and person. In more advanced recovery or developmental stages, active engagement in simple musical exercises increases vigilance and trains basic attention maintenance with emphasis on quantity rather than quality of response. Includes sensory stimulation, arousal, orientation, and vigilance and attention maintenance.
Population:
-Dementia: Alzheimer's Disease, vascular dementia, Lewy body dementia, frontal lobe dementia
-Developmental disabilities: TBI, birth defects, learning disorders, chromosomal disorders
-Disorders of consciousness: coma, vegetative states, stages of post-trauma recovery.
-Also been reports of use with ASD and potential applications with individuals with ADHD.
Therapeutic Mechanisms:
-Direct interaction between auditory signals and motor activation may enhance executive function and motor skills.
-Auditory cortical plasticity acts as a substrate for retraining functions even in a damaged brain.
-Auditory stimulation can increase autobiographical recall in cognitive problems by recruiting alternative pathways.
-Specific MT methods, such as spaced retrieval technique, can improve face/name recognition in memory loss.
-The differential cognitive load embedded in music perception can provide a range of stimuli, from basal pleasant auditory stimulation to more complex sensory stimulation.
-Familiar musical stimuli can create a template that serves as an aid to retain the patterning implied in memory functions, thereby recruiting working memory circuits.
-Mirror neurons
Auditory Perception Training (APT)
Definition:
-Focuses on auditory perception and sensory integration.
Composed of musical exercises that help one to identify and discriminate between different components of sound, like time, tempo, duration, pitch, rhythmic patterns, and speech.
-Integrates different sensory modalities (visual, tactile, and kinesthetic) during active musical exercises, such as playing from symbolic or graphic notation using tactile sound transmission or integrating movement and music.
-Cognition training includes both auditory perception and sensory integration.
Population:
-Auditory discrimination is crucial for sharpening cognitive function and for regaining or developing speech and language. Perception disturbances occur in different forms.
- Patients with developmental disorders
- Patients with intellectually disabling conditions of various etiologies.
- Hearing disorders or hearing loss.
- Patients with central auditory processing disorder (CAPD). Auditory processing disorder (APD).
-Others: - Down Syndrome
- ASD
- TBI
-Stroke
Therapeutic Mechanisms:
-Auditory discrimination is crucial for sharpening cognitive functions and for developing or regaining speech and language. Musical exercises are designed to aid the identification and discrimination of different sound components, such as time, tempo, duration, pitch, timbre, rhythmic patterns, and speech sounds.
-Musical training improves basic auditory analysis and the ability to distinguish subtle differences in sound and pitch. These skills are useful for reading.
-Increase in brain plasticity following musical training.
-Listening to musical instruments defines parameters of sound and auditory feedback.
-The act of playing music is highly motivating.
-Increase residual hearing.
Music Attention Control Training (MACT)
Definition:
-Provides "structured active or receptive musical exercises involving precomposed performance or improvisation in which musical elements cue different musical responses to practice attention functions."
-Attention: ability of an individual to select and focus on a mental or behavioral task, concentrate on that task for a designated amount of time, shift attention when needed between several tasks.
-Three ways the brain controls attention:
- Select and focus
- Sustain
- Switch (alternating or shift of attention)
- Divided attention. Two or more events simultaneously.
-Four domains in which attention operates: - Attention to space and analyzing spatial info
- Attention to time
- Sensory domain: info arriving through senses and process
- Attention to task: focus on behavioral goal
Population:
Patients with TBI, stroke, ASD, or Dementia.
Brain tumor, Multiple sclerosis, Parkinson's, other neurological diseases or injuries.
Therapeutic Mechanisms:
-Sustained, selective, alternating, and divided.
-Music adds new dimensions as an auditory sensory language to the rehab process of attention.
- Music rhythmic patterns drive attention focus by interacting with attention oscillators via coupling mechanisms.
- Music can facilitate divided attention: multidimensional stimuli (melody and rhythm)
- Music brings timing, grouping, and organization, so that attention can be sustained.
- Music recruits shared or parallel brain systems that assist the frontal lobes with alternating attention.
-Music provides the additional dimensions of emotion and motivation to help facilitate concentration and keep the person on task.
Musical Neglect Training (MNT)
Definition:
Includes active performance exercises on musical instruments that are structured in time, tempo, and rhythm, and use appropriate spatial configurations of the musical instruments to focus attention on a neglected or inattentively viewed visual field.
Second application: receptive music listening to stimulate hemispheric brain arousal while engaging in exercises that address visual neglect or inattention.
Population:
-Hemispatial neglect, neuropsychological condition in which after damage to one hemisphere of the brain, a deficit in attention to and awareness of one side of space is observed. Inability to perceive stimuli on one side of the body that's not related to sensory deficits. Contralateral to damaged hemisphere.
Commonly result of stroke or brain injury to right cerebral hemisphere causing neglect of left visual field. Right-sided is rare.
-Treatment: finding ways to bring attention to the left side. Going a few degrees past midline and progressing. Options include: prisms, visual scanning training, mental imagery training, video feedback training, and trunk rotation.
Therapeutic Mechanisms:
-Important to consider that auditory pathways have bilateral projections which activate both hemispheres ipsi-and cross-laterally. Auditory stimuli can be presented in verbal and non-verbal forms.
Inter-hemispheric imbalance between right and left hemispheric activation = cause of neglect. Verbal listening and processing can increase blood flow in both hemispheres. However, just verbal processing involves the left language side of the brain, music activates both sides. Increase depends on strategy used.
-Attention strategies and perhaps emotional processing activate right hemispheric activity.
Musical Executive Function Training (MEFT)
Definition:
-Improvisation and composition exercises in a group or individually to practice executive function skills such as organization, problem solving, decision making, reasoning, and comprehension.
Population:
ADHD, TBI, Stroke, Behavioral disorders
-Likely to be used with:
Brain tumor
Multiple sclerosis
Parkinson's Disease
Anoxia
Exposure to toxins
Other neurological diseases or injuries
-Also be used with healthy individuals to strengthen planning, organizational, and problem-solving skills in wellness training.
-current research doesn't support
Therapeutic Mechanisms:
-Music adds many dimensions to the process of rehab of Executive function:
- Music stimulates the brain and raises the level of activity needed to accomplish the EF task.
- Provides tangible cues and reminders when linked with specific tasks that need to be completed to accomplish a project.
- Provides timing, grouping, and organization so that the person can stay on task.
- Recruits shared or parallel brain systems that assist the frontal lobes in EF.
- Exercises create a task process and product in real time.
Music integrates affective and cognitive processes in EF training and, finally, adds emotion and motivation to keep the person on task.
Musical Mnemonics Training (MMT)
Definition:
-Memory: ability to re-create info or scenarios in your mind, based on your past experiences. Memory can be disrupted or even lost.
Working memory
Semantic memory
Episodic memory
Perceptual Representation System (PRS): Analyzes and compares new information with information that you already know.
Procedural
Prospective: reminds people to perform particular actions at the right moment.
-Mnemonics: systems that enable us to remember things more easily. Anything that increases recall. May be verbal, visual, movement, or musical.
-MMT = uses music as a mnemonic device to sequence and organize info and add meaning, pleasure, emotion, and motivation in order to enhance the person's ability to learn and recall info involved. Uses rhythms, songs, rhymes, chants, etc, to enrich learning and to increase our chances of successful remembering.
Population:
TBI, Stroke, Brain tumor, Multiple sclerosis, Parkinson's , Anoxia, Exposure to toxins, Other neurological diseases or injuries
-Has been found helpful when treating patients with Dementia and Alzheimer's Disease
Therapeutic Mechanisms:
-RECALL:
Repetition: repeat info frequently in order to establish it in memory. Use singing and rhythm to strengthen the repetition. Space the practice sessions over time.
-Emotion: Remember the memory and emotions are linked together in brain. Associate emotion with what you are learning. Use emotional and motivating music to learn.
-Confidence: believe that you can learn the info. Have a strong intention to keep the info in your memory for a long time. Use music to inspire learning efforts.
-Action: invest energy in the learning process. Focus attention fully on what you are learning. Use rhythm to sustain your focus while learning.
-Link: think of previous knowledge and link to current info. Sing new info to well-
Musical Echoic Memory Training (MEM)
Definition:
-Echoic memory is the earliest stage of auditory memory formation. Operates like a sensory memory register.
- Function is to retain immediate auditory information that a person has just perceived until it can be processed more elaborately in working memory.
- Or hold auditory information in the sensory register until subsequent sound is heard which then assigns meaning to the first sound, as in rapid processing of each speech sound sequences.
- Echoic memory is short. -----Defined as anywhere within the range of 2-4 seconds. Longer than iconic memory for visual info. It's longer because most salient visual information continues to be present for repeated scanning, whereas auditory information can never be rescanned unless it is actually repeated.
-Musical echoic memory training uses the immediate recall of musical sounds presented by singing, instrumental playing, or recorded music to retrain echoic memory.
Population:
-Patients with auditory memory dysfunction due to stroke in dorsolateral prefrontal or temporal-parietal cortex,
-Patients with TBI,
-Cochlear implant users,
-Children with developmental language disorders and ASD,
-And patients with Dementia or schizophrenia.
Therapeutic Mechanisms:
-Sensory data that enters the inner ear are perceptually organized into single coherent acoustical events forming an echoic memory.
-Music is a harmonically complex sound language, with a rich acoustical wave spectrum.
-Echoic memories in music consist of multiple simultaneously sounding vibration patterns with distinct frequencies and amplitudes that are perceptually fused or bound together.
-Music creates an enriched auditory environment to stimulate the auditory sensory register and create perceptual organization for echoic memory formation.
Associative Mood and Memory Training (AAMT)
Definition:
-Cognitive rehab technique that uses music to enhance memory processes in three ways--by producing a mood-congruent state to facilitate memory recall,
By activating associative mood and memory networks to access long-term memories, and
-By instilling a positive mood at both encoding and recall to enhance learning and memory function.
-Encoding - way in which details and info are intially experienced
Representation - how info is stored in memory
Retrieval - recovering info from LT memory and bringing it into consciousness for examination in working memory.
LG memory: implicit (automatic) and explicit (conscious recall).
Explicit memories include semantic and episodic memories. Combined = autobiographical.
-Goal of AAMT = improve cognitive functioning by recalling previous autobiographical memories, and establishing new ones.
Population:
-Neurologically based memory disorders
-Amnesia
-Anterograde amnesia: limits ability to form new memories following brain damage.
-Retrograde amnesia: limits ability to recall events prior to brain injury.
-Global amnesia: both of the above.
-Amnestic disorders may result from TBI, stroke, tumors, MS, or Dementia.
Therapeutic Mechanisms:
-Listening to music as an affective task activates interconnected network of both subcortical and cortical brain structures.
-Patterns of neural activity observed during emotional response to music have also been noted in response to other euphoria-producing stimuli, including food, sexual activity, and drugs of abuse.
-Dopaminergic mesocorticolimbic system that is activated during affective music listening tasks may also play a role in memory function.
-Activation of the rostral medial prefrontal cortex has been found to activate during a musical task. This structure is associated with autobiographical memory is the las
Music in Psychosocial Training and Counseling (MPC)
Definition:
-Guided music listening, musical role playing, and expressive improvisation or composition exercises. It uses musical performance to address issues of mood control, affective expression, cognitive coherence, reality orientation, and appropriate social interaction to facilitate psychosocial functions. The techniques are based on models derived from affect modification, associative network theory of mood and memory, social learning theory, classical and operant conditioning, and mood vectoring based on iso principle techniques.
-MPC focuses on psychosocial training. Involves techniques that have been described as activity or supportive, many of which may be appropriate for people whose cognitive and emotional functioning may be impaired by neurologic problems.
-Can utilize any music-based method that can help people with neurologic problems to improve their psychosocial functioning. It uses "musical performance to address issues of mood control, affective expression, cognitive coherence, reality orientation, and appropriate social interaction to facilitate psychosocial functions."
-Orienting to reality constantly, treatment is a process, behaviors are a coping mechanism to help align with present reality. If people think a certain way, they may feel better. Help establish meaning in the presence of injury rather than despite it.
-Consider: Diagnosis, capacity to process, progress made from session to session, developmental age and chronological age, preferences, and culture.
Population:
-ASD, TBI or stroke, Other neurological problems: Parkinon's Disease. To enable them to adjust to their changed status and to deal with deficits.
-Older adults and patients with Dementia, to enable them to deal with decreased cognitive and physical skills, including emotional reactions to losses, and to maintain functi
NMT Techniques and Definitions (NMT Academy material)
Sensorimotor Rehabilitation
Rhythmic Auditory Stimulation (RAS)
a neurologic technique used to facilitate the rehabilitation of movements that are intrinsically biologically rhythmical, most importantly gait. RAS uses the physiological effects of auditory rhythm on the motor system to improve the control of movement in rehabilitation of functional, stable and adaptive gait patterns in patients with significant gait deficits due to neurological impairment. RAS can be used in two different ways: 1) as an immediate entrainment stimulus providing rhythmic cues during movement, and 2) as a facilitating stimulus for training in order to achieve more functional gait patterns (Thaut 2005).
节奏性听觉刺激（Rhythmic Auditory Stimulation, RAS）
RAS 是利用稳定的节奏元素来改善各类神经疾病相关的异常步态,如脑卒中导致的偏瘫步态、帕金森病的慌张步态和冻结步态、脑瘫患者的异常步态等。
通过听觉节奏刺激,可以调动和激活大脑中与运动控制相关的神经网络,从而改善步行的速度、长度和对称性。
相较于传统的步行训练,RAS 可以带来更显著的效果,帮助患者更好地重建正常的步行模式。
Patterned Sensory Enhancement (PSE)
a technique which uses the rhythmic, melodic, harmonic and dynamic-acoustical elements of music to provide temporal, spatial, and force cues for movements which reflect functional exercises and activities of daily living. PSE is broader in application than RAS, because it is (a) applied to movements that are not rhythmical by nature (e.g., most arm and hand movements, functional movement sequences such as dressing or sit-to-stand transfers) and (b) it provides more than just temporal cues. PSE uses musical patterns to assemble single, discrete motions (e.g., arm and hand movements during reaching and grasping), into functional movement patterns and sequences. PSE cues movements temporally, spatially, and dynamically during training exercises (Thaut et al. 1991).
模式（听觉）感知增强（Patterned Sensory Enhancement, PSE）
PSE 通常应用于提高体力、耐力,改善平衡和姿势,增加上肢功能性运动技能。
PSE 利用符合特定动作韵律的音乐模式,将离散的运动组合成功能性的运动序列和模式。
这种听觉反馈有助于帮助患者更好地感知和控制所需的运动,从而提高运动质量和协调性。
PSE 适用于那些本质上缺乏节奏的运动,如手臂和手的操作动作,以及日常生活活动中的功能性动作序列。
Therapeutic Instrumental Music Performance (TIMP)
the playing of musical instruments in order to exercise and stimulate functional movement patterns. Appropriate musical instruments are selected in a therapeutically meaningful way in order to emphasize range of motion, endurance, strength, functional hand movements, finger dexterity, and limb coordination (Elliot 1982, Clark and Chadwick, 1980). During TIMP, instruments are not typically played in the traditional manner, but are placed in different locations to facilitate practice of the desired functional movements (Thaut 2005).
Speech and Language Rehabilitation
Melodic Intonation Therapy (MIT)
a treatment technique developed for expressive aphasia rehabilitation which utilizes a patient’s unimpaired ability to sing, to facilitate spontaneous and voluntary speech through sung and chanted melodies which resemble natural speech intonation patterns (Sparks et al. 1974). When using MIT with aphasia, the emphasis is to increase the linguistic or semantic aspects of verbal utterances (Thaut 2005)
旋律性训练治疗（MIT）
旋律性训练治疗（Melodic Intonation Therapy，MIT）是一种经典的言语治疗技术，主要用于治疗失语患者，尤其是非流畅性失语患者。这一方法使用音调和节奏的音乐元素来促进患者的言语表达。患者会通过吟唱特定的短语或句子，并结合特定的旋律和节奏，从而在治疗过程中刺激大脑的右半球。这种训练被认为通过刺激右脑功能来代偿左脑损伤，从而改善失语患者的言语输出。临床研究表明，MIT在恢复非流畅性失语患者的语言流畅性和语言表达方面具有显著效果，这成为了一种常见的言语康复技术。
Musical Speech Stimulation (MUSTIM)
the use of musical materials such as songs, rhymes, chants, and musical phrases simulating prosodic speech gestures to stimulate non-propositional speech. This technique uses the completion or initiation of over learned familiar song lyrics, association of words with familiar tunes, or musical phrases to elicit functional speech responses (Basso et al. 1979). For example, spontaneous completion of familiar sentences is stimulated through familiar tunes or obvious melodic phrases (e.g., “You are my ............”, or “How are you .........?”) (Thaut 2005).
音乐言语刺激（MUSTIM）
音乐言语刺激（Music Speech Stimulation，MUSTIM）是一种利用音乐刺激言语功能的治疗技术。这种方法旨在通过使用音乐来激发及改善患者的发声和言语能力。临床研究表明，MUSTIM在促进患者音乐能力并改善发声质量方面具有显著效果。利用音乐作为刺激方式，MUSTIM使患者产生积极的反应，在言语康复中被广泛应用，并被称为临床设置中最受欢迎的治疗方法之一。
Rhythmic Speech Cuing (RSC)
the use of rhythmic cuing to control the initiation and rate of speech thru cuing and pacing. The therapist may use the client’s hand, a drum, or possibly a metronome to prime speech patterns or pace the rate of speech. This technique can be useful to facilitate motor planning for a patient with apraxia, to cue muscular coordination for dysarthria, or assist in pacing with fluency disorders (Thaut 2005).
Vocal Intonation Therapy (VIT) is the use of intoned phrases simulating the prosody, inflection, and pacing of normal speech. This is done through vocal exercises which train all aspects of voice control including: inflection, pitch, breath control, timbre, and dynamics. An example would be to sing a five note scale and gradually move the starting pitch up or down by half steps with a child who has a limited pitch range in their normal speaking voice. This exercise could be further expanded by adding a functional sentence i.e., “Let’s go out and play (Thaut 2005).
节奏性言语提示（RSC）
节奏性言语提示（Rhythmic Speech Cuing，RSC）是一种用于帮助言语或语言障碍患者的治疗技术。这一方法涉及使用音频节奏或节拍作为提示来调控和规范患者的语言输出。通过该技术，患者使用节奏提示或节拍来同步和结构化他们的言语模式，从而改善言语的流畅性、节奏感和整体清晰度。RSC在帮助失语患者建立更规律和流畅的言语模式方面已经被证实是有益的。
Therapeutic Singing (TS)
a technique which involves the unspecified use of singing activities to facilitate initiation, development, and articulation in speech and language as well as to increase functions of the respiratory apparatus. Therapeutic singing can be used with a variety of neurological or developmental speech and language dysfunctions (Glover et al. 1996, Jackson et al. 1997, Thaut 2005).
Therapeutic Singing是一种使用非特定的唱歌活动来促进言语和语言功能的康复技术。它主要有以下作用:
促进言语功能的启动、发展和发音能力:TS通过各种唱歌活动来刺激和训练患者的言语功能,帮助改善语音表达。
增强呼吸和发声肌肉功能:TS可以有效地锻炼和改善言语发声所需的肌肉和呼吸能力。
提升认知、感知和运动功能:TS将唱歌融入到言语和语言治疗中,有助于提升患者的认知、感知和运动方面的能力。
增强情感表达和自我意识:TS为患者提供了一个安全、愉快的表达情感和增强自我认知的平台。
TS通常作为神经音乐治疗(NMT)技术的一部分应用于治疗各种神经性或发展性的言语和语言障碍,如中风后失语症、帕金森病、创伤性脑损伤等。研究表明,将TS与其他NMT技术结合使用可以取得很好的治疗成效。
Oral Motor and Respiratory Exercises (OMREX)
involves the use of musical materials and exercises, mainly through sound vocalization and wind instrument playing, to enhance articulatory control and respiratory strength and function of the speech apparatus. This technique would be used with such populations as developmental disorders, dysarthria, and muscular dystrophy (Hass and Distenfield 1986).
口腔运动和呼吸练习（OMREX） 包括使用音乐材料和练习，主要是通过声音发声和管乐器演奏，来增强发音控制和呼吸强度以及语言设备的功能。这种技术适用于发育障碍、构音障碍和肌肉萎缩症等人群。
Developmental Speech and Language Training Through Music (DSLM)
the specific use of developmentally appropriate musical materials and experiences to enhance speech and language development through singing, chanting, playing musical instruments, and combining music, speech and movement (Thaut 2005).
音乐促进言语和语言发展训练 (DSLM)，通过唱歌、吟诵、演奏乐器以及将音乐、语言和动作结合起来，使用适合儿童发展的音乐素材和体验，促进言语和语言的发展（Thaut，2005 年）。
Symbolic Communication Training Through Music (SYCOM)
the use of musical performance exercises using structured instrumental or vocal improvisation to train communication behavior, language pragmatics, appropriate speech gestures, emotional communication in nonverbal language system, that is sensory structured, has strong affective saliency, and can simulate communication structures in social interaction patterns in real time (Thaut 2005).
音乐符号交流训练 (SYCOM)，利用音乐表演练习，使用结构化的乐器或声乐即兴表演来训练交流行为、语言语用学、适当的言语手势、非口头语言系统中的情感交流，该系统是感官结构化的，具有强烈的情感突出性，并能实时模拟社会互动模式中的交流结构。
Cognitive Rehabilitation
Musical Sensory Orientation Training (MSOT)
the use of music, presented live or recorded, to stimulate arousal and recovery of wake states and facilitate meaningful responsiveness and orientation to time, place, and person. In more advanced recovery of developmental stages, training would involve active engagement in simple musical exercises to increase vigilance and train basic attention maintenance with emphasis on quantity rather than quality of response (Ogata 1995).
音乐感知训练（Musical Sensory Orientation Training, MSOT）
MSOT是NMT中用于认知康复的一种技术。它旨在通过感官刺激来激发和恢复患者的警觉状态,促进对时间、地点和人的有意义的反应和定向。MSOT包括感官刺激、警觉定向以及警惕和注意力维持等方面。1
这种技术可用于增强和促进语言发展、培养社交概念理解、促进记忆发展,以及激发认知功能。MSOT使用的音乐元素包括:通过歌词传递相关的非音乐信息,利用旋律创建助记工具以促进记忆提取,以及通过节奏模式强调语音模式、改善合适的语速和语调。逐步增加任务复杂度和有效应用音乐是MSOT技术的关键要素。
Musical Neglect Training (MNT)
involves active performance exercises on musical instruments, which are structured in time, tempo, and rhythm, with an appropriate spatial configuration of instruments to focus attention to neglected or unattended visual field. Musical Neglect Training may also involve receptive music listening to stimulate hemispheric brain arousal while engaging in exercises addressing visual neglect or inattention (Hommel et al. 1990: Frasinetti et al. 2002: Anderson and Phelps 2001, 305-309).
MNT是NMT中用于认知康复的另一种技术。它利用音乐干预来缓解患者在注意力、记忆和感知等方面的认知损害,常用于治疗偏颅认知障碍、创伤性脑损伤和精神疾病等患者。这种技术旨在激发患者的注意力和感知,提高环境的感知意识。
Auditory Perception Training (APT)
the use of musical exercises to discriminate and identify different components of sound, such as time, tempo, duration, pitch, timbre, rhythmic patterns, as well as speech sounds. Integration of different sensory modalities such as visual, tactile, and kinesthetic input are used during active musical exercises such as playing from symbolic or graphic notion, using tactile sound transmission, or integrating movement to music (Bettison 1996: Gfeller et al. 1997: Heaton et. al. 1988).
Musical Attention Control Training (MACT)
involves structured active or receptive musical exercises, using pre-composed performance or improvisation, in which musical elements cue different musical responses in order to practice sustained, selective, divided, and alternating attention functions (Thaut 2003)
Musical Mnemonics Training (MMT)
the use of musical exercises to address various memory encoding and decoding/recall functions. Immediate recall of sounds or sung words using musical stimuli may be used to address echoic functions. Musical stimuli may be used as a mnemonic device or memory template in a song, rhyme, chant, or to facilitate learning of nonmusical information by sequencing and organizing the information in temporally structured patterns or chunks (Deutsch 1982; Gfeller 1983; Wallace et al. 1994; Claussen 1997; Maeller 1996).
Associative Mood and Memory Training (AMMT)
involves musical mood induction techniques to instate a) a mood congruent mood state to facilitate memory recall, or b) to access associative mood and memory function through inducing a positive emotional state in the learning and recall process (Bower 1981; Dolan 2002)
Musical Executive Function Training (MEFT)
the use of improvisation and composition exercises in a group or individually to practice executive function skills such as organization, problem solving, decision making, reasoning, and comprehension, within a social; context that provides important therapeutic elements such as performance products in real time, temporal structure, creative process, affective content, sensory structure, and social interaction patterns (Dolan 2002).
音乐执行功能训练（Musical Executive Function Training, MEFT）
MEFT 利用音乐活动训练来改善患者的执行功能,如问题解决、决策制定、推理等高级认知技能。
通过即兴创作乐曲、填谱等训练,可以锻炼大脑的执行功能,对于认知功能康复效果显著。
MEFT 适用于各类因神经系统损伤导致认知功能障碍的患者,如创伤性脑损伤、中风、帕金森病等。
Cranial Nerve 颅神经
颅神经是直接从大脑或脑干发出的神经，它们负责传递大脑与身体其他部分之间的信息。人体共有12对颅神经，每对颅神经都有其特定的功能。以下是12对颅神经的中英双语列表及其主要功能：
- Olfactory Nerve (I) 嗅神经 - 负责嗅觉。
- Optic Nerve (II) 视神经 - 负责视觉信息的传递。
- Oculomotor Nerve (III) 动眼神经 - 控制大部分眼球运动、开合眼睑以及调节瞳孔大小。
- Trochlear Nerve (IV) 滑车神经 - 使眼球向下和向内运动。
- Trigeminal Nerve (V) 三叉神经 - 面部的主要感觉神经，同时控制咀嚼肌。
- Abducens Nerve (VI) 外展神经 - 使眼球向外运动。
- Facial Nerve (VII) 面神经 - 控制面部表情肌、分泌泪液和唾液，同时负责部分味觉。
- Vestibulocochlear Nerve (VIII) 前庭蜗神经 - 包括前庭神经和蜗神经，负责平衡感和听觉。
- Glossopharyngeal Nerve (IX) 舌咽神经 - 参与味觉、分泌唾液和调节心跳。
- Vagus Nerve (X) 迷走神经 - 广泛分布于心脏、肺、胃等器官，参与多种内脏功能的调节。
- Accessory Nerve (XI) 副神经 - 控制颈部和肩部的一些肌肉运动。
- Hypoglossal Nerve (XII) 舌下神经 - 控制舌头的运动。
这些颅神经在人体的感觉、运动和自主神经系统中扮演着至关重要的角色。损伤或疾病影响任何一条颅神经都可能导致相应的功能障碍。
语言运动方面的障碍：
Apraxia
Apraxia是一种运动障碍，指的是由于大脑的运动规划和执行过程出现问题而导致的运动困难。Apraxia的两种主要形式是先天性（congenital）和后天性（acquired）。
先天性Apraxia：先天性Apraxia，也称为发育性Apraxia，是指在儿童出生时就存在的运动障碍。这种形式的Apraxia通常与神经发育异常或遗传因素有关。儿童在发展语言和运动技能时可能会遇到困难，表现为言语和运动协调的问题。他们可能会有困难在口腔肌肉协调运动，导致发音不清晰或困难。
后天性Apraxia：后天性Apraxia是在个体的生命中某个时刻发生的运动障碍。这种形式的Apraxia通常是由于大脑损伤或疾病引起的，如中风、脑外伤、肿瘤或神经退行性疾病。后天性Apraxia可能会导致言语和运动的困难，个体可能会遇到发音困难、动作不协调或无法执行特定的运动序列。
Dysarthria
Dysarthria是一种由于神经肌肉系统的问题而导致的言语障碍。它影响了一个人的发音、音量、语速和语调等方面。Dysarthria通常是由于中枢神经系统（如大脑、脑干或小脑）或周围神经系统（如面神经或舌咽神经）的损伤或疾病引起的。
Dysarthria可以根据病因和症状特征分为七个主要类别，包括：
Flaccid Dysarthria（松弛性发音障碍）：这种类型的Dysarthria是由于运动神经元或神经肌肉接头的损伤或疾病引起的。症状包括发音模糊、音量减弱、语速减慢、口腔肌肉松弛和吞咽困难。常见的病因包括脑干或脑神经的损伤、肌肉萎缩性侧索硬化症等。
Spastic Dysarthria（痉挛性发音障碍）：这种类型的Dysarthria是由于中枢神经系统的上运动神经元损伤引起的。症状包括发音困难、音量增大、语速减慢、语调变化和口腔肌肉紧张。常见的病因包括中风、脑性瘫痪、多发性硬化症等。
Unilateral Upper Motor Neuron Dysarthria（单侧上运动神经元发音障碍）：这种类型的Dysarthria是由于中枢神经系统的一侧上运动神经元损伤引起的。症状包括发音困难、音量减弱、语速减慢、语调变化和口腔肌肉协调性问题。常见的病因包括中风、脑肿瘤等。
Hypokinetic Dysarthria（运动减少性发音障碍）：这种类型的Dysarthria是由于基底节运动控制区域的损伤引起的。症状包括发音模糊、音量减弱、语速减慢、语调单调和口腔肌肉僵硬。常见的病因包括帕金森病。
Hyperkinetic Dysarthria（运动过度性发音障碍）：这种类型的Dysarthria是由于基底节或其他运动控制区域的异常活动引起的。症状包括发音困难、音量变化、语速不稳定、语调变化和口腔肌肉不协调。常见的病因包括扭转痉挛、舞蹈病等。
Ataxic Dysarthria（共济失调性发音障碍）：这种类型的Dysarthria是由于小脑损伤或疾病引起的。症状包括发音困难、音量不稳定、语速不稳定、语调变化和口腔肌肉协调性问题。常见的病因包括小脑萎缩、小脑肿瘤等。
Mixed Dysarthria（混合性发音障碍）：这种类型的Dysarthria是指同时存在多种Dysarthria类型的病例。例如，一个人可能同时表现出痉挛性和松弛性Dysarthria的症状。混合性Dysarthria的症状和严重程度因个体和病因而异。
部分案例记录（版权原因，无图）
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Melodic Intonation Therapy vs Speech Repetition
比较旋律性语调疗法（Melodic Intonation Therapy, MIT）和传统的重复言语疗法在治疗表达性失语症（expressive aphasia）方面的效果。 -
attention
音乐练习能够以特定的方式强烈吸引并激活大脑的注意力网络。这些练习不仅能够维持注意力（sustain attention），还能增强选择性注意力（selective attention）和交替注意力（alternating attention）。这意味着音乐练习有助于提高注意力的持续集中、筛选重要信息的能力以及在不同任务之间切换注意力的灵活性。
音乐练习通过其结构的变化，能够以精确的方式激发注意力系统。例如，通过改变节奏模式，参与者需要在敲击时不断适应新的节奏，这种模式化敲击（patterned tapping）比简单的同步敲击（isochronous tapping）需要更多的注意力参与。这种练习能够激活大脑的前额叶皮层，特别是背外侧前额叶皮层（dorsolateral prefrontal cortex），这是与高级认知功能相关的脑区。
-- 模式化敲击：当参与者需要跟随变化的节奏模式敲击时，这比简单的同步敲击需要更多的认知努力，因此更多地激活了前额叶皮层。
-- 小的变化：即使是参与者没有意识到的小变化，他们的运动系统也会跟随音乐的节奏进行调整。
-- 大脑网络的激活：音乐练习能够激活大脑中的多个网络，包括与运动计时（motor timing）、时间差异（time differences）和时间认知（time and cognition）相关的网络。