How singing in a choir can help people find their voice after stroke

After Serge Beloncic suffered a stroke in 2022, he developed aphasia, a communication disorder that affects his ability to speak.

It was a life-changing adjustment for the 81-year-old scientist and former professor, who had long been accustomed to giving conferences and lecturing.

Since then, their communication has improved, but they still have problems.

“Sometimes I have to find my words,” he says. “Sometimes I speak, and sometimes I pause.”

Now, Beloncic is participating in a study to determine whether singing in a choir can help people with aphasia recover. Every week, he meets with a small group of other people with aphasia at a Montreal community centre.

On a recent autumn morning, after performing vocal tests and fitting a heart rate monitor for researchers, Beloncic sat behind a music stand with three other people and began to sing.

Accompanied by his vocal director at the piano, he began a gentle rendition of the famous Quebec song, you pay,

Belonsik says being part of the study has been a positive experience so far.

“I like it because it gives me the opportunity to speak and find my old voice.”

aphasia and music

randomized controlled trial It is led by Professor Anna Zumbansen of the School of Rehabilitation Sciences at the University of Ottawa, and is part of the SingWell initiative, an international network of researchers studying group singing. It involves 12 weekly singing sessions at four different sites, with participants who have developed aphasia from stroke.

There are sites in Montreal, Toronto, Ottawa and Tampa Bay, Florida.

“We’re hoping that this study will demonstrate that choir activity is really good for people,” said Edith Durand, an assistant speech-language pathology professor at the Université de Québec à Trois-Rivières and one of the study’s researchers.

“Good for their language, but also good for their social interactions,” Durand said, explaining that aphasia can lead to a decline in social participation.

previous studies is suggested singing can help Dr. Alexander Thiel, a stroke neurologist at Montreal’s Jewish General Hospital who is not involved in the study, said people with aphasia improve their ability to express themselves.

a practice called Melodic intonation therapy The focus is on the part of the brain that is not affected by the stroke – often the left side, which controls language, is affected in cases of aphasia – to organize communication through non-language functions such as rhythm and pitch.

“It certainly has a much broader meaning to present it in a choir setting,” Thiel said. “Speech is not just functional in the way we communicate with each other; it also has a social dimension.”

Thiel said that right now, treatment for aphasia focuses primarily on the acute phase, or the weeks and months after a stroke. Typically, patients are assessed and evaluated by a speech language pathologist for rehabilitation therapy, which can help reactivate the part of the brain that controls speech.

Doesn’t work for everyone

But, he said, it doesn’t work for everyone.

“If the damage is too great, there are no other networks we can tap in the left hemisphere,” he said. “Then there are right hemisphere areas that may be occupied to some extent.”

This is where the music comes in. Non-language functions like pitch are processed in the other hemisphere of the brain and can be taken advantage of to aid communication, Thiel said.

A recent systematic review While trials using music-based interventions found that they showed therapeutic potential, such as helping with the ability to name objects, the strength of the evidence is limited.

Thiel said that’s why more research, like Durand’s, is needed to confirm whether this type of therapy, done in groups, is effective for aphasia and whether the positive effects can last long.

“We’re raising the level of scientific rigor here,” said Frank Russo, a psychology professor at Toronto Metropolitan University and founder of Singwell.

“If there is something solid when it comes to clinical results,” he said, “then I think we are ready to share it with clinicians around the world who are interested in complementing what speech language pathologists are doing.”

Belonsik hopes this study will expand the scope of research about aphasia and its treatment.

“Maybe I can prove that it’s efficient, and it might be good for others to implement.”