Julian O Kelly
Royal Hospital for Neuro-disability, UK
Title: A neurophysiological and behavioral analysis of music therapy in the assessment and rehabilitation of those with disorders of consciousness
Biography
Biography: Julian O Kelly
Abstract
There is a need for standardized, bio-medically informed music therapy (MT) approaches in the assessment and rehabilitation of those with prolonged disorders of consciousness (PDOC), or Vegetative and Minimally Conscious States (VS/MCS). In particular, support and maintenance of arousal is essential for effective assessment of awareness and rehabilitation. Whilst pharma solutions are essential, MT may offer a cost effective, non-invasive complimentary treatment. Furthermore MT has no documented adverse side effects, and unlike other behavioral assessments is not dependent on verbal processing in patients. This perspective informs a research program exploring MT with PDOC outlined in this presentation. A summary of findings are detailed, including outcomes from a cross-over study comparing the rehabilitative and prognostic potential of MT to preferred text narration, using neurophysiological and behavioral measures. 12 PDOC patients’ data will be presented, focusing on EEG power spectra, coherence, heart rate variability and behavioral findings. Case material highlights improvements in the clinical state of an MCS patient during MT treatment using the Coma Recovery Scale and EEG measures. Significant differences (p≤ 0.001) in blink rate and arousal levels between MCS and VS patients at rest and in response to both treatments are detailed, with a continuum of neurophysiological responsiveness across cohorts. Findings indicate a significant role for MT in supporting arousal and awareness in PDOC, and for revealing where patients have intact responsiveness to salient stimuli. Implications for the complimentary role of MT alongside established pharma treatments for arousal maintenance and more verbally based behavioral assessments will be discussed.