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Melodic Intonation Therapy


Melodic Intonation Therapy (MIT) is a therapeutic process used by music therapists and speech-language pathologists to help patients with communication disorders caused by damage to the left hemisphere of the brain. This method of therapy uses musical elements, including melody and rhythm, to improve expressive language by capitalizing on preserved singing abilities and possibly engaging language-capable regions in the undamaged right hemisphere. According to recent research, it may not be melodic intonation that is the crucial element in MIT, but the combined use of rhythmic pacing and conversational speech formulas.

Neurological researchers Sparks, Helm, and Albert developed Melodic Intonation Therapy in 1973 while working with adults in the Aphasia Research Unit at the Boston VA Hospital. MIT is based on the hypothesis of these researchers that "increased use of the right hemisphere dominance for the melodic aspect of speech increases the role of that hemisphere in inter-hemispheric control of language, possibly diminishing the language dominance of the damaged left hemisphere." In order to do this, common words and phrases are turned into melodic phrases emulating typical speech intonation and rhythmic patterns. In doing so, MIT was intended to help individuals with aphasia recall words and use expressive language.

One study using positron emission tomography (PET) scans found that areas controlling speech in the left hemisphere were "reactivated" by the end of Melodic Intonation Therapy in 7 patients. Further work suggests that MIT can result in significant changes in brain structure through the brain's own neuroplasticity. Right-hemisphere axon connections in 6 patients were found to be increased in volume after MIT. At least theoretically, this could allow for language processing in right homologous areas, suggesting that the right hemisphere may compensate for an impaired left hemisphere by taking up language processing responsibilities. Some evidence suggests that the positive effects of MIT can be enhanced with non-invasive brain stimulation. During MIT training sessions, the researchers applied anodal transcranial direct current stimulation (tDCS) over the equivalent of Broca's area in the right hemisphere of 6 stroke patients with non-fluent aphasia. Compared to sham stimulation, the anodal stimulation led to a significant improvement in fluency.


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