In our research, we use a wide combination of auditory, neuropsychological, and language tests, questionnaires as well as neurophysiological, structural, and functional brain imaging measures to study the different perceptual, cognitive, verbal, motor, and affective processes closely linked to music in the healthy brain and how they are impaired – or sometimes preserved – in the damaged or degenerating brain. In addition to this fundamental research, a key part of our activity is applied research on the effects of music hobbies, interventions, and technology as tools to support healthy ageing and rehabilitation and care of persons with age-related neurological illnesses, including stroke, traumatic brain injury, and dementia.
Research
PREMUS project
Preservation and Efficacy of Music and Singing in Ageing, Aphasia, and Alzheimer’s Disease (PREMUS)
A large and innovative five-year (2019-2023) research project led by Prof. Särkämö (PI) and funded by a Starting Grant from the European Research Council (ERC). PREMUS comprises the following four studies, which explore the impact of ageing, aphasia, and Alzheimer’s disease on the neural processing of music and singing as well as the efficacy of choir singing for facilitating healthy neurocognitive ageing and recovery from aphasia.
Brain, Ageing, and Vocal Expression
Background
Previous studies suggest that singing is a highly complex and versatile activity for the human brain and that long-term singing training induces various auditory-cognitive benefits and neuroplasticity changes. In the young adult brain, singing is processed by a large-scale frontal, temporal, parietal, and subcortical network, which is more bilateral than the networks for language and music. Ageing is known to bring about different compensatory neural changes, such as a shift towards using more bilateral and prefrontal resources when performing cognitive or verbal tasks, to counter gradual cognitive decline.
Aims
This study aims to uncover the effect of ageing and singing experience on the neural networks involved in speech and singing perception and production, especially regarding their lateralization and prefrontal engagement. Furthermore, we aim to increase our understanding of the neural mechanisms mediating the positive emotional, cognitive, and social benefits of singing in ageing.
Methods
Using a cross-sectional design, we compare amateur singers and non-singers from three age groups (young, middle-age, and older adults) with (i) behavioural tasks measuring auditory, cognitive, language and singing skills; (ii) questionnaires on cognitive functioning, mood, social functioning, and quality of life; (iii) magnetic resonance imaging (MRI) of grey and white matter organization and structural connectivity; and (iv) resting-state and task-based functional MRI (fMRI) of activation patterns and functional connectivity associated with speech, music, and singing processing.
Main collaborative partners
Adult education centres and choirs in Uusimaa region; Aalto University / Advanced Magnetic Imaging Centre; University of Jyväskylä / Department of Music, Art and Culture Studies; Aarhus University / Center for Music and the Brain
Senior Choir Singing and Neurocognitive Ageing
Background
As the population ages, there is a growing interest towards lifestyle-related factors, including physical and cognitive activity, which can increase cognitive reserve and improve functioning in older age. Increasing evidence indicates that music engages a large-scale bilateral network in the brain and that regular musical activities can have positive effects on cognitive, emotional, and social well-being and brain structure and function, also in older adults. Choir singing involves many sensory-motor, cognitive, linguistic, emotional, and social processes, which makes it a promising tool for promoting psychological well-being in normal ageing.
Aims
The purpose of this study is to determine the long-term effects of regular choir singing on normal ageing in terms of domain-general cognitive functioning, emotional and social well-being, and specific auditory-cognitive brain processes crucial for perceiving the changing sound environment.
Methods
This is a longitudinal cohort study of healthy older adults (age 60+) recruited from adult education centres and senior organizations in Helsinki, Espoo, and Vantaa who are either active senior choir singers or do not practice choir singing. The participants are followed for a duration of three years using (i) questionnaires on cognitive functioning, mood, social functioning, and quality of life at 6-month intervals as well as (ii) neuropsychological testing of memory, attention, and executive function and (iii) electroencephalography (EEG) measurements of auditory sensory memory and attention at 12-month intervals.
Main collaborative partners
Adult education centres and choirs in Helsinki, Vantaa and Espoo regions; University of Jyväskylä / Department of Music, Art and Culture Studies; University of California San Francisco / Institute for Health & Aging
Singing Ability and Singing-Based Rehabilitation in Aphasia
Background
Singing is a highly stimulating and versatile activity for the brain, combining vocal-motor, auditory, linguistic, cognitive, emotional, and social brain processes, both in the left and right hemisphere. The capacity to sing is often preserved in aphasia after stroke, and singing-based methods, such as Melodic Intonation Therapy (MIT), can be effective in rehabilitating speech production in aphasia. Also emotionally and socially, singing could provide a powerful alternative channel for people with aphasia to express their emotions and interact with others.
Aims
The purpose of this study is to determine the clinical and neural efficacy of a novel singing-based intervention in post-stroke aphasia. Specifically, the targeted outcomes are verbal and vocal-motor skills, cognitive skills, emotional functioning and quality of life, caregivers’ psychological well-being, and structural and functional neuroplasticity. In addition, we explore the preservation of singing ability and music learning in aphasia and the neural mechanisms underlying them.
Methods
This is a randomized controlled trial (RCT) where post-stroke aphasia patients and their family members are recruited from Helsinki and Turku metropolitan areas. The participants receive a 4-month singing intervention comprising choir singing, group MIT, and tablet-based singing training at home. Outcome measures are performed three times over a 12-month follow-up, comprising (i) language and cognitive tests; (ii) music and singing tasks; (iii) questionnaires on mood, communication, social participation, and quality of life; (iv) electroencephalography (EEG) measurements of auditory sensory memory and verbal learning; and (v) structural and functional MRI (s/fMRI) measurements of brain regions, pathways, and networks associated with speech, music, and singing processing.
Main collaborative partners
Uusimaa and Turku Stroke Associations; Finnish Brain Association; Outloud Ltd; Helsinki University Central Hospital & HUS Medical Imaging Centre; Turku University Hospital & Medical Imaging Centre of Southwest Finland; University of Barcelona / Cognition and Brain Plasticity Unit; Harvard Medical School / Music and Neuroimaging Laboratory; University of Melbourne / Faculty of Fine Arts and Music; Aarhus University / Center for Music and the Brain
Music-Evoked Emotions and Memories in Alzheimer's Disease
Background
With the rapid ageing of the population and the increasing prevalence of age-related cognitive decline and dementia, there is a growing interest in music as a neurorehabilitation tool. In Alzheimer’s disease (AD), music provides a valuable and effective tool for supporting emotional, social, and cognitive functioning. Behavioural studies suggest that the perception, recall, production (singing), and emotional response to music is often remarkably well-preserved in AD compared to other cognitive domains affected by the disease. However, there is currently very little experimental evidence on how far along the AD severity continuum music-induced emotions and memories are spared and how this occurs at the brain level.
Aims
The purpose of this study is to explore the preservation of music-evoked emotions and memories, the mnemonic use of songs across the continuum from normal ageing to different stages of AD, and uncover the psychological and neural mechanisms underlying these phenomena.
Methods
In this cross-sectional study, we recruit healthy older adults and persons with AD who have varying levels of dementia (mild / moderate / severe) from the Helsinki metropolitan area. These subject groups are compared using (i) music and auditory tasks; (ii) neuropsychological tests of memory and executive function; (iii) questionnaires on mood and quality of life; (iv) mobile electoencephalography (EEG) and autonomic nervous system (ANS) measurements of auditory sensory memory and music encoding; and (v) structural and functional MRI (s/fMRI) measurements of brain regions, pathways, and networks associated with music, emotion, and memory.
Main collaborative partners
Laakso hospital / Geriatric outpatient clinic, Helsinki Alzheimer’s Association, Helsinki Senior Citizens Foundation, Kustaankartano Centre for the Elderly, Sentina Ltd, Helsinki University Central Hospital & HUS Medical Imaging Centre
Other clinical studies starting from 2004
Previously we have performed a number clinical studies exploring musical abilities and rehabilitative effects of music in traumatic brain injury, stroke and dementia.
Neurological Music Therapy in Traumatic Brain Injury (TBI) Rehabilitation
Background
Traumatic brain injury (TBI) often causes severe and extensive cognitive, motor, and emotional deficits, which are highly debilitating for the individual. In healthy persons and in neurological illnesses, such as stroke, musical training and music-based rehabilitation have been shown to enhance cognitive and emotional functioning and neuroplasticity, but the rehabilitative effects of music in TBI are still largely unknown.
Aims
The purpose of this study is to determine the clinical and neural efficacy of a novel neurological music therapy intervention in TBI. Specifically, the targeted outcomes are executive functions, attention, memory, motor skills, mood, quality of life, and structural and functional neuroplasticity.
Methods
This is a randomized controlled trial (RCT) in patients with moderate-severe TBI performed in Helsinki (2014-2018). The participants received a 3-month neurological music therapy intervention involving cognitive-motor training with drums and creative musical expression (music playing, song writing) or standard rehabilitation. Outcome measures were performed three times over a 6-month follow-up, comprising (i) neuropsychological tests of executive functions, attention, and memory; (ii) motor tests of upper-extremity movement control; (iii) questionnaires on mood, executive deficits, and quality of life; and (iv) structural and functional MRI (s/fMRI) measurements of brain regions, pathways, and networks associated with cognitive processing.
Main collaborative partners
Helsinki University Central Hospital / Department of Neurology, Brain Injury Outpatient Clinic, and HUS Medical Imaging Centre; Finnish Association of People with Physical Disabilities / Validia Rehabilitation Helsinki; Åbo Akademi University / Department of Psychology; University of Jyväskylä / Department of Music, Art and Culture Studies; University of Barcelona / Cognition and Brain Plasticity Unit
Publications
- Siponkoski ST, Martinez-Molina N, Kuusela L, Laitinen S, Holma M, Ahlfors M, Jordan-Kilkki P, Ala-Kauhaluoma K, Melkas S, Pekkola J, Rodriguez-Fornells A, Laine M, Ylinen A, Rantanen P, Koskinen S, Lipsanen J, Särkämö T. Music therapy enhances executive functions and prefrontal structural neuroplasticity after traumatic brain injury: Evidence from a randomized controlled trial. Journal of Neurotrauma 2020; 37: 618-634.
Deficits and Rehabilitative Use of Music Listening after Stroke
Background
Music listening engages many perceptual, cognitive, motor, and emotional processes in the brain. After stroke, damage to specific brain regions can give rise to amusia, a deficit in the ability to perceive music, but music listening may also act as a form environmental enrichment and provide stimulation to spared brain regions, potentially enhancing recovery.
Aims
In a series of three studies launched in 2004, our aim has been to determine the effects of daily music listening on cognitive, verbal, emotional, and neural recovery during the first months after stroke as well as explore ways to optimize the effects of music listening in terms of music material and music technology and clinical characteristics of the patients. Moreover, we study the neural basis of post-stroke amusia and its recovery as well as the mnemonic effects of songs on verbal learning.
Methods
The studies are two randomized controlled trials (RCT) of stroke patients performed in Helsinki (2004–2007) and Turku (2014–2016) where we compare the effects of daily listening to different types of music and speech (audiobooks) and standard care during the first two post-stroke months. Outcome measures were performed three times over a 6-month follow-up, comprising (i) language, cognitive, and music perception tests; (ii) questionnaires on mood and quality of life; (iii) magnetoencephalography (MEG) measurements of auditory sensory memory; and (iv) structural and functional MRI (s/fMRI) measurements of brain regions, pathways, and networks associated with speech and music processing. Additionally, a third study is a pilot study, which explores the short-term hormonal effects of music listening after stroke and the usability of music streaming applications after stroke.
Main collaborative partners
Helsinki University Central Hospital / Department of Neurology, BioMag Laboratory, and HUS Medical Imaging Centre; Turku University Hospital / Division of Clinical Neurosciences and Medical Imaging Centre of Southwest Finland; Åbo Akademi University / Department of Psychology; University of Jyväskylä / Department of Music, Art and Culture Studies; University of Montreal / International Laboratory for Brain, Music and Sound Research; University of Barcelona / Cognition and Brain Plasticity Unit
Publications
- Sihvonen AJ, Ripollés P, Särkämö T, Leo V, Rodríguez-Fornells A, Saunavaara J, Parkkola R, Soinila S. Tracting the neural basis of music: Deficient structural connectivity underlying acquired amusia. Cortex 2017; 97: 255-273.
- Sihvonen AJ, Särkämö T, Ripollés P, Leo V, Saunavaara J, Parkkola R, Rodríguez-Fornells A, Soinila S. Functional neural changes associated with acquired amusia in different stages of recovery after stroke. Scientific Reports 2017; 7: 11390.
- Sihvonen AJ, Ripollés P, Leo V, Rodríguez-Fornells A, Soinila S, Särkämö T. Revisiting the neural basis of acquired amusia: Structural changes underlying amusia recovery. Frontiers in Neuroscience: Auditory Cognitive Neuroscience 2017; 11: 426.
- Sihvonen AJ, Ripollés P, Leo V, Rodríguez-Fornells A, Soinila S, Särkämö T. Neural basis of amusia and its recovery after stroke. Journal of Neuroscience 2016; 36: 8872-8881.
- Särkämö T, Ripollés P, Vepsäläinen H, Autti T, Silvennoinen HM, Salli E, Laitinen S, Forsblom A, Soinila S, Rodríguez-Fornells A. Structural changes induced by daily music listening in the recovering brain after middle cerebral artery stroke: A voxel-based morphometry study. Frontiers in Human Neuroscience 2014; 8: 245.
- Särkämö T, Soto D. Music listening after stroke: Beneficial effects and potential neural mechanisms. Annals of the New York Academy of Sciences 2012; 4: 153-162.
- Särkämö T, Tervaniemi M, Soinila S, Autti T, Silvennoinen HM, Laine M, Hietanen M, Pihko E. Auditory and cognitive deficits associated with acquired amusia after stroke: A magnetoencephalography and neuropsychological follow-up study. PLoS ONE 2010; 5: e15157.
- Särkämö T, Pihko E, Laitinen S, Forsblom A, Soinila S, Mikkonen M, Autti T, Silvennoinen HM, Erkkilä J, Laine M, Peretz I, Hietanen M, Tervaniemi M. Music and speech listening enhance the recovery of early sensory processing after stroke. Journal of Cognitive Neuroscience 2010; 22: 2716-2727.
- Forsblom A, Särkämö T, Laitinen S, Tervaniemi M. The effect of music and audio book listening on people recovering from stroke: The patient’s point of view. Music and Medicine 2010; 2: 229-234.
- Särkämö T, Tervaniemi M, Soinila S, Autti T, Silvennoinen HM, Laine M, Hietanen M. Cognitive deficits associated with acquired amusia after stroke: A neuropsychological follow-up study. Neuropsychologia 2009; 47: 2642-2651.
- Forsblom A, Laitinen S, Särkämö T, Tervaniemi M. Therapeutic role of music listening in stroke rehabilitation. Annals of the New York Academy of Sciences 2009; 1169: 426-430.
- Särkämö T, Tervaniemi M, Soinila S, Autti T, Silvennoinen HM, Laine M, Hietanen M. Amusia and cognitive deficits after stroke: Is there a relationship? Annals of the New York Academy of Sciences 2009; 1169: 441-445.
- Särkämö T, Tervaniemi M, Laitinen S, Forsblom A, Soinila S, Mikkonen M, Autti T, Silvennoinen HM, Erkkilä J, Laine M, Peretz I, Hietanen M. Music listening enhances cognitive recovery and mood after middle cerebral artery stroke. Brain 2008; 131: 866-876.
Caregiver-implemented Musical Activities in Dementia Care
Background
In dementia, music can provide an important form of emotional expression, social interaction, and cognitive stimulation, and music therapy is a promising tool in improving mood and alleviating neuropsychiatric symptoms in moderate and severe dementia. Less is, however, known about the potential effects of caregiver-implemented musical leisure activities, especially in the early stage of dementia and for supporting cognitive functioning
Aims
The goal of the study was to determine the applicability and long-term effects of regular caregiver-implement musical activities in persons with dementia (PWDs) on the cognitive functioning, mood and quality of life of the PWDs and on the psychological well-being of their family caregivers.
Methods
In this randomized controlled trial (RCT) performed in five care units in Helsinki and Espoo (2009-2011), dyads of PWDs with mild-moderate dementia and their caregivers (family members and nurses) received a 3-month music coaching intervention, focusing on the everyday use of either singing or listening of familiar songs, or standard care. Outcome measures were performed three times over a 9-month follow-up, comprising (i) neuropsychological tests of memory and other cognitive functions and (ii) questionnaires on mood, quality of life and caregiver’s psychological wellbeing.
Main collaborative partners
Miina Sillanpää Foundation; University of Helsinki / Department of Teacher Education; Sibelius Academy; Helsinki Alzheimer’s Association; Tapiola Service Centre; Helsinki Senior Citizens Foundation; Kustaankartano Centre for the Elderly; University of California San Francisco / Institute for Health and Aging
Publications
- Särkämö T, Laitinen S, Numminen A, Kurki M, Johnson JK, Rantanen P. Pattern of emotional benefits induced by regular singing and music listening in dementia. Journal of the American Geriatrics Society 2016; 64: 439-440.
- Särkämö T, Laitinen S, Numminen A, Kurki M, Johnson JK, Rantanen P. Clinical and demographic factors associated with the cognitive and emotional efficacy of regular musical activities in dementia. Journal of Alzheimer’s Disease 2016; 49: 767-781.
- Särkämö T, Tervaniemi M, Laitinen S, Numminen A, Kurki M, Johnson J, Rantanen P. Cognitive, emotional and social benefits of regular musical activities in early dementia: Randomized controlled study. The Gerontologist 2014; 54: 634-650.