Lauletun musiikin vaikutus AVH:n jälkeiseen kielelliseen muistiin sekä pitkäaikaiseen AVH:sta toipumiseen

The prevalence of stroke increases in the ageing population entailing an enormous economic and societal burden. This has raised the need for motivating, effective and easily applicable rehabilitation tools to enhance recovery and neuroplasticity. Music is an important source of enjoyment and well-being across life and it provides a multidomain stimulus that is both pleasant and rewarding, and engages the brain extensively. Previous evidence suggests that daily music listening can enhance cognitive recovery and mood and induce functional and structural neuroplasticity changes after stroke. Songs may also function as a verbal learning aid in healthy subjects. The aim of this thesis was to further explore the specific role of vocal (sung) music as a tool to aid verbal learning and long-term recovery after stroke. In Studies I and II, stroke patients (N = 31) performed a verbal learning task where novel narrative stories were presented in both spoken and sung formats, and underwent MRI at acute and 6-month post-stroke stages. Study I showed that stroke patients, especially those with mild aphasia, learned and recalled the stories better when they were presented in sung than spoken format at the 6-month stage. Exploring the cognitive and neural mechanisms underlying this effect, Study II further showed that non-aphasic patients exhibited more stable recall, indicated by reduced serial position effects, whereas aphasic patients showed a larger recency effect and enhanced chunking in the sung than spoken task. Diffusion tensor imaging and voxel-based morphometry results indicated that these effects were coupled with greater volume of the left arcuate fasciculus in non-aphasics, and with greater volume of the right inferior fronto-occipital fasciculus and grey matter in a bilateral network of temporal, frontal, and parietal regions in aphasics. In Study III, data was pooled from two randomized controlled trials where stroke patients (N = 83) received an intervention involving daily listening to self-selected vocal music, instrumental music, or audiobooks during the first three months after stroke. The recovery was assessed with neuropsychological tests and a mood questionnaire at acute, 3-month and 6-month stages, and structural MRI and functional MRI (fMRI) at acute and 6-month stages. Compared to audiobooks, listening to music enhanced the recovery of language skills and verbal memory and reduced negative mood. Vocal music had the strongest rehabilitative effect on both language and verbal memory, and the positive effects of music listening on language recovery were seen especially in patients with aphasia. Results from voxel-based morphometry and resting-state, and task-based fMRI analyses showed that vocal music listening selectively increased grey matter volume in left temporal areas and functional connectivity in the default mode network from acute to 6-month stage. The findings of the present thesis provide further evidence that listening to vocal music is a useful tool to support cognitive and emotional recovery after stroke and to enhance early language recovery in aphasia. The rehabilitative effects are driven by both structural and functional plasticity changes in temporoparietal networks, which are crucial for emotional processing, language and memory.Väestön ikääntyessä yhä useampi sairastuu aivoverenkiertohäiriöön (AVH), minkä aiheuttama yksilöllinen ja yhteiskunnallinen haitta on valtava. Tästä johtuen tarvitaan motivoivia, tehokkaita ja helposti saatavilla olevia työkaluja tehostamaan kuntoutusta ja edesauttamaan aivojen muovautuvuutta toipumisvaiheessa. Musiikki on tärkeä nautinnon ja hyvinvoinnin lähde ja monipuolinen virike, joka miellyttää, palkitsee ja aktivoi aivoja laajalti. Aiemmissa tutkimuksissa on havaittu, että päivittäinen musiikin kuuntelu AVH:n jälkeisten kuukausien aikana tehostaa kognitiivisten toimintojen ja mielialan kuntoutumista ja saa aikaan toiminnallista ja rakenteellista muovautuvuutta otsa- ja ohimolohkoalueilla sekä limbisillä alueilla, ja että laulut toimivat kielellisen oppimisen tukena terveillä henkilöillä. Tässä väitöskirjassa tarkastellaan erityisesti lauletun musiikin vaikutusta kielelliseen oppimiseen sekä pitkäkestoiseen toipumiseen AVH:n jälkeen. Tutkimuksissa I ja II AVH-potilaille (N = 31) tehtiin kielellinen oppimistehtävä, jossa heille esitettiin uusia tarinoita sekä laulettuna että puhuttuna, ja aivojen rakenteellinen magneettikuvaus (MRI) akuuttivaiheessa ja 6 kk sairastumisen jälkeen. Tutkimus I osoitti, että erityisesti ne potilaat, joilla oli lievä afasia, oppivat ja muistivat toipumisvaiheessa 6 kk sairastumisen jälkeen laulettuna esitetyn tarinan paremmin verrattuna puhuttuna esitettyyn. Tutkimus II selvitti tämän taustalla olevia kognitiivisia ja neuraalisia mekanismeja ja osoitti, että ei-afaattiset potilaat muistivat lauletun tarinan puhuttua tasaisemmin, mikä näkyi pienentyneenä sarjapositiovaikutuksena, kun taas afasiapotilailla lauletun tarinan muistamisessa ilmeni suurempi äskeisyysvaikutus ja tehokkaampi mieltämisyksiköiden muodostaminen (engl. chunking). Diffuusiotensorikuvantamisella ja vokselipohjaisella morfometrialla (VBM) saadut tulokset osoittivat, että nämä efektit olivat yhteydessä vasemman arcuate fasciculus (AF) –radaston tilavuuteen ei-afasiapotilailla ja oikean inferior fronto-occipital fasciculus (IFOF) –radaston sekä bilateraalisten ohimo-, otsa- ja päälakilohkoalueiden tilavuuteen afasiapotilailla. Tutkimuksessa III yhdistettiin kahden satunnaistetun kontrolloidun tutkimuksen AVH-potilaiden aineistot (N = 83) ja tutkittiin, miten kahden kuukauden ajan tapahtuva päivittäinen laulumusiikin, instrumentaalimusiikin tai äänikirjojen kuuntelu vaikuttaa toipumiseen. Toipumista arvioitiin neuropsykologisella tutkimuksella, mielialakyselyllä ja aivojen rakenteellisella ja toiminnallisella MRI (fMRI) -tutkimuksella akuuttivaiheesta aina 6 kk:n vaiheeseen. Äänikirjoihin verrattuna musiikin kuuntelu edisti puhetoimintojen ja kielellisen muistin kuntoutumista sekä vähensi negatiivista mielialaa. Laulumusiikilla oli voimakkain vaikutus sekä puheen että muistin kuntoutumiseen etenkin afasiapotilailla. VBM- ja fMRI-tulokset osoittivat, että laulumusiikin kuuntelu lisäsi harmaan aineen tilavuutta vasemmalla ohimolohkolla ja toiminnallista konnektiivisuutta oletustilaverkostossa 6 kk aikana. Tämän väitöskirjan tulokset tuovat lisää näyttöä päivittäisen musiikin kuuntelun positiivisesta vaikutuksesta ja tukevat sen käyttöä toimivana, helppona ja edullisena työkaluna, joka edistää AVH:n jälkeistä kognitiivista ja emotionaalista toipumista. Tämä juontuu rakenteellisista ja toiminnallisista muutoksista ohimo- ja päälakilohkoalueiden verkostoissa, mitkä ovat ratkaisevia tunteiden käsittelyn, kielen sekä muistin kannalta. Tutkimus tuo uutta tietoa etenkin laulumusiikin kuuntelun vaikutuksesta kuntoutumiseen sekä laulujen käytöstä oppimisen ja muistin tukena, erityisesti afasiasta toipumisessa

Working Concepts of the Exhibit

Most of my endeavors are initially worked out in pencil on graph paper. Graph paper allows for a personal system of notation. By this method I can work rapidly towards a total composition. The final selection is the one which is most completely perceived on paper in simplest terms, and that which most solidly incorporates the successful elements of past works. The use of graph paper also allows me to consider projects in a variety of media; canvas and acrylic, earth, interiors and exteriors, floors and ceilings, small and large. The basic design elements of all of these can be noted easily on graph paper. In this show, I have confined myself to use of materials easily represented in the scheme of the graph paper grid. The basic elements are chairs, cement form pans, chalk line, measurements, elevation, given space, floor key and ceiling design. &nbsp;</p

The motherhood penalties : insights from women in UK academia

We use an original survey of academic women in the UK to investigate different dimensions of the motherhood penalty. Being a mother has no effect on salaries, but still slows down career progression even in such a high-skilled sector. Motherhood has an ambivalent impact on women’s perception of their working environment: improving satisfaction, but reducing perception of salary fairness relative to men. Our paper also explores how different policies can mitigate the motherhood penalties. We find that more generous maternity provisions are associated with higher salary, potentially because generosity reduces the crowding out of research activity. Better availability of childcare and an even distribution of responsibilities within the household correlate positively with earnings. Our findings also highlight the importance of a supportive work environment for mothers’ career and well-being at the workplace. Taken together, these findings suggest the necessity of a multi-faceted policy response to the motherhood penalties

Motherhood in academia : a novel dataset with an application to maternity leave uptake

Legislation over the past two decades enhanced the availability and quantity of statutory maternity leave in the United Kingdom. In high-skilled sectors, many employers top up this maternity leave in an effort to retain and develop the careers of women. As leave provision became more generous, debates emerged as to the role, if any, these enhanced benefits have in retaining women in high status occupation and facilitating their career growth. Further, individual situations and employment status may prevent women from taking advantage of enhanced benefits. This paper presents findings from a comprehensive survey of thousands of women in the UK Higher Education sector and documents how the lives of academic mothers changed over the past quarter century. Contract status and the partner’s participation in parenting has significant effects on the types of maternity leave taken. We reflect on these findings and discuss future research in the area of labour market equity and productivity the availability of this comprehensive quantitative survey of academic women can facilitate

Uso de aditivos químicos y emulsión asfáltica en la base granular para optimizar las propiedades mecánicas de un pavimento

La estabilización de suelos es el proceso mediante el cual estos se someten a ciertas manipulaciones o diferentes tratamientos de modo tal que se puedan aprovechar sus mejores cualidades, obteniéndose resultados capaces de soportar los efectos del tránsito y las condiciones de climas más severas. Se define como el mejoramiento de sus propiedades físicas a través de algún procedimiento mecánico e incorporación de diferentes productos químicos, naturales o sintéticos. En la presente tesis se utilizaron productos químicos como polímero poliacrilamida, polímero acrílico de estireno reticulado, aceite sulfanado organosilano, polímero cohesionador, así como también emulsión asfáltica para verificar las mejoras en las propiedades mecánicas para una base granular. A partir de los ensayos a los diferentes suelos encontrados en la carretera de tercera clase CU-1885 se tomó la decisión de estabilizar los suelos y así estos puedan servir como base granular para la carretera de tercera clase de un tramo de aproximadamente 14 km. Se tomaron como referencia tres canteras donde a partir de ensayos de laboratorio como CBR se realizaron las comparaciones de sus propiedades mecánicas en estado natural y luego del proceso de estabilización con los aditivos antes mencionados. Los resultados de la presente investigación nos demostraron que la adición de estos productos mejora las propiedades mecánicas, resistencia del suelo y de esta manera es muy probable que se prolongue la vida útil de la carretera en estudio

Resting-state language network neuroplasticity in post-stroke music listening: A randomized controlled trial

Recent evidence suggests that post-stroke vocal music listening can aid language recovery, but the network-level functional neuroplasticity mechanisms of this effect are unknown. Here, we sought to determine if improved language recovery observed after post-stroke listening to vocal music is driven by changes in longitudinal resting-state functional connectivity within the language network. Using data from a single-blind randomized controlled trial on stroke patients (N = 38), we compared the effects of daily listening to self-selected vocal music, instrumental music and audio books on changes of the resting-state functional connectivity within the language network and their correlation to improved language skills and verbal memory during the first 3 months post-stroke. From acute to 3-month stage, the vocal music and instrumental music groups increased functional connectivity between a cluster comprising the left inferior parietal areas and the language network more than the audio book group. However, the functional connectivity increase correlated with improved verbal memory only in the vocal music group cluster. This study shows that listening to vocal music post-stroke promotes recovery of verbal memory by inducing changes in longitudinal functional connectivity in the language network. Our results conform to the variable neurodisplacement theory underpinning aphasia recovery.Peer reviewe

Music-based interventions in neurological rehabilitation

During the past ten years, an increasing number of controlled studies have assessed the potential rehabilitative effects of music-based interventions, such as music listening, singing, or playing an instrument, in several neurological diseases. Although the number of studies and extent of available evidence is greatest in stroke and dementia, there is also evidence for the effects of music-based interventions on supporting cognition, motor function, or emotional wellbeing in people with Parkinson's disease, epilepsy, or multiple sclerosis. Music-based interventions can affect divergent functions such as motor performance, speech, or cognition in these patient groups. However, the psychological effects and neurobiological mechanisms underlying the effects of music interventions are likely to share common neural systems for reward, arousal, affect regulation, learning, and activity-driven plasticity. Although further controlled studies are needed to establish the efficacy of music in neurological recovery, music-based interventions are emerging as promising rehabilitation strategies.Peer reviewe

Neural basis of acquired amusia and its recovery after stroke

Although acquired amusia is a relatively common disorder after stroke, its precise neuroanatomical basis is still unknown. To evaluate which brain regions form the neural substrate for acquired amusia and its recovery, we performed a voxel-based lesion-symptom mapping (VLSM) and morphometry (VBM) study with 77 human stroke subjects. Structural MRIs were acquired at acute and 6 month poststroke stages. Amusia and aphasia were behaviorally assessed at acute and 3 month poststroke stages using the Scale and Rhythm subtests of the Montreal Battery of Evaluation of Amusia (MBEA) and language tests. VLSM analyses indicated that amusia was associated with a lesion area comprising the superior temporal gyrus, Heschl's gyrus, insula, and striatum in the right hemisphere, clearly different from the lesion pattern associated with aphasia. Parametric analyses of MBEA Pitch and Rhythm scores showed extensive lesion overlap in the right striatum, as well as in the right Heschl's gyrus and superior temporal gyrus. Lesions associated with Rhythm scores extended more superiorly and posterolaterally. VBM analysis of volume changes from the acute to the 6 month stage showed a clear decrease in gray matter volume in the right superior and middle temporal gyri in nonrecovered amusic patients compared with nonamusic patients. This increased atrophy was more evident in anterior temporal areas in rhythm amusia and in posterior temporal and temporoparietal areas in pitch amusia. Overall, the results implicate right temporal and subcortical regions as the crucial neural substrate for acquired amusia and highlight the importance of different temporal lobe regions for the recovery of amusia after stroke

Sung melody enhances verbal learning and recall after stroke

Coupling novel verbal material with a musical melody can potentially aid in its learning and recall in healthy subjects, but this has never been systematically studied in stroke patients with cognitive deficits. In a counterbalanced design, we presented novel verbal material (short narrative stories) in both spoken and sung formats to stroke patients at the acute poststroke stage and 6 months poststroke. The task comprised three learning trials and a delayed recall trial. Memory performance on the spoken and sung tasks did not differ at the acute stage, whereas sung stories were learned and recalled significantly better compared with spoken stories at the 6 months poststroke stage. Interestingly, this pattern of results was evident especially in patients with mild aphasia, in whom the learning of sung versus spoken stories improved more from the acute to the 6-month stages compared with nonaphasic patients. Overall, these findings suggest that singing could be used as a mnemonic aid in the learning of novel verbal material in later stages of recovery after stroke.Peer reviewe