NIMHANS Pioneers Music-Based Neuro-Rehabilitation for Stroke Patients in Bengaluru
In a groundbreaking development for neurological care, neuropsychologists at the National Institute of Mental Health and Neurosciences (NIMHANS) in Bengaluru have been intensively exploring the application of music-based techniques in neuro-rehabilitation, with a particular focus on stroke recovery over the past several years. The innovative interventions, which are administered to at least ten patients monthly, have demonstrated a crucial role in assisting stroke survivors to regain their cognitive functions and improve their quality of life.
Evidence-Based Approaches and Patient Success Stories
Dr. Shantala Hegde, a professor and consultant neuropsychologist at NIMHANS, along with her PhD students Preeti Kodancha and Shreyas Krishnakumar, has been at the forefront of this research, working directly with stroke patients. Dr. Hegde emphasizes that their methodology relies strictly on evidence-based, neuroscience-driven tools. The music utilized in these therapies is universal rather than culture-specific, encompassing simple elements such as metronomes, basic rhythmic counting like "1-2-3-4," structured rhythm phrases, and rhythmic syllables. These components are strategically employed to train intact brain regions to compensate for areas that have been damaged by stroke.
A compelling case study involves VS, a 42-year-old human resources executive from Bengaluru with a pre-existing history of systemic lupus erythematosus and congestive heart failure. At age 37, approximately six months after her second spontaneous abortion linked to assisted reproductive treatment, she suffered a left middle cerebral artery ischemic stroke. After an extended hospitalization, VS was left unable to walk or speak and exhibited signs of post-stroke depression.
Nearly three years later, in April 2024, VS presented at NIMHANS with persistent cognitive and communication challenges. A comprehensive neuropsychological assessment identified deficits in expressive and written language, verbal fluency, working memory, response inhibition, verbal learning, arithmetic abilities, and logical sequencing of ideas. At this critical juncture, psychologists introduced music-based rehabilitation strategies alongside other therapeutic interventions.
Neurologic music therapy techniques were deployed to enhance engagement and support the recovery of speech, motor coordination, and cognitive skills. With these targeted approaches, VS exhibited remarkable improvements in expressive speech, basic arithmetic, work engagement, and independence in daily activities. Dr. Hegde explains, "Music is one of the highest forms of cognitive function, though it is often viewed merely as something cultural or recreational. In neuropsychological rehabilitation, I use music very differently. I break it down into its fundamental components and use those building blocks to enhance core cognitive functions including attention, memory, planning, decision-making, and response inhibition."
Expanding Impact Across Bengaluru's Healthcare Landscape
Dr. Hegde further illustrated the efficacy of this approach with another case involving a 27-year-old medical representative who suffered a stroke. While he could comprehend spoken language in multiple tongues, he was unable to speak, read, or write, with numbers presenting a specific hurdle. Therapy for this patient concentrated on using rhythm to retrain speech and numerical capabilities.
Gradually, his speech became more fluid, and complex medication names were practiced using rhythmic cues. Numerical skills were reconstructed through finger movements and rhythmic patterns. Over time, he regained the ability to count into the thousands, write phone numbers, calculate money, and communicate medication dosages effectively.
Across Bengaluru, clinicians in various settings are adopting music to support patients with traumatic brain injuries. Neha Cadabam, senior psychologist and executive director at Cadabams Hospitals, notes, "Patients are identified through multidisciplinary assessments involving neurologists, psychologists, and rehabilitation specialists, and the therapy is integrated into personalised recovery plans rather than used as a standalone intervention."
Dr. Johnson Pradeep R, associate professor in the department of psychiatry at St. John's Hospital, also incorporates music into his practice. He states, "Along with regular interventions, we often use music for patients to relax, particularly for those with post-traumatic stress disorder (PTSD)." This widespread adoption underscores the growing recognition of music's therapeutic potential in neurological rehabilitation, marking a significant advancement in patient care and recovery strategies.
