NMT for Parkinson's Disease
NMT for Parkinson's Disease
Parkinson's Disease (PD) is defined by characteristic motor symptoms including slow
 movements, small movements, difficulty with movement initiation and disruptions in timing.
 Besides gross motor symptoms, fine motor impairments in PD cause difficulties with everyday
 tasks such as writing, self-care, and fine object manipulation. These activity limitations
 can lead to disability, social isolation, and a reduced quality of life. In a series of
 breakthrough studies Michael Thaut and colleagues developed Neurologic Music Therapy (NMT)
 and found it can address many gross motor impairments and improve gait and balance. Other
 music therapies such as Music-supported Therapy (MST) have proven motor benefits in stroke
 patients through movement exercises with musical instruments. However, the pathological basal
 ganglia (BG) in PD brains leads to a reduced supply of those internally generated movements.
 In contrast, externally cued movements (eg. via a beat or a rhythm) during NMT sessions are
 instantaneously entrained to the period of a rhythmic stimulus possibly without involvement
 of the BG. The underlying idea is that rhythm is the essential component relating music
 specifically to motor behavior. The mechanism of action is called "rhythmic entrainment"
 where one system's motion or signal frequency entrains the frequency of another system. The
 effect of NMT on fine motor function has not been investigated yet. Music activities are
 important in the lives of many older adults. Notably, the use of music has been associated
 with increased well-being for older adults, as it fosters social connection and mood
 regulation. Furthermore, many musical activities have limited physical demands, making them
 attainable for individuals who are living with mobility impairments or other physical
 restrictions. Based on the literature and the investigators preliminary studies, the
 investigators propose to test the efficacy of Neurologic Music Therapy in comparison to Music
 Supported Therapy and Occupational Therapy (OT) as standard of care on adults in the
 Parkinson's spectrum. The investigators have defined a working plan using different musical
 instruments and growing tempo to specifically improve fine motor movements.
Inclusion Criteria:

 -  Age 45 to 85

 -  Diagnosis of Parkinson's Disease using the UK Brain Bank Criteria

 -  Fine motor impairments (if available, scores 2 and higher on the UPDRS motor
 examination part III.23 and 24)

 -  Medication stable for at least 30 days.

 Exclusion Criteria:

 -  Features suggestive of other causes of parkinsonism, including cerebrovascular disease
 or history of major head trauma

 -  Inability to move fingers or hands

 -  Hoehn and Yahr stage 4 and higher

 -  Ferrous metal implants which may interfere with the MEG data acquisition and/or be an
 MRI safety concern

 -  Dementia

 -  Participants engaged in other research studies involving music therapies

 -  Participants whose insurance does not cover Occupational Therapy costs or who have no
 insurance.