Modern Foreign Neurocognitive Approaches to the use of the Music-Enriched Environment in the Rehabilitation of Aphasic Disorders and Alzheimer's type Dementia



This paper presents an analysis of current foreign trends in neurocognitive rehabilitation of cognitive disorders in Alzheimer's dementia (AD) and neuropsychological rehabilitation of the most common form of vascular cognitive disorders (VCD) - aphasia. Two approaches to the restoration of higher mental functions (HMF), based on a different understanding of the neuroplasticity mechanisms, are described. The description presents non-invasive and functional methods of direct stimulation of HMF. Various methods of transcranial brain stimulation and Intensive Language-Action Therapy (ILAT) are reviewed and analyzed. The data of experimental studies present the application of these methods to the restoration of Broca's aphasia. The paper also considers an approach to neurorehabilitation based on the methodology of "workaround" recovery of HMF using sensory-enriched environment. The article describes and analyzes the theoretical foundations of Music Intonation Therapy (MIT), Thérapie mélodique est rythmée) (TMR), palliative MIT, Music Therapy (MT). The paper carries out an analytical review of the implementation of abovementioned methods in aphasics. Also, programs and neurocognitive correction methods in mild cognitive impairment (MCI) are considered. The paper describes the possibilities of using active and passive MT, STAM-DEM Therapy, and Multimodal Cognitive Enhancement Therapy (MCET) in AD. The study presents the data of systematic and meta-analytical reviews on their use in MCI. The paper describes the methodology of "musical" neuropsychological diagnostics in dementia.

General Information

Keywords: brain plasticity, brain stimulation, neuropsychological rehabilitation, vascular cognitive impairment, dementia, aphasia, executive function impairment, memory disorders, sensory-enriched environment, music-enriched environment

Journal rubric: Neurosciences

Article type: review article


Received: 30.12.2020


For citation: Shipkova K.M. Modern Foreign Neurocognitive Approaches to the use of the Music-Enriched Environment in the Rehabilitation of Aphasic Disorders and Alzheimer's type Dementia [Elektronnyi resurs]. Sovremennaia zarubezhnaia psikhologiia = Journal of Modern Foreign Psychology, 2021. Vol. 10, no. 4, pp. 126–137. DOI: 10.17759/jmfp.2021100412. (In Russ., аbstr. in Engl.)


  1. Tsvetkova L.S. Neiropsikhologicheskaya reabilitatsiya bol'nykh: rech' i intellektual'naya deyatel'nost': uchebnoe posobie [Neuropsychological rehabilitation of patients: speech and intellectual activity: textbook]. Moscow: Publishing house MGPPU, 1985. 327 p. (In Russ.).
  2. Van de Sandt-Koenderman M. et al. A case study of melodic intonation therapy (MIT) in the subacute stage of aphasia: early re-reactivation of left hemisphere structures [Elektronnyi resurs]. Procedia Social and Behavioral Sciences, 2010. Vol. 6, pp. 241–243. DOI:10.1016/j.sbspro.2010.08.121
  3. Pysanenko K. et al. Acoustically Enriched Environment during the Critical Period of Postnatal Development Positively Modulates Gap Detection and Frequency Discrimination Abilities in Adult Rats [Elektronnyi resurs]. Neural Plasticity, 2021. Vol. 2021, 12 p. DOI:10.1155/2021/6611922
  4. Aldridge D. Music and Alzheimer's disease-assessment and therapy: discussion paper [Elektronnyi resurs]. Journal of Royal Society of Medicine, 1993. Vol. 86, no. 2, pp. 93–95. URL: (Accessed 28.09.2021).
  5. Altenmüller E., Schlaug G. Apollo's gift: new aspects of neurologic music therapy [Elektronnyi resurs]. Progress in Brain Research, 2015. Vol. 217, pp. 237–252. DOI:10.1016/bs.pbr.2014.11.029
  6. Taub E. et al. An operant approach to rehabilitation medicine: overcoming learned nonuse by shaping [Elektronnyi resurs]. Journal of the Experimental Analysis of Behavior, 1994. Vol. 61, no. 2, pp. 281–293. DOI:10.1901/jeab.1994.61-281
  7. Warren J.E. et al. Anterior temporal lobe connectivity correlates with functional outcome after aphasic stroke [Elektronnyi resurs]. Brain, 2009. Vol. 132, pp. 3428–3442. DOI:10.1093/brain/awp270
  8. Assessment: Melodic Intonation Therapy. Report of the therapeutics and technology assessment Subcommittee of the American Academy of Neurology [Elektronnyi resurs]. American Academy of Neurology (ed.). Neurology, 1994. Vol. 44, pp. 566–568. DOI:10.1212/wnl.44.3_part_1.566
  9. Baird A., Samson S. Music and dementia [Elektronnyi resurs]. Progress in Brain Research, 2015. Vol. 217, pp. 207–235. DOI:10.1016/bs.pbr.2014.11.028
  10. Ball N.J., Mercado E. III., Orduña I. Enriched Environments as a Potential Treatment for Developmental Disorders: A Critical Assessment [Elektronnyi resurs]. Frontiers in Psychlogy, 2019. Vol.10, article ID 466, 12 p. DOI:10.3389/fpsyg.2019.00466
  11. Breier J.I. et al. Changes in maps of language activity activation following melodic intonation therapy using magnetoencephalography: two case studies [Elektronnyi resurs]. Journal of Clinical and Experimental Neuropsychology, 2010. Vol. 32, no. 3, pp. 309–314. DOI:10.1080/13803390903029293
  12. Habibi A. et al. Childhood music training induces change in micro and macroscopic brain structure: results from a longitudinal study [Elektronnyi resurs]. Cerebral Cortex, 2017. Vol. 28, no. 12, pp. 4336–4347. DOI:10.1093/cercor/bhx286
  13. Clarke S., Bindschaedler C., Crottaz-Herbette S. Impact of cognitive neuroscience on stroke rehabilitation [Elektronnyi resurs]. Stroke, 2015. Vol. 46, no. 5, pp. 1408–1413. DOI:10.1161/strokeaha.115.007435
  14. Särkämö T. et al. Clinical and demographic factors associated with the cognitive and emotional efficacy of regular musical activities in dementia [Elektronnyi resurs]. Journal of Alzheimer’s Disease, 2016. Vol. 49, no. 3, pp. 767–781. DOI:10.3233/JAD-150453
  15. Yun S.J. et al. Cognitive Training Using Fully Immersive, Enriched Environment Virtual Reality for Patients With Mild Cognitive Impairment and Mild Dementia: Feasibility and Usability Study [Elektronnyi resurs]. Journal of Medical Internet Research Serious Games, 2020. Vol. 8, no. 4, 11 p. DOI:10.2196/18127
  16. Pulvermüller F. et al. Constraint-Induced Therapy of Chronic Aphasia After Stroke [Elektronnyi resurs]. Stroke, 2001. Vol. 32, no. 7, pp. 1621–1626. DOI:10.1161/01.str.32.7.1621
  17. Särkämö T. et al. Editorial: Music, brain, and rehabilitation: emerging therapeutic applications and potential neural mechanisms [Elektronnyi resurs]. Frontiers in Human Neuroscience, 2016. Vol. 10, article ID 103,5 p. DOI:10.3389/fnhum.2016.00103
  18. Stahl B. et al. Efficacy of intensive aphasia therapy in patients with chronic stroke: a randomised controlled trial [Elektronnyi resurs]. Journal of Neurology, Neurosurgery and Psychiatry, 2018. Vol. 89, pp. 586–592. DOI:10.1136/jnnp-2017-315962
  19. Vive S. et al. Enriched, Task-Specific Therapy in the Chronic Phase after Stroke: An Exploratory Study [Elektronnyi resurs]. Journal of Neurologic Physical Therapy, 2020. Vol. 44, no. 2, pp. 145–155. DOI:10.1097/NPT.0000000000000309
  20. Global action plan on the public health response to dementia 2017-2025 [Elektronnyi resurs]. World Health Organisation. 2017. URL: (Accessed 26.12.2020).
  21. Heiss W.D., Thiel A.A. A proposed regional hierarchy in recovery of post-stroke aphasia [Elektronnyi resurs]. Brain and Language, 2006. Vol. 98, no. 1, pp. 118–123. DOI:10.1016/j.bandl.2006.02.002
  22. Li X. et al. Hippocampal subfield volumetry in patients with subcortical vascular mild cognitive impairment [Elektronnyi resurs]. Scientific reports. 2016. Vol. 6, article ID 20873, 8 p. DOI:10.1038/srep20873
  23. Kurland J. Intensive language action therapy in chronic aphasia: A randomized clinical trial. Examining guidance by constraint [Elektronnyi resurs]. American Journal of Speech-Language Pathology, 2016. Vol. 25, no. 4, pp. 798–812. DOI:10.1044/2016_AJSLP-15-0135
  24. Merrett D., Peretz I., Wilson S.J. Neurobiological, cognitive, and emotional mechanisms in Melodic Intonation Therapy [Elektronnyi resurs]. Frontiers in Human Neuroscience, 2014. Vol. 8, Article ID 401, 17 p. DOI:10.3389/fnhum.2014.00401
  25. Kivipelto M. et al. Midlife vascular risk factors and Alzheimer's disease in later life: longitudinal, population based study [Elektronnyi resurs]. British Medical Journal, 2001. Vol. 322, pp. 1447–1451. DOI:10.1136/bmj.322.7300.1447
  26. Moreira Sh.V., Justi F.R.D.R., Moreira M. Can musical intervention improve memory in Alzheimer’s patients? Evidence from a systematic review [Elektronnyi resurs]. Dementia and Neuropsychologia, 2018. Vol. 12, no. 2, pp. 133–142. DOI:10.1590/1980-57642018dn12-020005
  27. Han J.W. et al. Multimodal cognitive enhancement therapy for patients with mild cognitive impairment and mild dementia: A multi-center, randomized, controlled, double blind, crossover trial [Elektronnyi resurs]. Journal of Alzheimer’s Disease, 2017. Vol. 55, no. 2, pp. 787–796. DOI:10.3233/JAD-160619
  28. Särkämö T. et al. Music listening enhances cognitive recovery and mood after middle cerebral artery stroke [Elektronnyi resurs]. Brain, 2008. Vol. 131. pp. 866–876. DOI:10.1093/brain/awn013
  29. Moreno-Morales C., et al. Music therapy in the treatment of dementia: A systematic review and meta-analysis [Elektronnyi resurs]. Frontiers in Medicine, 2020. Vol. 7, 11 p. DOI:10.3389/fmed.2020.00160
  30. Mishra A. et al. Neuroplasticity and environment: A pharmacotherapeutic approach toward preclinical and clinical understanding [Elektronnyi resurs]. Current Opinion in Environmental Science & Health, 2021. Vol. 19, 10 p. DOI:10.1016/j.coesh.2020.09.004
  31. Nissim N.R., Moberg P.J., Hamilton R.H. Efficacy of noninvasive brain stimulation (tDCS or TMS) paired with language therapy in the treatment of primary progressive aphasia: an exploratory meta-analysis [Elektronnyi resurs]. Brain Sciences, 2020. Vol. 10, no. 9, 17 p. DOI:10.3390/brainsci10090597
  32. Petersen R.S. Mild cognitive impairment as a diagnostic entity [Elektronnyi resurs]. Journal of Internal Medicine, 2004. Vol. 256, no. 3, pp. 183–194. DOI:10.1111/j.1365-2796.2004.01388.x
  33. Racette A., Bard C., Peretz I. Making non-fluent aphasics speak: sing along [Elektronnyi resurs]. Brain, 2006. Vol. 129, pp. 2571–2584. DOI:10.1093/brain/awl250
  34. Belin P. et al. Recovery from nonfluent aphasia after melodic intonation therapy: a PET study [Elektronnyi resurs]. Neurology, 1996. Vol. 47, no. 6, pp. 1504–1511. DOI:10.1212/wnl.47.6.1504
  35. Barker W.W. et al. Relative frequencies of Alzheimer disease, Lewy body, vascular and frontotemporal dementia, and hippocampal sclerosis in the State of Florida Brain Bank [Elektronnyi resurs]. Alzheimer disease and associated disorders, 2002. Vol. 16, no. 4, pp. 203–212. DOI:10.1097/00002093-200210000-00001
  36. Raboyeau G. et al.Right hemisphere activation in recovery from aphasia: lesion effect or function recruitment? [Elektronnyi resurs]. Neurology, 2008. Vol. 70, no. 4, pp. 290–298. DOI:10.1212/01.wnl.0000287115.85956
  37. Sacuiu S.F. Dementias [Elektronnyi resurs]. Handbook of Clinical Neurology, 2016. Vol. 138, pp. 123–132. DOI:10.1016/B978-0-12-802973-2.00008-2
  38. Schlaug G., Marchina S., Norton A. Evidence for plasticity in white matter tracts of chronic aphasic patients undergoing intense intonation-based speech therapy [Elektronnyi resurs]. Annals of New York Academy of Science, 2009. Vol. 1169, pp. 385–394. DOI:10.1111/j.1749-6632.2009.04587
  39. Schlaug G., Marchina S., Wan C.Y. The use of non-invasive brain stimulation techniques to facilitate recovery from post-stroke aphasia [Elektronnyi resurs]. Neuropsychology Review, 2011. Vol. 21, pp. 288–301. DOI:10.1007/s11065-011-9181-y
  40. Schoentgen B., Gagliardi G., Défontaines B. Environmental and Cognitive Enrichment in Childhood as Protective Factors in the Adult and Aging Brain [Elektronnyi resurs]. Frontiers in Psychology, 2020. Vol. 11, Article ID 1814, 12 p. DOI:10.3389/fpsyg.2020.01814
  41. Soria-Urios G., Duque P., García-Moreno J.M. Música y cerebro (II): evidencias cerebrales del entrenamiento musical [Elektronnyi resurs]. Revista de Neurologia, 2011. Vol. 53, pp. 739–746. DOI:10.33588/rn.5312.2011475
  42. Ceccato E. et al. STAM protocol in dementia: a multicenter, single-blind, randomized, and controlled trial [Elektronnyi resurs]. American Journal of Alzheimer's Disease and other Dementias, 2012. Vol. 27, no. 5, pp. 301–310. DOI:10.1177/1533317512452038
  43. Su F., Xu W. Enhancing brain plasticity to promote stroke recovery [Elektronnyi resurs]. Frontiers in Neurology, 2020. Vol. 11, article ID 554089, 15 p. DOI:10.3389/fneur.2020.554089
  44. Taub E. et al. Technique to improve chronic motor deficit after stroke [Elektronnyi resurs]. Archives of Physical Medicine and Rehabilitation, 1993. Vol. 74, no. 4, pp. 347–354. URL: (Accessed 29.09.2021).
  45. Thaut M.H., McIntosh G.C., Hoemberg V. Neurobiological foundations of neurologic music therapy: rhythmic entrainment and the motor system [Elektronnyi resurs]. Frontiers in Psychology, 2015. Vol. 5, article ID 1185, 6 p. DOI:10.3389/fpsyg.2014.01185
  46. Van der Meulen I. et al. The efficacy and timing of melodic intonation therapy in subacute aphasia [Elektronnyi resurs]. Neurorehabilitation and Neural Repair, 2014. Vol. 28, no. 6, pp. 536–544. DOI:10.1177/1545968313517753
  47. Turkeltaub P.E. et al. The right hemisphere is not unitary in its role in aphasia recovery [Elektronnyi resurs]. Cortex, 2012. Vol. 48, pp. 1179–1186. DOI:10.1016/j.cortex.2011.06.010
  48. Elsner B. et al. Transcranial direct current stimulation (tDCS) for improving aphasia in adults with aphasia after stroke [Elektronnyi resurs]. Cochrane Database of Systematic Reviews, 2019, no. 5, article ID CD009760, 95 p. DOI:10.1002/14651858.cd009760.pub4
  49. Zumbansen A., Peretz I., Hébert S. Melodic Intonation Therapy: back to basics for future research [Elektronnyi resurs]. Frontiers in Neurology, 2014. Vol. 5, Article ID 7, 11 p. DOI:10.3389/fneur.2014.00007
  50. Zumbansen A., Tremblay P. Music-based interventions for aphasia could act through a motor-speech mechanism: a systematic review and case–control analysis of published individual participant data [Elektronnyi resurs]. Aphasiology. 2019. Vol. 33, pp. 466–497. DOI:10.1080/02687038.2018.1506089

Information About the Authors

Karine M. Shipkova, PhD in Psychology, Associate Professor, Leading Researcher, V. Serbsky National Medical Research Center of Psychiatry and Narcology, Moscow, Russia, ORCID:, e-mail:



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