Parkinson's disease (PD) is among the most common neurological diseases and its prevalence will continue to increase due to the aging of the global population. Although our ability to medically treat gross motor symptoms have advanced tremendously since the 1960's based on advances in our understanding of neurophysiology, medication side effects and limited benefit for fine motor functions often leave PD patients with significant fine motor disability. It is time to consider alternative treatments to specifically target motor physiology and rehabilitate motor function.I propose that the treatment of fine motor symptoms in PD via Neurologic Music Therapy (NMT) is effective and that this treatment can be further optimized through an understanding of its neurobiological mechanisms.My long-term goal is to advance our fundamental understanding of the neurophysiology of fine motor dysfunction across neuropsychiatric disorders, with a specific emphasis on brain networks connectivity, in order to develop novel fine motor therapies. My short-term goal for this proposal is to unravel the auditory-motor oscillatory pathways targeted by NMT and to investigate the potential rehabilitative benefit in PD. I hypothesize that auditory-motor entrainment of beta and gamma oscillations through NMT results in changing patterns of functional cortical connectivity critical to normal fine motor skills, and that are disrupted by subcortical pathology in PD.This hypothesis has been formulated on the basis of preliminary data presented in this proposal and other previously published work.The research objectives of this proposal are to use magnetoencephalography (MEG) to improve our understanding of auditory-motor entrainment of beta and gamma rhythms via NMT, to probe its feasibility in PD and to further test its benefit on fine motor problems in PD. We will accomplish the objectives of this application by pursuing the following Specific Aims:1) To characterize Neurologic Music Therapy specific networks and efficacy no brain function in comparison with Occupational Therapy or no treatment; and 2) To assess the functional impact of Neurologic Music Therapy on fine motor skills and quality of life in PD.The approach is innovative becauseit combines investigation of rhythmic entrainment of the motor cortex as a symptomatic treatment with a feasibility study applied to a movement disorder. The proposed research is significant because it will lay the foundation for an empirically testable therapeutic model of motor rehabilitation relevant to alternative and complementary interventions for fine motor dysfunction in neuropsychiatric disorders and will provide the first substantive evidence of the oscillatory mechanisms of NMT and its effects on fine motor control. The training objectives of this award will help me develop new skills and methods to establish my independence and obtain R01 funding to advance this unique and important research program.
Fine motor problems are encountered by people with movement disorders like Parkinson?s disease, older adults, and other diseased populations, but there are no effective treatments. Our preliminary data and other published studies suggest that Neurologic Music Therapy (NMT) might be a groundbreaking treatment for movement disorders via auditory-motor entrainment of motor function. This proposal will identify the underlying brain pathways of motor activity entrainment using magnetoencephalography during a randomized controlled trial of NMT to determine its therapeutic potential.
