Therapeutic benefits of music-based synchronous finger tapping in Parkinson's disease-an fNIRS study protocol for randomized controlled trial in Dalian, China

Lanlan Pu, Nauman Khalid Qureshi, Joanne Ly, Bingwei Zhang, Fengyu Cong, William C Tang, Zhanhua Liang, Lanlan Pu, Nauman Khalid Qureshi, Joanne Ly, Bingwei Zhang, Fengyu Cong, William C Tang, Zhanhua Liang

Abstract

Background: Music therapy improves neuronal activity and connectivity of healthy persons and patients with clinical symptoms of neurological diseases like Parkinson's disease, Alzheimer's disease, and major depression. Despite the plethora of publications that have reported the positive effects of music interventions, little is known about how music improves neuronal activity and connectivity in afflicted patients.

Methods: For patients suffering from Parkinson's disease (PD), we propose a daily 25-min music-based synchronous finger tapping (SFT) intervention for 8 weeks. Eligible participants with PD are split into two groups: an intervention group and a control arm. In addition, a third cohort of healthy controls will be recruited. Assessment of finger tapping performances, the Unified Parkinson's Disease Rating Scale (UPDRS), an n-back test, the Montreal Cognitive Assessment (MoCA), as well as oxygenated hemoglobin (HbO2), deoxygenated hemoglobin (HbR), and total hemoglobin activation collected by functional near-infrared spectroscopy (fNIRS) are measured at baseline, week 4 (during), week 8 (post), and week 12 (retention) of the study. Data collected from the two PD groups are compared to baseline performances from healthy controls.

Discussion: This exploratory prospective trial study investigates the cortical neuronal activity and therapeutic effects associated with an auditory external cue used to induce automatic and implicit synchronous finger tapping in patients diagnosed with PD. The extent to which the intervention is effective may be dependent on the severity of the disease. The study's findings are used to inform larger clinical studies for optimization and further exploration of the therapeutic effects of movement-based music therapy on neural activity in neurological diseases.

Trial registration: ClinicalTrials.gov NCT04212897 . Registered on December 30, 2019. The participant recruitment and study protocol have received ethical approval from the First Affiliated Hospital of Dalian Medical University. The hospital Protocol Record number is PJ-KY-2019-123. The protocol was named "fNIRS Studies of Music Intervention of Parkinson's Disease." The current protocol is version 1.1, revised on September 1, 2020.

Keywords: Explicit and implicit timing; Motor-control; Music therapy; Parkinson’s disease; Randomized controlled trials; Synchronous finger tapping; fNIRS.

Figures

Fig. 1
Fig. 1
Expected trial plan. Not included in the diagram are excluded participants that may stop participation at any time during weeks 0–12 due to various reasons including failure to meet inclusion criteria or inability to continue at-home intervention. The intervention tasks are 25 min total, with two 10-min sets with a 5-min break between each set
Fig. 2
Fig. 2
Standard Protocol Items: Recommendation for Interventional Trials (SPIRIT). W, weeks; SFT, synchronous finger tapping; HC, healthy control; CFT, continuous finger tapping; fNIRS, functional near-infrared spectroscopy; MoCA, Montreal Cognitive Assessment Test; UPDRS, Unified Parkinson’s Disease Rating Scale
Fig. 3
Fig. 3
Schematic of experimental paradigm. BR, baseline rest; SFT, synchronous finger tapping; CFT, continuous finger tapping. In the SFT task, visual stimuli will appear at three different rates 1000 ms, 1500 ms, and 2000 ms respectively

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