Melodic Intonation Therapy for aphasia: A multi-level meta-analysis of randomized controlled trials and individual participant data

Autor(en)
Tudor Catalin Popescu, Benjamin Stahl, Brenton M. Wiernik, Hannah Helm, Michaela Zemanek, Felix Haiduk, Theresa Matzinger, Roland Beisteiner, William Tecumseh Sherman Fitch
Abstrakt

Melodic Intonation Therapy (MIT) is a prominent rehabilitation program for individuals with post-stroke aphasia. Our meta-analysis investigated the efficacy of MIT while considering quality of outcomes, experimental design, influence of spontaneous recovery, MIT protocol variant, and level of generalization. Extensive literature search identified 606 studies in major databases and trial registers; of those, 22 studies—overall 129 participants—met all eligibility criteria. Multi-level mixed- and random-effects models served to separately meta-analyze randomized controlled trial (RCT) and non-RCT data. RCT evidence on validated outcomes revealed a small-to-moderate standardized effect in noncommunicative language expression for MIT—with substantial uncertainty. Unvalidated outcomes attenuated MIT's effect size compared to validated tests. MIT's effect size was 5.7 times larger for non-RCT data compared to RCT data (g̅case report = 2.01 vs. g̅RCT = 0.35 for validated Non-Communicative Language Expression measures). Effect size for non-RCT data decreased with number of months post-stroke, suggesting confound through spontaneous recovery. Deviation from the original MIT protocol did not systematically alter benefit from treatment. Progress on validated tests arose mainly from gains in repetition tasks rather than other domains of verbal expression, such as everyday communication ability. Our results confirm the promising role of MIT in improving trained and untrained performance on unvalidated outcomes, alongside validated repetition tasks, and highlight possible limitations in promoting everyday communication ability.

Organisation(en)
Department für Verhaltens- und Kognitionsbiologie, Bibliotheks- und Archivwesen, Institut für Anglistik und Amerikanistik
Externe Organisation(en)
Charité - Universitätsmedizin Berlin, University of South Florida, Medical School Berlin, Hochschule für Gesundheit und Medizin, Medizinische Universität Wien, Università degli Studi di Trento, Max-Planck-Institut für Kognitions- und Neurowissenschaften, Ernst Moritz Arndt Universität Greifswald, Nicolaus Copernicus University
Journal
Annals of the New York Academy of Sciences
Band
1516
Seiten
76-84
Anzahl der Seiten
9
ISSN
0077-8923
DOI
https://doi.org/10.1111/nyas.14848
Publikationsdatum
08-2022
Peer-reviewed
Ja
ÖFOS 2012
302038 Klinische Neuropsychologie
Schlagwörter
ASJC Scopus Sachgebiete
Biochemistry, Genetics and Molecular Biology(all), Neuroscience(all), History and Philosophy of Science
Link zum Portal
https://ucris.univie.ac.at/portal/de/publications/melodic-intonation-therapy-for-aphasia-a-multilevel-metaanalysis-of-randomized-controlled-trials-and-individual-participant-data(38e2094b-168b-4a6f-a2c9-bf0c0bb52771).html