Neuro Q no.1 = Neuro Quran

Transcription

1 TRANSDISCIPLINARY RESEARCH SEMINAR CLINICAL SCIENCE RESEARCH PLATFORM 27 July 2010 School of Medical Sciences USM Health Campus Neuro Q no.1 = Neuro Quran Dr.Muzaimi Mustapha Department of Neurosciences School of Medical Sciences

2 Stroke Burden Leading morbidity Significant mortality Economically costly Treatable Preventable

3 Stroke Heterogeneity Hemorrhagic stroke (20%) Ischaemic stroke (80%) Atherothromboembolic (large vessel) disease (50%) Intracerebral hemorrhage (80%) Lacunar (small vessel) disease (25%) Cardio embolism (20%) Subarachnoid haemorrhage (20%) Cryptogenic (5%)

4 Stroke Management 1. Imaging 2. Hyperacute/Acute management 3. Stroke rehabilitation 4. Stroke prevention Outlined in the Malaysian: Key impairments: motor function language cognition sensory processing emotion Clinical Practice Guideline (CPG): Management of Stroke 2008 National Institute of Health (NIH), Ministry of Health: Stroke as health research priority in the 9 th Malaysia Plan (Needs Analysis) Evidence based medicine

5 Music Therapy For Acquired Brain Injury 7 trials (184 participants). 4 on stroke, 3 use RAS. Rhythmic auditory stimulation (RAS) appears beneficial for improving gait parameters in stroke patients, including gait velocity, cadence, stride length and gait symmetry. Results encouraging, but more RCTs needed. More research is needed to examine the effects of sound therapy on other outcomes for routine use in clinical practice.

6 RAS: Center for Biomedical Research in Music (CBRM) CBRM Robert F.Unkefer Academy of Neurologic Music Therapy Neuroscience Research Laboratories Neurologic Music Therapy Clinics (OutReach) AFFILIATIONS College of Liberal Arts Cellular and Integrative Neuroscience Program Department of Electrical Engineering Biomedical Engineering Program Regional Hospitals

7 Music Therapy And Medicine Rhythmic Auditory Stimulation (RAS) Patterned Sensory Enhancement (PSE) Therapeutic Instrumental Music Playing (TIMP) Speech Stimulation Melodic Intonation Therapy (MIT) Rhythmic Speech Cuing (RSC) Vocal Intonation Therapy (VIT) Therapeutic Singing (TS) Oral Motor and Respiratory Exercises (OMREX) Thaut (1999) Training Manual for Neurologic Music Therapy. CBRM: Colorado State University

8 If You Couldn t Find It, There s Business Stroke rehabilitation Key impairments: motor function language cognition sensory processing emotion

9 Working Mechanisms: Rhythm and The Brain Rhythmic entrainment occurs through direct projection to the motor system, beginning with the encoding of information in the auditory system. Information transfers directly to motor areas or that the auditory cortex contributes to entrainment via common thalamic projections shared with cortical motor areas. LaGasse et al 2009

10 Spiritual Rhythm and The Brain Western sciences have converged on naturalistic explanations of the world: physics, biology, neuroscience, etc. Casts doubt on supernatural realities. Science and religion or spirituality do not mix. Evidence based medicine: Psychological therapies Behaviour Therapy Cognitive Therapy Cognitive Behaviour Therapy (CBT) Dialectical Behaviour Therapy (DBT) Interpersonal Psychotherapy (IPT) Mindfulness Based CBT Acceptance and Commitment Therapy Aimed at symptom reduction deal with thoughts, feelings behaviour, relationships, etc. Acknowledge that human beings have metacognitive awareness like to contemplate, ponder, reflect on their experiences and the world around them Early Muslim scholars described and taught cognitive behavioural models and methods: exposure, cognitive restructuring, behaviour change (Ibn al Qayyim; Al Ghazali) Islamic teachings / practices embody potent cognitive & behavioural prescriptions: decreases physiological arousal (anxiety) and enhances emotional functioning (mood control). Spiritual Rhythm

11 Spiritual Rhythm and The Brain Islamic Concept of Self: Metacognitive Awareness Aql (intellect, rational/reasoning mind) Qalb (spiritual heart, seat of knowledge, intention, belief, justice) Nafs (ego, feelings, desires, negative thoughts) Ruh (the spirit, the true human, the one in charge, live on after physical death)

12 Spiritual Rhythm : The Holy Quran In the Name of Allah, Most Gracious, Most Merciful (and) when My servants ask of Me, I am truly near (them): I head the call of every caller when he calls on Me. Let them also, with a will, listen to My call, and believe in Me: That they may walk in the right way. (2:186)

13 In Summary: Neuro Quran Stroke rehabilitation Physical & Psychological Leading morbidity Significant mortality Economically costly Treatable Preventable Music Therapy Evidence based medicine RAS, PSE, TIMP, MIT, VIT, OMREX, etc Spiritual Rhythm Neuro Quran