Why some stroke survivors can’t speak but can sing

Imagine waking up and being unable to communicate. This frightening scenario happens to about a third of stroke survivors, says speech therapist Bernadette Matthias.

The condition, known as aphasia, is caused by damage to parts of the brain that are responsible for language. It can lead to difficulty with understanding speech, problems with reading and writing, as well as trouble with speaking.

In a surprising twist, though, some aphasia sufferers can sing. Matthias, who is also the director of the Conservatorium of Newcastle Brainwaves Choir, explains that this is because the brain uses different networks for processing speech and language than it does for music.

Music in the mind

While language is mainly managed on the brain’s left side, music “activates a great deal of the brain across both sides,” Matthias says. “You can sing but not be able to speak because of that rich interconnection of the brain – when music occurs it activates a lot more than just speech alone.”

Furthermore, stroke survivors may regain their ability to speak due to neuroplasticity, in which the intact parts of the brain can compensate for the damaged areas, she adds.

Matthias’ interest in the area began about 10 years ago, when studies started showing the beneficial effects of singing for aphasia sufferers.

A 2008 study, for example, compared two patients with similar stroke size and location. The patient who was treated with a type of singing therapy made greater gains than the one treated with a control. Imaging showed that singing therapy caused activation on the right side of the brain.

Benefits boosted by numbers

The benefits seem to apply particularly to singing in a group. Matthias’ choir of stroke survivors and their carers began in 2012, when she started researching the impact of choral singing on communication, mood, social participation, and quality of life for people who’d had a stroke.

Her research is ongoing, but she says there were noticeable improvements in the fluency, clarity and intelligibility of speech for at least some people. “They’d say, ‘I felt like I could speak more fluently; my speech was a bit easier and I was more confident’,” Matthias says. “One woman felt she could go for a job interview and she got that job.”

“In the second week a woman said, ‘I heard words, Bernadette! I heard my husband, who hasn’t spoken other than ooh and ahh for the last 6 months’”.

This trend has been borne out by research. A 2006 study found that people with aphasia recalled more words when singing than speaking, and that choral singing was more effective than choral speech. This led the authors to conclude that “choral singing appears to be an effective means of speech therapy.”

Singing pluses for stroke survivors

Matthias points out that losing your ability to communicate has far-reaching consequences. “After a stroke so many survivors become very isolated, particularly if they have aphasia,” she says.

“It’s really hard to engage and continue a relationship with someone who all of a sudden can’t express anything to you, so they lose their friends.”

Joining a choir helps them develop social connections with others who’ve been on a similar journey. “Even when they can’t communicate that is pretty powerful and rewarding,” she says. “They get together, have a sing and leave all the rest of the stuff at the door.”

“It’s therapy that doesn’t feel like therapy.”

Most of her choir members have never sung before, so they are also learning a new skill – one that may even lead to being able to communicate with friends and loved ones again.

Interested readers can find out more about the Conservatorium Brainwaves Choir on their Facebook page.​​