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Gabrielle Giffords, Broca's area and song therapy
November 17, 2011 4:21 AM   Subscribe

"I miss Tucson. The Mountains. Blue Skies. Even the heat." ABC News has documented the recovery of Congresswoman Gabrielle Giffords from a gunshot wound sustained in January, in conjunction with the release of "Gabby: A Story of Courage and Hope", written by Giffords and her husband, Mark Kelly.

(Previously)

The full special, here, is unfortunately viewable only in the US, but ABC also provided a slideshow on some of the aspects of Gifford's recovery here.

Key to Gifford's story is Broca's area - the first part of the brain to be assigned a specific role, after Pierre Paul Broca discovered lesions in the left hemisphere of the brains of two patients whose ability to speak had become severely impaired. Broca's area and Wernicke's area have long been identified as key to generating and comprehending speech (broadly speaking), with damages to each resulting in non-fluent ("Broca's aphasia") and fluent (patient can speak fluently, but has problems comprehending language) aphasia.

Progressive, slow damage to Broca's area has seen language function migrate to other areas - as in the case of the subject of this case study, who experienced only damage to the use of indirect speech and relative clauses after Broca's area was surgically removed from his brain. Research at the University of Rochester further identified that speech functions were distributed across the brain. However, sudden trauma - for example from strokes or gunshot wounds - can have a catastrophic effect on fluency.

The damage to Giffords' brain being thankfully localised, her right hemisphere remained almost entirely intact. Giffords has been "relearning" speech using techniques based on Melodic Intonation Therapy, where patients are encouraged to approach words through songs, and then to step down the level of musicality in their intonation towards normal speech.

Dr Gottfried Schlaug, of the Music and Neuroimaging Laboratory at Beth Israel Deaconess and Harvard Medical School, talks about the neuroplastic implications of musical training in a Library of Congress "Music and the Brain" podcast.

Using techniques similar to those used to teach stroke victims how to recover speech, Congresswoman Giffords is now able to form sentences, including the statement "I want to get back to work".
posted by running order squabble fest (16 comments total) 13 users marked this as a favorite

 
The intonation at the heart of MIT was originally intended to engage the right hemisphere, given its dominant role in processing spectral information, global features of music, and prosody. The right hemisphere may be better suited for processing slowly-modulated signals, while the left hemisphere may be more sensitive to rapidly-modulated signals. Therefore, it is possible that the slower rate of articulation and continuous voicing that increases connectedness between syllables and words in singing, may reduce dependence on the left hemisphere.

...

Tapping the left hand may engage a right-hemisphere sensorimotor network that controls both hand and mouth movements. It may also facilitate sound-motor mapping, which is a critical component of meaningful vocal communication. Furthermore, tapping, like a metronome, may pace the speaker and provide continuous cueing for syllable production.

Physical therapy for the brain. It seems like very primitive science, but it's always fascinating to see that effective therapies can be developed without fully understanding what's going on.

("Tapping the left hand." There's a good right-wing conspiracy theory to be built around this.)
posted by three blind mice at 4:47 AM on November 17, 2011


Mark Kelly was on The Daily Show this week, talking about her recovery, and how she used to push him to achieve as much as he was capable, and now he's pushing her to get back to her rightful place...theirs seems like the kind of relationship where the sum really is greater than the parts. Inspiring.
posted by Rodrigo Lamaitre at 4:58 AM on November 17, 2011 [1 favorite]


Thanks for such a good post, Running Order Squabble Fest.

Gabby Giffords' recovery process is interesting on so many levels... the personal story is compelling. And in your first link, Bob Woodruff is the reporter - it's great to see him doing so well, and also to see him advancing stories related to head injuries. I'd encourage people to watch the special, even though it was overhyped ad nauseum.

The music therapy is fascinating and I am glad you posted the links to it. To be honest, when I first saw a therapist working with Gabby by having her sing along to songs, it seemed pretty simplistic and discouraging to me. I was sad to see this brilliant woman reduced to singing silly pop lyrics and struggling with single words. Understanding the theory behind the therapy - that the music might provide a bridge to verbal speech restoration - that is fascinating and hopeful. Plus, I think my initial reaction of shock and sadness at realization of the scope of the loss has been supplanted by my awe at the miracle of her recovery, her strength, and her progress. It's pretty courageous of both Gabby and Mark to share the details of this process - it may educate us all and give hope to many.

I have a friend with a sister who has a form of progressive aphasia - I don't know all the details about her condition, but I am going to pass on the link to the Music and Neuroimaging Laboratory, Stroke Recovery Laboratory in Boston.
posted by madamjujujive at 5:53 AM on November 17, 2011


> It's pretty courageous of both Gabby and Mark to share the details of this process - it may educate us all and give hope to many.

I agree with this statement. A lot of patients can get discouraged because so much of what doctors do is random walk in nearly null space of stuff that worked on a few patients in the past and there isn't anything else we can do so let's try this. Evidence that it did work and so it's worth trying is valuable.

Giffords and her husband have nothing to lose and I wish them luck.
posted by bukvich at 6:25 AM on November 17, 2011 [1 favorite]


("Tapping the left hand." There's a good right-wing conspiracy theory to be built around this.)

three blind mice: Don't google "gabrielle giffords antichrist" or you will be very, very sad about humanity.
posted by Saxon Kane at 6:50 AM on November 17, 2011


three blind mice: Don't google "gabrielle giffords antichrist" or you will be very, very sad about humanity.


Oh my God I thought you were joking what is this I don't even.
posted by running order squabble fest at 6:52 AM on November 17, 2011


Don't google "gabrielle giffords antichrist" or you will be very, very sad about humanity.

Wow. I had recently seen some articles/videos claiming that the whole shooting was faked (portrayed by actors), but I think that Antichrist stuff tops it on the nuttiness scale.
posted by stifford at 6:57 AM on November 17, 2011


Mark Kelly was also interviewed on NPR this week. The interview includes a segment from the audiobook of Gabby, with Giffords reading her own words.

(Mark Kelly was also featured as part of the U2 360 tour, with a video he made on the ISS. It moved me to tears when it came on screen right after the end of "Stay (Faraway So Close)", which ends with the lyrics "just the bang and the clatter as an angel hits the ground".)
posted by hippybear at 7:09 AM on November 17, 2011


Saxon Kane: "Don't google "gabrielle giffords antichrist" or you will be very, very sad about humanity."

From the link:

For those unfamiliar with Christian eschatology, the poster is referencing a key passage in the Book of Revelation regarding the prophetic beast:
And I saw one of his heads as if it had been mortally wounded, and his deadly wound was healed. And all the world marveled and followed the beast. [Revelation 13:3]
Further proof that when the Antichrist returns, it will do so while endlessly quoting Scripture.

My money's on a more charismatic and learned version of Fred Phelps.
posted by DaShiv at 7:22 AM on November 17, 2011


I remember that 'head wound' stuff being said about the Kennedys. itallkindofmakessenseifyoureallythinkaboutitandwhyistheweathersoweird
posted by Trochanter at 7:43 AM on November 17, 2011


I'm so glad she is doing better. However, I can't be the only one reminded of Little Fluffy Clouds.
posted by exogenous at 9:51 AM on November 17, 2011


(Mark Kelly was also featured as part of the U2 360 tour, with a video he made on the ISS . It moved me to tears when it came on screen right after the end of "Stay (Faraway So Close)", which ends with the lyrics "just the bang and the clatter as an angel hits the ground".)

I do standby EMS at a lot of big concerts and special events around Chicago and I was assigned to the 360 tour at Soldier Field this past summer. I gotta say, the whole "Space Oddity" theme that the show was pushing really clicked during the ISS part with Kelly. The most profound moment for me was his 'sign off', where he addressed the entire crowd with: "Tell my wife I love her very much. She knows." After those words had struck everyone, I remember looking at my partner and seeing the affected sneer he'd had on his face all night completely gone. After hearing him complain about the liberal undertones of the event for an hour and a half, all he could say in that moment was, "...that was pretty fucking cool."
posted by condor at 10:03 AM on November 17, 2011 [5 favorites]


She was in my town recently, and came to the business I work for (sadly after I had left for the day) to hang out on her last night. Honored, and bummed I didn't get a chance to thank her for her inspirational courage and service to the country, as well as totally nerd out at Mark.
posted by lazaruslong at 4:16 PM on November 17, 2011


The most profound moment for me was his 'sign off', where he addressed the entire crowd with: "Tell my wife I love her very much. She knows." After those words had struck everyone, I remember looking at my partner and seeing the affected sneer he'd had on his face all night completely gone. After hearing him complain about the liberal undertones of the event for an hour and a half, all he could say in that moment was, "...that was pretty fucking cool."

He is basically Astronaut Mike Dexter, isn't he? I have such a man-crush at this point, it's kind of absurd.
posted by running order squabble fest at 5:05 AM on November 18, 2011


When I heard she would do an interview with Sawyer I remembered a comment made in the MeFi Tucson shooting thread - that whenever she did an interview it would get massive ratings. (And I think it did.)

I've followed her story with intense interest all along, to the point Google almost knows what I want after I've typed just a "g." But I've been too busy this week to track down the book yet. (There might still be one or two things in it that I don’t already know.)

He is basically Astronaut Mike Dexter, isn't he?
Ah, astronaut Mike Dexter, my favorite fictional astronaut. (Although the astronaut who made paninis in a recent Community episode is gaining in my heart.)
posted by NorthernLite at 10:14 AM on November 18, 2011


Broca's area and Wernicke's area have long been identified as key to generating and comprehending speech (broadly speaking), with damages to each resulting in non-fluent ("Broca's aphasia") and fluent (patient can speak fluently, but has problems comprehending language) aphasia.

Whenever I read about aphasia, I'm always reminded of The President's Speech.
posted by homunculus at 1:35 PM on November 19, 2011


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