<International Circulation>: You mentioned that music and language activate similar pathways， but what are the differences between music and simple spoken language?

　　Prof. Michael H. Thaut: Music is not processed in the “music brain” areas， it actually engages the whole brain from the spinal cord and the brain stem to activating general centers that deal with cognition， speech and language， and the motor system. It engages the whole brain in complex ways. This how we can use music to access to regions that control attention， memory， and motor system. Music is a pervasive auditory stimulus that can engages the whole brain.

　　《国际循环》：您提到音乐与语言可激活类似的通路，那音乐与我们通常所说的语言有何区别？

　　Michael H. Thaut教授：音乐并不是在所谓的“音乐大脑”区域中被处理，而是经由延髓及脑干通过整个大脑到达可处理认知、语言及运动的中枢，以一种复杂的方式让整个大脑都运作起来。这就是我们能够用音乐来控制注意力、记忆及运动系统的原因所在。音乐是一种无处不在的、能够动员整个大脑的听觉刺激。

　　<International Circulation>: How is it individualized to the patient， especially when it comes to the stroke?

　　Prof. Michael H. Thaut: Music is individualized to the diagnostic goal. In a stroke， the big areas are in movement and speech. In cases where there is a weak leg and strong leg or one arm is semi-paralyzed， we use music to activate the motor system， as the auditory system can prime the motor system. That is why we dance to music and do not dance to flash lights. The timing in the rhythms helps the brain reorganize， plan， and execute movement. A stroke patient that limps after a stroke can relearn to walk with symmetry following a beat. We started that research about 20 years ago and has been well-replicated by research groups now. That is one big area. The other area is aphasia. While this patients cannot speak， they can sing because music moves the speech pathways from the left hemisphere to the right hemisphere. If the left hemisphere is damaged， the patient cannot speak anymore. When we ask the patient to sing， instead of speaking sentences， then the whole network shifts. This allows them regain speech. The technique is called melodic intonation therapy and has also been well researched.

　　《国际循环》：应如何将音乐疗法个体化地应用到患者尤其是卒中患者中？

　　Michael H. Thaut教授：应根据诊断选择个体化的音乐。卒中治疗的主要目的是改善运动与语言。例如，对于一条腿有力，另一条腿无力的患者或一支胳膊半瘫的患者，我们可应用音乐激活其运动系统，因为听觉系统可刺激运动系统。这是我们随音乐而非闪烁灯光跳舞的原因。定时节奏能帮助大脑重组、计划及执行运动。卒中后跛行的患者可以跟随节拍重新学习对称性行走。我们在20年前就开始了相关研究，其结果已被多个研究小组复制。这是音乐疗法很大的作用。另一个作用是治疗失语。当患者不能说话时，他们可以唱歌，因为音乐可将语言通路从左侧大脑半球移至右侧大脑半球。如果左侧大脑半球受损，患者就不能说话。当我们要求患者唱歌而不是说话时，整个网络将发生转变。这有望使患者重新开始讲话。这种方法被称为“旋律发音疗法”，已经被很好地研究。

　　<International Circulation>: When it comes to singing， can they return to normal speech pattenrs?

　　Prof. Michael H. Thaut: Yes， but It is a long process. The interesting thing is that they do not really sing as in an opera， but there is a musical inflection. It is not difficult to move to a normal speech process from their singing. We know from brain imaging that we are not just utilizing the alternate hemisphere， but also retraining the damaged hemisphere. They can learn how to speak again.

　　《国际循环》：就唱歌而言，患者能否恢复到正常讲话的形式？

　　Michael H. Thaut教授：答案是肯定的，但需要一个很长的过程。有趣的是，患者并不是真的像歌剧那样演唱，但会有一个变调点。从歌声向正常讲话的转变过程并不是很难。从大脑成像结果我们知道，我们不仅仅是利用备用大脑半球，而是对受损大脑半球进行再培训使其重新学会如何说话。

　　<International Circulation>: When it comes to efficacy， what kinds of patients are more suited to this therapy? What are some of the barriers you encounter?

　　Prof. Michael H. Thaut: Neurologic music therapy is well-research with a wide group of patients including stroke， Parkinson’s， cerebral palsy， and traumatic brain injury， but it can also be used in developmental disabilities in children and dementia. It has not been well researched tin the field of psychiatric rehabilitation. The problem in psychiatry is that we do have good treatments in general for these patients. We have medication that is mostly from the 1950s and we do not have good behavioral interventions in psychiatry. This is where neurologic music therapy is not well research. In the other patient groups mentioned， it is quite well researched.

　　《国际循环》：就其疗效而言，哪些患者更适合这种疗法？您在应用音乐疗法时遇到的障碍有哪些？

　　Michael H. Thaut教授：目前多项研究已评估了神经音乐疗法在卒中、帕金森病、脑瘫及脑外伤等患者中的应用。该疗法还可用于儿童发育障碍及老年痴呆症。但在神经疾病康复领域未能被较好地研究。其在精神病学领域应用所面临的问题是，对这些患者来说我们已经有了很好的治疗方法。精神病学领域的治疗药物大多可追溯到20世纪50年代，但缺乏较好的行为干预方法。因此，在该领域中神经音乐疗法未得到较好研究。而在所提到的其他患者群体中，神经音乐疗法均得到了相当好的研究。

　　<International Circulation>: How much of music therapy involves patients learning to play an instrument? Some studies have suggested it may be useful in elderly populations.

　　Prof. Michael H. Thaut: This is not a part of neurologic music therapy. We use music to engage the patient. For example， they can use a percussion instrument to regain their arm function. We have to set this up that does not require music skills. It is purely functional. The idea of using music to keep the brain healthy is backed up by a fair amount of evidence. Involvement in music can be quite healthy.

　　《国际循环》：音乐疗法对让患者学习演奏乐器有多大的作用？有研究提示其对老年人群是非常有用的。

　　Michael H. Thaut教授：这并不是神经音乐疗法的一部分。我们是用音乐让患者参与进来。例如，他们可以应用打击乐器来恢复其手臂的功能。这并不需要音乐技能，纯粹是功能性的。大量证据表明，音乐的目的在于保持大脑的健康状态。

　　<International Circulation>: What are the most exciting areas in music therapy right now in this field outside of stroke therapy?

　　Prof. Michael H. Thaut: There is good research for neurologic music therapy with Parkinson’s disease. The last ten years have seen a lot of interesting research into development disabilities， such as autism and dementia and Alzheimer’s.

　　《国际循环》：除卒中治疗外，目前音乐疗法在哪些领域的研究最令人兴奋？

　　Michael H. Thaut教授：有很多神经音乐疗法治疗帕金森病的好研究。过去10年还有很多关于音乐疗法治疗孤独症、老年痴呆症及阿尔茨海默病等发育障碍的有趣研究。