In the Covid 19 pandemic varied neurological manifestations are being recognised increasingly where both central nervous system and peripheral nervous system are majorly being affected. Music Therapy (MT) is used in a wide spectrum of neurological disorders like Autism, Stroke, Parkinson’s disease, Alzheimer’s disease, Traumatic Brain Injury. Though evidence may be limited on some methods, sound healing has been found to be effective for stress reduction and relaxation and has been shown to offer many health benefits also to overcome during and post Covid treatment at the hospitals, says Dr. Ansu Sen, MD/DM Neurology, Senior Consultant (Neurologist), Ramakrishna Mission Sewa Prathisthan, Columbia Asia Hospitals, Kolkata, Government of West Bengal in conversation with Puja Banerjee, Assistant Editor, Elets News Network (ENN).
Q How Covid19 has affected the Nervous system of the human anatomy?
In the early days of the coronavirus disease 2019 (COVID-19) pandemic, involvement by neurologists seemed unnecessary. The virus was thought to lead to a respiratory illness, largely sparing the brain and the rest of the nervous system. Stroke is presenting feature especially ischemic strokes. Acute disseminated encephalomyelitis in which patients may present with altered sensorium seizures is another manifestation. Among peripheral nervous system Gullain Barre syndrome in which patients present with rapidly progressive symmetrical limb weakness and loss of reflexes is an important complication. Rhabdomyolysis due to COVID 19 has also been reported.
Q How is the management of patients with neurological issues being treated?
Management of patients with COVID-19 and stroke remains an area in need of further investigation. Hospital protocols that screen for and quickly recognize stroke are complicated by coexisting respiratory and other complications in these patients, which may require deep sedation in those who are critically ill, obscuring recognition of neurologic changes. Stroke networks, designed to rapidly triage patients to centers where acute stroke treatments including thrombectomy can be rapidly performed, have been disrupted by fractured transfer protocols in hospital systems stretched to the limit at the height of the pandemic. Secondary prevention strategies including anti thrombotic medications may need to be modified in patients who increasingly present with both clotting and hemorrhagic complications.
Q What are the major areas of the Central Nervous System of the human body being affected due to Covid19?
Neurologic complications have not been limited to the central nervous system (CNS). Like other SARS viruses, reports of SARS-CoV-2 neuromuscular complications have emerged; including cases of presumably post infectious Guillain-Barre syndrome and a muscle disorder characterized by myalgias and elevated creatine kinase levels in serum. The pandemic has also once again made neurologists keenly aware of striking disparities of care in the field. Well-established differences in the rates and severity of conditions such as stroke, epilepsy, and dementia among patients with varied socioeconomic and ethnic backgrounds have been compounded by a pandemic that disproportionally affects many of these same groups. Neurologists are challenged more than ever to directly address these disparities to ensure the provision of equitable and outstanding care for all persons with diseases of the nervous system, regardless of their background.
Q How important is Music Therapy in combatting Covid19?
Neurology is an art, if we master this skillfully, the subject becomes wonderful. Neurology combines Science and Art together. Every Neurologist is an artiste and every artiste is a Neurologist, as we deal with the mind of an individual, the rhythm in music instructs the brain.
Music Therapy (MT) is used in a wide spectrum of neurological disorders like Autism, Stroke, Parkinson’s Disease, Alzheimer’s disease, Traumatic Brain Injury, especially during Covid pandemic worldwide. Though evidence may be limited on some methods, sound healing has been found to be effective for stress reduction and relaxation and has been shown to offer many health benefits. Vibroacoustic sound therapy improves pain management and more. When we hear a rhythm or song it activates the auditory system which activates motor system at a subconscious level. In Stroke which the commonest neurological emergency it has been found that MT improve three areas of functioning with survivor’s motor speech and cognition. MT can induce changes in brain plasticity and cause activation of auditory-motor circuits that improve motor skills after stroke. It has a striking effect on Alzheimer’s disease also. There exists a branch of MT that deals specifically with speech disorder called Melodic Intonation Therapy.
So there is functional recovery with improvements in socialisation, motivation mood and depression in the post recovery of Covid 19. MT has enabled some autistic children to relate to others and to have improved learning skills. Listening to music can have a tremendously relaxing effect on the minds and bodies, especially slow, quiet classical music.This type of music can have a beneficial effect on our physiological functions, slowing the heart rate, lowering blood pressure, and decreasing the levels of stress hormones, which is very important in the Covid era especially