How singing in a choir might help people find their voices after a stroke

After Serge Belloncik suffered a stroke in 2022, he developed aphasia, a communication disorder affecting his ability to speak. 

It was a life-changing adjustment for the 81-year-old scientist and former professor, long accustomed to giving conferences and delivering lectures.

Since then, his communication has improved, but he still has trouble.

“Sometimes I must find my words,” he says. “Sometimes I speak, and sometimes I stop.”

Now, Belloncik is taking part in a study to determine if singing in a choir can help people with aphasia in their recovery. Every week, he gets together with a small group of others with aphasia at a Montreal community centre. 

On a recent fall morning, after doing vocal tests and putting on a heart-rate monitor for researchers to track, Belloncik sat with three others behind a music stand and began to sing.

Accompanied by their vocal director on piano, they began a gentle rendition of the well-known Quebec song, Gens du pays.

Belloncik says being part of the study has been a positive experience so far. 

“I like it because it gives me occasion to speak, and to find my old voice.”

Aphasia and music

The randomized controlled trial is led by Anna Zumbansen, a professor with the school of rehabilitation sciences at the University of Ottawa, and is part of the SingWell initiative, an international network of researchers studying group singing. It involves 12 weekly choir sessions at four different sites, with participants who have developed aphasia from strokes. 

There are sites in Montreal, Toronto, Ottawa and Tampa Bay, Fla. 

“We are hoping this study will demonstrate that choir activity is really good for people,” said Édith Durand, an assistant speech-language pathology professor at the Université de Québec à Trois-Rivières and one of the study’s researchers. 

“Good for their language, but good for their social relations, too,” Durand said, explaining that aphasia can lead to a drop in social participation.

WATCH | A look at how the choir works:

Can joining a choir help stroke survivors? Researchers want to find out

A Quebec-based study is looking to find out whether singing in a choir can help the recovery of stroke survivors with aphasia — a condition that affects the ability to understand or produce speech.

Previous studies have suggested singing can help people with aphasia improve their capacity to express themselves, said Dr. Alexander Thiel, a stroke neurologist at the Jewish General Hospital in Montreal, who is not involved in the study. 

A practice called melodic intonation therapy focuses on the part of the brain not affected by the stroke — often the left side, which controls language, is affected in cases of aphasia — to modulate communication through non-language functions, like rhythm and pitch.

“Offering this in the setting of a choir, of course, has a much broader meaning,” said Thiel. “Speech is not only functional in the way that we communicate with each other; it also has the social dimension.”

Thiel said right now, treatment for aphasia focuses primarily on the acute phase, or the weeks and months after the stroke. Typically, patients are evaluated and assessed by speech language pathologists for rehabilitation therapy, which can help reactivate the part of the brain that controls speech. 

Doesn’t work for all

But, he said, that doesn’t work for everyone. 

“If the damage is very large, there are no more networks we can tap in on the left hemisphere,” he said. “Then there are right-sided hemisphere regions which can take over, to a certain extent.”

That’s where music comes in. Non-language functions like pitch, Thiel said, are processed in the brain’s other hemisphere and may be leveraged to help with communication.

A recent systematic review of trials using music-based interventions found while they showed therapeutic potential, like helping in the ability to name objects, the strength of the evidence remains limited. 

Thiel said that’s why more research like Durand’s is needed, to confirm whether these kinds of therapies, done in groups, are effective for aphasia and whether positive impacts can last long term.

“We are upping the bar of scientific rigour here,” said Frank Russo, a psychology professor at Toronto Metropolitan University and the founder of SingWell. 

“If there is something concrete when it comes to the clinical outcomes,” he said, “then I think we are ready to share this with clinicians around the world who may be interested in supplementing what speech language pathologists are doing.”

Belloncik is hopeful the study will add to the body of research around aphasia and how to treat it. 

“Maybe I can prove that it’s efficient, and that this can be good to apply for others.”