Julie Stillman was 55 years old when a blood vessel in her brain suddenly burst. The hemorrhagic stroke left her unable to form a simple sentence—a severe blow to a woman who had built a career in book publishing.
It also robbed her of the ability to speak properly. But not the ability to sing.
Now 69, Stillman is one of dozens of stroke and brain injury survivors who are raising their voices with glee as part of the Vermont aphasia choir. There are a few choirs popping up all over the world, giving stroke survivors and people with dementia or other brain injuries a chance to take advantage of one of the few remaining means of communication for them.
“To hear that clarity and volume, it’s like magic,” said Stillman’s husband, Jeff Nagel, whose last smooth conversation he had with his wife 14 years ago on the phone, an hour before finding her on the floor of their home. “It is amazing to see this happen.”
Nearly a third of people who survive strokes have aphasia, a speech disorder that makes it difficult to express or understand language as a result of damage to the brain. But scientists have long known that even when people with certain types of aphasia lose the ability to speak, they are often able to sing, a phenomenon attributed to the various brain regions responsible for producing music and language.
Studies of this phenomenon and how music affects the brain have led to the development of a variety of music-assisted therapies, such as melodic toning therapy, which trains stroke survivors to communicate rhythmically to build stronger connections between brain regions. Other treatments focus on listening to music or teaching people to play musical instruments, such as keyboards or drums.
A growing body of research shows that these types of treatments can play an important role in helping stroke survivors recover.
As early as 2008, researchers published work in the journal Brain that showed that simply listening to music for an hour each day improved memory and attention, as well as mood, during the early stages of stroke recovery. A follow-up to that study in 2014 provided insights into how and why: Listening to music stimulated structural changes in the areas of the brain responsible for verbal memory, language skills, and focused attention. Going deeper, the investigators were able to show that audio music was superior to instrumental music or listening to audio books in stimulating brain changes that led to the recovery of memory and language.
Karen McFeeters Leary, the speech-language pathologist who founded the Vermont Aphasia Choir, knew stroke survivors could sing from her speech-pathology studies.
“When we assess people who have a stroke or a speech impairment, we always check their ability to sing,” said Leary, who is also a singer-songwriter.
Stillman and Nagel were among the first to join when Leary launched the choir in 2014, with only 11 stroke survivors and their spouses and caregivers. Since then, the group has doubled in size. She is recruited through stroke support groups and the University of Vermont, which has a speech-language pathology program and an outpatient clinic.
To her surprise, the chorus quickly turned into something much more than an opportunity for people to express themselves through the song. Help create a community for people who have become socially isolated because of their condition. “They lose friendships, sometimes husbands,” Leary said. “I feel very lonely.”
But through the choir, they find others who understand what they are going through. “Common experience, that’s the big thing,” she said. “I’ve seen some very depressed individuals definitely find themselves thriving again.”
“The choir was a wonderful support group in a different way than what we had in speech therapy,” Nagel said. “We made a lot of friends.”
And through those friendships, they expanded Stillman’s ability to resume some of her old hobbies, such as the love of boats. Another choir member introduced them to an adaptive rowing group in which stroke survivors and others with physical disabilities use special equipment that allows them to row with one arm. They are now active participants in both groups, enjoying a social life they never thought they would see again.
Nagle also believes his wife’s language abilities improve during choral season, which runs from March through June, when it culminates in a free public concert.
Researchers such as Pablo Ripollés say it’s possible that daily musical engagement can make a difference. As assistant professor of psychology and co-director of the New York University Music and Sound Research Laboratory in New York City, Ripollés was one of a group of researchers who identified how listening to music alters brain structure in stroke survivors.
Ripolis said scientists know that providing a rich environment can stimulate the brain and promote recovery after a stroke. His research has focused on using music to provide this enrichment, especially during the early stages of recovery when people are limited in what they can do.
“There is one thing you can do for these patients, even when they are in bed,” he said. “Maybe they can’t move well, but you can provide a rich environment by having them listen to music.”
The benefits of music therapy can vary, and the amount of damage the stroke has caused to the brain affects how well it can recover. “We have good evidence that music therapy works in people who haven’t had a catastrophic brain injury,” Ripolis said. “Maybe a major one, but it’s not disastrous.”
He said more research is needed to see if music therapy can be more effective than traditional speech therapies. But in the meantime, stroke survivors can listen to their favorite music or join a choir, if one is available in their area.
“This is something you can do on your own and for free,” Ripolis said. “It won’t hurt you, and it might do you some good.”