Objective: The objective of this study was to examine the potential mechanisms associated with improvement in clinical motor symptoms in persons with Parkinson’s disease (PD).

Background: Research has revealed that group therapeutic singing (GTS) is an effective treatment strategy to improve respiratory control and muscle activity associated with swallow in persons with PD. GTS can also be enjoyable and offer a way to relieve stress, have fun, and improve other motor symptoms. Yet, the underlying mechanism that may explain the significant improvements with GTS remain unknown.

Method: Seventeen participants with PD that engage in weekly group singing completed the study. Participants were tested on medication and had been singing in the group for a mean of 2.4 ± 1.4 years. Self-report and physiological data were collected prior to and after 1 hour of GTS. The Unified Parkinson’s Disease Rating Scale (UPDRS) was collected to assess clinical motor symptoms and later scored by a trained rater masked to pre/post collection. Subjective measures of anxiety, sadness, happiness, and anger were also collected to measure emotion and affect. Heart rate, blood pressure, and salivary cortisol provided an index of physiological stress. Inflammatory cytokines were isolated from the serum and provided an index of neural inflammation. Finally oxytocin was also isolated from the serum and provided an index of bonding.

Results: Motor symptoms significantly improved (p = 0.026) after one session of GTS. Participants subjectively felt less anxious (p = 0.05) and less sad (p = 0.002) after the singing group. There were no significant differences in happiness or anger. Heart rate, blood pressure, and cortisol levels were also reduced, but did not reach significance. In addition, inflammatory cytokines and oxytocin did not reach significance. When examining the relationship between the physiological outcome measures and the change in motor UPDRS, a significant association between change in cortisol and motor UPDRS was revealed (R = 0.560, p = 0.047). No other associations were revealed.

Conclusion: These results suggest that a reduction in physiological stress due to GTS may be related to improvements in motor symptoms. GTS holds promise as an alternative treatment strategy for persons with PD that has a broad impact on motor symptoms, stress, and quality of life.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/mechanisms-underlying-therapeutic-group-singing-in-persons-with-parkinsons-disease/