Les effets des interventions musicales sur le fonctionnement cognitif chez une population cérébrolésée : une revue systématique de la littérature

Les lésions cérébrales acquises (LCA), qu’il s’agisse d’un accident vasculaire cérébral (AVC) ou d’un traumatisme cranio-cérébral (TCC), résultent en conséquences sévères. La littérature révèle entre autres, une altération de la cognition dont notamment des déficits des fonctions exécutives, attentionnelles et mnésiques. À la suite d’un AVC, une négligence visuo-spatiale est aussi fréquemment observée. Afin de stimuler ces fonctions cognitives, des interventions musicales (IM) ont été employées dans la réhabilitation neurologique des individus cérébrolésés. Cette revue systématique vise à 1) recenser les effets des IM sur la cognition chez une population cérébrolésée adulte; 2) décrire les modalités des IM utilisées; 3) jauger de l’adéquation des outils psychométriques administrés en regard de la fonction cognitive évaluée. Quatre bases de données informatisées ont été sondées. Les études expérimentales, quasi-expérimentales et intra-sujets présentant un échantillon de participants AVC ou TCC modéré ou sévère (phase subaiguë ou chronique) ont été incluses. Toute étude dispensant une IM et mesurant son effet sur la cognition par le biais d’outils psychométriques normés a été incluse. Quatorze études ont été retenues par la méthode PRISMA. Les résultats permettent de constater l’efficience des IM actives sur la flexibilité cognitive et sur la négligence visuo-spatiale. Les données sont trop peu nombreuses pour statuer de l’efficacité des IM sur les fonctions attentionnelles et mnésiques. L’hétérogénéité des modalités des IM dispensées contraint la formulation de recommandations à cet effet. Les définitions des fonctions évaluées devraient être approfondies et le choix des outils optimisé, et ce, en considérant les effets de pratique et de plafond. Cette recension permet d’orienter les recherches futures et contribuent à la réflexion quant aux IM proposées et les épreuves neuropsychologiques administrées chez la population cérébrolésée. Acquired brain injury (ABI) whether it is a stroke or a traumatic brain injury (TBI), results in severe consequences for the affected individuals. The literature reveals, among other things, an alteration in cognition, including deficits in executive, attentional and memory functions. Visuospatial neglect is also frequently observed following a stroke. In order to stimulate these cognitive functions, musical interventions (MI) have been employed in the neurological rehabilitation of brain injured individuals. The aim of this systematic review is; 1) identify and synthesize findings regarding the effects of MI on cognition in an adult brain-injured population; 2) define the modalities and content of the music-based interventions used; 3) determine the relevance and adequacy of the psychometric tools administered regarding the assessed cognitive functions. Four computerized databases were surveyed. Experimental, quasi-experimental and within-subject studies with a sample of participants with stroke or moderate to severe TBI (subacute or chronic phase) were included. Any study providing MI and measuring its effect on cognition using psychometric tools was included. Fourteen studies were retained by the PRISMA method. The results show the efficiency of active musical interventions on executive functions (cognitive flexibility) and on visuospatial neglect. However, there is insufficient data to judge the effectiveness of musical interventions on attentional and memory functions. The heterogeneity of the modalities of dispensed MI hinders the formulation of recommendations. The definitions of the functions evaluated should be defined in-depth the choice of tools optimized, considering the ceiling and practice effects of practice and ceiling. These findings provide guidance for future research and contribute to the development of proposed interventions and neuropsychological tests for adults with acquired brain injury.

Keyphrases: Accident vasculaire cérébral, Interventions musicales, Fonctions exécutives, fonctions attentionnelles, Fonctions mnésiques, Négligence visuo-spatiale, Neuropsychologie clinique, Revue systématique, Cognition, Lésion cérébrale acquise, Traumatisme craniocérébral, Adultes, Acquired brain injury, Cerebrovascular accidents, Traumatic brain injury, Musical interventions, Music therapy, Cognition, Executive functions, Attentional functions, Memory functions, Visuospatial neglect, Adults, Clinical neuropsychology, Systematic review