Music and anxiety in Williams syndrome: a harmonious or discordant relationship?

In this two-part study, we assessed musical involvements in two samples of persons with Williams syndrome compared to others with mental retardation and also related musicality to anxiety and fears in Study 2. Relative to others with mental retardation, those with Williams syndrome were more likely to take music lessons, play an instrument, and have higher ratings of musical skills. In the Williams syndrome groups only, fewer externalizing symptoms were associated with listening to music, whereas less anxiety and fewer fears were associated with the frequency, duration, and skill in producing music as well as emotional responses to negatively toned music. Implications are discussed for future research on musical processing, musical interventions, and well-being in Williams syndrome and other groups.     

Music play therapy: An integrated approach

The concept of integrating some of the basic principles of nondirective play therapy and music therapy provides a basis for a new combined therapy modality best called nondirective music play therapy. Nondirective music play therapy takes place in a playroom supplied with musical instruments instead of toys and other traditional play therapy materials. As in nondirective play therapy, a child is free to play out his feelings. Musical instruments are both structured and unstructured. The unstructured aspect of musical instruments allows for exploration of feelings, as do traditional play therapy materials. However, musical instruments, and music itself (by virtue of the implied association), also have a strong inherent structure. A child typically soon tires of random exploration and seeks to play a specific melody or rhythmic pattern, or becomes involved in a shared musical relationship with the therapist. At this point, a child voluntarily commits himself to a structure, which can then be manipulated for his benefit. This combination of freedom and structure can be of great value for many types of children. A case study of a moderately retarded boy in a music play therapy setting is presented in detail and the clinical possibilities of this approach are demonstrated.     

L’anhédonie musicale : des neurosciences à la psychiatrie

Music has always been part of our culture. Listening to it can convey strong and many emotions in humans. By its capacity to move us, it occupies an important value in the lives of people. There are important differences in the ability to enjoy listening to music. Some people will find music more enjoyable than others. Part of the population is unable to experience pleasure, or has lost the ability to do so. This fact is called “musical anhedonia”. Mas-Herrero et al. have developed a psychometric instrument that studies this sensitivity to musical reward; this is the “Barcelona Music Reward Questionnaire”. Mas-Herrero et al. in 2014, measured the physiological responses of subjects insensitive to music. They found that these people had no changes in their heart rate, temperature or sweat levels when listening to a piece of music, as well as no subjective sensations such as a chill. They thus confirmed the existence of this musical anhedonia. It is to be distinguished from amusia, which concerns the capacities of sensory perception to music. Amusia, that is not associating with the presence of musical anhedonia, is a rare phenomenon, which appears to involve the lower right frontal gyrus and the upper and right middle temporal gyrus. It is most often the consequence of ischemic or hemorrhagic vascular injury and is more frequent and severe in the presence of an injury to the right hemisphere. Several studies highlight the existence of a musical anhedonia in healthy subjects, not depressed, in the absence of amusia, but also in the absence of a loss of pleasure to the presentation of other stimuli, such as money in particular. We speak of “specific” musical anhedonia to describe a loss of pleasure that only concerns musical stimuli. It is a rare phenomenon. There does not seem to be a relationship between a perception deficit and musical anhedonia. In 5% of people, musical anhedonia is congenital. It can also be acquired following focal brain lesions of various locations. In this case, people with it have lost their ability to enjoy listening to music, which they were likely to experience before. Musical reward appears to be processed by the connectivity that exists between the auditory cortical areas, responsible for analyzing musical content and located at the level of the superior temporal gyrus, and areas of the reward system, responsible for assigning a value, such as the nucleus accumbens (at the level of the ventral striatum), the caudate nucleus (at the level of the dorsal striatum) and the limbic system (amygdala and anterior insula). The enjoyment of listening to music varies from individual to individual on a spectrum from musical anhedonia to musicophilia. Thus, some people are more sensitive than others to the emotional stimuli generated by music. The “Barcelona Music Reward Questionnaire” by Mas-Herrero et al. allows individuals to be divided into three classes according to their emotional and sensory experience of music: “anhedonic”, “hedonic” and “highly hedonic” or musicophiles. The context in which a melody is heard for the first time would be crucial. Indeed, there would be an association between a positive or negative emotional experience with music. It also appears that the same neural circuits are activated when listening to sad or happy music, resulting in dopaminergic release. Musical pleasure seems to remain intact in a wide variety of neurological disorders involving impaired cognitive functions, such as Alzheimer's disease, frontotemporal dementia and even Parkinson's disease. Anhedonia is one of the psychopathological features present in many mental disorders such as major depression and schizophrenia. Although anhedonia is a major symptom of depression, the literature on the subject has not yet established the link between musical anhedonia and depression. When it comes to schizophrenia, anhedonia can be considered a negative symptom of the disease. To date, we have not found any studies linking depression and loss of pleasure specific to music.     

The Role of Music in a Salutogenic Approach to Health

This article introduces the reader to the role of music in a salutogenic approach to health, focusing on lay musical practice in public health policy and mental health promotion. Several participants reported how they used music as an alternative to medication or medical treatment, often transcending pain and suffering through personal, musical practices. The participants described how musicking can enhance coping mechanisms, providing a sense of coherence and zest for life, for example how using music may activate individuals in difficult periods in their lives, and retrieve or mobilise a stronger self. Individuals have learned how listening, playing and singing for self or others can be used as a ‘technology’ to achieve a sense of wholeness in body and mind, often described as ‘musicking’. According to mood, context, need or situation, it is the combination of musical practices, properties and activities that tends to produce a personal or social healing effect.     

Aspects of psychotherapies. Music therapy and its specificity]

Musicotherapy, associating art and science, concerns a sensorial approach, in a therapeutic aim, through sound and music, to psychological difficulties, of numerous somatic and psychosomatic troubles, as well as neurotic and psychotic disease. Music therapy is one of the art-therapy methods, all of them dealing with mediation in reference to Winnicott, leading the patients to active and creative participation and being most of the time shorter than classical verbal therapies. It may be considered as being related to the main theories of modern psychotherapies, and refers either to Psychoanalysis or to behaviour therapies, or to cognitive therapies, or to humanistic therapies ... but, whatever its main basic theory, musicotherapy shows its specificity. Its specific features are: the variety and complexity of its techniques; the specificity of the therapeutic relation; patient, music, and therapist are united through a triangular relationship; transference is of a special quality; the way the therapist answers the patient and helps him may be either verbal or musical. Practising music and listening to music must not be considered as a therapy. Music is not therapeutic in itself. It becomes so when music is used in techniques organised in a therapeutic aim. Musicotherapy may be necessary for a patient who suffers, who asks to be helped and who finds through music a way of expression and communication. The therapeutic aim has nothing to do with musical training. Musicotherapy concerns children as well as adults and elderly people, but requires different techniques adapted to the category of patients.(ABSTRACT TRUNCATED AT 250 WORDS)     

Expectations of hospitalized cancer and cardiac patients regarding the medical and psychotherapeutic benefits of music therapy

Cancer and cardiac patients were surveyed to determine if their expectations regarding the potential medical and psychotherapeutic benefits of music therapy and the relative effectiveness of different musical activities and styles would vary according to diagnostic group, and musical background. A total of 182 patients participated, 55 with various forms of cancer, and 127 with various cardiac conditions. The mean age was 59.8 years. The results showed that their expectations varied in certain benefit areas, music activities, and musical styles, according to: whether the patient had cancer or a cardiac condition, whether the patient had received music therapy previously, and whether the patient had studied music previously. Implications are drawn for introducing music therapy to cancer and cardiac patients.     

Modularity of music: evidence from a case of pure amusia

A case of pure amusia in a 20 year old left handed non-professional musician is reported. The patient showed an impairment of music abilities in the presence of normal processing of speech and environmental sounds. Furthermore, whereas recognition and production of melodic sequences were grossly disturbed, both the recognition and production of rhythm patterns were preserved. This selective breakdown pattern was produced by a focal lesion in the left superior temporal gyrus. This case thus suggests that not only linguistic and musical skills, but also melodic and rhythmic processing are independent of each other. This functional dissociation in the musical domain supports the hypothesis that music components have a modular organisation. Furthermore, there is the suggestion that amusia may be produced by a lesion located strictly in one hemisphere and that the superior temporal gyrus plays a crucial part in melodic processing.     

Musical and poetic creativity and epilepsy

Associations between epilepsy and musical or poetic composition have received little attention. We reviewed the literature on links between poetic and musical skills and epilepsy, limiting this to the Western canon. While several composers were said to have had epilepsy, John Hughes concluded that none of the major classical composers thought to have had epilepsy actually had it. The only composer with epilepsy that we could find was the contemporary composer, Hikari Oe, who has autism and developed epilepsy at age 15 years. In his childhood years, his mother found that he had an ability to identify bird sound and keys of songs and began teaching him piano. Hikari is able to compose in his head when his seizures are not severe, but when his seizures worsen, his creativity is lost. Music critics have commented on the simplicity of his musical composition and its monotonous sound.Our failure to find evidence of musical composers with epilepsy finds parallels with poetry where there are virtually no established poets with epilepsy. Those with seizures include Lord George Byron in the setting of terminal illness, Algernon Swinburne who had alcohol-related seizures, Charles Lloyd who had seizures and psychosis, Edward Lear who had childhood onset seizures, and Vachel Lindsay. The possibility that Emily Dickinson had epilepsy is also discussed.It has not been possible to identify great talents with epilepsy who excel in poetic or musical composition. There are few published poets with epilepsy and no great composers. Why is this? Similarities between music and poetry include meter, tone, stress, rhythm, and form, and much poetry is sung with music. It is likely that great musical and poetic compositions demand a greater degree of concentration and memory than is possible in epilepsy, resulting in problems retaining a musical and mathematical structure over time. The lack of association between recognizable neuropsychiatric disorders and these skills is a gateway to understanding facets of the relationship between the brain and creativity.This article is part of a Special Issue entitled “Epilepsy, Art, and Creativity”.     

Musicality Correlates With Sociability and Emotionality in Williams Syndrome

Williams syndrome (WS) is a neurogenetic developmental disorder characterized by peaks and valleys of cognitive abilities. One peak that has been understudied is the affinity that many individuals with WS have with music. It remains unknown whether their high levels of musical interest, skill, and expressivity are related to their sociable personality or their verbal intelligence. We examined the relationships between musicality (musical interest, creativity, and expressivity), sociability (social-emotionality, social approach), and language comprehension in WS and typically developing (TD) controls. Findings suggest that emotion-expressivity through music in WS may be linked to sensitivity and responsivity to emotions of others, whereas general interest in music may be related to greater linguistic capacity in TD individuals. Musicality and sociability may be more closely related in WS relative to typical development. Implications for future interventions for this neurodevelopmental condition are discussed.     

Constructing a grounded theory of young people's recovery of musical identity in mental illness

Musical identity is a highly relevant, yet little researched area within mental illness. In this study, the researchers explore how 11 young people's musical identities changed during their experiences of, and recovery from mental illness. The researchers use a constructivist grounded theory approach to collect and analyse in-depth interviews with young people attending a music therapy programme at a youth mental health service. Findings are presented as a constructivist grounded theory of young people's recovery of musical identity. This interpretation illustrates how aspects of these young people's pathology presents as ‘musical symptoms’ during acute illness and the ways in which young people engage in processes of ‘bridging’ and ‘playing out’ musical identity in the community. The role of music therapy in supporting young people's recovery from mental illness is presented, and the need to consider community-based music services is discussed.     

Music and epilepsy: a critical review

The effect of music on patients with epileptic seizures is complex and at present poorly understood. Clinical studies suggest that the processing of music within the human brain involves numerous cortical areas, extending beyond Heschl's gyrus and working within connected networks. These networks could be recruited during a seizure manifesting as musical phenomena. Similarly, if certain areas within the network are hyperexcitable, then there is a potential that particular sounds or certain music could act as epileptogenic triggers. This occurs in the case of musicogenic epilepsy, whereby seizures are triggered by music. Although it appears that this condition is rare, the exact prevalence is unknown, as often patients do not implicate music as an epileptogenic trigger and routine electroencephalography does not use sound in seizure provocation. Music therapy for refractory epilepsy remains controversial, and further research is needed to explore the potential anticonvulsant role of music. Dopaminergic system modulation and the ambivalent action of cognitive and sensory input in ictogenesis may provide possible theories for the dichotomous proconvulsant and anticonvulsant role of music in epilepsy. The effect of antiepileptic drugs and surgery on musicality should not be underestimated. Altered pitch perception in relation to carbamazepine is rare, but health care professionals should discuss this risk or consider alternative medication particularly if the patient is a professional musician or native-born Japanese. Studies observing the effect of epilepsy surgery on musicality suggest a risk with right temporal lobectomy, although the extent of this risk and correlation to size and area of resection need further delineation. This potential risk may bring into question whether tests on musical perception and memory should form part of the preoperative neuropsychological workup for patients embarking on surgery, particularly that of the right temporal lobe.     

Interaction between musical emotion and facial expression as measured by event-related potentials

We examined the integrative process between emotional facial expressions and musical excerpts by using an affective priming paradigm. Happy or sad musical stimuli were presented after happy or sad facial images during electroencephalography (EEG) recordings. We asked participants to judge the affective congruency of the presented face–music pairs. The congruency of emotionally congruent pairs was judged more rapidly than that of incongruent pairs. In addition, the EEG data showed that incongruent musical targets elicited a larger N400 component than congruent pairs. Furthermore, these effects occurred in nonmusicians as well as musicians. In sum, emotional integrative processing of face–music pairs was facilitated in congruent music targets and inhibited in incongruent music targets; this process was not significantly modulated by individual musical experience. This is the first study on musical stimuli primed by facial expressions to demonstrate that the N400 component reflects the affective priming effect.     

Playing piano in the mind--an fMRI study on music imagery and performance in pianists

Reading of musical notes and playing piano is a very complex motor task which requires years of practice. In addition to motor skills, rapid and effective visuomotor transformation as well as processing of the different components of music like pitch, rhythm and musical texture are involved. The aim of the present study was the investigation of the cortical network which mediates music performance compared to music imagery in 12 music academy students playing the right hand part of a Bartok piece using functional magnetic resonance imaging (fMRI). In both conditions, fMRI activations of a bilateral frontoparietal network comprising the premotor areas, the precuneus and the medial part of Brodmann Area 40 were found. During music performance but not during imagery the contralateral primary motor cortex and posterior parietal cortex (PPC) bilaterally was active. This reflects the role of primary motor cortex for motor execution but not imagery and the higher visuomotor integration requirements during music performance compared to simulation. The notion that the same areas are involved in visuomotor transformation/motor planning and music processing emphasizes the multimodal properties of cortical areas involved in music and motor imagery in musicians.     

The advantage of a decreasing right-hand superiority: the influence of laterality on a selected musical skill (sight reading achievement)

In this study, the unrehearsed performance of music, known as 'sight reading', is used as a model to examine the influence of motoric laterality on highly challenging musical performance skills. As expertise research has shown, differences in this skill can be partially explained by factors such as accumulated practise and an early start to training. However, up until now, neurobiological factors that may influence highly demanding instrumental performance have been widely neglected. In an experiment with 52 piano students at a German university music department, we could show that the most challenging musical skill, sight reading (which is characterized by extreme demands on the performer's real time information processing), is positively correlated with decreasing right-hand superiority of performers. Laterality was measured by the differences between left and right-hand performance in a speed tapping task. SR achievement was measured using an accompanying task paradigm. An overall superiority of 22% for non-right-handed pianists was found. This effect is gender-related and stronger in non-right-handed males (r(24) = -0.49, p<0.05) than in non-right-handed females (r(28) = -0.16, p>0.05). We conclude that non-right-handed motoric laterality is associated with neurobiological advantages required for sight reading, an extremely demanding musical subskill.     

A case of musical agraphia

Damage to the left upper parietal lobule causes pure agraphia. However, we experienced a patient who exhibited musical agraphia following such a lesion after the agraphia improved. The patient was a 53-year-old female piano teacher. After surgery, she exhibited agraphia and musical agraphia. There was no expressive amusia, receptive amusia, aphasia, agnosia or apraxia. Fifteen months post-surgery, when her agraphia had resolved, her abilities to read, write, and copy music were evaluated. She could read and write single notes and musical signs, but her ability to write a melody was seriously impaired. Furthermore, the salient impairment was in writing rhythm rather than pitch. She could copy music, but only slowly. We consider her a case of pure musical agraphia.     

Music therapy for dementia and higher cognitive dysfunction: a review

Music is known to affect the human mind and body. Music therapy utilizes the effects of music for medical purposes. The history of music therapy is quite long, but only limited evidence supports its usefulness in the treatment of higher cognitive dysfunction. As for dementia, some studies conclude that music therapy is effective for preventing cognitive deterioration and the occurrence of behavioral and psychological symptoms of dementia (BPSD). In patients receiving music therapy for the treatment of higher cognitive dysfunction, aphasia was reported as the most common symptom. Many studies have been conducted to determine whether singing can improve aphasic symptoms: singing familiar and/or unfamiliar songs did not show any positive effect on aphasia. Melodic intonation therapy (MIT) is a method that utilizes melody and rhythm to improve speech output. MIT is a method that is known to have positive effects on aphasic patients. Some studies of music therapy for patients with unilateral spatial neglect; apraxia; hemiparesis; and walking disturbances, including parkinsonian gait, are available in the literature. Studies showed that the symptoms of unilateral spatial neglect and hemiparesis significantly improved when musical instruments were played for several months as a part of the music therapy. Here, I describe my study in which mental singing showed a positive effect on parkinsonian gait. Music is interesting, and every patient can go through training without any pain. Future studies need to be conducted to establish evidence of the positive effects of music therapy on neurological and neuropsychological symptoms.     

The sound of music: differentiating musicians using a fast, musical multi-feature mismatch negativity paradigm

Musicians' skills in auditory processing depend highly on instrument, performance practice, and on level of expertise. Yet, it is not known though whether the style/genre of music might shape auditory processing in the brains of musicians. Here, we aimed at tackling the role of musical style/genre on modulating neural and behavioral responses to changes in musical features. Using a novel, fast and musical sounding multi-feature paradigm, we measured the mismatch negativity (MMN), a pre-attentive brain response, to six types of musical feature change in musicians playing three distinct styles of music (classical, jazz, rock/pop) and in non-musicians. Jazz and classical musicians scored higher in the musical aptitude test than band musicians and non-musicians, especially with regards to tonal abilities. These results were extended by the MMN findings: jazz musicians had larger MMN-amplitude than all other experimental groups across the six different sound features, indicating a greater overall sensitivity to auditory outliers. In particular, we found enhanced processing of pith and sliding up to pitches in jazz musicians only. Furthermore, we observed a more frontal MMN to pitch and location compared to the other deviants in jazz musicians and left lateralization of the MMN to timbre in classical musicians. These findings indicate that the characteristics of the style/genre of music played by musicians influence their perceptual skills and the brain processing of sound features embedded in a musical context. Musicians' brain is hence shaped by the type of training, musical style/genre, and listening experiences.     

Pleasurable emotional response to music: A case of neurodegenerative generalized auditory agnosia

Recent functional neuroimaging studies implicate the network of mesolimbic structures known to be active in reward processing as the neural substrate of pleasure associated with listening to music. Psychoacoustic and lesion studies suggest that there is a widely distributed cortical network involved in processing discreet musical variables. Here we present the case of a young man with auditory agnosia as the consequence of cortical neurodegeneration who continues to experience pleasure when exposed to music. In a series of musical tasks, the subject was unable to accurately identify any of the perceptual components of music beyond simple pitch discrimination, including musical variables known to impact the perception of affect. The subject subsequently misidentified the musical character of personally familiar tunes presented experimentally, but continued to report that the activity of ‘listening’ to specific musical genres was an emotionally rewarding experience. The implications of this case for the evolving understanding of music perception, music misperception, music memory, and music-associated emotion are discussed.     

Amusie acquise et anhédonie musicale

Amusia is defined as an auditory agnosia, specifically related to music, resulting from a cerebral lesion or being of congenital origin. Amusia is rarely associated to musical anhedonia. We report the case of a 43-year-old patient who suffered in January 2012 from a right ischemic lesion affecting the superior temporal cortex, in particular lateral Heschl Gyrus and the posterior part of the Superior Temporal Gyrus (Brodmann areas 21 and 22). Neuropsychological tests revealed an amusia combined to musical anhedonia. The specificity of this case is based on the combination of both syndromes highlighting the relation between neural networks involved in the processing of musical information in both its perceptual and emotional components.     

Neural discrimination of nonprototypical chords in music experts and laymen: an MEG study

At the level of the auditory cortex, musicians discriminate pitch changes more accurately than nonmusicians. However, it is not agreed upon how sound familiarity and musical expertise interact in the formation of pitch-change discrimination skills, that is, whether musicians possess musical pitch discrimination abilities that are generally more accurate than in nonmusicians or, alternatively, whether they may be distinguished from nonmusicians particularly with respect to the discrimination of nonprototypical sounds that do not play a reference role in Western tonal music. To resolve this, we used magnetoencephalography (MEG) to measure the change-related magnetic mismatch response (MMNm) in musicians and nonmusicians to two nonprototypical chords, a "dissonant" chord containing a highly unpleasant interval and a "mistuned" chord including a mistuned pitch, and a minor chord, all inserted in a context of major chords. Major and minor are the most frequently used chords in Western tonal music which both musicians and nonmusicians are most familiar with, whereas the other chords are more rarely encountered in tonal music. The MMNm was stronger in musicians than in nonmusicians in response to the dissonant and mistuned chords, whereas no group difference was found in the MMNm strength to minor chords. Correspondingly, the length of musical training correlated with the MMNm strength for the dissonant and mistuned chords only. Our findings provide evidence for superior automatic discrimination of nonprototypical chords in musicians. Most likely, this results from a highly sophisticated auditory system in musicians allowing a more efficient discrimination of chords deviating from the conventional categories of tonal music.