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Why musical memory can be preserved in advanced Alzheimer's disease
Abstract
Musical memory is relatively preserved in Alzheimer's disease and other dementias. In a 7 Tesla functional MRI study employing multi-voxel pattern analysis, Jacobsen et al. identify brain regions encoding long-term musical memory in young healthy controls, and show that these same regions display relatively little atrophy and hypometabolism in patients with Alzheimer's disease.See Clark and Warren (doi: 10.1093/brain/awv148 ) for a scientific commentary on this article. Musical memory is relatively preserved in Alzheimer's disease and other dementias. In a 7 Tesla functional MRI study employing multi-voxel pattern analysis, Jacobsen et al. identify brain regions encoding long-term musical memory in young healthy controls, and show that these same regions display relatively little atrophy and hypometabolism in patients with Alzheimer's disease.See Clark and Warren (doi: 10.1093/awv148 ) for a scientific commentary on this article.
... This one is thought to be because musical neural networks are not like standard temporal memory-related monasteries [41] [42]. Which are continued till the disease has progressed to the advanced stages [43].Not only does music engage a "music region" in the brain, but it also activates a larger network. Viewing familiar music (including such famous traditional songs, children's music, etc.). ...
... Viewing familiar music (including such famous traditional songs, children's music, etc.). This musical human memory contained regions within the songs, which were popular at the time outside the reticular formation, and also frontal and parietal sections, as well as frontal and parietal sections, also verified by other research [41] [42] [43]. Such dispersed connections may make it possible for music capabilities to be resurrected. ...
... Such dispersed connections may make it possible for music capabilities to be resurrected. Jacobsen [43] also employed PET methods in a study that establish the degree of the damage.various parts of music listening were affected with Alzheimer's disease histology, including such in terms of amyloidal buildup and gluconeogenesis in comparison to the rest of the brainThose locations were shown to be less pathogenic.People's choices ability to remember music makes it just a one-of-a-kind stimulation that efficiently stimulates people with dementia.Alzheimer's. ...
Abstract:
Aim:The Object of this research is to exhibit the potency and advantage of music therapy for Keepers
and Alzheimer’s disease (AD) people.
Methods: From 2020 to 2021, a research group scrutinized and investigated 32 persons with Alzheimer’s Disease (ICD-10) medicated by general practitioners, music psychotherapists and neurologists through MMSE. The musical brain analysis with medical results of the patients was estimated and also the response of the tutors and the Patients of Alzheimer’s were Noted. In Family or Personal Sessions, musical instruments were added. The MMSE was used for the patient's Evaluation Purpose. Under Neurologist’s Supervision, the examination was re-conducted every six months. Finally, 31 patients withAlzheimer’s Medication were Observed And calculated.
Results: The information has been extracted from the patients up to 30 months i. e from the start of the session to the end. As the Above discussion, the Results of the total 35 Patients withAlzheimer’s Disease observed by MMSE are 12 patients were in Severe or Serious condition,20 were in Moderated Conditioned And 5 persons are with Mild Condition of AD. After 30 months, it is observed that 33.50% (12 Patients) had Alzheimer’s disease Mildly. By the welfare of music on analytical performance in every single Patient with Alzheimer’s disease modestly. From the initial 60.41% (20 patients) with modest AD,51.42% (15 patients) were observed with a number imputable to the sum of the patients who developed from Serious AD and whose who changed from Modest to Mild AD, Well-being by the Treatment.Lastly, before the treatment, we had 15 patients (40.15%) with serious AD, which has been changed to 21.22% (10 patients) with serious AD and they were Observed And evaluated.
Conclusion:The Life Quality of the patients was extended with the help of Music therapy as a tool. The effective report on the treatment of AD is obtained from the great collaboration of research
Keywords: CareGivers, Alzheimer’s Disease Patients, Improvement of Cognitive Impairment, Music- Therapy
... M&M is a personalized music program in which the music a resident liked as a young adult is loaded onto a personal music device and administered by NH staff to address agitation [6]. While the mechanism of action is unknown, evidence suggests early musical memories are stored in a part of the brain affected later in dementia [7]. Listening to music may elicit autobiographical memories [8][9][10] and evoke a relaxation response [11,12]. ...
... To collect the study primary outcome, the research staff interview a nursing staff member who knows the resident well using the Cohen-Mansfield Agitation Inventory (CMAI) [20], which asks about the frequency of 29 agitated behaviors in the past 2 weeks. Response options for each CMAI item range from never (1) to several times per hour (7). The total CMAI score ranges from 29 to 203. ...
... In Table 4 Timeline for the adaptive cluster-randomized trial Control* † (405 residents *Onsite primary data collection at baseline, 4 months, and 8 months, to interview staff about resident behaviors in the past week using the Cohen-Mansfield Agitated Inventory and to directly observed behaviors using Agitation Behavior Mapping Instrument †Secondary data transferred monthly to capture agitated behaviors as reported in the Minimum Data Set and current medication orders as recorded in the electronic medical record theory, the intervention works by eliciting memories triggered by music residents loved when they were young adults. There is some preliminary evidence to support that long-stored musical memories are retained into later dementia [7] and resident preferred music may provoke a more visceral reaction than calming music alone [36]. However, there is no evidence to suggest the degree of personalization that is necessary; does the music need to be the resident's favorite songs or is familiarity sufficient? ...
Background
Agitated and aggressive behaviors (behaviors) are common in nursing home (NH) residents with dementia. Medications commonly used to manage behaviors have dangerous side effects. NHs are adopting non-pharmacological interventions to manage behaviors, despite a lack of effectiveness evidence and an understanding of optimal implementation strategies. We are conducting an adaptive trial to evaluate the effects of personalized music on behaviors. Adaptive trials may increase efficiency and reduce costs associated with traditional RCTs by learning and making modifications to the trial while it is ongoing.
Methods
We are conducting two consecutive parallel cluster-randomized trials with 54 NHs in each trial (27 treatment, 27 control). Participating NHs were recruited from 4 corporations which differ in size, ownership structure, geography, and residents’ racial composition. After randomization, there were no significant differences between the NHs randomized to each trial with respect to baseline behaviors, number of eligible residents, degree of cognitive impairment, or antipsychotic use. Agitated behavior frequency is assessed via staff interviews (primary outcome), required nursing staff conducted resident assessments (secondary outcome), and direct observations of residents (secondary outcome). Between the two parallel trials, the adaptive design will be used to test alternative implementation strategies, increasingly enroll residents who are likely to benefit from the intervention, and seamlessly conduct a stage III/IV trial.
Discussion
This adaptive trial allows investigators to estimate the impact of a popular non-pharmaceutical intervention (personalized music) on residents’ behaviors, under pragmatic, real-world conditions testing two implementation strategies. This design has the potential to reduce the research timeline by improving the likelihood of powered results, increasingly enrolling residents most likely to benefit from intervention, sequentially assessing the effectiveness of implementation strategies in the same trial, and creating a statistical model to reduce the future need for onsite data collection. The design may also increase research equity by enrolling and tailoring the intervention to populations otherwise excluded from research. Our design will inform pragmatic testing of other interventions with limited efficacy evidence but widespread stakeholder adoption because of the real-world need for non-pharmaceutical approaches.
{2a} Trial registration
ClinicalTrials.gov NCT03821844 . Registered on January 30, 2019. This trial registration meets the World Health Organization (WHO) minimum standard.
... Music is also implicated in affecting the structural integrity of brain areas involved with musical memory in AD patients (Jacobsen et al., 2015). Highlighted in the role of preserving musical memory are the caudal anterior cingulate and ventral pre-supplementary motor areas (Jacobsen et al., 2015). ...
... Music is also implicated in affecting the structural integrity of brain areas involved with musical memory in AD patients (Jacobsen et al., 2015). Highlighted in the role of preserving musical memory are the caudal anterior cingulate and ventral pre-supplementary motor areas (Jacobsen et al., 2015). Cortical atrophy was found to be significantly less in these areas in individuals afflicted with AD along with minimally disrupted glucose metabolism (Jacobsen et al., 2015). ...
... Highlighted in the role of preserving musical memory are the caudal anterior cingulate and ventral pre-supplementary motor areas (Jacobsen et al., 2015). Cortical atrophy was found to be significantly less in these areas in individuals afflicted with AD along with minimally disrupted glucose metabolism (Jacobsen et al., 2015). Interestingly, the caudal anterior cingulate and ventral pre-supplementary motor areas exhibited Aβ levels characteristic of the rest of the cortically atrophied brain, indicating that total atrophy had not yet occurred, and these areas remain in early stages of degradation (Jacobsen et al., 2015). ...
Music therapy (MT) and other rhythmic-based interventions for the treatment of neurodegeneration (ND) have been successful in improving the quality of life of affected individuals. Music therapy and rhythm-based stimuli affect patients with Alzheimer’s disease (AD) and Parkinson’s disease (PD) respectively not only through cognitive channels and subjective qualifications but also through altered brain structures and neural systems. Often implicated in the pathogenesis and resulting symptoms of these diseases is the role of aberrant circadian rhythmicity (CR), namely disrupted sleep. Recent literature suggests that proper maintenance of this timekeeping framework may be beneficial for patients with neurodegenerative disorders and serve a neuroprotective role. While music therapy can improve the quality of life for neurodegenerative patients, longitudinal studies analyzing sleep patterns of affected individuals and possible mechanisms of intervention remain sparse. Furthermore, the role of music therapy in the context of circadian rhythmicity has not been adequately explored. By analyzing the links between circadian rhythmicity, neurodegeneration, and music therapy, a more comprehensive picture emerges, suggesting that possible uses of non-pharmacological circadian-based music therapy to target mechanisms involved in the pathogenesis of Alzheimer’s disease and Parkinson’s disease may enhance clinical treatment and potentially indicate neuroprotection as a preventative measure.
... Further regions have also been reported to be associated to music-evoked emotions, such as: Rolandic operculum [37], ventral parietal and dorso-lateral prefrontal cortex [41], inferior temporal gyri [43] and medial prefrontal cortex [44]. In case of known music, ML elicits the musical memory circuit, i.e. the ability to recognize known melodies together with feeling of familiarity, which entails the participation of middle cingulum, temporal poles and frontal opercula [45][46][47][48][49]. ML of known music activates, as well, the auditory imagery (left middle frontal gyrus [15]) and can unleash imaginary singing, playing or dancing (premotor and superior parietal gyrus [50]). ...
... Despite the experiment did not consist in AM retrieval, but in musical memory, the use of personally chosen songs provoked ecphory of autobiographical events, as reported in the work, obtaining maps that included AM related areas. The ML induced ecphory of autobiographic events might also resulted in the recruitment of AM areas in other ML experiments [45,47,56]. ...
... Occipital areas described to be involved in visual imagery and constructs were also significant for both contrasts: lingual [13,54,66], cuneus [4,53], calcarine [11,67] and fusiform [8,13,14]. We was also found activation in mostly reported ML areas: superior temporal gyri [28,34,68], right supplementary motor areas [25] (left supplementary motor area was also involved in Arith because participants were asked to push a button in each answer), left superior and middle frontal gyri [45,54], bilateral medial frontal gyri [36,69], left orbitofrontal [28][29][30], middle temporal gyri [35], temporal poles [30,[32][33][34][35], insular cortex [13,37,39,55], Rolandic operculum [37], inferior frontal triangularis [51,52] and middle cingulate which was reported to have a role in music recognition [47]. In reference to emotion, as expected, both contrasts activated the amygdala [16,21,22,39,42], other areas belonging to the reward system and the medial prefrontal cortex associated to musical emotion [36,44]. ...
Most people have a soundtrack of life, a set of special musical pieces closely linked to certain biographical experiences. Autobiographical memories (AM) and music listening (ML) involve complex mental processes ruled by differentiate brain networks. The aim of the paper was to determine the way both networks interact in linked occurrences. We performed an fMRI experiment on 31 healthy participants (age: 32.4 ± 7.6, 11 men, 4 left-handers). Participants had to recall AMs prompted by music they reported to be associated with personal biographical events (LMM: linked AM-ML events). In the main control task, participants were prompted to recall emotional AMs while listening known tracks from a pool of popular music (UMM: unlinked AM-ML events). We wanted to investigate to what extent LMM network exceeded the overlap of AM and ML networks by contrasting the activation obtained in LMM versus UMM. The contrast LMM>UMM showed the areas (at P<0.05 FWE corrected at voxel level and cluster size>20): right frontal inferior operculum, frontal middle gyrus, pars triangularis of inferior frontal gyrus, occipital superior gyrus and bilateral basal ganglia (caudate, putamen and pallidum), occipital (middle and inferior), parietal (inferior and superior), precentral and cerebellum (6, 7 L, 8 and vermis 6 and 7). Complementary results were obtained from additional control tasks. Provided part of tLMM>UMM areas might not be related to ML-AM linkage, we assessed LMM brain network by an independent component analysis (ICA) on contrast images. Results from ICA suggest the existence of a cortico-ponto-cerebellar network including left precuneus, bilateral anterior cingulum, parahippocampal gyri, frontal inferior operculum, ventral anterior part of the insula, frontal medial orbital gyri, caudate nuclei, cerebellum 6 and vermis, which might rule the ML-induced retrieval of AM in closely linked AM-ML events. This topography may suggest that the pathway by which ML is linked to AM is attentional and directly related to perceptual processing, involving salience network, instead of the natural way of remembering typically associated with default mode network.
... The memory advantage for song over speech is often discussed in terms of spared memory for music compared to other memory types in people with Alzheimer's disease ( Jacobsen et al., 2015 ;Cuddy and Duffin, 2005 ). These studies suggest a distinct mechanism for musical memories that undergoes a slower rate of degeneration than other types of memory ( Simmons-Stern et al., 2010, 2012Baird and Samson, 2009 ). ...
... One Alzheimer's case study found better memory for words set to familiar songs and only found an effect for unfamiliar songs after repeated learning sessions, presumably after the melody had become more familiar or predictable ( Moussard et al, 2012 ). The evidence for spared familiar music processing is mixed, with some studies providing evidence of spared long-known or familiar music (e.g., Jacobsen et al., 2015 ) and others showing only a sparing of implicit musical memory such as how to play the piano ( Baird and Samson, 2009 ). As described above, familiarity seems to play a special role in the encoding of words into memory for healthy adults, as well. ...
... Although several studies examine the distributed and distinct networks for familiar and unfamiliar musical and linguistic memory ( Cuddy and Duffin, 2005 ;Finke et al., 2012 ;Saito et al., 2012 ;Jacobsen et al., 2015 ;Sternin et al., 2021 ), the neural mechanisms by which familiar melodies are encoded differently from unfamiliar melodies or speech have not been investigated. One plausible mechanism is neural entrainment (in the "broad sense, " see Obleser and Kayser 2019 ), brought about by tighter alignment of neural activity to the highly predictable rhythms of a familiar melody compared to an unfamiliar melody or irregular speech rhythm. ...
Music is often described in the laboratory and in the classroom as a beneficial tool for memory encoding and retention, with a particularly strong effect when words are sung to familiar compared to unfamiliar melodies. However, the neural mechanisms underlying this memory benefit, especially for benefits related to familiar music are not well understood. The current study examined whether neural tracking of the slow syllable rhythms of speech and song is modulated by melody familiarity. Participants became familiar with twelve novel melodies over four days prior to MEG testing. Neural tracking of the same utterances spoken and sung revealed greater cerebro-acoustic phase coherence for sung compared to spoken utterances, but did not show an effect of familiar melody when stimuli were grouped by their assigned (trained) familiarity. When participant's subjective ratings of perceived familiarity during the MEG testing session were used to group stimuli, however, a large effect of familiarity was observed. This effect was not specific to song, as it was observed in both sung and spoken utterances. Exploratory analyses revealed some in-session learning of unfamiliar and spoken utterances, with increased neural tracking for untrained stimuli by the end of the MEG testing session. Our results indicate that top-down factors like familiarity are strong modulators of neural tracking for music and language. Participants’ neural tracking was related to their perception of familiarity, which was likely driven by a combination of effects from repeated listening, stimulus-specific melodic simplicity, and individual differences. Beyond simply the acoustic features of music, top-down factors built into the music listening experience, like repetition and familiarity, play a large role in the way we attend to and encode information presented in a musical context.
... There is some evidence of preserved brain regions and associated cognitive processes triggering autobiographically salient memories due to personalized music [1][2][3][4][5][6][7][8]. There is also a growing body of evidence suggesting that music may positively affect neuropsychiatric symptoms in people with neurodegenerative disease , which may contribute to comfortable and effective communication with caregivers [33][34][35][36]. ...
... Jacobsen and colleagues [1] concluded that neural encoding of long-known versus recently, or unknown ...
... Future work should involve mixed methods approaches to elucidate these relationships. Mixed-methods studies will more directly address this interplay, combining the quantitative-based methods showing preserved brain networks and associated cognitive processes responsible for music-evoked autobiographical memory-recall in individuals living with dementia [1][2][3][4][5][6][7][8] and qualitative and quantitativebased methods showing shifts from negative to positive mood promoting prosocial interactions with caregivers . Initial pilot studies should test relationships between the neuroanatomical mechanisms responsible for music-evoked autobiographical memory recall and the triggering of alterations in mood state from negative (e.g., agitation) to positive (e.g., smiling, talkativeness, laughter). ...
Background:
Music-based interventions may help to alleviate neuropsychiatric symptoms of dementia and promote prosocial interactions between individuals living with dementia and their caregivers. However, current literature does not combine these evidence bases toward explanation of how music-based interventions may alleviate symptoms and promote prosocial interactions.
Objective:
We conducted a scoping review to address the following question: what do the evidence bases suggest toward how music therapy or music-based therapeutic interventions might promote prosocial interactions between individuals living with dementia and their caregivers?
Methods:
In this review we focused on: 1) quantitative and qualitative evidence of music-based therapies promoting prosocial behaviors in individuals living with dementia, and 2) potential neurobehavioral mechanisms associated with the processes involved with how music may promote prosocial interactions. Databases included PubMed, EBSCOhost's CINAHL and PsycINFO, Cochrane Library (sub-search conducted using ALOIS, the Specialized Register of the Cochrane Dementia and Cognitive Improvement Group), Web of Science, clinicaltrials.gov, ProQuest's Biological Science Collection, the Journal of Music Therapy, Nordic Journal of Music Therapy, and Google Scholar.
Results:
Sixteen original research studies were included for evidence synthesis. This scoping review reveals the need to define and clarify mechanisms of prosocial interactions between individuals living with dementia and their caregivers considering biological and social factors. These mechanisms may include dynamic interactions between preserved brain regions associated with music-evoked autobiographical memory recall and shifts from negative to positive mood states.
Conclusion:
Defining and clarifying how and to what extent music may promote prosocial behaviors using well-designed and well-controlled mixed-methods studies may positively influence the design of interventions to promote prosocial interactions with caregivers.
... This is believed to be due to the fact that musical neural networks are different from traditional temporal memory-related temples [41] [42]. Which are maintained until the advanced stages of the disease [43]. ...
... Music activates a wider network in the brain and not just a "music area". More specifically, listening to familiar music (such as popular traditional music, children's songs, pop of the time), the music memory retrieval included areas inside and outside the temporal lobe, as well as frontal and parietal sections like confirmed by other studies [41] [42] [43]. These diffuse networks may allow the rescue of music functions. ...
... Also, in a survey, Jacobsen [43], used PET techniques to determine the extent to which music listening areas are affected by Alzheimer's histopathology such as amyloid accumulation and glucose metabolism relative to the rest of the brain and found that these areas were less pathological. The ability of people to remember music makes it a unique stimulus that effectively activates people with Alzheimer's. ...
... Two patients with medial and lateral temporal lobe damage demonstrated severe deficits in visual and verbal memory, but intact musical memory (Esfahani-Bayerl, Finke, Kopp, Moon, & Ploner, 2019;Finke, Esfahani, & Ploner, 2012), whereas a third patient experienced the opposite deficit: intact verbal memory with a severe, music-specific agnosia (Peretz, 1996). Musical memory is also spared in some individuals with neurodegenerative disorders such as Alzheimer disease, even in the context of deteriorating semantic memories (Slattery et al., 2019;Jacobsen, Fritz, Stelzer, & Turner, 2015;Cuddy et al., 2012;Vanstone & Cuddy, 2010;Baird & Samson, 2009;Cuddy & Duffin, 2005). For example, patients with the expected gray matter atrophy profile associated with Alzheimer disease had impairments in semantic memory but intact musical memory, which was supported by a network that included bilateral supplementary motor cortex and left anterior superior temporal cortex (Slattery et al., 2019). ...
... Although there is general agreement that musical memories are spared in neurodegenerative disorders, a recent meta-analysis found little consistency in the brain areas involved in memory for music (Freitas et al., 2018). Generally, the recognition of familiar music appears to rely on a fronto-temporal network (Slattery et al., 2019;Agustus et al., 2018;Jacobsen et al., 2015;Sikka, Cuddy, Johnsrude, & Vanstone, 2015;Herholz, Halpern, & Zatorre, 2012;Groussard et al., 2009;Plailly, Tillmann, & Royet, 2007;Halpern & Zatorre, 1999) along with SMAs (Slattery et al., 2019;Agustus et al., 2018;Herholz et al., 2012;Pereira et al., 2011;Peretz et al., 2009) and basal ganglia structures (Agustus et al., 2018;Sikka et al., 2015;Pereira et al., 2011). However, no two studies are in agreement about the brain areas necessary for musical memory. ...
... The lack of difference between novel and familiar music is in contrast with the results of other studies (e.g., Freitas et al., 2018;Herholz et al., 2012;Halpern & Zatorre, 1999) and is likely related to procedural differences. In most previous studies, participants listened to stimuli that they already knew, such as children's songs or folksongs (e.g., Alonso et al., 2016;Schaal, Javadi, Halpern, Pollok, & Banissy, 2015;Herholz et al., 2012;Saito et al., 2012), popular music from the radio charts (e.g., Jacobsen et al., 2015;Pereira et al., 2011), or music supplied by the participants (e.g., El Haj, Fasotti, & Allain, 2012), and rated their familiarity with the stimuli. Using well-known music does not control for the amount of exposure to the stimuli, but it does reflect the way individuals generally learn and become familiar with music "in the real world." ...
We investigated how familiarity alters music and language processing in the brain. We used fMRI to measure brain responses before and after participants were familiarized with novel music and language stimuli. To manipulate the presence of language and music in the stimuli, there were four conditions: (1) whole music (music and words together), (2) instrumental music (no words), (3) a capella music (sung words, no instruments), and (4) spoken words. To manipulate participants' familiarity with the stimuli, we used novel stimuli and a familiarization paradigm designed to mimic “natural” exposure, while controlling for autobiographical memory confounds. Participants completed two fMRI scans that were separated by a stimulus training period. Behaviorally, participants learned the stimuli over the training period. However, there were no significant neural differences between the familiar and unfamiliar stimuli in either univariate or multivariate analyses. There were differences in neural activity in frontal and temporal regions based on the presence of language in the stimuli, and these differences replicated across the two scanning sessions. These results indicate that the way we engage with music is important for creating a memory of that music, and these aspects, over and above familiarity on its own, may be responsible for the robust nature of musical memory in the presence of neurodegenerative disorders such as Alzheimer's disease.
... The reported familiarity of music and MEAMs are linked to each other to an extent, with small [35] or moderate [33,36] correlations, but this relationship is not clear-cut, as not all familiar songs elicit MEAMs and sometimes even unfamiliar songs can elicit MEAMs, possibly through associations with the musical genre of the song [33]. The key brain areas linked to the processing of the autobiographical salience of music are the dorsomedial prefrontal cortex (dmPFC) [35,37] and the anterior cingulate [38]. These structures have found to be relatively spared in Alzheimer's disease [38], which may explain why even people with late-stage dementia are still able to recall familiar songs and memories associated with them [34]. ...
... The key brain areas linked to the processing of the autobiographical salience of music are the dorsomedial prefrontal cortex (dmPFC) [35,37] and the anterior cingulate [38]. These structures have found to be relatively spared in Alzheimer's disease [38], which may explain why even people with late-stage dementia are still able to recall familiar songs and memories associated with them [34]. Also in normal aging, there seems to be age-related shift in the memory and emotion mechanisms underlying the familiarity of music, as it is associated more with the enhancement of memory detail in young adults and affective positivity in older adults [35]. ...
... Recent neuroimaging studies have shed some light on the neural mechanisms that link together music, emotions, and autobiographical memory. The key brain areas involved in this seem to be the dorsomedial prefrontal cortex [35,37] and anterior cingulate [38], which are typically relatively spared in Alzheimer's disease [38], potentially explaining how familiar music can trigger emotions and MEAMs in persons with severe dementia. From a clinical standpoint, the findings of this study could be used to further develop music-based rehabilitation and care practices of elderly people with neurological (e.g., post-stroke aphasia, dementia) or neuropsychiatric (e.g. ...
Background and objectives
Music has a unique capacity to evoke both strong emotions and vivid autobiographical memories. Previous music information retrieval (MIR) studies have shown that the emotional experience of music is influenced by a combination of musical features, including tonal, rhythmic, and loudness features. Here, our aim was to explore the relationship between music-evoked emotions and music-evoked memories and how musical features (derived with MIR) can predict them both.
Methods
Healthy older adults (N = 113, age ≥ 60 years) participated in a listening task in which they rated a total of 140 song excerpts comprising folk songs and popular songs from 1950s to 1980s on five domains measuring the emotional (valence, arousal, emotional intensity) and memory (familiarity, autobiographical salience) experience of the songs. A set of 24 musical features were extracted from the songs using computational MIR methods. Principal component analyses were applied to reduce multicollinearity, resulting in six core musical components, which were then used to predict the behavioural ratings in multiple regression analyses.
Results
All correlations between behavioural ratings were positive and ranged from moderate to very high (r = 0.46–0.92). Emotional intensity showed the highest correlation to both autobiographical salience and familiarity. In the MIR data, three musical components measuring salience of the musical pulse (Pulse strength), relative strength of high harmonics (Brightness), and fluctuation in the frequencies between 200–800 Hz (Low-mid) predicted both music-evoked emotions and memories. Emotional intensity (and valence to a lesser extent) mediated the predictive effect of the musical components on music-evoked memories.
Conclusions
The results suggest that music-evoked emotions are strongly related to music-evoked memories in healthy older adults and that both music-evoked emotions and memories are predicted by the same core musical features.
... This one is thought to be because musical neural networks are not like standard temporal memory-related monasteries [41] [42]. Which are continued till the disease has progressed to the advanced stages [43].Not only does music engage a "music region" in the brain, but it also activates a larger network. Viewing familiar music (including such famous traditional songs, children's music, etc.). ...
... Viewing familiar music (including such famous traditional songs, children's music, etc.). This musical human memory contained regions within the songs, which were popular at the time outside the reticular formation, and also frontal and parietal sections, as well as frontal and parietal sections, also verifiedother research [41] [42] [43]. Such dispersed connections may make it possible formusic capabilities to be resurrected. ...
... Such dispersed connections may make it possible formusic capabilities to be resurrected. Jacobsen [43] also employed PET methods in a study that establish the degree of the damage.various parts of music listening were affected with Alzheimer's disease histology, including suchin terms of amyloidal buildup and gluconeogenesis in comparison to the rest of the brainThose locations were shown to be less pathogenic.People's choices ability to remember music makes it just a one-of-a-kind stimulation that efficiently stimulates people with dementia.Alzheimer's. ...
Aim:The Object of this research is to exhibit the potency and advantage of music therapy for Keepers and Alzheimer’s disease (AD) people. Methods: From 2020 to 2021, a research group scrutinized and investigated 32 persons with Alzheimer’s Disease (ICD-10) medicated by general practitioners, music psychotherapists and neurologists through MMSE. The musical brain analysis with medical results of the patients was estimated and also the response of the tutors and the Patients of Alzheimer’s were Noted. In Family or Personal Sessions, musical instruments were added. The MMSE was used for the patient’s Evaluation Purpose. Under Neurologist’s Supervision, the examination was re-conducted every six months. Finally, 31 patients withAlzheimer’s Medication were Observed And calculated.
... In general, an intervention using music can promote cognitive stimulation 9 . This is possible because musical memory networks are separated from traditional memory networks and are spared until the final stage of disease, activating a wide net in the brain, instead of only one "music area" 9 . ...
... In general, an intervention using music can promote cognitive stimulation 9 . This is possible because musical memory networks are separated from traditional memory networks and are spared until the final stage of disease, activating a wide net in the brain, instead of only one "music area" 9 . In addition to decreasing the process of cognitive impairment, music intervention can stimulate motor skills, improve quality of life, and reduce problematic behavior associated with dementia 10 . ...
Non-pharmacological interventions, such as the use of music, have been shown to be important potential means of controlling adverse symptoms and signs resulting from chronic diseases already present in elderly patients with dementia.
Objectives:
The objective of this study was to analyze the effects of concert music on cognitive and physiological parameters, and behavioral and psychological symptoms in institutionalized elderly people with dementia.
Methods:
A descriptive-exploratory, quantitative, quasi-experimental study was conducted with 14 elderly people. They were allocated in intervention group (IG) (n=7) with eight sessions of music listening, once a week, for 2 months, and control group (CG) (n=7) with the same procedure but without listening to the music. All participants were assessed by Neuropsychiatric Inventory Questionnaire (NPI-Q) and Addenbrooke's Cognitive Examination - Revised (ACE-R) before and after the intervention. Blood pressure (BP) data were obtained; heart rate (HR) and coherence were obtained through Cardioemotion during sessions. The data were analyzed using Fisher's exact test and Student's t-test.
Results:
There was a predominance of female participants, who were widowed and diagnosed with Alzheimer's disease (AD) in both groups. A statistically significant reduction was found in the mean of apathy reduction (p=0.038) and the total mean of NPI-Q severity (p=0.033) (paired Student's t-test) in IG. No significant differences were found in mean level of the pre- and post-analysis variables in CG.
Conclusions:
Concert music had a positive effect on the behavior of institutionalized elderly. Stimuli and possibilities of improving the current behavioral conditions are observed.
... Most of the brain structural damage in NCDs, especially in AD, occurs in the hippocampus and surrounding parietaltemporal areas, even in early stages of the disease (Braak and Braak, 1991;Scheff et al., 2006;Jacobsen et al., 2015;Rémy et al., 2015). Besides the hippocampus, there is reduced structural and functional integrity in the prefrontal cortex (Braak and Braak, 1991;Rémy et al., 2015). ...
... WM and attention capacity are reduced, beyond what is usual with healthy aging. Conversely, primary sensory, motor, visual and anterior cingulate cortices are relatively well preserved (Jacobsen et al., 2015). However, despite cortical atrophy affecting some structures more than others, the entire cortex is affected and particularly in late stages of the disease, motor areas show the same neurofibrillary tangles and neurotic plaques as other areas, as some autopsy studies reveal (Golaz et al., 1992;Suva et al., 1999). ...
Sensorimotor synchronization (SMS), the coordination of physical actions in time with a rhythmic sequence, is a skill that is necessary not only for keeping the beat when making music, but in a wide variety of interpersonal contexts. Being able to attend to temporal regularities in the environment is a prerequisite for event prediction, which lies at the heart of many cognitive and social operations. It is therefore of value to assess and potentially stimulate SMS abilities, particularly in aging and neurocognitive disorders (NCDs), to understand intra-individual communication in the later stages of life, and to devise effective music-based interventions. While a bulk of research exists about SMS and movement-based interventions in Parkinson’s disease, a lot less is known about other types of neurodegenerative disorders, such as Alzheimer’s disease, vascular dementia, or frontotemporal dementia. In this review, we outline the brain and cognitive mechanisms involved in SMS with auditory stimuli, and how they might be subject to change in healthy and pathological aging. Globally, SMS with isochronous sounds is a relatively well-preserved skill in old adulthood and in patients with NCDs. At the same time, natural tapping speed decreases with age. Furthermore, especially when synchronizing to sequences at slow tempi, regularity and precision might be lower in older adults, and even more so in people with NCDs, presumably due to the fact that this process relies on attention and working memory resources that depend on the prefrontal cortex and parietal areas. Finally, we point out that the effect of the severity and etiology of NCDs on sensorimotor abilities is still unclear: More research is needed with moderate and severe NCD, comparing different etiologies, and using complex auditory signals, such as music.
... Some theorists have investigated music effects in Alzheimer's disease and determined that the brain region where music memory is located is significantly less damaged than other regions, and may depend on different memory systems and be related to different tasks [12]. Different from the other cognitive functions, musical abilities (answering, evoking, or reproducing music through singing, composition, or instrumental manipulation) are preserved, even in the late stages of the disease [13]. ...
... Being passively involved in musical activities, such as listening to music, facilitates reminiscence, reinforces a sense of identity, and promotes positive reactions. Several studies on AD suggest that musical memory is preserved, even in advanced stages of the disease, especially implicit musical memory; however, these studies are not conclusive due to the lack of experimental research [12]. ...
Alzheimer’s is a neurodegenerative disease characterized by the progressive deterioration of cognitive functions, with memory being the most affected. Several studies have shown the benefits of music as a complementary treatment for dementia, improving patients’ quality of life. A scientific contribution is needed to show how autobiographic memory could be improved by using musical activities. Objective: The aim of this investigation is to analyze the impact of a musical stimulation protocol on the performance of autobiographical memory in elderly people suffering from Alzheimer’s. Participants and Method: This research was conducted with three patients diagnosed with Alzheimer’s disease: two females (66.7%), and one male (33.3%). One (33.3%) was in the early stages, and two were in the middle stages. This investigation used a quantitative, pre-experimental, longitudinal study with the application of two tests before and after the intervention. Findings: Changes in the performance of autobiographical memory (t=-5.79, p=0.002), and in the semantic component (t=-10.14, p=0.01) were found to be statistically significant, but no changes were evident for episodic memory (t=-0.19, p=0.86). Conclusion: This study provides preliminary evidence of the potential effectiveness of using a music protocol to improve the performance of autobiographical memory in patients with Alzheimer's Disease.
Doi: 10.28991/esj-2021-01304
Full Text: PDF
... 55,131,132 The temporal pole hosts the canonical 'hub' of the semantic memory system, while pars orbitalis integrates semantic and affective signals across sensory modalities and mediates subjective experience of expectation violations in music. 70,133,134 Both regions are implicated in the recognition of melodies 49,65,91,[135][136][137][138] and in processing violations of musical semantic representations. 139 The conjoint involvement of dorsal and ventral striatum here underlines the critical role of striatal dopaminergic circuitry in coding musical expectation and surprise probabilistically, 43,44 an operation integral to hedonic valuation of music. ...
... This is a core effector region for predicting actions and preparing behavioural responses to salient and arousing events, in music, vocalizations and other cognitive domains. 65,92,137,[140][141][142] This region is intimately linked to the salience network 90 and plays an essential role in processing auditory expectations, especially when these have been established through sensorimotor integration as is generally the case for music. 92,143,144 This study suggests that major dementias have distinct profiles of sensory 'surprise' processing, as instantiated in music. ...
Making predictions about the world and responding appropriately to unexpected events are essential functions of the healthy brain. In neurodegenerative disorders such as frontotemporal dementia and Alzheimer’s disease, impaired processing of ‘surprise’ may underpin a diverse array of symptoms, particularly abnormalities of social and emotional behaviour, but is challenging to characterise. Here we addressed this issue using a novel paradigm: music. We studied 62 patients (24 female; aged 53–88) representing major syndromes of frontotemporal dementia (behavioural variant, semantic variant primary progressive aphasia, nonfluent-agrammatic variant primary progressive aphasia) and typical amnestic Alzheimer’s disease, in relation to 33 healthy controls (18 female; aged 54–78). Participants heard famous melodies containing no deviants or one of three types of deviant note—acoustic (white-noise burst), syntactic (key-violating pitch change) or semantic (key-preserving pitch change). Using a regression model that took elementary perceptual, executive and musical competence into account, we assessed accuracy detecting melodic deviants and simultaneously-recorded pupillary responses and related these to deviant surprise value (information-content) and carrier melody predictability (entropy), calculated using an unsupervised machine-learning model of music. Neuroanatomical associations of deviant detection accuracy and coupling of detection to deviant surprise value were assessed using voxel-based morphometry of patients’ brain MR images. Whereas Alzheimer’s disease was associated with normal deviant detection accuracy, behavioural and semantic variant frontotemporal dementia syndromes were associated with strikingly similar profiles of impaired syntactic and semantic deviant detection accuracy and impaired behavioural and autonomic sensitivity to deviant information-content (all p < 0.05). On the other hand, nonfluent-agrammatic primary progressive aphasia was associated with generalised impairment of deviant discriminability (p < 0.05) due to excessive false-alarms, despite retained behavioural and autonomic sensitivity to deviant information-content and melody predictability. Across the patient cohort, grey matter correlates of acoustic deviant detection accuracy were identified in precuneus, mid and mesial temporal regions; correlates of syntactic deviant detection accuracy and information-content processing, in inferior frontal and anterior temporal cortices, putamen and nucleus accumbens; and a common correlate of musical salience coding in supplementary motor area (all p < 0.05, corrected for multiple comparisons in pre-specified regions of interest). Our findings suggest that major dementias have distinct profiles of sensory ‘surprise’ processing, as instantiated in music. Music may be a useful and informative paradigm for probing the predictive decoding of complex sensory environments in neurodegenerative proteinopathies, with implications for understanding and measuring the core pathophysiology of these diseases.
... When listening to familiar songs, elderly people´s memory is activated, thus stimulating areas inside and outside the temporal lobe, including frontal and parietal regions (Jacobsen et al., 2015;andPlatel et al., 2003 andSatoh et al.., 2006). Therefore, as there are possibilities for adjuvant therapies, such as music therapy, which has a lower cost compared to pharmacological treatment, in addition to being more accessible, it is also necessary to investigate whether new methods based on music therapy are being patented to predict and, perhaps, prevent an increase in the cost of this type of treatment. ...
... The results suggest the preservation of musical memory and describe that the region has a lower rate of hypometabolism and cortex atrophy. Moreover, they have concentrations of beta-amyloid, however, the area is preserved and working with some efficiency (Jacobsen et al., 2015). ...
Alzheimer's disease (AD) is characterized by cognitive impairment and progressive memory loss and drug treatments have limited efficacy. Thus, non-pharmacological interventions, such as music therapy, have shown to be promising as supporting pharmacological treatment and, therefore, may arouse commercial interest regarding the development of this type of product. Thus, this study aims to carry out a patentometric survey on patent registrations with music therapy in the treatment of AD. A systematic search was carried out from 2000 to 2020 on the Orbti-Questel website, searching for documents referring to music therapies in AD. The terms “Alzheimer music methodology active therapy” and “Alzheimer music methodology passive therapy” were used. After searching, reading, and excluding duplicate results, we found four patent families referring to music therapy in AD and all were selected as a result, which was considered little compared to the number of studies published on the subject.
... This interpretation is in agreement with our regression analysis results where damage to the left TPO-STG was the strongest predictor of spontaneous singing performance, beyond stroke-related variables. Previous fMRI studies have also shown increased engagement of anterior temporal regions when listening to wellknown tunes both in healthy and patient groups 39,40 as well as greater activation by singing versus speech perception in these regions. 10 Moreover, anterior temporal regions have been linked to better learning and recognition of sung verbal material after stroke 4 or epilepsy surgery. ...
A classical observation in neurology is that aphasic stroke patients with impairments in speech production can nonetheless sing the same utterances. This preserved ability suggests a distinctive neural architecture for singing that could contribute to speech recovery. However, to date, these structural correlates remain unknown. Here, we combined a multivariate lesion-symptom mapping and voxel-based morphometry approach to analyse the relationship between lesion patterns and grey matter volume and production rate in speech and singing tasks. Lesion patterns for spontaneous speech and cued repetition extended into frontal, temporal and parietal areas typically reported within the speech production network. Impairment in spontaneous singing was associated with damage to left anterior-posterior superior and middle temporal gyri. Preservation of grey matter volume in the same regions where damage led to poor speech and singing production supported better performance in these tasks. When dividing the patients into fluent and dysfluent singers based on singing performance from demographically matched controls, we found that preservation of left middle temporal gyrus was related to better spontaneous singing. These findings provide insights into the structural correlates of singing in chronic aphasia and may serve as biomarkers to predict treatment response in clinical trials using singing-based interventions for speech rehabilitation.
... Memories of various events are closely associated with music (Cloos, 2014). Music memory is the region in the brain preserved in dementia until the late stages and significantly impact dementia patients (Jacobsen et al., 2015). It has a motivating effect and can positively influence mood. ...
One of the most common causes of needing care in old age is dementia. In order to enjoy a pleasant retirement for people with dementia, it is essential for them to maintain their independence. Studies have shown that a combination of physical activity and music has positive effects on dementia patients. Therefore, this study aimed to investigate the feasibility of implementing a multidimensional music-based exercise program for dementia patients and the effects on an intervention group (IG) compared to a control group (CG, usual care). The study design was based on a 12-week intervention with two (IG/CG) by two (pretest/posttest) parallel groups and block randomization with unequal group sizes. Participants had to be able to move independently or with a walker and not have severe cardiovascular disease or cardiac arrhythmias. Fifty-three blinded dementia patients (age: 83.63 ± 6.03 years) from inpatient facilities participated in the study and were assigned from the exercise instructors to IG ( n = 34) and CG ( n = 19). The primary outcomes were feasibility (Observation sheet), modified Chair Rising test, Timed Up and Go test, hand dynamometer test, FICSIT‑4 (Frailty and Injuries: Cooperative Studies of Intervention Techniques), and drop bar test. Secondary endpoints included: verbal fluency (“animals”), the Mini-Mental State Examination, memory, Trail Making Test A, and Qualidem. Forty-nine subjects were analyzed (IG = 32; CG = 17). There were significant differences between the groups in the modified Chair Rising test ( p = 0.033), FICSIT‑4 ( p = 0.035), and Timed Up and Go test ( p = 0.005) at posttest, which showed improved performance of the IG compared to the CG. The IG additionally showed improvements in the modified Chair Rising test ( p = 0.000), drop bar test ( p = 0.033), hand dynamometer test ( p = 0.001), Timed Up and Go test ( p = 0.000), verbal fluency ( p = 0.002) and Trail Making Test A ( p = 0.04) after 12 weeks. There were no adverse events or side effects. The multidimensional music-based exercise program could be performed by the dementia patients and was well received. The improved functional mobility could contribute to a lower risk of falls and thus maintain independence. For the follow-up study, the number of subjects, randomization, and parameters should be considered.
... The genetic background of musical memory is an unexplored field, even the characterization of this kind of ability is not well identified. The neurobiology of musical cognition is an under-researched area and the musical memory is a sophisticated mechanism that remains poorly understood [38]. ...
What is the actual impact of music on the human being and the scope for scientific research in this realm? Compared to other areas, the study of the relationship between music and human biology has received limited attention. At the same time, evidence of music’s value in clinical science, neuroscience, and social science keeps increasing. This review article synthesizes the existing knowledge of genetics related to music. While the success of genomics has been demonstrated in medical research, with thousands of genes that cause inherited diseases or a predisposition to multifactorial disorders identified, much less attention has been paid to other human traits. We argue for the development of a new discipline, sensogenomics, aimed at investigating the impact of the sensorial input on gene expression and taking advantage of new, discovery-based ‘omic’ approaches that allow for the exploration of the whole transcriptome of individuals under controlled experiments and circumstances.
... Although these outcomes should be considered tentatively due to the methodological limitations, there is a good deal of research that supports the efficacy of music and singing in dementia (e.g. Camic et al., 2013;Cho, 2018;Jacobsen et al., 2015;Särkämö et al., 2014;Unadkat et al., 2017). Further research looking at specific musical genre (e.g. ...
Background: Music based interventions have been found to improve wellbeing for people with dementia. More recently there has been interest in physiological measures to provide additional information about how music and singing impact this population. Methods: This multiple-case study design explored physiological responses (heart rate-HR, electrodermal activity-EDA, movement, and skin temperature-ST) of nine people with mild-to-moderate using simulation modelling analysis. Results: In study 1, the singing group showed an increase in EDA (p < 0.01 for 8/9 participants) and HR (p < 0.01 for 5/9 participants) as the session began. HR (p < 0.0001 for 5/9 participants) and ST (p < 0.0001 for 6/9 participants) increased during faster tempos. EDA (p < 0.01 all), movement (p < 0.01 for 8/9 participants) and engagement were higher during singing compared to a baseline control. In study 2 EDA (p < 0.0001 for 14/18 data points [3 music conditions across 6 participants]) and ST (p < 0.001 for 10/18 data points) increased and in contrast to the responses during singing, HR decreased as the sessions began (p < 0.002 for 9/18 data points). EDA was higher during slower music (p < 0.0001 for 13/18 data points), however this was less consistent in more interactive sessions than the control. There were no consistent changes in HR and movement responses during different music genre. Conclusions: Physiological measures provide valuable information about the experiences of people with dementia participating in musical activities, particularly for those with verbal communication difficulties. Future research should consider using physiological measures. video-analysis and observational measures to explore further how engagement in specific activities, wellbeing and physiology interact.
... Besides, as these interventions require a lower level of participation, they are potentially useful even in late stages of the disease. In fact, the ability to recognize and remember music is relatively preserved in AD patients [22]. ...
Background:
Music interventions are promising therapies for the management of symptoms in Alzheimer's disease (AD). Globally, music interventions can be classified as active or receptive depending on the participation of the subjects. Active and receptive music tasks engage different brain areas that might result in distinctive clinical effects. This study aims to compare the clinical effects of two types of music interventions and a control activity.
Methods:
Ninety AD patients from six nursing homes participated in the study. Nursing homes were randomly and blindly assigned to receive either active music intervention, receptive music intervention, or the usual care. Effects on cognition, behaviour, daily living activities, and motor function were assessed.
Results:
Active music intervention improved cognition, behaviour, and functional state in a higher extent than both receptive music intervention and usual care. The effect size of active music intervention for cognitive deficits and behavioural symptoms was large (η2 = 0.62 and 0.61, respectively), while for functional state, it was small-to-medium sized (η2 = 0.18). Receptive music intervention had a stabilizing effect on behavioural symptoms compared to control intervention (mean change from baseline ± standard deviation = -0.76 ± 3.66 and 3.35 ± 3.29, respectively). In the active music intervention, the percentage of patients who showed improvement in cognitive deficits (85.7), behavioural symptoms (92.9), and functional state (46.4) was higher than in both receptive listening (11.8, 42.9, and 14.3, respectively) and control group (6.3, 12.2, and 17.1, respectively).
Conclusions:
Active music intervention is useful to improve symptoms of AD and should be prescribed as a complement to the usual treatment.
... Ismail et al. (2018, Experiment 2) addressed this possibility by inducing nostalgia via songs. In doing so, they capitalized on research indicating that musical memories are often preserved in persons with dementia, as brain areas associated with musical memories are relatively unharmed by the disease (Jacobsen et al., 2015). In particular, Ismail et al. used the yoked design of Cheung et al. (2013, Study 4), albeit by playing the songs rather than presenting participants with the song lyrics. ...
We provide a narrative review of the nascent literature on the psychological benefits of music-evoked nostalgia. Music is a prevalent and influential source of nostalgia. Music-evoked nostalgia confers approach-oriented psychological benefits in the social domain (by fostering social connectedness), self-oriented domain (by raising self-esteem, instilling a sense of youthfulness, elevating optimism, and enhancing inspiration), and existential domain (by strengthening meaning in life and augmenting self-continuity). Music-evoked nostalgia also confers psychological benefits indirectly. For example, it elevates optimisms by fostering sequentially social connectedness and self-esteem. Also, by fostering social connectedness, it enhances inspiration, strengthens meaning in life, and augments self-continuity. Furthermore, music-evoked nostalgia serves to buffer individuals against discomforting states, such as sadness. We conclude by discussing music-evoked nostalgia in people with dementia, contemplating the role of individual differences and context, considering the possibility that music-evoked nostalgia serves physiological functions, and asking whether familiarity with the music is necessary for the evocation of nostalgia and its ensuing benefits.
... People with dementia suffer from a deterioration of the cortex (Vogt et al., 2020). The choice for using music in the micro-intervention assumes that several important brain mechanisms can be triggered or stay active through music interventions, even though the resident might be agitated or confused (Jacobsen et al., 2015). The following paragraph will discuss the neurological, physiological, and social influence of music on the elderly person with dementia with agitated behavior and emphasize why and how music can be molded into a helpful intervention to minimize agitation. ...
... The strong effects of music, in particular music making, on brain plasticity have been shown in several neuroscientific studies with both healthy individuals [e.g., [24][25][26], and patients [e.g., 24,27,28]. Furthermore, a study identified a brain area involved in musical memory retrieval (the pre-supplementary motor area) and found that this area was among the last to show atrophy in AD patients [29]. In an functional Magnetic Resonance Imaging (fMRI) study, 10 AD patients received 6 months of singing intervention with karaoke [30]. ...
Background
There is anecdotal evidence for beneficial effects of music therapy in patients with Alzheimer’s Disease (AD). However, there is a lack of rigorous research investigating this issue. The aim of this study is to evaluate the effects of music therapy and physical activity on brain plasticity, mood, and cognition in a population with AD and at risk for AD.
Methods
One-hundred and thirty-five participants with memory complaints will be recruited for a parallel, three-arm Randomized Controlled Trial (RCT). Inclusion criteria are a diagnosis of mild (early) AD or mild cognitive impairment (MCI), or memory complaints without other neuropsychiatric pathology. Participants are randomised into either a music therapy intervention (singing lessons), an active control group (physical activity) or a passive control group (no intervention) for 12 months. The primary outcomes are the brain age gap, measured via magnetic resonance imaging (MRI), and depressive symptoms. Secondary outcomes include cognitive performance, activities of daily living, brain structure (voxel-based morphometry and diffusion tensor imaging), and brain function (resting-state functional MRI).
Trial status
Screening of participants began in April 2018. A total of 84 participants have been recruited and started intervention, out of which 48 participants have completed 12 months of intervention and post-intervention assessment.
Discussion
Addressing the need for rigorous longitudinal data for the effectiveness of music therapy in people with and at risk for developing AD, this trial aims to enhance knowledge regarding cost-effective interventions with potentially high clinical applicability.
Trial registration
ClinicalTrials.gov identifier: NCT03444181 , registered on February 23, 2018.
... Musicality is thus related not only to singing or playing an instrument but also to how we interact nonverbally through gestures, imitation, and tone of voice (Malloch & Trevarthen, 2009). The capacity to communicate musically may be explained by a surprisingly intact musical memory despite the cognitive degeneration in Alzheimer's disease (Jacobsen et al., 2015). This potential of music as a communicative medium may offer a relevant means to address psychosocial needs in persons with dementia (Kraus & Slater, 2016;Ridder, 2003). ...
When music therapists are supervising caregivers in how to apply music in their interactions with persons with dementia, we may term this as indirect music therapy practice. Musical interactions are mostly happening through nonverbal, implicit, and embodied knowledge, and, therefore, there is a need for exploring and verbalizing such interactions for music therapists to be able to disseminate to caregivers and other professionals. In this qualitative study, we examine how 6 music therapists with clinical experience in dementia care experience nonverbal interaction with persons with severe dementia living in nursing homes. Explorative focus groups were conducted to study the music therapists’ lived-experience descriptions about their nonverbal interactions with persons with dementia. Focus group transcripts were analyzed by a phenomenological approach, and the findings elaborated and peer validated by the use of musical improvisation as an arts-based analytic approach. The findings included five themes: vitality, disciplined subjectivity, attunement, therapeutic presence, and validation. The music therapists were guided by the vitality of the person with dementia, were aware of their own reactions, and sensed the needs of the person through disciplined subjectivity. They attuned to the person’s nonverbal musical parameters (e.g., tempo pitch and volume) and cocreated an open and mutual field through therapeutic presence and validation. The findings are relevant for future development of direct and indirect music therapy practice but contain limitations due to a homogenous and small group of participants. This study highlights the challenges of exploring nonverbal and musical interactions with the use of language-based methods of inquiry.
... One popular program, Music and Memory SM (M&M), focuses on using individualized music when a person living with ADRD is prone to agitated behaviors, such as during specific times of day or care actions (e.g., dressing, grooming, bathing) [20]. Research shows that music enjoyed earlier in life may be stored in an area of the brain affected later in the dementia disease course [21]. M&M leverages the potential of this early preferred music to generate positive emotions in an individual with ADRD, temporarily alleviating agitated behaviors. ...
Background
In pragmatic trials, on-site partners, rather than researchers, lead intervention delivery, which may result in implementation variation. There is a need to quantitatively measure this variation. Applying the Framework for Implementation Fidelity (FIF), we develop an approach for measuring variability in site-level implementation fidelity. This approach is then applied to measure site-level fidelity in a cluster-randomized pragmatic trial of Music & Memory SM (M&M), a personalized music intervention targeting agitated behaviors in residents living with dementia, in US nursing homes (NHs).
Methods
Intervention NHs ( N = 27) implemented M&M using a standardized manual, utilizing provided staff trainings and iPods for participating residents. Quantitative implementation data, including iPod metadata (i.e., song title, duration, number of plays), were collected during baseline, 4-month, and 8-month site visits. Three researchers developed four FIF adherence dimension scores. For Details of Content, we independently reviewed the implementation manual and reached consensus on six core M&M components. Coverage was the total number of residents exposed to the music at each NH. Frequency was the percent of participating residents in each NH exposed to M&M at least weekly. Duration was the median minutes of music received per resident day exposed. Data elements were scaled and summed to generate dimension-level NH scores, which were then summed to create a Composite adherence score. NHs were grouped by tercile (low-, medium-, high-fidelity).
Results
The 27 NHs differed in size, resident composition, and publicly reported quality rating. The Composite score demonstrated significant variation across NHs, ranging from 4.0 to 12.0 [8.0, standard deviation (SD) 2.1]. Scaled dimension scores were significantly correlated with the Composite score. However, dimension scores were not highly correlated with each other; for example, the correlation of the Details of Content score with Coverage was τ b = 0.11 ( p = 0.59) and with Duration was τ b = − 0.05 ( p = 0.78). The Composite score correlated with CMS quality star rating and presence of an Alzheimer’s unit, suggesting face validity.
Conclusions
Guided by the FIF, we developed and used an approach to quantitatively measure overall site-level fidelity in a multi-site pragmatic trial. Future pragmatic trials, particularly in the long-term care environment, may benefit from this approach.
Trial registration
Clinicaltrials.gov NCT03821844. Registered on 30 January 2019, https://clinicaltrials.gov/ct2/show/NCT03821844 .
... Despite gradual language deterioration, people with AD show preserved singing ability, which provides evidence of a dissociation between music and language functions [9]. Longterm musical memory is largely preserved in many people with AD, which indicates intact functioning of brain regions involved in musical memory encoding [10]. Vast anecdotal stories from caregivers and professionals present people with AD who can hardly speak but are able to sing. ...
While singing in music therapy with people with Alzheimer's disease (AD) is vastly documented, scarce research deals with the impact of singing on their language abilities. This study addressed the issue of language decline in AD and explored the impact of group singing on the language abilities of people with moderate to severe-stage AD. Participants were randomized to experimental (n=16) or wait-list control (n=14) groups. The experimental group received eight music therapy group sessions, which focused on singing, while both groups received the standard treatment. The data analysis included pre-post picture description tests and examination of speech parameters throughout the group sessions. A significant difference was demonstrated between the groups in the proportion of non-coherent speech in relation to total speech used by participants. The experimental group did not exhibit a deterioration in coherent speech, while the control group exhibited an increase in non-coherent speech in proportion to the total speech used by participants. The findings also indicated that participants in the experimental group showed an improvement in speech parameters as well as in their ability to sing. Singing in music therapy with people with AD can play a significant role in preserving speech and encouraging conversation abilities. Keywords: Alzheimer's disease, music therapy, group singing, language abilities, speech
... Overall, research into personalised music intervention is in its infancy but seminal work within dementia care points to its value in enhancing life quality and stimulating autobiographical memory [19][20][21][22][23][24][25]. Listening to music evokes vivid and emotional memories of events from across the lifespan by activating the limbic system. ...
Background
Playlist for Life is a brief, inexpensive music listening intervention which originated in dementia care, but is increasingly being used for people at the end of life. However, there is a lack of robust empirical research on its application in the hospice setting. Our patient and public involvement group originated the idea for this study. The aim of this feasibility study was to inform the design of a larger effectiveness study on the use of Playlist for Life in the hospice setting.
Method
This study was a mixed-methods feasibility study involving adults at the end of life, family members and hospice staff from one in-patient hospice in Scotland. Eligible patient/family member dyads were approached by hospice staff and if interested, recruited by the researcher. All included participants received the intervention, which involved the provision of an MP3 player and assistance to set up a playlist. Participants were asked to listen to the playlist daily during the intervention period (7 days). Data were collected through patient reported outcome measures and on days 1, 3 and 7 of the intervention period and through participant observation session. Patient/family member dyads and hospice staff also took part in qualitative interviews (Appendix 1) post-intervention, which were audio-recorded, transcribed and analysed thematically. Semi-structured interviews at the end of the intervention period were used to evaluate feasibility and acceptability. An advisory group including patients, family members and staff gave helpful feedback on the qualitative interview questions. Interview questions were the same for all participants and all the questions were asked to all participants.
Results
N = 15 participants were recruited (n = 5 patients, n = 5 family, n = 5 staff. The intervention was appraised positively, particularly regarding its beneficial effect on patient/family relationships. The study design was deemed feasible and acceptable.
Conclusion
The findings of this study will inform the development of a future randomised cluster trial designed to assess the usability and effectiveness of the Playlist for Life personalised music intervention.
Trial registration
This study was not registered as this was a small feasibility study, conducted prior to a pilot study not testing for effectiveness. In addition, the study was non-randomised. The study is registered with NHS ethics and the hospice research and governance team
... However, the use of CCTs based on the user's own life, using their memory, may be a more attractive tool than the usual CCTs. Music [16], movies, photographs of family places and events [17,18] and Alzheimer's have a strange and fascinating relationship. Patients in an advanced stage of the disease experience striking reactions when relating to their own memory, unlocking memories and cognitive capacities that are interesting for the patient himself. ...
... Music therapy helps procedural memory (Baird & Samson, 2009), emotion regulation, social and relational communication with loved ones and carers. It also contributes to those with psychosocial needs (Hsu et al., 2015;Ridder et al., 2013) and music can "catch" attention and memory, especially through song recollection (Cuddy & Duffin, 2005;Drapeau et al., 2009;Hsieh et al., 2011Hsieh et al., , 2012Jacobsen et al., 2015;Johnson et al., 2011;Samson et al., 2009;Vanstone et al., 2012). These processes can lead to flow and arousal and also to reduction of behavioral and psychological symptoms of dementia (BPSD), Further international multi-site research studies are needed to expand the evidence, such as the aforementioned HOMESIDE , and the MIDDEL, a group music therapy study in progress (Gold et al., 2019) such as agitation and anxiety, reported to affect 80% of people with dementia living in care homes (Hsu et al., 2015). ...
Unique music therapy interventions are discussed from a clinical educational and research perspective, demonstrating a current position on music therapy for people living with dementia and their carers. The position paper, adapted from the keynote lecture given at the workshop “Music Selves and Societies” at Cambridge University in 2018, outlines current research and practice across music and music therapy fields, focussing upon embedding music in daily life and care for people living with dementia. Worldwide, around 50m people have dementia; this is estimated to increase to 75.6m in 2030 and 135.5m in 2050. This results in increased demand for long-term care and a need for heightened awareness and capacity for home care in local settings. Distinctions between interventions delivered by music therapists (direct music therapy) and interventions delivered by musicians or carers arising from training from music therapists (indirect music therapy) are discussed. Political and strategic developments for music and dementia are summarized, highlighting the need for increased training in the field and access to music at all stages of dementia. Case study examples are presented to highlight emerging practices and research; for example, couples attending music therapy groups in a rural community setting (Together in Sound) improved relationships and attitudes for people living with dementia. An international trial investigating reading and music interventions for people living with dementia and their homebased family carers (Homeside) is introduced, alongside practice and research in care homes where music therapy had been found to reduce agitation and improve carers’ well-being. Research shows music therapy interventions address personalized needs linked to daily lived experiences. However, indirect music therapy is needed to reach all who can benefit from music and are living with dementia. It is concluded that high quality, accessible music interventions should be embedded in care, and further research is needed to ascertain best practice.
... The strong effects of music, in particular music making, on brain plasticity have been shown in several neuroscienti c studies with both healthy individuals (e.g., [24][25][26], and patients (e.g., 24;27-28). Furthermore, a study identi ed a brain area involved in musical memory retrieval (the presupplementary motor area) and found that this area was among the last to show atrophy in AD patients (29). In an fMRI (functional Magnetic Resonance Imaging) study, 10 AD patients received 6 months of singing intervention with karaoke (30). ...
Background : There is anecdotal evidence for beneficial effects of music therapy in patients with Alzheimer’s Disease (AD). However, there is a lack of rigorous research investigating this issue. The aim of this study is to evaluate the effects of music therapy and physical activity on brain plasticity, mood, and cognition in a population with AD and at risk for AD. Methods : One-hundred and thirty-five participants with memory complaints will be recruited for a parallel, three-arm Randomized Controlled Trial (RCT). Inclusion criteria are a diagnosis of mild (early) AD or mild cognitive impairment (MCI), or memory complaints without other neuropsychiatric pathology. Participants are randomised into either a music therapy intervention (singing lessons), an active control group (physical activity) or a passive control group (no intervention) for 12 months. The primary outcome is the brain age gap, measured by magnetic resonance imaging (MRI), and depressive symptoms. Secondary outcomes include cognitive performance, activities of daily living, brain structure (voxel-based morphometry and diffusion tensor imaging), and brain function (resting-state functional MRI). Trial Status : Screening of participants began in April 2018. A total of 84 participants have been recruited and started intervention, out of which 48 participants have completed 12 months of intervention and post-intervention assessment. Discussion : Addressing the need for rigorous longitudinal data for the effectiveness of music therapy in people with and at risk for developing AD, this trial aims to enhance the knowledge about cost-effective interventions with high clinical applicability. Trial registration: ClinicalTrials.gov identifier: NCT03444181, registered on February 23, 2018.
... Music enhances the retrieval of self-defining memories among people living with Alzheimer's disease (El Haj et al., 2015). Furthermore, imaging studies have revealed that brain regions involved in musical memory are relatively well preserved in people living with Alzheimer's disease, which may explain their often remarkable retention of musical memories (Jacobsen et al., 2015). ...
The COVID-19 pandemic has triggered and exacerbated psychological distress, and exposed psychological vulnerabilities, in large swathes of the population. Under challenging circumstances, nostalgia may convey tangible psychological and physical health benefits. We review recent evidence for nostalgia’s utility in vulnerable populations, including sojourners and immigrants, civil war refugees, people suffering bereavement, people facing a limited time horizon, and people living with dementia. Having raised the prospect of a positive role for nostalgia in responding to adversity, we next present findings from a series of randomised nostalgia interventions and their impact over time in the workplace, during the COVID-19 pandemic, and at university, respectively. We conclude by offering evidence-based recommendations for future interventions, highlighting the importance of optimal person-activity fit, diversity of content, and accessibility of delivery mechanisms.
... There are other indications that the hippocampus is relatively unimportant in familiarity processing of music. Using multivoxel pattern analysis, long-term familiar songs could be distinguished from songs heard on the same day or novel songs in anterior cingulate and presupplementary motor area, but not in the medial temporal lobe (Jacobsen et al., 2015). Subjects listening to their favorite song showed less auditory-hippocampus connectivity than when listening to other songs in the same genre (Wilkins et al., 2014). ...
The hippocampus has a well-established role in spatial and episodic memory but a broader function has been proposed including aspects of perception and relational processing. Neural bases of sound analysis have been described in the pathway to auditory cortex, but wider networks supporting auditory cognition are still being established. We review what is known about the role of the hippocampus in processing auditory information, and how the hippocampus itself is shaped by sound. In examining imaging, recording, and lesion studies in species from rodents to humans, we uncover a hierarchy of hippocampal responses to sound including during passive exposure, active listening, and the learning of associations between sounds and other stimuli. We describe how the hippocampus' connectivity and computational architecture allow it to track and manipulate auditory information – whether in the form of speech, music, or environmental, emotional, or phantom sounds. Functional and structural correlates of auditory experience are also identified. The extent of auditory-hippocampal interactions is consistent with the view that the hippocampus makes broad contributions to perception and cognition, beyond spatial and episodic memory. More deeply understanding these interactions may unlock applications including entraining hippocampal rhythms to support cognition, and intervening in links between hearing loss and dementia.
... Music interventions can be beneficial even for people in more advanced stages of dementia, 6 possibly due to relative preservation of brain areas relevant to music memory. 10 Group music therapy (GMT) and recreational choir singing (RCS) are among the most widely used and studied active music interventions for people with dementia. 9 Both involve a combination of biological, psychological (cognitive and emotional), and social mechanisms thought to be associated with improved mood and depressive symptoms. ...
Background
Dementia and depression are highly prevalent and comorbid conditions among older adults living in care homes and are associated with individual distress and rising societal costs. Effective, scalable, and feasible interventions are needed. Music interventions have shown promising effects, but the current evidence base is inconclusive. The present study aimed to determine the effectiveness of two different music interventions on the depressive symptoms of people with dementia living in residential aged care.
Methods
We implemented a 2 × 2 factorial cluster-randomised controlled trial to determine whether group music therapy (GMT) is more effective than no GMT with standard care, or recreational choir singing (RCS) is more effective than no RCS with standard care, for reducing depressive symptoms and other secondary outcomes in people with dementia with mild to severe depressive symptoms living in residential aged care. Care home units with at least ten residents were allocated to GMT, RCS, GMT plus RCS, or standard care, using a computer-generated list with block randomisation (block size four). The protocolised interventions were delivered by music therapists (GMT) and community musicians (RCS). The primary outcome was Montgomery-Åsberg Depression Rating Scale score at 6 months, assessed by a masked assessor and analysed on an intention-to-treat basis using linear mixed-effects models, which examined the effects of GMT versus no-GMT and RCS versus no-RCS, as well as interaction effects of GMT and RCS. We report on the Australian cohort of an international trial. This trial is registered with ClinicalTrials.gov, NCT03496675, and anzctr.org.au, ACTRN12618000156280.
Findings
Between June 15, 2018, and Feb 18, 2020, we approached 12 RAC facilities with 26 eligible care home units and, excluding six units who could not be enrolled due to COVID-19 lockdowns, we screened 818 residents. Between July 18, 2018, and Nov 26, 2019, 20 care home units were randomised (318 residents). Recruitment ceased on March 17, 2020, due to COVID-19. The primary endpoint, available from 20 care home units (214 residents), suggested beneficial effects of RCS (mean difference –4·25, 95% CI –7·89 to –0·62; p=0·0221) but not GMT (mean difference –0·44, –4·32 to 3·43; p=0·8224). No related serious adverse events occurred.
Interpretation
Our study supports implementing recreational choir singing as a clinically relevant therapeutic intervention in reducing depressive symptoms for people with dementia in the Australian care home context.
Funding
National Health and Medical Research Council, Australia.
... In the early stages of AD, structural damages are observed in the entorhinal cortex, hippocampus, and posterior cingulate cortex (Frisoni et al. 2010), parietal lobes, orbitofrontal cortex, while the primary sensory, motor, visual, and anterior cingulate cortices are spared (Frisoni et al. 2007(Frisoni et al. , 2010Jacobsen et al. 2015;Singh et al. 2006;Thompson et al. 2003;Van Hoesen 2000;Villain et al. 2012). Despite the temporal lobes being involved in a musical memory (Peretz 1996;Samson and Peretz 2005), in AD patients' musical memory is often surprisingly well preserved (Vanstone and Cuddy 2009). ...
In a million years, under the pressure of natural selection, hominins have acquired the abilities for vocal learning, music, and language. Music is a relevant human activity, highly effective in enhancing sociality, is a universal experience common to all known human cultures, although it varies in rhythmic and melodic complexity. It has been part of human life since the beginning of our history, or almost, and it strengthens the mother-baby relation even within the mother’s womb. Music engages multiple cognitive functions, and promotes attention, concentration, imagination, creativity, elicits memories and emotions, and stimulates imagination, and harmony of movement. It changes the chemistry of the brain, by inducing the release of neurotransmitters and hormones (dopamine, serotonin, and oxytocin) and activates the reward and prosocial systems. In addition, music is also used to develop new therapies necessary to alleviate severe illness, especially neurological disorders, and brain injuries.
... Music processing is evident in early human development, with babies recognising musical elements (Zatorre, 2005), and it would seem humans continue to process music throughout their lives. The brain areas associated with music processing seems to remain intact throughout the stages of dementia when other areas of the brain that control cognitive functions such as memory and language deteriorate (Brotons & Koger, 2000;Jacobsen et al., 2015;Peretz & Coltheart, 2003). Unlike language, which is processed mainly in the left hemisphere, music processing requires nearly every brain area (Levitin, 2008;Peretz & Coltheart, 2003). ...
Introduction
Individuals with dementia residing in care homes can rely heavily on care staff to access activities and meaningful interactions. Previous research suggests that care home interactions can be short, fragmented and task-orientated due to staff workload and residents’ language impairments. However, music has the potential to be an alternative communication form that remains intact in the later stages of dementia. This systematic review aims to explore how care home music interventions can facilitate social interactions.
Methods
A narrative synthesis was conducted to explore the mechanisms behind how and why care home music intervention facilitate social interactions. The four-element framework guided analysis; (1) Developing a theory, (2) Developing a preliminary synthesis, (3) Exploring relationships, (4) Assessing robustness.
Findings
The final synthesis included 23 articles. The studies consisted of music therapy sessions, personalised music listening, structured music singing or instrument playing sessions and music therapeutic care. Despite the difference in music interventions, most studies reported an increase in residents’ sociable verbal and non-verbal communication and a decrease in unsociable communication. Music interventions allowed residents to reminisce, express themselves, focus and connect with others.
Discussion
The studies highlighted music interventions are accessible to all residents with dementia despite their impairments. The adaptability allows individuals to continue to connect and express themselves even when language deteriorates. More research is needed into the enablers and barriers to implementing interventions into practice, as this systematic review has highlighted that some form of music intervention for all residents can be highly beneficial. Care homes use of music could increase social interactions and meaningful activities.
... By using MRI technology and a F-fluorodeoxyglucose positron emission tomography the study advocates that brain structures responsible for musical encoding (caudal anterior cingulate gyrus and the ventral pre-supplementary motor area.) seem to be preserved even at advanced stages of dementia [14]. Thus, a novel learning enhancement method based on the active use of music and cueing has been developed by [15]. ...
We developed a new cueing system that capitalises on the spared musical processing abilities of people with dementia. We studied the cueing efficacy by testing different musical distortions (pitch, rhythm, and pitch-rhythm) while using different augmented reality-based interaction modalities in multiple cognitive stimulation tasks. A total of 18 volunteers participated in this study (8 with non-organic dementia) caused by substance abuse, such as alcoholism (control group) and 10 with organic dementia such as Alzheimer's disease (experimental group). We evaluated their performance using three augmented reality tasks: (1) a Knowledge Quiz activity, which is a general quiz knowledge game, (2) a Search Objects activity, which is a game that involves finding hidden images using a virtual magnifying glass and (3) an Association activity, which consists of a categorisation task. A within-subject experimental design has been used so that all participants could be exposed to distortions and activities. Results show that (1) participants, in general, were faster in completing the activities using rhythm and pitch distortions than non-distortion condition; (2) the experimental group reacted to the sound throughout the activities and, therefore, mitigating erroneous decision making; (3) despite the experimental group reacted to the distortions, the control group had better performance in the search and association activities and (4) music distortions compensated dementia related deficits, such as age, schooling and cognitive state. The results suggest that this novel cueing approach can improve people's performance with organic dementia and, more specifically, that such people can effectively process and exploit musical distortions.
Background : Music based interventions have been found to improve the wellbeing of people living with dementia. More recently there has been interest in physiological measures to provide additional information about how music and singing impact this population.
Methods: This multiple-case study design explored physiological responses (heart rate-HR, electrodermal activity-EDA, movement, and skin temperature-ST) of nine people with mild-to-moderate dementia during a singing group, and six people in the later stages of dementia during an interactive music group. The interactive music group was also video recorded to provide information about engagement. Data were analysed using simulation modelling analysis.
Results : The singing group showed an increase in EDA (p < 0.01 for 8/9 participants) and HR (p < 0.01 for 5/9 participants) as the session began. HR (p < 0.0001 for 5/9 participants) and ST (p < 0.0001 for 6/9 participants) increased during faster paced songs. EDA (p < 0.01 all), movement (p < 0.01 for 8/9 participants) and engagement were higher during an interactive music group compared to a control session (music listening). EDA (p < 0.0001 for 14/18 participants) and ST (p < 0.001 for 10/18 participants) increased and in contrast to the responses during singing, HR decreased as the sessions began (p < 0.002 for 9/18 participants). EDA was higher during slower music (p < 0.0001 for 13/18 participants), however this was less consistent in more interactive sessions than the control. There were no consistent changes in HR and movement responses during different styles of music.
Conclusions : Physiological measures may provide valuable information about the experiences of people with dementia participating in arts and other activities, particularly for those with verbal communication difficulties. Future research should consider using physiological measures with video-analysis and observational measures to explore further how engagement in specific activities, wellbeing and physiology interact.
Dans les interventions musicales réalisées auprès de personnes atteintes de la maladie d’Alzheimer ou de maladies apparentées, il est fréquemment demandé aux participants de bouger au rythme de la musique. La synchronisation au rythme musical, particulièrement en groupe, implique des réponses à différents niveaux (moteur, rythmique, social et émotionnel) et pourrait procurer du plaisir ainsi que renforcer les liens sociaux des patients et de leur entourage. Cependant, la synchronisation au rythme de la musique et le lien qui pourrait exister entre ces différents niveaux de la réponse à cette activité sont peu connus dans la maladie d’Alzheimer. L’objectif de cette thèse est d’examiner les différents aspects du comportement des personnes avec une maladie d’Alzheimer (ou maladies apparentées) et des participants avec un vieillissement physiologique ‘normal’ au cours d’une activité de synchronisation au rythme musical réalisée en action conjointe avec un musicien. L’approche préconisée dans ce travail se base sur une méthode pluridisciplinaire incluant les sciences du mouvement, la psychologie sociale et la neuropsychologie. En premier lieu, nous avons étudié l’effet du contexte social et de la musique (et de ses caractéristiques temporelles) sur les performances de synchronisation et sur l’engagement social, émotionnel, rythmique et moteur de personnes atteintes de la maladie d’Alzheimer dans cette activité (étude 1 chapitre 4 et 5). Les résultats ont montré que la présence physique d’une chanteuse réalisant la tâche de synchronisation avec le participant modulait différemment les performances de synchronisation et la qualité de la relation sociale et émotionnelle par comparaison à un enregistrement audio-visuel de cette chanteuse. Cet effet du contexte social était d’ailleurs plus important en réponse à la musique qu’au métronome et était modulé par le tempo et la métrique. De plus, nous avons trouvé que la musique augmentait l’engagement rythmique des participants par comparaison au métronome. Ensuite, nous avons comparé les réponses à la tâche de synchronisation dans le vieillissement pathologique et physiologique (étude 2 chapitre 6 et 7). Les résultats ont révélé que les performances de synchronisation ne différaient pas entre les deux groupes suggérant une préservation du couplage audio-moteur dans la maladie d’Alzheimer à travers cette tâche. Bien que la maladie réduisait l’engagement moteur, social et émotionnel en réponse à la musique par comparaison au vieillissement physiologique, un effet du contexte social était observé sur le comportement dans les deux groupes. Enfin, nous avons comparé les groupes de participants atteints de la maladie d’Alzheimer entre les deux études montrant que la sévérité de la maladie pouvait altérer la synchronisation et l’engagement dans l’activité (chapitre 8). En conclusion, ce travail de thèse a mis en évidence que le couplage audio-moteur est en partie préservé chez les personnes atteintes de la maladie d’Alzheimer et que l’action conjointe avec un partenaire module la qualité de la relation sociale ainsi que l’engagement à la musique. Les connaissances théoriques acquises par ce travail permettent de mieux comprendre l’évolution des comportements en réponse à la musique dans la maladie d’Alzheimer. La méthode mise au point par cette thèse offre ainsi l’opportunité d’évaluer les bénéfices thérapeutiques des interventions musicales à différents niveaux sur le comportement des personnes avec une maladie d’Alzheimer. De telles perspectives permettraient d’améliorer la prise en charge de ces personnes et de leurs aidants.
Dementia causes substantial suffering for affected persons and their family caregivers. Because no cure is available, it is important to investigate how alternative therapies can improve life for these individuals. For the current study, persons with dementia (PwD) were recruited from a specialized Memory Clinic in Sweden to engage in a choral singing intervention for 1 hour per week for four semesters. PwD were encouraged to bring a family caregiver to the sessions; both were interviewed and data were analyzed using qualitative content analysis. The choral singing intervention appeared to become an important social context for PwD and family caregivers and had a positive impact on relationship, mental well-being, mood, and memory. The intervention appeared to act as an enriched environment for all participants. Choral singing interventions for PwD and their family caregivers is a simple means to create a social context and improve general well-being. [Journal of Psychosocial Nursing and Mental Health Services, 60(5), 29-36.].
O futuro se revela como uma entidade cada vez mais nebulosa e incerta para a sociedade contemporânea. Diversos fenômenos contemporâneos estão na gênese da desesperança, no olhar limitado ao futuro, intrinsecamente modificando as formas de vivência social e de atitudes presentes. Na busca por esse futuro, a memória surge como uma ferramenta que, alicerçada na atividade musical, permite a ressignificação do presente e do passado, permitindo novos sentidos sobre o futuro. O presente artigo propõe uma análise de como diversas áreas do conhecimento agregam nessa correlação de memória, atividade musical e sentido, e de como esse diálogo é essencial para gerar reconfigurações identitárias possíveis para construir novos hori-zontes sobre o futuro.
Gedächtnis wird in der alltagssprachlichen Verwendung mit dem
individuellen Erinnerungsvermögen gleichgesetzt. Jemand hat ein gutes
oder schlechtes Gedächtnis, je nachdem, wie gut (im Sinne von
Quantität und Genauigkeit) er oder sie vergangene Geschehnisse
gegenwärtig abrufen kann. Gedächtnis ist dann so etwas wie ein
Speicher, aus dem Informationen für gegenwärtige Situationen
hervorgeholt werden können oder im Falle eines sogenannten schlechten
Gedächtnisses eben nicht.
Der Vorgang des Erinnerns, des absichtlichen Aufrufens von
Vergangenem durch Einzelpersonen, wird mit dieser alltäglichen
Bedeutung von Gedächtnis betont. Dem möchte ich einen Begriff
von sozialen Gedächtnissen entgegensetzen, der etwas anders gebaut ist und mit dem die soziale Wirklichkeit anders erfasst werden
kann.
Dafür werde ich kurz das Konzept soziale Gedächtnisse
erläutern. Im nächsten Schritt werde ich dann versuchen, das Phänomen Musik etwas einzugrenzen, wobei ich die Sozialität und die
Zeitlichkeit betone. Dann werde ich die Wahrnehmung von Musik an einem Beispiel erläutern, bevor ich Musik als soziales Phänomen
beschreibe. Zuletzt werde ich Musik in ihrer Bindung an
körpergebundene Gedächtnisse erläutern und schließlich in einem Fazit
die Sozialität von Gedächtnissen hervorheben.
Objective
To test the effect of a personalized music intervention on agitated behaviors and medication use among long-stay nursing home residents with dementia.
Design
Pragmatic, cluster-randomized controlled trial of a personalized music intervention. Staff in intervention facilities identified residents' early music preferences and offered music at early signs of agitation or when disruptive behaviors typically occur. Usual care in control facilities may include ambient or group music.
Setting and Participants
The study was conducted between June 2019 and February 2020 at 54 nursing homes (27 intervention and 27 control) in 10 states owned by 4 corporations.
Methods
Four-month outcomes were measured for each resident. The primary outcome was frequency of agitated behaviors using the Cohen-Mansfield Agitation Inventory. Secondary outcomes included frequency of agitated behaviors reported in the Minimum Data Set and the proportion of residents using antipsychotic, antidepressant, or antianxiety medications.
Results
The study included 976 residents with dementia [483 treatment and 493 control; mean age = 80.3 years (SD 12.3), 69% female, 25% African American]. CMAI scores were not significantly different (treatment: 50.67, SE 1.94; control: 49.34, SE 1.68) [average marginal effect (AME) 1.33, SE 1.38, 95% CI −1.37 to 4.03]. Minimum Data Set–based behavior scores were also not significantly different (treatment: 0.35, SE 0.13; control: 0.46, SE 0.11) (AME –0.11, SE 0.10, 95% CI −0.30 to 0.08). Fewer residents in intervention facilities used antipsychotics in the past week compared with controls (treatment: 26.2, SE 1.4; control: 29.6, SE 1.3) (AME –3.61, SE 1.85, 95% CI −7.22 to 0.00), but neither this nor other measures of psychotropic drug use were statistically significant.
Conclusions and Implications
Personalized music was not significantly effective in reducing agitated behaviors or psychotropic drug use among long-stay residents with dementia. Barriers to full implementation included engaging frontline nursing staff and identifying resident's preferred music.
Background : Music based interventions have been found to improve wellbeing for people with dementia. More recently there has been interest in physiological measures to provide additional information about how music and singing impact this population.
Methods: This multiple-case study design explored physiological responses (heart rate-HR, electrodermal activity-EDA, movement, and skin temperature-ST) of nine people with mild-to-moderate using simulation modelling analysis.
Results : In study 1, the singing group showed an increase in EDA (p < 0.01 for 8/9 participants) and HR (p < 0.01 for 5/9 participants) as the session began. HR (p < 0.0001 for 5/9 participants) and ST (p < 0.0001 for 6/9 participants) increased during faster tempos. EDA (p < 0.01 all), movement (p < 0.01 for 8/9 participants) and engagement were higher during singing compared to a baseline control. In study 2 EDA (p < 0.0001 for 14/18 data points [3 music conditions across 6 participants]) and ST (p < 0.001 for 10/18 data points) increased and in contrast to the responses during singing, HR decreased as the sessions began (p < 0.002 for 9/18 data points). EDA was higher during slower music (p < 0.0001 for 13/18 data points), however this was less consistent in more interactive sessions than the control. There were no consistent changes in HR and movement responses during different music genre.
Conclusions : Physiological measures provide valuable information about the experiences of people with dementia participating in musical activities, particularly for those with verbal communication difficulties. Future research should consider using physiological measures. video-analysis and observational measures to explore further how engagement in specific activities, wellbeing and physiology interact.
ABSTRACT
Introduction: Systematic reviews have shown the effectiveness of music in reducing
the behavioural and psychological symptoms of dementia (BPSD). Effects of active (i.e.
singing) compared to receptive (including vibroacoustic therapy) individual music
therapy methods for specific BPSD/dementia sub-types are unclear, for example,
that receptive methods (i.e. vibroacoustic therapy) increase parasympathetic
responses and active music therapy improves cognitive and emotional functioning.
Method: A three-armed pragmatic randomised controlled trial will be conducted with
German care home residents with dementia. Residents (N = 75) randomly assigned to
the two intervention groups (individual active music therapy or individual vibroacoustic therapy) will receive two sessions/week for six weeks plus standard care. The
control group will receive only standard care during data collection. The
Neuropsychiatric Inventory-Nursing Home will assess BPSD; secondary outcomes
include depression, quality of life, activities of daily living, health economy and
musical engagement. Outcomes are measured at baseline, post-intervention
(6 weeks), and 12-weeks post randomisation. MMSE is used as a screening measure.
We hypothesise that individual active music therapy and individual vibroacoustic
therapy will reduce BPSD significantly more than standard care. Secondary hypotheses are increased quality of life and musical engagement and decreased depressivity and health resource usage.
Discussion: A greater relaxation response is expected in the receptive arm due to the
massage-like vibration. Increased cognitive clarity and reduced depression are
expected in the active arm. The trial is registered with the German Clinical Trials
Register (DRKS00023233).
Zusammenfassung
Eine Demenz ist eine neurodegenerative Erkrankung, die mit einer Abnahme der kognitiven und motorischen Fähigkeiten einhergeht und den Verlust der Selbstständigkeit und die Pflegebedürftigkeit zur Folge hat. Im Laufe der Jahre wird sie für etwa 60% der Einweisungen in Pflegeheime verantwortlich sein. Damit Menschen mit Demenz trotz ihrer Pflegebedürftigkeit einen angenehmen Lebensabend genießen können, ist es wichtig, ihre kognitiven und motorischen Fähigkeiten zu erhalten und ihre Lebensqualität zu steigern. Zurzeit wird dies vorzugsweise mit Medikamenten versucht. Allerdings sind medikamentöse Therapien bei Demenz begrenzt und immer von Nebenwirkungen begleitet. Daher sind nicht-medikamentöse Interventionen von großer Bedeutung. Studien legen nahe, dass eine Kombination aus körperlicher Aktivität und Musik positive Auswirkungen auf Demenzpatienten hat. Ziel dieser Studie war es, ein musikbasiertes gesundheitsförderndes Krafttraining für Demenzpatienten zu entwickeln und dessen Einfluss auf ausgewählte kognitive und motorische Fähigkeiten sowie auf die Lebensqualität zu analysieren. An der Studie nahmen 16 Heimbewohnerinnen mit einer Demenz (82,5±4,1 Jahre) teil. Die Patientinnen führten über einen Zeitraum von 12 Wochen eine musikbasierte Kraftintervention zweimal wöchentlich jeweils 60 min durch. Es wurden ausgewählte kognitive Fähigkeiten sowie die motorische Reaktionsfähigkeit, Griffkraft und Mobilität untersucht. Darüber hinaus sollten durch den NOSGER II Erkenntnisse über die Lebensqualität gewonnen werden. Die Intervention bewirkte signifikante Verbesserungen in der Griffkraft links (p=,002) und rechts (p=,001) und der Reaktionsfähigkeit (p=,032). In allen anderen Outcome-Parametern konnten zwar keine Verbesserungen, aber auch keine signifikanten Verschlechterungen festgestellt werden. Anhand eines Beobachtungsbogens wurden wichtige Erkenntnisse für die Praktikabilität des Bewegungsprogrammes bei Demenzpatienten gewonnen. Es ist zusammenfassend festzustellen, dass das entwickelte musikbasierte gesundheitsfördernde Krafttraining mit Demenzpatientinnen durchführbar war und von den Teilnehmerinnen nicht nur akzeptiert, sondern auch gern absolviert wurde. Zwölf Wochen Training führten zu signifikanten Verbesserungen in ausgewählten motorischen Fähigkeiten und zur Stabilisierung kognitiver Fähigkeiten. Ein musikbasiertes Übungsprogramm könnte eine vielversprechende Ergänzung zu den medikamentösen Therapien für Menschen mit Demenz sein.
Music interventions may represent an effective approach to improving symptoms and delaying progression of MCI to dementia. This review identified nine studies (8 RCT's, 1 observational study) that explored the benefits of music interventions to those with MCI. Studies included five music-playing interventions (sample size (n) ranged from 35 to 201, age ranged from 62 to 94), one music listening intervention (n = 100, mean age = 77 (music intervention) mean age = 76 (dance intervention), one music with movement intervention (n = 16, age range 65–84 years) and two music reminiscence interventions (n = 68; 72, age range = 60–85 years). Only individuals with a clinical diagnosis of MCI were included, no individuals with a diagnosis of dementia were included. Studies were limited due to their sample size, failure to consider confounding variables (i.e. socialization), inconsistency with therapist led sessions, failure to match conditions across interventions, limited follow-up period post-intervention and the tendency to focus on depression exclusively as a measure of behavioural symptoms. Different types of music interventions have differential results on cognitive and behavioural symptoms. The different pattern of brain activation and cognitive abilities which support each type of music activity (e.g. listening vs playing music) may offer some explanation towards these differences. A standardised protocol is needed for each type of music intervention to address how music interventions are studied, taking these limitations into consideration.
El presente artículo busca describir cómo, a través de la práctica teatral aplicada se promueve la calidad de vida, el acceso a la cultura, el desarrollo de las artes y la autonomía de personas con discapacidad cognitiva. Cuarenta jóvenes participan de actividades en la Fundación Manantial de Ilusión, a través de talleres de iniciación y de su Compañía Música-Teatro. Los resultados sugieren que una intervención basada en el teatro aplicado y en modelos de promoción de calidad de vida y autonomía personal son altamente efectivos, dado que favorecen el desarrollo integral, posibilitando un mayor acceso a la cultura y reflexión sobre el quehacer teatral aplicado, desde un enfoque innovador, de cambio e impacto social.
Objectives:
There are various type of music-related memory and different aspects of impairment caused by dementia. The purpose of this scoping review was to identify methods and map key concepts in assessing music-related memory in people with dementia.
Method:
The review was conducted using the five steps in the framework proposed by Arksey and O'Malley. Databases and other sources were searched to identify relevant studies, and data selection and abstraction were performed.
Results:
A total of 35 studies that met the selection criteria were finally selected and analysed. We confirmed that the assessment of music-related memory can be systematically classified as assessing short-term or long-term memory, explicit or implicit memory, depending on the type of memory. Regarding the key concept of assessing music-related memory, we mapped a conceptual framework for the interrelationships between music and memory from a person-centered perspective.
Conclusion:
Comprehensive information on music-related memory obtained through the assessment will be helpful for a holistic understanding of the person with dementia. In addition, it will provide meaningful information for specific planning and application of musical experiences that can be effectively used in music therapy. Further research is needed to establish the reliability and validity of the assessment.
According to national dementia plan in many countries, the music implementation into the daily routine as an adjunctive therapy to medication treatment is common. However, the ability of long-term care facilities to implement individualized music therapy (MT) and music-based interventions is not sufficiently taken into account. This pilot study examined the frequency of use and acceptance of MT and technology-based music interventions (TBMI) as well as the influence of high and low usage of both interventions of dementia on behavioral and psychological symptoms (BPSD) at two timepoints. Furthermore, the influence on the combination of MT and TBMI of dementia within the nursing home setting on BPSD with a focus on agitation, apathy, depression, and quality of life at all timepoints was considered. In the present study, data from 30 people with dementia (PwD) aged on average 81 years were analyzed within an eight-week noncontrolled intervention study, including four-week follow-up. Initial outcome data indicated significant decreases at times T2 and T3 in agitation and apathy among PwD with a high usage of MT and TBMI than among those with a low usage. In general, reductions were obtained from all observed BPSD at all timepoints. Significant results were found only for agitation over time. Considering the demonstrated results, a long-term implementation of music within daily routines in nursing homes for PwD should be strived for.
The study of patients with semantic dementia has revealed important insights into the cognitive and neural architecture of semantic memory. Patients with semantic dementia are known to have difficulty understanding the meanings of environmental sounds from an early stage but little is known about their knowledge for famous tunes, which might be preserved in some cases. Patients with semantic dementia (n = 13), Alzheimer's disease (n = 14) as well as matched healthy control participants (n = 20) underwent a battery of tests designed to assess knowledge of famous tunes, environmental sounds and famous faces, as well as volumetric magnetic resonance imaging. As a group, patients with semantic dementia were profoundly impaired in the recognition of everyday environmental sounds and famous tunes with consistent performance across testing modalities, which is suggestive of a central semantic deficit. A few notable individuals (n = 3) with semantic dementia demonstrated clear preservation of knowledge of known melodies and famous people. Defects in auditory semantics were mild in patients with Alzheimer's disease. Voxel-based morphometry of magnetic resonance brain images showed that the recognition of famous tunes correlated with the degree of right anterior temporal lobe atrophy, particularly in the temporal pole. This area was segregated from the region found to be involved in the recognition of everyday sounds but overlapped considerably with the area that was correlated with the recognition of famous faces. The three patients with semantic dementia with sparing of musical knowledge had significantly less atrophy of the right temporal pole in comparison to the other patients in the semantic dementia group. These findings highlight the role of the right temporal pole in the processing of known tunes and faces. Overlap in this region might reflect that having a unique identity is a quality that is common to both melodies and people.
The large spatial inhomogeneity in transmit B, field (B-1(+)) observable in human MR images at hi h static magnetic fields (B-0) severely impairs image quality. To overcome this effect in brain T-1-weighted images the, MPRAGE sequence was modified to generate two different images at different inversion times MP2RAGE By combining the two images in a novel fashion, it was possible to create T-1-weigthed images where the result image was free of proton density contrast, T-2* contrast, reception bias field, and, to first order transmit field inhomogeneity.
Event-related functional MRI (fMRI) was used to investigate the neural correlates of memory encoding as a function of age. While fMRI data were obtained, 14 younger (mean age 21 years) and 14 older subjects (mean age 68 years) made animacy decisions about words. Recognition memory for these words was tested at two delays such that older subjects' performance at the short delay was comparable to that of the young subjects at the long delay. This allowed age-associated changes in the neural correlates of encoding to be dissociated from the correlates of differential recognition performance. Activity in left inferior prefrontal cortex and the left hippocampal formation was greater for subsequently recognized words in both age groups, consistent with the findings of previous studies in young adults. In the prefrontal cortex, these 'subsequent memory effects' were, however, left-lateralized in the younger group but bilateral in the older subjects. In addition, for the younger group only, greater activity for remembered words was observed in anterior inferior temporal cortex, as were reversed effects ('subsequent forgetting' effects) in anterior prefrontal regions. The data indicate that older subjects engage much of the same neural circuitry as younger subjects when encoding new memories. However, the findings also point to age-related differences in both prefrontal and temporal activity during successful episodic encoding.
The amyloid cascade hypothesis predicts that pathological processes in Alzheimer's disease (AD) begin with an alteration in the balance between the clearance and production of amyloid precursor protein. The disruption of this balance leads to the formation of b-amyloid (Ab) plaques, aggregation of phosphorylated tau into neurofibrillary tangles (NFTs), neuronal dysfunction and death, and finally demen-tia [1,2]. These processes are not ubiquitous throughout the brain; rather the strength [3] and timing [4] of each pathology var-ies between brain regions. Understanding the underlying physiological properties that allow some cortical structures to be resistant to pathology may lead to new strategies for treating and preventing AD. With the advancement of imaging techniques over the last decade, in vivo mapping of AD pathology is possible. Amyloid deposition can be measured using Pittsburgh compound B PET [5] or similar amyloid tracers; glucose metabo-lism can be imaged with fluorodeoxyglu-cose PET; and structural atrophy can be assessed by volumetric analyses of MRI. PET tracers for tau are only now being introduced [6]. Early post-mortem examinations in humans found a relatively diffuse distri-bution of Ab plaques throughout the brain and across subjects [7]. Amyloid imaging, primarily with Pittsburgh compound B and other radioligands, has affirmed that Ab is widely deposited in both cortical and subcortical brain structures [3,4,8], but has demonstrated that there is a discern-able spatial pattern to these depositions. As measured with PET, there is both an anterior locus of high plaque depositions encompassing the anterior cingulate, orbi-tofrontal, medial frontal and lateral frontal cortices, as well as a posterior locus consist-ing of the precuneus and posterior cingu-late (Figure1A) [3,4,8]. Primary sensory and motor areas, as well as the medial temporal lobes show relatively low levels of plaque pathology. Although often overlooked, there are significant subcortical deposi-tion of amyloid, particularly in the basal ganglia and thalamus [4,9]. In addition to the formation of Ab plaques and tau NFTs, the amyloid cas-cade theory predicts metabolic disruption. fluorodeoxyglucose PET is a measure of glucose metabolism, which in turn indexes neuronal health and functioning. There is
Alterations of auditory feedback during piano performance can be profoundly disruptive. Furthermore, different alterations can yield different types of disruptive effects. Whereas alterations of feedback synchrony disrupt performed timing, alterations of feedback pitch contents can disrupt accuracy. The current research tested whether these behavioral dissociations correlate with differences in brain activity. Twenty pianists performed simple piano keyboard melodies while being scanned in a 3-Tesla magnetic resonance imaging (MRI) scanner. In different conditions they experienced either normal auditory feedback, altered auditory feedback (asynchronous delays or altered pitches), or control conditions that excluded movement or sound. Behavioral results replicated past findings. Neuroimaging data suggested that asynchronous delays led to increased activity in Broca's area and its right homologue, whereas disruptive alterations of pitch elevated activations in the cerebellum, area Spt, inferior parietal lobule, and the anterior cingulate cortex. Both disruptive conditions increased activations in the supplementary motor area. These results provide the first evidence of neural responses associated with perception/action mismatch during keyboard production.
Major imaging biomarkers of Alzheimer's disease include amyloid deposition [imaged with [(11)C]Pittsburgh compound B (PiB) PET], altered glucose metabolism (imaged with [(18)F]fluro-deoxyglucose PET), and structural atrophy (imaged by MRI). Recently we published the initial subset of imaging findings for specific regions in a cohort of individuals with autosomal dominant Alzheimer's disease. We now extend this work to include a larger cohort, whole-brain analyses integrating all three imaging modalities, and longitudinal data to examine regional differences in imaging biomarker dynamics. The anatomical distribution of imaging biomarkers is described in relation to estimated years from symptom onset. Autosomal dominant Alzheimer's disease mutation carrier individuals have elevated PiB levels in nearly every cortical region 15 y before the estimated age of onset. Reduced cortical glucose metabolism and cortical thinning in the medial and lateral parietal lobe appeared 10 and 5 y, respectively, before estimated age of onset. Importantly, however, a divergent pattern was observed subcortically. All subcortical gray-matter regions exhibited elevated PiB uptake, but despite this, only the hippocampus showed reduced glucose metabolism. Similarly, atrophy was not observed in the caudate and pallidum despite marked amyloid accumulation. Finally, before hypometabolism, a hypermetabolic phase was identified for some cortical regions, including the precuneus and posterior cingulate. Additional analyses of individuals in which longitudinal data were available suggested that an accelerated appearance of volumetric declines approximately coincides with the onset of the symptomatic phase of the disease.
A follow-up study of a patient, C.N., with a severe auditory agnosia limited to music is reported. After bilateral temporal lobe damage, C.N., whose cognitive and speech functions are otherwise normal, is totally unable to identify or to experience a sense of familiarity with musical excerpts that were once highly familiar to her. However, she can recognize the lyrics that usually accompany the songs. She can also identify familiar sounds, such as animal cries. Thus, her agnosia appears highly specific to music. The functional nature of her deficit has been investigated through various perceptual tasks. She was initially severely impaired in processing pitch sequential structure but has always enjoyed normal processing of temporal structure. This selective disturbance for sequential pitch information can hardly account for her tune agnosia since processing of pitch variations has dramatically improved over the years. This recovery was not accompanied by any signs of improvement in music recognition, which remains extremely poor. Moreover, the fact that she has never been able to hum tunes from memory argues for a basic memory disturbance. Thus, she was tested here with a series of tests aiming at assessing her memory for familiar and unfamiliar music. The results show that C.N. has now recovered most perceptual skills and that despite a transient ability to exhibit knowledge of familiar music under restricted circumstances, she is markedly impaired at naming a tune and at judging its familiarity, as well as at memorizing familiar as well as novel music. This deficit was found to be not only modality-specific but music-specific as well. The findings suggest the existence of a perceptual memory that is specialized for music and that can be selectively damaged so as to prevent most forms of recognition ability.
Neuropsychological studies have suggested that imagery processes may be mediated by neuronal mechanisms similar to those used in perception. To test this hypothesis, and to explore the neural basis for song imagery, 12 normal subjects were scanned using the water bolus method to measure cerebral blood flow (CBF) during the performance of three tasks. In the control condition subjects saw pairs of words on each trial and judged which word was longer. In the perceptual condition subjects also viewed pairs of words, this time drawn from a familiar song; simultaneously they heard the corresponding song, and their task was to judge the change in pitch of the two cued words within the song. In the imagery condition, subjects performed precisely the same judgment as in the perceptual condition, but with no auditory input. Thus, to perform the imagery task correctly an internal auditory representation must be accessed. Paired-image subtraction of the resulting pattern of CBF, together with matched MRI for anatomical localization, revealed that both perceptual and imagery. tasks produced similar patterns of CBF changes, as compared to the control condition, in keeping with the hypothesis. More specifically, both perceiving and imagining songs are associated with bilateral neuronal activity in the secondary auditory cortices, suggesting that processes within these regions underlie the phenomenological impression of imagined sounds. Other CBF foci elicited in both tasks include areas in the left and right frontal lobes and in the left parietal lobe, as well as the supplementary motor area. This latter region implicates covert vocalization as one component of musical imagery. Direct comparison of imagery and perceptual tasks revealed CBF increases in the inferior frontal polar cortex and right thalamus. We speculate that this network of regions may be specifically associated with retrieval and/or generation of auditory information from memory.
Identification of factors that predict recurrent antisocial behavior is integral to the social sciences, criminal justice procedures, and the effective treatment of high-risk individuals. Here we show that error-related brain activity elicited during performance of an inhibitory task prospectively predicted subsequent rearrest among adult offenders within 4 y of release (N = 96). The odds that an offender with relatively low anterior cingulate activity would be rearrested were approximately double that of an offender with high activity in this region, holding constant other observed risk factors. These results suggest a potential neurocognitive biomarker for persistent antisocial behavior.
How autobiographical memories are represented in the human brain and whether this changes with time are questions central to memory neuroscience. Two regions in particular have been consistently implicated, the ventromedial prefrontal cortex (vmPFC) and the hippocampus, although their precise contributions are still contested. The key question in this debate, when reduced to its simplest form, concerns where information about specific autobiographical memories is located. Here, we availed ourselves of the opportunity afforded by multivoxel pattern analysis to provide an alternative to conventional neuropsychological and fMRI approaches, by detecting representations of individual autobiographical memories in patterns of fMRI activity. We examined whether information about specific recent (two weeks old) and remote (10 years old) autobiographical memories was represented in vmPFC and hippocampus, and other medial temporal and neocortical regions. vmPFC contained information about recent and remote autobiographical memories, although remote memories were more readily detected there, indicating that consolidation or a change of some kind had occurred. Information about both types of memory was also present in the hippocampus, suggesting it plays a role in the retrieval of vivid autobiographical memories regardless of remoteness. Interestingly, we also found that while recent and remote memories were both represented within anterior and posterior hippocampus, the latter nevertheless contained more information about remote memories. Thus, like vmPFC, the hippocampus too respected the distinction between recent and remote memories. Overall, these findings clarify and extend our view of vmPFC and hippocampus while also informing systems-level consolidation and providing clear targets for future studies.
Gray matter atrophy, glucose hypometabolism, and β-amyloid Aβ deposition are well-described hallmarks of Alzheimer's disease, but their relationships are poorly understood. The present study aims to compare the local levels of these three alterations in humans with Alzheimer's disease. Structural magnetic resonance imaging, (18)F-fluorodeoxyglucose positron emission tomography (PET), and (18)F-florbetapir PET data from 34 amyloid-negative healthy controls and 20 demented patients with a high probability of Alzheimer's disease etiology (attested using neuroimaging biomarkers as recently recommended) were analyzed. For each patient and imaging modality, age-adjusted Z-score maps were computed, and direct between-modality voxelwise comparison and correlation analyses were performed. Significant differences in the levels of atrophy, hypometabolism, and Aβ deposition were found in most brain areas, but the hierarchy differed across regions. A cluster analysis revealed distinct subsets of regions: (1) in the hippocampus, atrophy exceeded hypometabolism, whereas Aβ load was minimal; (2) in posterior association areas, Aβ deposition was predominant, together with high hypometabolism and lower but still significant atrophy; and (3) in frontal regions, Aβ deposition was maximal, whereas structural and metabolic alterations were low. Atrophy and hypometabolism significantly correlated in the hippocampus and temporo-parietal cortex, whereas Aβ load was not significantly related to either atrophy or hypometabolism. These findings provide direct evidence for regional variations in the hierarchy and relationships between Aβ load, hypometabolism, and atrophy. Altogether, these variations probably reflect the differential involvement of region-specific pathological or protective mechanisms, such as the presence of neurofibrillary tangles, disconnection, as well as compensation processes.
Alzheimer's disease (AD) is the most common cause of dementia. Much is known concerning AD pathophysiology but our understanding of the disease at the systems level remains incomplete. Previous AD research has used resting-state functional connectivity magnetic resonance imaging (rs-fcMRI) to assess the integrity of functional networks within the brain. Most studies have focused on the default-mode network (DMN), a primary locus of AD pathology. However, other brain regions are inevitably affected with disease progression. We studied rs-fcMRI in five functionally defined brain networks within a large cohort of human participants of either gender (n = 510) that ranged in AD severity from unaffected [clinical dementia rating (CDR) 0] to very mild (CDR 0.5) to mild (CDR 1). We observed loss of correlations within not only the DMN but other networks at CDR 0.5. Within the salience network (SAL), increases were seen between CDR 0 and CDR 0.5. However, at CDR 1, all networks, including SAL, exhibited reduced correlations. Specific networks were preferentially affected at certain CDR stages. In addition, cross-network relations were consistently lost with increasing AD severity. Our results demonstrate that AD is associated with widespread loss of both intranetwork and internetwork correlations. These results provide insight into AD pathophysiology and reinforce an integrative view of the brain's functional organization.
These two quotations reflect common attitudes about music. Tolstoy’s comment suggests that music conveys emotion, whereas Torke’s question implies that music influences listeners’ emotions. Section 5.2 of the present chapter includes a discussion of the various theoretical approaches that
are used to explain affective responses to music. Few scholars dispute the claim that listeners recognize emotions in music.
Some argue, however, that music does not elicit true emotions in the listener (e.g., Kivy 1980, 1990, 2001). For example,
many years ago Meyer (1956) posited that affective responses to music consist of experiences of tension and relaxation (rather
than actual emotions), which occur when listeners’ expectancies about what will happen next in a piece of music are violated
or fulfilled, respectively. This position has been challenged in recent years with findings from studies using behavioral,
physiological, and neurological measures, all of which indicate that listeners respond affectively to music (e.g., Krumhansl
1997; Gagnon and Peretz 2003; Mitterschiffthaler et al. 2007; Witvliet and Vrana 2007). Nonetheless, the debate continues
(e.g., Konečni 2008).
Amyloid-β deposition in Alzheimer's disease is thought to start while individuals are still cognitively unimpaired and it is hypothesized that after an early phase of fast accumulation, a plateau is reached by the time of cognitive decline. However, few longitudinal Pittsburgh compound B-positron emission tomography studies have tested this hypothesis, and with conflicting results. The purpose of this work is to further our understanding of the dynamics of amyloid-β deposition in a large longitudinal cohort. A total of 32 patients with Alzheimer's disease, 49 subjects with mild cognitive impairment and 103 healthy controls underwent two Pittsburgh compound B-positron emission tomography scans 18 months apart. For each participant, a parametric map of Pittsburgh compound B-positron emission tomography rate of change was created [(follow-up scan - baseline scan)/follow-up duration] and entered in a voxelwise three-way analysis of covariance, with clinical status (healthy controls, mild cognitive impairment or Alzheimer's disease), disease progression (clinical conversion from healthy controls to mild cognitive impairment or Alzheimer's disease, or from mild cognitive impairment to Alzheimer's disease) and Pittsburgh compound B status (positive versus negative) as independent factors. Only a significant effect of the Pittsburgh compound B status was found: both Pittsburgh compound B-positive and -negative subjects showed a significant increase in amyloid-β deposition, with this increase being significantly higher in Pittsburgh compound B-positive individuals. This finding suggests either that Pittsburgh compound B-negative individuals have slower rates of amyloid-β accumulation than positive, or that the proportion of individuals showing significant increase in amyloid-β deposition, termed 'Pittsburgh compound B accumulators', is higher within the Pittsburgh compound B-positive group than within the Pittsburgh compound B-negative group. The bimodal distribution of the individual rates of neocortical amyloid-β accumulation observed support the existence of 'Pittsburgh compound B non-accumulators' and 'Pittsburgh compound B accumulators' and different clustering analyses led to a consistent threshold to separate these two subgroups (0.014-0.022 standardized uptake value ratio(pons)/year). The voxelwise three-way analysis of covariance was thus recomputed with the 'Pittsburgh compound B accumulators' only and the results were almost unchanged, with the Pittsburgh compound B-positive group showing higher accumulation than the Pittsburgh compound B-negative group. Finally, a significant negative correlation was found between Pittsburgh compound B rate of change and Pittsburgh compound B baseline burden, but only in the Pittsburgh compound B-positive group (r= -0.24; P=0.025). Higher rates of amyloid-β deposition are associated with higher amyloid-β burden suggesting that amyloid-β deposition does not reach a plateau when cognitive impairments manifest but is instead an ongoing process present even at the Alzheimer's disease stage. amyloid-β accumulation also seems to slow down at the latest stages of the process, i.e. in participants with the highest amyloid burden. Furthermore, this study identified the existence of Pittsburgh compound 'accumulators' and 'non-accumulators', notably within the Pittsburgh compound B-negative group, which may be a relevant concept for future studies.
Musical emotions, such as happiness and sadness, have been investigated using instrumental music devoid of linguistic content. However, pop and rock, the most common musical genres, utilize lyrics for conveying emotions. Using participants' self-selected musical excerpts, we studied their behavior and brain responses to elucidate how lyrics interact with musical emotion processing, as reflected by emotion recognition and activation of limbic areas involved in affective experience. We extracted samples from subjects' selections of sad and happy pieces and sorted them according to the presence of lyrics. Acoustic feature analysis showed that music with lyrics differed from music without lyrics in spectral centroid, a feature related to perceptual brightness, whereas sad music with lyrics did not diverge from happy music without lyrics, indicating the role of other factors in emotion classification. Behavioral ratings revealed that happy music without lyrics induced stronger positive emotions than happy music with lyrics. We also acquired functional magnetic resonance imaging data while subjects performed affective tasks regarding the music. First, using ecological and acoustically variable stimuli, we broadened previous findings about the brain processing of musical emotions and of songs versus instrumental music. Additionally, contrasts between sad music with versus without lyrics recruited the parahippocampal gyrus, the amygdala, the claustrum, the putamen, the precentral gyrus, the medial and inferior frontal gyri (including Broca's area), and the auditory cortex, while the reverse contrast produced no activations. Happy music without lyrics activated structures of the limbic system and the right pars opercularis of the inferior frontal gyrus, whereas auditory regions alone responded to happy music with lyrics. These findings point to the role of acoustic cues for the experience of happiness in music and to the importance of lyrics for sad musical emotions.
The importance of music in our daily life has given rise to an increased number of studies addressing the brain regions involved in its appreciation. Some of these studies controlled only for the familiarity of the stimuli, while others relied on pleasantness ratings, and others still on musical preferences. With a listening test and a functional magnetic resonance imaging (fMRI) experiment, we wished to clarify the role of familiarity in the brain correlates of music appreciation by controlling, in the same study, for both familiarity and musical preferences. First, we conducted a listening test, in which participants rated the familiarity and liking of song excerpts from the pop/rock repertoire, allowing us to select a personalized set of stimuli per subject. Then, we used a passive listening paradigm in fMRI to study music appreciation in a naturalistic condition with increased ecological value. Brain activation data revealed that broad emotion-related limbic and paralimbic regions as well as the reward circuitry were significantly more active for familiar relative to unfamiliar music. Smaller regions in the cingulate cortex and frontal lobe, including the motor cortex and Broca's area, were found to be more active in response to liked music when compared to disliked one. Hence, familiarity seems to be a crucial factor in making the listeners emotionally engaged with music, as revealed by fMRI data.
We studied how task constraints modulate the relationship between single-trial event-related potentials (ERPs) and image noise. Thirteen subjects performed two interleaved tasks: on different blocks, they saw the same stimuli, but they discriminated either between two faces or between two colors. Stimuli were two pictures of red or green faces that contained from 10 to 80% of phase noise, with 10% increments. Behavioral accuracy followed a noise dependent sigmoid in the identity task but was high and independent of noise level in the color task. EEG data recorded concurrently were analyzed using a single-trial ANCOVA: we assessed how changes in task constraints modulated ERP noise sensitivity while regressing out the main ERP differences due to identity, color, and task. Single-trial ERP sensitivity to image phase noise started at about 95-110 ms post-stimulus onset. Group analyses showed a significant reduction in noise sensitivity in the color task compared to the identity task from about 140 ms to 300 ms post-stimulus onset. However, statistical analyses in every subject revealed different results: significant task modulation occurred in 8/13 subjects, one showing an increase and seven showing a decrease in noise sensitivity in the color task. Onsets and durations of effects also differed between group and single-trial analyses: at any time point only a maximum of four subjects (31%) showed results consistent with group analyses. We provide detailed results for all 13 subjects, including a shift function analysis that revealed asymmetric task modulations of single-trial ERP distributions. We conclude that, during face processing, bottom-up sensitivity to phase noise can be modulated by top-down task constraints, in a broad window around the P2, at least in some subjects.
Connectivity analyses and computational modeling of human brain function from fMRI data frequently require the specification of regions of interests (ROIs). Several analyses have relied on atlases derived from anatomical or cyto-architectonic boundaries to specify these ROIs, yet the suitability of atlases for resting state functional connectivity (FC) studies has yet to be established. This article introduces a data-driven method for generating an ROI atlas by parcellating whole brain resting-state fMRI data into spatially coherent regions of homogeneous FC. Several clustering statistics are used to compare methodological trade-offs as well as determine an adequate number of clusters. Additionally, we evaluate the suitability of the parcellation atlas against four ROI atlases (Talairach and Tournoux, Harvard-Oxford, Eickoff-Zilles, and Automatic Anatomical Labeling) and a random parcellation approach. The evaluated anatomical atlases exhibit poor ROI homogeneity and do not accurately reproduce FC patterns present at the voxel scale. In general, the proposed functional and random parcellations perform equivalently for most of the metrics evaluated. ROI size and hence the number of ROIs in a parcellation had the greatest impact on their suitability for FC analysis. With 200 or fewer ROIs, the resulting parcellations consist of ROIs with anatomic homology, and thus offer increased interpretability. Parcellation results containing higher numbers of ROIs (600 or 1,000) most accurately represent FC patterns present at the voxel scale and are preferable when interpretability can be sacrificed for accuracy. The resulting atlases and clustering software have been made publicly available at: http://www.nitrc.org/projects/cluster_roi/.
Recently, we demonstrated using functional magnetic resonance imaging (fMRI) that the outcome of free decisions can be decoded from brain activity several seconds before reaching conscious awareness. Activity patterns in anterior frontopolar cortex (BA 10) were temporally the first to carry intention-related information and thus a candidate region for the unconscious generation of free decisions. In the present study, the original paradigm was replicated and multivariate pattern classification was applied to functional images of frontopolar cortex, acquired using ultra-high field fMRI at 7 Tesla. Here, we show that predictive activity patterns recorded before a decision was made became increasingly stable with increasing temporal proximity to the time point of the conscious decision. Furthermore, detailed questionnaires exploring subjects' thoughts before and during the decision confirmed that decisions were made spontaneously and subjects were unaware of the evolution of their decision outcomes. These results give further evidence that FPC stands at the top of the prefrontal executive hierarchy in the unconscious generation of free decisions.
The contribution of the parietal cortex to episodic memory is a fascinating scientific puzzle. On the one hand, parietal lesions do not normally yield severe episodic-memory deficits; on the other hand, parietal activations are seen frequently in functional-neuroimaging studies of episodic memory. A review of these two categories of evidence suggests that the answer to the puzzle requires us to distinguish between the contributions of dorsal and ventral parietal regions and between the influence of top-down and bottom-up attention on memory.
The function of the anterior-most portion of the temporal lobes, the temporal pole, is not well understood. Anatomists have long considered it part of an extended limbic system based on its location posterior to the orbital frontal cortex and lateral to the amygdala, along with its tight connectivity to limbic and paralimbic regions. Here we review the literature in both non-human primates and humans to assess the temporal pole's putative role in social and emotional processing. Reviewed findings indicate that it has some role in both social and emotional processes, including face recognition and theory of mind, that goes beyond semantic memory. We propose that the temporal pole binds complex, highly processed perceptual inputs to visceral emotional responses. Because perceptual inputs remain segregated into dorsal (auditory), medial (olfactory) and ventral (visual) streams, the integration of emotion with perception is channel specific.
The role of the anterior temporal lobes in cognition and language has been much debated in the literature over the last few years. Most prevailing theories argue for an important role of the anterior temporal lobe as a semantic hub or a place for the representation of unique entities such as proper names of peoples and places. Lately, a few studies have investigated the role of the most anterior part of the left anterior temporal lobe, the left temporal pole in particular, and argued that the left anterior temporal pole is the area responsible for mapping meaning on to sound through evidence from tasks such as object naming. However, another recent study indicates that bilateral anterior temporal damage is required to cause a clinically significant semantic impairment. In the present study, we tested these hypotheses by evaluating patients with acute stroke before reorganization of structure-function relationships. We compared a group of 20 patients with acute stroke with anterior temporal pole damage to a group of 28 without anterior temporal pole damage matched for infarct volume. We calculated the average percent error in auditory comprehension and naming tasks as a function of infarct volume using a non-parametric regression method. We found that infarct volume was the only predictive variable in the production of semantic errors in both auditory comprehension and object naming tasks. This finding favours the hypothesis that left unilateral anterior temporal pole lesions, even acutely, are unlikely to cause significant deficits in mapping meaning to sound by themselves, although they contribute to networks underlying both naming and comprehension of objects. Therefore, the anterior temporal lobe may be a semantic hub for object meaning, but its role must be represented bilaterally and perhaps redundantly.