Masayuki Satoh

Activated brain regions in musicians during an ensemble: a PET study.

As in visual processing, we speculated that, in music processing, different brain regions would activate according to the mode of music listening. Using motets by a famous composer, we studied changes in regional cerebral blood flow (rCBF) with positron emission tomography associated with concentrating on the alto-part within the harmony (alto-part-listening condition) compared to listening to the harmony as a whole (harmony-listening condition). The alto-part-listening condition was associated with bilateral increases of rCBF in superior parietal lobules, precunei, premotor areas and orbital frontal cortices. Superior parietal lobules are likely to be responsible for auditory selective attention to the alto part within the harmony and the analysis of tone pitch on a mental score. The precuneus possibly participated in writing tones of the alto part on a mental score. Based on our findings, we propose that both auditory selective attention and analytic processing play an important role in concentrating on a certain vocal part within a harmony. During the harmony-listening condition, temporal poles, the anterior portion of the cingulate gyrus, occipital cortex and the medial surface of the cerebellum were bilaterally activated. Further studies are necessary to clarify the difference in music processing between musicians and nonmusicians.

Musical anhedonia: Selective loss of emotional experience in listening to music

Recent case studies have suggested that emotion perception and emotional experience of music have independent cognitive processing. We report a patient who showed selective impairment of emotional experience only in listening to music, that is musical anhednia. A 71-year-old right-handed man developed an infarction in the right parietal lobe. He found himself unable to experience emotion in listening to music, even to which he had listened pleasantly before the illness. In neuropsychological assessments, his intellectual, memory, and constructional abilities were normal. Speech audiometry and recognition of environmental sounds were within normal limits. Neuromusicological assessments revealed no abnormality in the perception of elementary components of music, expression and emotion perception of music. Brain MRI identified the infarct lesion in the right inferior parietal lobule. These findings suggest that emotional experience of music could be selectively impaired without any disturbance of other musical, neuropsychological abilities. The right parietal lobe might participate in emotional experience in listening to music.

Training in Mental Singing while Walking Improves Gait Disturbance in Parkinson’s Disease Patients

Patients with Parkinson’s disease (PD) have various types of gait disturbance that are thought to result from impairments in motor timing. Gait disturbances are markedly improved with the use of appropriate visual and auditory cues. In this study, patients suffering from mild to moderate PD underwent a structured music therapy session in which they were trained to walk while mentally singing. The patients were trained in 7 progressive tasks, with a final goal of walking while mentally singing. Before and after the training session, they were videotaped. The video was analyzed for time and steps while walking straight paths and while turning. After a single session of training, the time and steps were significantly improved in both situations. Follow-up interviews with the patients indicated that they effectively utilized mental singing while walking in their daily lives. We propose that singing regulates basal ganglia function and allows patients with PD to keep time regularly. The task used in the present study was simple, required no special tools, and could be utilized anytime and anyplace. Thus, walking while mentally singing has potential for improving the gait of individuals with PD.

A case of amusia caused by the infarction of anterior portion of bilateral temporal lobes.

It remains an unsettled question which brain regions participate in music perception. During singing a familiar song, the retrieval from long-term memory is necessary, but the mechanism of that retrieval is still unclear. We carried out a detailed examination of musical ability in a patient with amusia and control subjects and identified the lesion sites of our patient using MRI. Compared with controls, the patient manifested the following impairments in music perception: (i) the recognition and discrimination of familiar melodies; (ii) the discrimination of unfamiliar phrases; (iii) the discrimination of isolated chords. During singing familiar nursery songs, the patient showed the replacement of one phrase of the melody. In MRI, the patient had old infarction in the anterior portion of the temporal lobes bilaterally. In conclusion, the anterior temporal lobes participate in the perception and expression of music. During singing, the song is retrieved from long-term memory by a unit of one phrase. The dysfunction of that retrieval caused the replacement of the succeeding phrases of the original with the wrong tune, and we named this phenomenon paramelodia.

Plasma protein profiling for potential biomarkers in the early diagnosis of Alzheimer’s disease

Abstract Objectives: Alzheimer’s disease (AD) is the most common cause of dementia in elderly persons. Since the pathology of AD develops slowly from a preclinical or early phase into a fully expressed clinical syndrome, at the time of diagnosis the disease has been progressing for many years. To facilitate the early diagnosis of AD, we performed protein profiling of blood in patients with mild AD as defined by the Functional Assessment Staging (FAST) scale. Methods: Plasma samples from mild AD patients and healthy controls were analyzed using two-dimensional differential gel electrophoresis (2D-DIGE) combined with matrix-assisted laser desorption ionization time-of-flight tandem mass spectrometry (MALDI-TOF/TOF/MS) followed by peptide mass fingerprinting. Results: Three downregulated proteins were identified: apolipoprotein A-1, alpha-2-HS-glycoprotein, and afamin. Two proteins, including apolipoprotein A-4 and fibrinogen gamma chain, were upregulated in mild AD patients. Discussion: Our results suggest that altered expression levels of these proteins in plasma may yield candidate biomarkers for the early diagnosis of AD. Abbreviations: AD, Alzheimer’s disease; FAST, Functional Assessment Staging; 2D-DIGE, two-dimensional differential gel electrophoresis; MALDI-TOF/TOF/MS, matrix-assisted laser desorption ionization time-of-flight tandem mass spectrometry; CSF, cerebrospinal fluid; Aβ, amyloid beta; MMSE, Mini Mental State Examination; MRI, magnetic resonance imaging; NINCDS-ADRDA, National Institute for Neurological Diseases and Stroke/Alzheimer’s Disease and Related Disorders Association; CHAPS, 3-((3-cholamidopropyl) dimethylammonio)-1-propanesulfonate; DTT, dithiothreitol; SDS-PAGE, SDS-polyacrylamide gel electrophoresis; DIA, differential in-gel analysis; BVA, biological variation analysis; CBB, Coomassie brilliant blue; 2DE, two-dimensional gel electrophoresis; TFA, trifluoroacetic acid; ACTH, adrenocorticotropic hormone; Apo A-1, apolipoprotein A-1; AHSG, alpha-2-HS-glycoprotein; Apo A-4, apolipoprotein A-4; MCI, mild cognitive impairment.

A Case of Auditory Agnosia with Impairment of Perception and Expression of Music: Cognitive Processing of Tonality

There is fairly general agreement that the melody and the rhythm are the independent components of the perception of music. In the theory of music, the melody and harmony determine to which tonality the music belongs. It remains an unsettled question whether the tonality is also an independent component of the perception of music, or a by-product of the melody and harmony. We describe a patient with auditory agnosia and expressive amusia that developed after a bilateral infarction of the temporal lobes. We carried out a detailed examination of musical ability in the patient and in control subjects. Comparing with a control population, we identified the following impairments in music perception: (a) discrimination of familiar melodies; (b) discrimination of unfamiliar phrases, and (c) discrimination of isolated chords. His performance in pitch discrimination and tonality were within normal limits. Although intrasubject statistical analysis revealed significant difference only between tonality task and unfamiliar phrase performance, comparison with control subjects suggested a dissociation between a preserved tonality analysis and impairment of perception of melody and chords. By comparing the results of our patient with those in the literature, we may say that there is a double dissociation between the tonality and the other components. Thus, it seems reasonable to suppose that tonality is an independent component of music perception. Based on our present and previous studies, we proposed the revised version of the cognitive model of musical processing in the brain.

A longitudinal study of neuromelanin-sensitive magnetic resonance imaging in Parkinson's disease.

PURPOSE Neuromelanin-sensitive MR imaging (NMI) is an increasingly powerful tool for the diagnosis of Parkinsons disease (PD). This study was undertaken to evaluate longitudinal changes on NMI in PD patients. METHODS We examined longitudinal changes on NMI in 14 PD patients. The area and contrast ratio (CR) of the substantia nigra pars compacta (SNc) were comparatively analyzed. RESULTS The total area and CR of the SNc upon follow-up NMI were significantly smaller than those on initial NMI (from 33.5±18.9 pixels and 6.35±2.86% to 21.5±16.7 pixels and 4.19±2.11%; Wilcoxon signed-rank test, p<0.001 and p=0.022, respectively). The area and CR of the dominant side SNc upon initial NMI were significantly greater than those on follow-up NMI (from 15.3±9.1 pixels and 6.5±2.7% to 7.9±8.5 pixels and 3.7±2.9%; Wilcoxon signed-rank test, p=0.002 and p=0.007, respectively). On a case-by-case basis, the area of the SNc invariably decreased upon follow-up NMI in all patients. We further demonstrated that the total area and CR of the SNc negatively correlated with disease duration (Pearson correlation coefficient, r=-0.63, p<0.001 and r=-0.41, p=0.031, respectively). In area analyses, our results demonstrated very high intraclass correlation coefficients for both intra- and inter-rater reliability. CONCLUSION NMI is a useful and reliable tool for detecting neuropathological changes over time in PD patients.

Three Cases of Focal Embouchure Dystonia: Classifications and Successful Therapy Using a Dental Splint

Background: Focal embouchure dystonia (FED) is a type of task-specific dystonia affecting wind instrument players, and it frequently ends their professional careers. The results of the treatments of FED in the reported literature are disappointing. Objective: We report 3 patients with FED who were brass instrument players. In 1 patient, we evaluated the usefulness of a dental splint. Methods and Results: Patient 1 was a 28-year-old trumpeter who was suffering from an intermittent tremor of the lower jaw. Following the usage of a dental splint, her symptoms disappeared completely. Patient 2 was a 29-year-old horn player with atonia of the lower facial muscles. In this case, medication with various drugs brought no benefit, and he ended his career. Patient 3 was a 43-year-old trombone player who suffered involuntary contractions and relaxation of the perioral muscles along with clumsiness of tongue movement. Extraction of double teeth and long-term cessation of playing for 20 years did not bring any positive effects. Conclusion: We propose that FED can be categorized into three subgroups according to masticatory, facial and lingual types, and that the dental splint might be a useful therapeutic strategy for the masticatory type of FED.

The effectiveness of istradefylline for the treatment of gait deficits and sleepiness in patients with Parkinson’s disease

PURPOSE Istradefylline is useful in treating the wearing-off state in Parkinsons disease (PD). We investigated the effectiveness of istradefylline (ISD) in improving arousal, sleep, and gait deficits in patients with PD. METHODS We examined 14 patients with PD treated with ISD. We assessed the patients using the Unified Parkinsons Disease Rating Scale, Parkinsons Disease Questionnaire, Timed Up-and-Go test (TUG), Freezing of Gait Questionnaire (FOG-Q), Epworth Sleepiness Scale (ESS), and Parkinsons Disease Sleep Scale (PDSS) before and 1 month after ISD use. RESULTS ESS scores were significantly lower 1 month after the start of ISD treatment (6.79±6.50) than before the intervention (8.14±6.15, Wilcoxon signed-rank test, p=0.0033). PDSS scores were not significantly different 1 month after beginning the treatment (112±23mm) when compared to those before the intervention (110±27mm, Wilcoxon signed-rank test, p=0.40). TUG scores were not changed after 1 month of ISD use (14.9±8.3s) when compared to those before the intervention (21.3±30.0s, Wilcoxon signed-rank test, p=0.59). Although these measures were not significantly affected by ISD treatment, some patients remarkably improved after the treatment. FOG-Q scores were significantly lower 1 month after the beginning of treatment (9.79±7.16) than those before the intervention (12.14±5.82, Wilcoxon signed-rank test, p=0.030). CONCLUSIONS ISD may improve daytime sleepiness and FOG in patients with PD.

Physical Exercise with Music Reduces Gray and White Matter Loss in the Frontal Cortex of Elderly People: The Mihama-Kiho Scan Project

Findings from previous studies suggest that physical exercise combined with cognitive training produces more positive effects on cognitive function in elderly people than physical exercise alone. However, the brain plasticity associated with these proposed benefits of combined therapy has not yet been investigated in elderly subjects. We hypothesized that the dual task group would experience greater benefits than the physical exercise alone and non-exercise control groups with regard to both cognitive function and brain plasticity. This study investigated the effect of physical exercise with musical accompaniment on structural brain changes in healthy elderly people. Fifty-one participants performed physical exercise (once a week for an hour with professional trainers) with musical accompaniment (ExM), 61 participants performed the same exercise without music (Ex), and 32 participants made up the non-exercise group (Cont). After the 1-year intervention, visuospatial functioning of the ExM but not the Ex group was significantly better than that of the Cont group. Voxel-based morphometry analyses revealed that the ExM group showed greater right superior frontal gyrus volume and preserved volumes of the right anterior cingulate gyrus, left superior temporal gyrus, and insula. These results indicate that compared with exercise alone, physical exercise with music induces greater positive effects on cognitive function and leads to subtle neuroanatomical changes in the brains of elderly people. Therefore, physical exercise with music may be a beneficial intervention to delay age-related cognitive decline.