Model of music cognition and amusia | Neurología (English Edition)

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In Darwin's book The Descent of Man, and Selection in Relation to Sex (1871), the author addresses the enigmatic origin of music in human evolution without reaching any conclusions. He expressed his astonishment and perplexity with music's biological function within our species as follows: “[musical faculties] must be ranked among the most mysterious with which he is endowed”. Music arises as an innate ability that precedes spoken language. In fact, babies are sensitive to melodies and rhythms even before being born. As we grow, we learn that music is a fundamental element of our culture which fosters a particular style of communication and social interaction, as well as the ability to express emotion.<a class="elsevierStyleCrossRefs" href="#bib0005">1–3</a> As with verbal linguistic functions, the processing of music requires a structure of specific neuronal networks, since recent evidence indicates that musical processing is different from other cognitive processes. In fact, selective impairments in musical processing show that those neuronal networks involved in music are independent from other networks responsible for processing speech and ambient sounds.<a class="elsevierStyleCrossRefs" href="#bib0020">4–8</a> Over the last few years, there have been important advances in our understanding of brain processes involved in music. This progress has enabled researchers to design cognitive models based on the findings of the neurosciences.<a class="elsevierStyleCrossRef" href="#bib0045">9</a>Music cognition modelWhen we listen to music, a series of basic processes are activated, such as recognition of the melody, musical memory, recognition of lyrics, emotional state, and many others. The integration of all of these processes at once is due to a complex brain processing mechanism in which multiple neural circuits participate simultaneously and/or successively. Theoretical models based on scientific evidence are needed if we are to identify the tasks involved in musical processing and understand potential interactions between them.Peretz and Coltheart designed a functional architecture model for musical processing using studies of brain-damaged patients.<a class="elsevierStyleCrossRef" href="#bib0050">10</a> According to this model, which was based on the perception of monophonic (single-voice) melodies, music reception is organised by 2 systems working independently at the same time. The one called the melodic system (MS) is responsible for melody processing, while the other, known as the temporal system (TS), is responsible for musical tempo processing, as its name suggests. The MS is responsible for processing all melody information, and it also discriminates between 2 crucial components: tones (each note in the melody) and intervals or difference between tones (distance between them and whether the change is ascending or descending). Processing the melody or melodic contour processing requires integrating all components within an overall perception mechanism. Recent research has shown that melodic processing occurs in the right superior temporal gyrus through its connections with ipsilateral frontal areas.<a class="elsevierStyleCrossRef" href="#bib0055">11</a> In addition, the TS is responsible for temporally placing the melody defined by the MS by means of 2 processes: rhythm (note duration) and musical metre (number of primary and secondary beats per unit of time, or time signature [2/4 time; 6/8 time]). The TS is finally integrated in an overall perception mechanism.<a class="elsevierStyleCrossRef" href="#bib0060">12</a> In addition, rhythm processing may be altered without the metre being affected and vice versa, as will be described in a later section.Both systems work together, so a damaged brain may selectively lose its understanding of the ‘how’ (MS) or ‘when’ (TS) in its perception of music. Both networks (MS and TS) send information to the musical lexicon so as to create the musical repertoire (MR), or collection of known musical works. The musical lexicon includes the MR and contains the perceptual representation of all musical pieces and works to which we have been exposed in our lifetimes. The musical lexicon also includes musical memory, which stores all new musical pieces and works so that both familiar and non-familiar melodies can be recognised. Therefore, when the musical lexicon is damaged, the subject cannot recognise familiar melodies or record new ones. Output from the musical lexicon occurs either spontaneously or after receiving a stimulus and it is transmitted to a number of different components depending on what is required: (a) activation of the phonological lexicon (input and output) in order to retrieve lyrics; (b) phonological and articulation planning to prepare for the singing process; (c) activation of motor functions for music production, and (d) activation of multimodal associative memories to retrieve non-musical information (title of a musical piece, context of a concert, feelings evoked by a melody). Concerning the last requirement (d), perceptual modules are connected to emotional pathways alongside memory processes, but independently from them. This enables a listener to recognise a musical piece and experience emotions. Emotional processing is independent from the non-emotional analysis of music, and may therefore be damaged selectively.<a class="elsevierStyleCrossRef" href="#bib0050">10</a> Recent functional neuroimaging studies with positron emission tomography (PET) and functional magnetic resonance imaging (fMRI) are providing scientific validation for the theoretical model proposed by Peretz and Coltheart.<a class="elsevierStyleCrossRefs" href="#bib0065">13–15</a>In conclusion, impairment of any of these connections would explain difficulties integrating musical processes among patients with brain damage. Without these fundamental pillars, melody, harmony, scale, and other musical features cannot be perceived, just as texts without words, syllables, or letters cannot be understood in the context of language.Definition and types of amusiaAmusia is a generic term for a syndrome also known as music agnosia caused by damage to one or more basic processes in music perception. The term ‘amusia’ was coined by Steinhals in 1871 as a general term for the inability to perceive music.<a class="elsevierStyleCrossRefs" href="#bib0080">16–18</a> Later on, following in the footsteps of Kussmaul, Lichtheim, and Wernicke, the German physician and anatomist Knoblauch proposed a diagrammatic model of music (1888/1890), which is now considered to be the first cognitive model for music processing.<a class="elsevierStyleCrossRef" href="#bib0095">19</a> Amusia may be acquired or congenital.Acquired amusia occurs due to brain injury. Depending on its location, injury may modify multiple musical functions (for example, expression, perception, execution, rhythm, reading, and writing), which is why researchers have described the numerous clinical types of amusia listed below. We do not know the incidence of acquired amusia. A review of the literature between 1965 and 2010 reveals several published cases of acquired amusia with widely different symptoms and anatomical locations (<a class="elsevierStyleCrossRefs" href="#tbl0005">Tables 1 and 2</a>).<a class="elsevierStyleCrossRefs" href="#bib0090">18,20–30</a><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><elsevierMultimedia ident="tbl0010"></elsevierMultimedia>Congenital amusia appears at birth and it is also known as ‘tone deafness’ since almost all of these patients present pitch processing deficits. According to some studies, congenital amusia seems to be present in 5% of the population.<a class="elsevierStyleCrossRef" href="#bib0155">31</a> Studies with twins and direct relatives of patients with congenital amusia have also shown deficits in pitch processing, suggesting that this disorder is hereditary and associated with structural variations in the frontal and temporal lobes.<a class="elsevierStyleCrossRefs" href="#bib0160">32–35</a>As with the classifications of aphasias, attempts to categorise amusias have generated controversy and given rise to a long list of diagnostic labels. Another factor that complicates the process of creating a reliable system for classifying amusia is that amusias are considered rare disorders and most clinical and pathological descriptions are based on isolated cases. In one attempt to classify the syndrome, Arthur L. Benton identified more than a dozen different types of amusias, including receptive and expressive amusia.<a class="elsevierStyleCrossRef" href="#bib0180">36</a> According to current clinical classifications, motor amusia refers to the loss of ability to sing, whistle, or hum; sensory amusia (tone deafness), the loss of ability to discriminate pitches; musical amnesia, the loss of ability to recognise known pieces of music; musical apraxia or instrumental amusia, the loss of ability to play an instrument; musical agraphia, the inability to write music; and musical alexia, the inability to read music.Recall that patients with amusia (congenital or acquired) experience difficulties in understanding music, although their auditory systems and other cognitive functions remain intact, no associated neurological disorders are present, and their environmental exposure to music is sufficient.<a class="elsevierStyleCrossRef" href="#bib0055">11</a> However, evidence shows that the loss of musical abilities is not necessarily related to the loss of verbal functions, as can be observed in patients who preserve their musical abilities in spite of losing the ability to produce spoken language (aphasia). An example of such a phenomenon is the fascinating case of Russian composer Vissarion Y. Shebalin (1902–1963). This case was exhaustively studied by Alexander R. Luria et al.<a class="elsevierStyleCrossRef" href="#bib0185">37</a> and published under the title ‘Aphasia in a composer’. Surprisingly, after suffering a stroke with associated complications of Wernicke's aphasia and jargon aphasia, he was able to compose his fifth symphony and thus demonstrate that his musical abilities were completely intact. However, other patients who suffered brain damage preserve their ability to recognise lyrics to known songs, poems, familiar voices, and environmental sounds, but are incapable of recognising the music accompanying them.<a class="elsevierStyleCrossRef" href="#bib0190">38</a> Furthermore, other cases combine amusia with aphasia, as occurred with French composer Maurice Ravel (1875–1937). Ravel lost certain musical abilities in the context of developing progressive primary Wernicke's aphasia, ideomotor apraxia, alexia, and agraphia. Although the composer was rendered incapable of singing, playing the piano, writing, and reading music, he could recognise melodies and respond to them on an emotional level. Ravel was unable to express and write the music created by his brain, and it remained imprisoned in his mind. Upon attending a concert and hearing his own musical works, he exclaimed in frustration: “Et puis, j’avais encore tant de musique dans la tête” (And I had so much music left in my head!).<a class="elsevierStyleCrossRef" href="#bib0150">30</a>Subjects with ‘tone deafness’ do not discriminate between tone directions (an essential step in the creation of a melodic contour). They cannot recognise familiar melodies or sing in tune, and they cannot identify musicians who are out of tune; all melodies sound similar to them. They are unable to see the point of music. As Sigmund Freud himself stated, “I do not understand music and its aesthetic effects”.<a class="elsevierStyleCrossRef" href="#bib0080">16</a> Therefore, ‘tone deafness’ may be considered the opposite of absolute or perfect pitch (the ability to identify different tones without the benefit of an external reference as the result of an extraordinary auditory memory). Cases of rhythm deafness without tone deafness have also been described (‘rhythm agnosia’). However, this condition is uncommon, since rhythm involves many areas of the brain.<a class="elsevierStyleCrossRef" href="#bib0195">39</a> In general, subjects with congenital amusia, and most cases of acquired amusia, tend to present musical tone processing deficits. However, rhythm impairment only affects a few of these cases.<a class="elsevierStyleCrossRefs" href="#bib0150">30,40,41</a> Patients with tone deafness or complete receptive amusia do not usually enjoy music, since they cannot perceive it as such. Music may even be unpleasant to these patients, who may develop strategies for avoiding musical events of all types (they do not attend concerts or listen to music in private). After hearing Rachmaninoff's Piano Concerto No. 2, a patient with congenital amusia and tone deafness stated, “It is furious and deafening”.<a class="elsevierStyleCrossRef" href="#bib0210">42</a> Amusic patients report perceiving music as strident, grating, explosive, and similar to the sound of banging pots and pans together. It has been suggested that patients with severe amusia may present, in addition to tone deafness, impaired processing of timbre, or the ‘colour’ of a sound. This property is independent from the sound's pitch, and can be illustrated as the difference in sound when the same note is played on a piano and on a violin. For this reason, severe amusia is also called ‘dystimbria’.<a class="elsevierStyleCrossRefs" href="#bib0145">29,39,43</a>Anatomical correlates of musical processingFindings from recent research into the musical brain indicate that associating musical functions with the right hemisphere and linguistic functions with the left hemisphere is erroneous and simplistic.Documented cases of amusia show that not all musical deficits are located in the right hemisphere (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>). We also know that musical processing differs between subjects and that professional musicians and non-musicians process music in different ways, since they use different areas of the brain. While both hemispheres complement each other in the task of perceiving both melodic and temporal systems, the right hemisphere plays a more important role in overall perception, especially in right-handed non-musicians. The right primary auditory cortex (Brodmann area 41) and secondary auditory cortex (BA 42) are crucial to the perception of music. Therefore, a congenital or acquired anomaly in the right auditory cortex predicts significant musical impairment.<a class="elsevierStyleCrossRefs" href="#bib0020">4,44</a> A recent study of right-handed patients with right and left middle cerebral artery infarction showed that those with damage to the right hemisphere had more severe amusia than amusic patients with damage to the left hemisphere.<a class="elsevierStyleCrossRef" href="#bib0225">45</a> Nevertheless, musical specialisation among right-handed professional musicians involves multiple areas of the left hemisphere, promoting interconnection between the two hemispheres and establishing more specific and concrete functions. Neuroimaging studies in professional musicians have shown the importance of the left hemisphere during musical tasks requiring more analytical processing.<a class="elsevierStyleCrossRefs" href="#bib0230">46,47</a><elsevierMultimedia ident="fig0005"></elsevierMultimedia>Recent knowledge about the structures involved in musical processing is mainly based on study of the correlations between affected areas and musical deficits identified in published cases (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>). With the help of new technologies and research, our knowledge is progressing significantly.<a class="elsevierStyleCrossRef" href="#bib0240">48</a>In 1865, Bouillaud<a class="elsevierStyleCrossRef" href="#bib0245">49</a> described the first series of patients with brain damage and loss of musical abilities. Henschen published the first monograph on amusia in 1920.<a class="elsevierStyleCrossRef" href="#bib0250">50</a> In 1962, Milner researched musical functions in a group of patients with intractable epilepsy who underwent temporal lobectomy. Peretz<a class="elsevierStyleCrossRef" href="#bib0255">51</a> studied patients who underwent left and right temporal corticectomy. They concluded that the right hemisphere is responsible for melody and melodic contour in general terms, while the left hemisphere has the more specific task of encoding each note and interval in that melodic contour. However, there is no clear association between rhythm and a specific hemisphere; rhythm is processed in multiple areas and rhythm impairment has been found in patients with either right-sided or left-sided brain damage.<a class="elsevierStyleCrossRef" href="#bib0260">52</a>With regard to musical memory, some studies have revealed that the process of learning and retaining unfamiliar melodies involves the right hemisphere, while the process of recognising familiar melodies seems to depend more on the left hemisphere.<a class="elsevierStyleCrossRefs" href="#bib0265">53,54</a>According to MRI volumetric studies, patients with congenital amusia present less white matter than healthy subjects, especially in BA 47/44 of the right inferior frontal gyrus (rIFG). The reduction in white matter volume has been related to abnormal results on tests for detecting off-pitch notes in a musical phrase and melodic pitch memory in the Montreal Battery of Evaluation of Amusia (MBEA).<a class="elsevierStyleCrossRef" href="#bib0275">55</a> Recent fMRI studies have shown lack of activation of the RIFG in amusic patients.<a class="elsevierStyleCrossRef" href="#bib0280">56</a> Other PET studies<a class="elsevierStyleCrossRefs" href="#bib0285">57–59</a> have also revealed activation of the RIFG in healthy subjects during tasks involving musical memory. These areas probably participate in pitch processing by means of frontotemporal connections with the right auditory cortex of the temporal lobe. These connections are underdeveloped in amusic subjects. In contrast, these studies found that amusic patients had more grey matter in the same region of the rIFG (BA 47) than healthy subjects. The increase in grey matter in the rIFG may be due to an impairment in neuronal migration similar to those described in epilepsy and developmental dyslexia. However, it is more reasonable to assume that impaired musical perception is due to a reduced volume of white matter rather than to an increase in grey matter thickness. As mentioned previously, the abnormal rIFG found in congenitally amusic patients is probably related to genetic conditions<a class="elsevierStyleCrossRef" href="#bib0300">60</a> involved in the development of early neuronal migration through frontotemporal connections,<a class="elsevierStyleCrossRefs" href="#bib0105">21–24</a> since both frontal and temporal lobes are necessary for music processing. Therefore, amusia may appear when one or both lobes, or the frontotemporal connections, have suffered unilateral or bilateral damage. On the other hand, although researchers have not yet found morphological anomalies in the white and grey matter of the right auditory temporal cortex in congenital amusic subjects, we cannot rule out this possibility.<a class="elsevierStyleCrossRefs" href="#bib0275">55–61</a>Cognitive evaluation and rehabilitation for amusiaContrary to what Knoblauch thought, amusia does not only affect professional musicians.<a class="elsevierStyleCrossRef" href="#bib0080">16</a> In our experience, amusic subjects with no musical knowledge are unlikely to report their condition since they lack sufficient musical knowledge to perceive their own deficits. On the other hand, professional musicians and music lovers are quick to identify any musical deficits. If amusia were to be studied as systematically as language and cognitive functions, researchers would probably confirm that amusia is much more frequent than the literature suggests. Therefore, standardised evaluations need to be employed if we are to further our knowledge of musical abilities.The MBEA<a class="elsevierStyleCrossRef" href="#bib0310">62</a> was designed in 1987 as a tool for assessing amusic patients. Musical perception and musical memory are the most commonly studied musical functions. The MBEA includes 6 tests which allow researchers to assess perception of melodic contour, intervals, musical scales, rhythm, musical metre, and musical memory. Each test includes 30 unfamiliar musical phrases. Less well-known evaluation tools include the one developed by Wertheim and Botez in 1959, which involved adapting the test to the patient's pre-symptomatic musical level after first classifying subjects’ musical abilities;<a class="elsevierStyleCrossRef" href="#bib0315">63</a> the Gordon musical aptitude profile;<a class="elsevierStyleCrossRef" href="#bib0320">64</a> and the Bentley measures of musical abilities.<a class="elsevierStyleCrossRef" href="#bib0325">65</a>In the last few years, researchers have been showing increasing interest in understanding the potential links between amusia and cognitive impairment in areas such as memory, visuospatial capacity, attention, etc. A recent study on acquired amusia in patients with right middle cerebral artery infarction showed that amusic patients score lower on tests of memory, attention, and cognitive flexibility than non-amusic subjects do.<a class="elsevierStyleCrossRef" href="#bib0330">66</a>On the other hand, it is reasonable to think that perception of melodic contour in amusic patients may also affect the intonation (prosody) of speech.<a class="elsevierStyleCrossRef" href="#bib0335">67</a> However, some studies show that 2 perceptual processes are at work: one for singing intonation and another for speaking intonation. Patel argues that ‘melodic contour deafness’ is not exclusive to music, as it also affects spoken language.<a class="elsevierStyleCrossRef" href="#bib0340">68</a> Other studies have shown that musical perception depends on the same cognitive processes needed for spatial processing. Researchers have described cases of amusic patients with spatial impairment, which were believed to be related to poor mental representation of pitch intervals.<a class="elsevierStyleCrossRef" href="#bib0345">69</a>We often hear tone-deaf subjects say, “I can’t play music since my ear is not good, but I love it”. These people are unable to sing in tune and they cannot tell when others are off-pitch, but they do enjoy music. Our opinion is that they should not be considered amusic in the strict sense of the term. Such individuals are probably lacking in musical education or exposure to music. Although their musical abilities remain intact, they are inactive. Alternatively, these individuals may be considered to have a ‘tolerant’ form of amusia, which may improve with the help of directed music training. Music teachers often improve their students’ musical abilities, since the ear for music can become more fine-tuned<a class="elsevierStyleCrossRef" href="#bib0350">70</a> by the repetition of specific musical tasks which discriminate pitches, chords, intervals, rhythms, tonalities, and melodies. These tasks are activated when we play an instrument or attend a concert, for example. In addition, neuroimaging studies have found neuroplasticity in the musical pathways. This phenomenon is related to more ample musical experience, acquired by either playing or listening to music constantly (experience-based neuroplasticity).<a class="elsevierStyleCrossRefs" href="#bib0355">71–73</a> This is why some authors suggest that neuronal organisation in subjects with congenital amusia is not only endogenous, but also related to limited exposure to music. Amusic subjects are less likely to listen to music since it brings no pleasure. Therefore, avoiding exposure to music over the long term may lead to a decrease in the plasticity of frontotemporal connections (learning non-use). It is fundamental that we employ neuroimaging to study the neuroplasticity of the musical networks during directed musical tasks. This may lead to the discovery of rehabilitation techniques for amusic patients. In 2008, Weill-Chounlamountry et al.<a class="elsevierStyleCrossRef" href="#bib0370">74</a> developed the first rehabilitation therapy for amusia. Their patient had suffered a cerebral infarction which caused tone deafness by impairing his pitch discrimination and therefore melody discrimination, but which did not affect his sense of rhythm. Researchers employed a computer programme that administered selective rehabilitation methods focusing solely on melody discrimination. This technique improved the patient's results on post-therapy MBEA tests. In addition, music plays an important role in correcting other cognitive deficits (melodic intonation therapy in patients with aphasia).<a class="elsevierStyleCrossRefs" href="#bib0375">75,76</a>ConclusionsAlthough several different areas of the brain are involved in music processing, more studies are needed in order to gain a better understanding of anatomical correlates. Although we do possess a large body of knowledge about speech and its corresponding areas of the brain, hemispheric specificity in music and brain regions involved in each of the components of music (pitch, rhythm, timbre, melody, musical memory) remain largely enigmatic. Neuroimaging tests (fMRI, PET, MEG) in amusic patients and in subjects with deficits in specific music processes will add to our knowledge of musical networks and refine models of anatomical and functional correlates. Congenital and acquired amusia may be more frequent than the literature suggests. The scarcity of tools for neuropsychological diagnosis and patients’ lack of awareness of their amusia may presumably explain the low rates of detection of these disorders.FundingThis study received no public or private financial support.Conflict of interestThe authors have no conflict of interest to declare." "textoCompletoSecciones" => array:1 [ "secciones" => array:13 [ 0 => array:2 [ "identificador" => "xres175714" "titulo" => array:4 [ 0 => "Abstract" 1 => "Introduction" 2 => "Discussion" 3 => "Conclusions" ] ] 1 => array:2 [ "identificador" => "xpalclavsec164050" "titulo" => "Keywords" ] 2 => array:2 [ "identificador" => "xres175713" "titulo" => array:4 [ 0 => "Resumen" 1 => "Introducción" 2 => "Desarrollo" 3 => "Conclusiones" ] ] 3 => array:2 [ "identificador" => "xpalclavsec164051" "titulo" => "Palabras clave" ] 4 => array:2 [ "identificador" => "sec0005" "titulo" => "Introduction" ] 5 => array:2 [ "identificador" => "sec0010" "titulo" => "Music cognition model" ] 6 => array:2 [ "identificador" => "sec0015" "titulo" => "Definition and types of amusia" ] 7 => array:2 [ "identificador" => "sec0020" "titulo" => "Anatomical correlates of musical processing" ] 8 => array:2 [ "identificador" => "sec0025" "titulo" => "Cognitive evaluation and rehabilitation for amusia" ] 9 => array:2 [ "identificador" => "sec0030" "titulo" => "Conclusions" ] 10 => array:2 [ "identificador" => "sec0035" "titulo" => "Funding" ] 11 => array:2 [ "identificador" => "sec0040" "titulo" => "Conflict of interest" ] 12 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2011-02-15" "fechaAceptado" => "2011-04-07" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec164050" "palabras" => array:7 [ 0 => "Amusia" 1 => "Music cognition" 2 => "Brain and music" 3 => "Musical perception" 4 => "Musical memory" 5 => "Musical neuroscience" 6 => "Musical rehabilitation" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec164051" "palabras" => array:7 [ 0 => "Amusia" 1 => "Cognición musical" 2 => "Cerebro y música" 3 => "Percepción musical" 4 => "Memoria musical" 5 => "Neurociencia de la música" 6 => "Rehabilitación y música" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:2 [ "titulo" => "Abstract" "resumen" => "IntroductionThe study of the neural networks involved in music processing has received less attention than work researching the brain's language networks. For the last two decades there has been a growing interest in discovering the functional mechanisms of the musical brain and understanding those disorders in which brain regions linked with perception and production of music are damaged. DiscussionCongenital and acquired musical deficits in their various forms (perception, execution, music-memory) are grouped together under the generic term amusia. In this selective review we present the “cutting edge” studies on the cognitive and neural processes implicated in music and the various forms of amusia. ConclusionsMusical processing requires a large cortico-subcortical network which is distributed throughout both cerebral hemispheres and the cerebellum. The analysis of healthy subjects using functional neuroimaging and examination of selective deficits (e.g., tone, rhythm, timbre, melodic contours) in patients will improve our knowledge of the mechanisms involved in musical processing and the latter's relationship with other cognitive processes." ] "es" => array:2 [ "titulo" => "Resumen" "resumen" => "IntroducciónEl estudio de las redes neuronales implicadas en el procesamiento de la música ha recibido menos atención que la dispensada al lenguaje proposicional. Desde hace dos décadas existe un interés creciente en conocer los mecanismos funcionales del cerebro musical y los trastornos que surgen del daño de las estructuras implicadas en la percepción y producción de la música. DesarrolloLos déficits congénitos y adquiridos del procesamiento musical en cualquiera de sus componentes (percepción, ejecución, memoria musical) se engloban dentro del término genérico amusia. En este trabajo se presenta una revisión selectiva del «estado-del-arte» de los procesos cognitivos y neurales implicados en la música y los diferentes tipos de amusias. ConclusionesEl procesamiento musical depende de una amplia red neural córtico-subcortical distribuida en ambos hemisferios cerebrales y cerebelo. El análisis de sujetos sanos con neuroimagen funcional y de los déficits selectivos en los componentes musicales (p. ej., tono, ritmo, timbre, contorno melódico) en pacientes con amusia mejorarán nuestro conocimiento acerca de los mecanismos implicados en el procesamiento musical y su relación con otros procesos cognitivos." ] ] "NotaPie" => array:2 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "Please cite this article as: García-Casares N, et al. Modelo de cognición musical y amusia. Neurología. 2013;28:179–86." ] 1 => array:2 [ "etiqueta" => "☆☆" "nota" => "A portion of the content of this text has been sent to Neurowikia, a webpage hosting neurological topics." ] ] "multimedia" => array:3 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 2473 "Ancho" => 2010 "Tamanyo" => 287722 ] ] "descripcion" => array:1 [ "en" => "Anatomical locations and significant deficits in cases of acquired amusia Axial MRI (MRIcron: x 91, y 126, z 83)." ] ] 1 => array:7 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:1 [ "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><tbody title="tbody"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Aetiology, n=53 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Infarct 33 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Haemorrhage 9 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Infectious disease 2 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Degenerative disease 5 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Tumour 3 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Arteriovenous malformation 1 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Age \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">≤50 years: 18 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">>50 years: 35 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Sex \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Men: 17 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Women: 36 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Dominant hand \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Right 48 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Left 1 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Ambidextrous 3 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Professional musician \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Yes 25 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">No 28 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Hemisphere of the lesion \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Right 12 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Left 19 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Bilateral 22 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Aphasia \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Yes \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">No 23 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab268076.png" ] ] ] ] "descripcion" => array:1 [ "en" => "Main characteristics of acquired amusia (cases published in the literature between 1965 and 2010)." ] ] 2 => array:7 [ "identificador" => "tbl0010" "etiqueta" => "Table 2" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:2 [ "leyenda" => "Most cases present multiple deficits; only the most important is listed." "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Type of deficit \t\t\t\t\t\t\n \t\t\t\t</td></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Pitch discrimination 29Rhythm discrimination 22Melody recognition 20Timbre discrimination 15Singing 12Playing instruments 10Emotional connection to music 9Reading music 8Writing music 9Voice discrimination 3Environmental sound discrimination 4 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab268075.png" ] ] ] ] "descripcion" => array:1 [ "en" => "Types of deficits in acquired amusia (1965–2010)." ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:76 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Music and the bra: studies in the neurology of music" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "M.N. 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Model of music cognition and amusia

Modelo de cognición musical y amusia

N. García-Casaresa,b,

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Nagcasares@gmail.com

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, M.L. Berthier Torresa,b, S. Froudist Walsha, P. González-Santosa,b

a Unidad de Neurología Cognitiva y Afasias, Centro de Investigaciones Médico-Sanitarias (CIMES), Málaga, Spain

b Departamento de Medicina, Facultad de Medicina, Universidad de Málaga, Málaga, Spain

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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">From the depths of antiquity&#44; music has occupied a privileged position in all cultures&#59; this most universal form of language is a complex phenomenon which is difficult to describe&#46; In Darwin&#39;s book <span class="elsevierStyleItalic">The Descent of Man&#44; and Selection in Relation to Sex</span> &#40;1871&#41;&#44; the author addresses the enigmatic origin of music in human evolution without reaching any conclusions&#46; He expressed his astonishment and perplexity with music&#39;s biological function within our species as follows&#58; &#8220;&#91;musical faculties&#93; must be ranked among the most mysterious with which he is endowed&#8221;&#46; Music arises as an innate ability that precedes spoken language&#46; In fact&#44; babies are sensitive to melodies and rhythms even before being born&#46; As we grow&#44; we learn that music is a fundamental element of our culture which fosters a particular style of communication and social interaction&#44; as well as the ability to express emotion&#46;<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1&#8211;3</span></a> As with verbal linguistic functions&#44; the processing of music requires a structure of specific neuronal networks&#44; since recent evidence indicates that musical processing is different from other cognitive processes&#46; In fact&#44; selective impairments in musical processing show that those neuronal networks involved in music are independent from other networks responsible for processing speech and ambient sounds&#46;<a class="elsevierStyleCrossRefs" href="#bib0020"><span class="elsevierStyleSup">4&#8211;8</span></a> Over the last few years&#44; there have been important advances in our understanding of brain processes involved in music&#46; This progress has enabled researchers to design cognitive models based on the findings of the neurosciences&#46;<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">9</span></a></p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Music cognition model</span><p id="par0010" class="elsevierStylePara elsevierViewall">When we listen to music&#44; a series of basic processes are activated&#44; such as recognition of the melody&#44; musical memory&#44; recognition of lyrics&#44; emotional state&#44; and many others&#46; The integration of all of these processes at once is due to a complex brain processing mechanism in which multiple neural circuits participate simultaneously and&#47;or successively&#46; Theoretical models based on scientific evidence are needed if we are to identify the tasks involved in musical processing and understand potential interactions between them&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">Peretz and Coltheart designed a functional architecture model for musical processing using studies of brain-damaged patients&#46;<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">10</span></a> According to this model&#44; which was based on the perception of monophonic &#40;single-voice&#41; melodies&#44; music reception is organised by 2 systems working independently at the same time&#46; The one called the melodic system &#40;MS&#41; is responsible for melody processing&#44; while the other&#44; known as the temporal system &#40;TS&#41;&#44; is responsible for musical tempo processing&#44; as its name suggests&#46; The MS is responsible for processing all melody information&#44; and it also discriminates between 2 crucial components&#58; tones &#40;each note in the melody&#41; and intervals or difference between tones &#40;distance between them and whether the change is ascending or descending&#41;&#46; Processing the melody or melodic contour processing requires integrating all components within an overall perception mechanism&#46; Recent research has shown that melodic processing occurs in the right superior temporal gyrus through its connections with ipsilateral frontal areas&#46;<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">11</span></a> In addition&#44; the TS is responsible for temporally placing the melody defined by the MS by means of 2 processes&#58; rhythm &#40;note duration&#41; and musical metre &#40;number of primary and secondary beats per unit of time&#44; or time signature &#91;2&#47;4 time&#59; 6&#47;8 time&#93;&#41;&#46; The TS is finally integrated in an overall perception mechanism&#46;<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">12</span></a> In addition&#44; rhythm processing may be altered without the metre being affected and vice versa&#44; as will be described in a later section&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">Both systems work together&#44; so a damaged brain may selectively lose its understanding of the &#8216;how&#8217; &#40;MS&#41; or &#8216;when&#8217; &#40;TS&#41; in its perception of music&#46; Both networks &#40;MS and TS&#41; send information to the musical lexicon so as to create the musical repertoire &#40;MR&#41;&#44; or collection of known musical works&#46; The musical lexicon includes the MR and contains the perceptual representation of all musical pieces and works to which we have been exposed in our lifetimes&#46; The musical lexicon also includes musical memory&#44; which stores all new musical pieces and works so that both familiar and non-familiar melodies can be recognised&#46; Therefore&#44; when the musical lexicon is damaged&#44; the subject cannot recognise familiar melodies or record new ones&#46; Output from the musical lexicon occurs either spontaneously or after receiving a stimulus and it is transmitted to a number of different components depending on what is required&#58; &#40;a&#41; activation of the phonological lexicon &#40;input and output&#41; in order to retrieve lyrics&#59; &#40;b&#41; phonological and articulation planning to prepare for the singing process&#59; &#40;c&#41; activation of motor functions for music production&#44; and &#40;d&#41; activation of multimodal associative memories to retrieve non-musical information &#40;title of a musical piece&#44; context of a concert&#44; feelings evoked by a melody&#41;&#46; Concerning the last requirement &#40;d&#41;&#44; perceptual modules are connected to emotional pathways alongside memory processes&#44; but independently from them&#46; This enables a listener to recognise a musical piece and experience emotions&#46; Emotional processing is independent from the non-emotional analysis of music&#44; and may therefore be damaged selectively&#46;<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">10</span></a> Recent functional neuroimaging studies with positron emission tomography &#40;PET&#41; and functional magnetic resonance imaging &#40;fMRI&#41; are providing scientific validation for the theoretical model proposed by Peretz and Coltheart&#46;<a class="elsevierStyleCrossRefs" href="#bib0065"><span class="elsevierStyleSup">13&#8211;15</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">In conclusion&#44; impairment of any of these connections would explain difficulties integrating musical processes among patients with brain damage&#46; Without these fundamental pillars&#44; melody&#44; harmony&#44; scale&#44; and other musical features cannot be perceived&#44; just as texts without words&#44; syllables&#44; or letters cannot be understood in the context of language&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Definition and types of amusia</span><p id="par0030" class="elsevierStylePara elsevierViewall">Amusia is a generic term for a syndrome also known as music agnosia caused by damage to one or more basic processes in music perception&#46; The term &#8216;amusia&#8217; was coined by Steinhals in 1871 as a general term for the inability to perceive music&#46;<a class="elsevierStyleCrossRefs" href="#bib0080"><span class="elsevierStyleSup">16&#8211;18</span></a> Later on&#44; following in the footsteps of Kussmaul&#44; Lichtheim&#44; and Wernicke&#44; the German physician and anatomist Knoblauch proposed a diagrammatic model of music &#40;1888&#47;1890&#41;&#44; which is now considered to be the first cognitive model for music processing&#46;<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">19</span></a> Amusia may be acquired or congenital&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">Acquired amusia occurs due to brain injury&#46; Depending on its location&#44; injury may modify multiple musical functions &#40;for example&#44; expression&#44; perception&#44; execution&#44; rhythm&#44; reading&#44; and writing&#41;&#44; which is why researchers have described the numerous clinical types of amusia listed below&#46; We do not know the incidence of acquired amusia&#46; A review of the literature between 1965 and 2010 reveals several published cases of acquired amusia with widely different symptoms and anatomical locations &#40;<a class="elsevierStyleCrossRefs" href="#tbl0005">Tables 1 and 2</a>&#41;&#46;<a class="elsevierStyleCrossRefs" href="#bib0090"><span class="elsevierStyleSup">18&#44;20&#8211;30</span></a></p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0040" class="elsevierStylePara elsevierViewall">Congenital amusia appears at birth and it is also known as &#8216;tone deafness&#8217; since almost all of these patients present pitch processing deficits&#46; According to some studies&#44; congenital amusia seems to be present in 5&#37; of the population&#46;<a class="elsevierStyleCrossRef" href="#bib0155"><span class="elsevierStyleSup">31</span></a> Studies with twins and direct relatives of patients with congenital amusia have also shown deficits in pitch processing&#44; suggesting that this disorder is hereditary and associated with structural variations in the frontal and temporal lobes&#46;<a class="elsevierStyleCrossRefs" href="#bib0160"><span class="elsevierStyleSup">32&#8211;35</span></a></p><p id="par0045" class="elsevierStylePara elsevierViewall">As with the classifications of aphasias&#44; attempts to categorise amusias have generated controversy and given rise to a long list of diagnostic labels&#46; Another factor that complicates the process of creating a reliable system for classifying amusia is that amusias are considered rare disorders and most clinical and pathological descriptions are based on isolated cases&#46; In one attempt to classify the syndrome&#44; Arthur L&#46; Benton identified more than a dozen different types of amusias&#44; including receptive and expressive amusia&#46;<a class="elsevierStyleCrossRef" href="#bib0180"><span class="elsevierStyleSup">36</span></a> According to current clinical classifications&#44; motor amusia refers to the loss of ability to sing&#44; whistle&#44; or hum&#59; sensory amusia &#40;tone deafness&#41;&#44; the loss of ability to discriminate pitches&#59; musical amnesia&#44; the loss of ability to recognise known pieces of music&#59; musical apraxia or instrumental amusia&#44; the loss of ability to play an instrument&#59; musical agraphia&#44; the inability to write music&#59; and musical alexia&#44; the inability to read music&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">Recall that patients with amusia &#40;congenital or acquired&#41; experience difficulties in understanding music&#44; although their auditory systems and other cognitive functions remain intact&#44; no associated neurological disorders are present&#44; and their environmental exposure to music is sufficient&#46;<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">11</span></a> However&#44; evidence shows that the loss of musical abilities is not necessarily related to the loss of verbal functions&#44; as can be observed in patients who preserve their musical abilities in spite of losing the ability to produce spoken language &#40;aphasia&#41;&#46; An example of such a phenomenon is the fascinating case of Russian composer Vissarion Y&#46; Shebalin &#40;1902&#8211;1963&#41;&#46; This case was exhaustively studied by Alexander R&#46; Luria et al&#46;<a class="elsevierStyleCrossRef" href="#bib0185"><span class="elsevierStyleSup">37</span></a> and published under the title &#8216;Aphasia in a composer&#8217;&#46; Surprisingly&#44; after suffering a stroke with associated complications of Wernicke&#39;s aphasia and jargon aphasia&#44; he was able to compose his fifth symphony and thus demonstrate that his musical abilities were completely intact&#46; However&#44; other patients who suffered brain damage preserve their ability to recognise lyrics to known songs&#44; poems&#44; familiar voices&#44; and environmental sounds&#44; but are incapable of recognising the music accompanying them&#46;<a class="elsevierStyleCrossRef" href="#bib0190"><span class="elsevierStyleSup">38</span></a> Furthermore&#44; other cases combine amusia with aphasia&#44; as occurred with French composer Maurice Ravel &#40;1875&#8211;1937&#41;&#46; Ravel lost certain musical abilities in the context of developing progressive primary Wernicke&#39;s aphasia&#44; ideomotor apraxia&#44; alexia&#44; and agraphia&#46; Although the composer was rendered incapable of singing&#44; playing the piano&#44; writing&#44; and reading music&#44; he could recognise melodies and respond to them on an emotional level&#46; Ravel was unable to express and write the music created by his brain&#44; and it remained imprisoned in his mind&#46; Upon attending a concert and hearing his own musical works&#44; he exclaimed in frustration&#58; &#8220;<span class="elsevierStyleItalic">Et puis&#44; j&#8217;avais encore tant de musique dans la t&#234;te</span>&#8221; &#40;And I had so much music left in my head&#33;&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0150"><span class="elsevierStyleSup">30</span></a></p><p id="par0055" class="elsevierStylePara elsevierViewall">Subjects with &#8216;tone deafness&#8217; do not discriminate between tone directions &#40;an essential step in the creation of a melodic contour&#41;&#46; They cannot recognise familiar melodies or sing in tune&#44; and they cannot identify musicians who are out of tune&#59; all melodies sound similar to them&#46; They are unable to see the point of music&#46; As Sigmund Freud himself stated&#44; &#8220;I do not understand music and its aesthetic effects&#8221;&#46;<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">16</span></a> Therefore&#44; &#8216;tone deafness&#8217; may be considered the opposite of absolute or perfect pitch &#40;the ability to identify different tones without the benefit of an external reference as the result of an extraordinary auditory memory&#41;&#46; Cases of rhythm deafness without tone deafness have also been described &#40;&#8216;rhythm agnosia&#8217;&#41;&#46; However&#44; this condition is uncommon&#44; since rhythm involves many areas of the brain&#46;<a class="elsevierStyleCrossRef" href="#bib0195"><span class="elsevierStyleSup">39</span></a> In general&#44; subjects with congenital amusia&#44; and most cases of acquired amusia&#44; tend to present musical tone processing deficits&#46; However&#44; rhythm impairment only affects a few of these cases&#46;<a class="elsevierStyleCrossRefs" href="#bib0150"><span class="elsevierStyleSup">30&#44;40&#44;41</span></a> Patients with tone deafness or complete receptive amusia do not usually enjoy music&#44; since they cannot perceive it as such&#46; Music may even be unpleasant to these patients&#44; who may develop strategies for avoiding musical events of all types &#40;they do not attend concerts or listen to music in private&#41;&#46; After hearing Rachmaninoff&#39;s <span class="elsevierStyleItalic">Piano Concerto No&#46; 2</span>&#44; a patient with congenital amusia and tone deafness stated&#44; &#8220;It is furious and deafening&#8221;&#46;<a class="elsevierStyleCrossRef" href="#bib0210"><span class="elsevierStyleSup">42</span></a> Amusic patients report perceiving music as strident&#44; grating&#44; explosive&#44; and similar to the sound of banging pots and pans together&#46; It has been suggested that patients with severe amusia may present&#44; in addition to tone deafness&#44; impaired processing of timbre&#44; or the &#8216;colour&#8217; of a sound&#46; This property is independent from the sound&#39;s pitch&#44; and can be illustrated as the difference in sound when the same note is played on a piano and on a violin&#46; For this reason&#44; severe amusia is also called &#8216;dystimbria&#8217;&#46;<a class="elsevierStyleCrossRefs" href="#bib0145"><span class="elsevierStyleSup">29&#44;39&#44;43</span></a></p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Anatomical correlates of musical processing</span><p id="par0060" class="elsevierStylePara elsevierViewall">Findings from recent research into the musical brain indicate that associating musical functions with the right hemisphere and linguistic functions with the left hemisphere is erroneous and simplistic&#46;</p><p id="par0065" class="elsevierStylePara elsevierViewall">Documented cases of amusia show that not all musical deficits are located in the right hemisphere &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41;&#46; We also know that musical processing differs between subjects and that professional musicians and non-musicians process music in different ways&#44; since they use different areas of the brain&#46; While both hemispheres complement each other in the task of perceiving both melodic and temporal systems&#44; the right hemisphere plays a more important role in overall perception&#44; especially in right-handed non-musicians&#46; The right primary auditory cortex &#40;Brodmann area 41&#41; and secondary auditory cortex &#40;BA 42&#41; are crucial to the perception of music&#46; Therefore&#44; a congenital or acquired anomaly in the right auditory cortex predicts significant musical impairment&#46;<a class="elsevierStyleCrossRefs" href="#bib0020"><span class="elsevierStyleSup">4&#44;44</span></a> A recent study of right-handed patients with right and left middle cerebral artery infarction showed that those with damage to the right hemisphere had more severe amusia than amusic patients with damage to the left hemisphere&#46;<a class="elsevierStyleCrossRef" href="#bib0225"><span class="elsevierStyleSup">45</span></a> Nevertheless&#44; musical specialisation among right-handed professional musicians involves multiple areas of the left hemisphere&#44; promoting interconnection between the two hemispheres and establishing more specific and concrete functions&#46; Neuroimaging studies in professional musicians have shown the importance of the left hemisphere during musical tasks requiring more analytical processing&#46;<a class="elsevierStyleCrossRefs" href="#bib0230"><span class="elsevierStyleSup">46&#44;47</span></a></p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0070" class="elsevierStylePara elsevierViewall">Recent knowledge about the structures involved in musical processing is mainly based on study of the correlations between affected areas and musical deficits identified in published cases &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41;&#46; With the help of new technologies and research&#44; our knowledge is progressing significantly&#46;<a class="elsevierStyleCrossRef" href="#bib0240"><span class="elsevierStyleSup">48</span></a></p><p id="par0075" class="elsevierStylePara elsevierViewall">In 1865&#44; Bouillaud<a class="elsevierStyleCrossRef" href="#bib0245"><span class="elsevierStyleSup">49</span></a> described the first series of patients with brain damage and loss of musical abilities&#46; Henschen published the first monograph on amusia in 1920&#46;<a class="elsevierStyleCrossRef" href="#bib0250"><span class="elsevierStyleSup">50</span></a> In 1962&#44; Milner researched musical functions in a group of patients with intractable epilepsy who underwent temporal lobectomy&#46; Peretz<a class="elsevierStyleCrossRef" href="#bib0255"><span class="elsevierStyleSup">51</span></a> studied patients who underwent left and right temporal corticectomy&#46; They concluded that the right hemisphere is responsible for melody and melodic contour in general terms&#44; while the left hemisphere has the more specific task of encoding each note and interval in that melodic contour&#46; However&#44; there is no clear association between rhythm and a specific hemisphere&#59; rhythm is processed in multiple areas and rhythm impairment has been found in patients with either right-sided or left-sided brain damage&#46;<a class="elsevierStyleCrossRef" href="#bib0260"><span class="elsevierStyleSup">52</span></a></p><p id="par0080" class="elsevierStylePara elsevierViewall">With regard to musical memory&#44; some studies have revealed that the process of learning and retaining unfamiliar melodies involves the right hemisphere&#44; while the process of recognising familiar melodies seems to depend more on the left hemisphere&#46;<a class="elsevierStyleCrossRefs" href="#bib0265"><span class="elsevierStyleSup">53&#44;54</span></a></p><p id="par0085" class="elsevierStylePara elsevierViewall">According to MRI volumetric studies&#44; patients with congenital amusia present less white matter than healthy subjects&#44; especially in BA 47&#47;44 of the right inferior frontal gyrus &#40;rIFG&#41;&#46; The reduction in white matter volume has been related to abnormal results on tests for detecting off-pitch notes in a musical phrase and melodic pitch memory in the Montreal Battery of Evaluation of Amusia &#40;MBEA&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0275"><span class="elsevierStyleSup">55</span></a> Recent fMRI studies have shown lack of activation of the RIFG in amusic patients&#46;<a class="elsevierStyleCrossRef" href="#bib0280"><span class="elsevierStyleSup">56</span></a> Other PET studies<a class="elsevierStyleCrossRefs" href="#bib0285"><span class="elsevierStyleSup">57&#8211;59</span></a> have also revealed activation of the RIFG in healthy subjects during tasks involving musical memory&#46; These areas probably participate in pitch processing by means of frontotemporal connections with the right auditory cortex of the temporal lobe&#46; These connections are underdeveloped in amusic subjects&#46; In contrast&#44; these studies found that amusic patients had more grey matter in the same region of the rIFG &#40;BA 47&#41; than healthy subjects&#46; The increase in grey matter in the rIFG may be due to an impairment in neuronal migration similar to those described in epilepsy and developmental dyslexia&#46; However&#44; it is more reasonable to assume that impaired musical perception is due to a reduced volume of white matter rather than to an increase in grey matter thickness&#46; As mentioned previously&#44; the abnormal rIFG found in congenitally amusic patients is probably related to genetic conditions<a class="elsevierStyleCrossRef" href="#bib0300"><span class="elsevierStyleSup">60</span></a> involved in the development of early neuronal migration through frontotemporal connections&#44;<a class="elsevierStyleCrossRefs" href="#bib0105"><span class="elsevierStyleSup">21&#8211;24</span></a> since both frontal and temporal lobes are necessary for music processing&#46; Therefore&#44; amusia may appear when one or both lobes&#44; or the frontotemporal connections&#44; have suffered unilateral or bilateral damage&#46; On the other hand&#44; although researchers have not yet found morphological anomalies in the white and grey matter of the right auditory temporal cortex in congenital amusic subjects&#44; we cannot rule out this possibility&#46;<a class="elsevierStyleCrossRefs" href="#bib0275"><span class="elsevierStyleSup">55&#8211;61</span></a></p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Cognitive evaluation and rehabilitation for amusia</span><p id="par0090" class="elsevierStylePara elsevierViewall">Contrary to what Knoblauch thought&#44; amusia does not only affect professional musicians&#46;<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">16</span></a> In our experience&#44; amusic subjects with no musical knowledge are unlikely to report their condition since they lack sufficient musical knowledge to perceive their own deficits&#46; On the other hand&#44; professional musicians and music lovers are quick to identify any musical deficits&#46; If amusia were to be studied as systematically as language and cognitive functions&#44; researchers would probably confirm that amusia is much more frequent than the literature suggests&#46; Therefore&#44; standardised evaluations need to be employed if we are to further our knowledge of musical abilities&#46;</p><p id="par0095" class="elsevierStylePara elsevierViewall">The MBEA<a class="elsevierStyleCrossRef" href="#bib0310"><span class="elsevierStyleSup">62</span></a> was designed in 1987 as a tool for assessing amusic patients&#46; Musical perception and musical memory are the most commonly studied musical functions&#46; The MBEA includes 6 tests which allow researchers to assess perception of melodic contour&#44; intervals&#44; musical scales&#44; rhythm&#44; musical metre&#44; and musical memory&#46; Each test includes 30 unfamiliar musical phrases&#46; Less well-known evaluation tools include the one developed by Wertheim and Botez in 1959&#44; which involved adapting the test to the patient&#39;s pre-symptomatic musical level after first classifying subjects&#8217; musical abilities&#59;<a class="elsevierStyleCrossRef" href="#bib0315"><span class="elsevierStyleSup">63</span></a> the Gordon musical aptitude profile&#59;<a class="elsevierStyleCrossRef" href="#bib0320"><span class="elsevierStyleSup">64</span></a> and the Bentley measures of musical abilities&#46;<a class="elsevierStyleCrossRef" href="#bib0325"><span class="elsevierStyleSup">65</span></a></p><p id="par0100" class="elsevierStylePara elsevierViewall">In the last few years&#44; researchers have been showing increasing interest in understanding the potential links between amusia and cognitive impairment in areas such as memory&#44; visuospatial capacity&#44; attention&#44; etc&#46; A recent study on acquired amusia in patients with right middle cerebral artery infarction showed that amusic patients score lower on tests of memory&#44; attention&#44; and cognitive flexibility than non-amusic subjects do&#46;<a class="elsevierStyleCrossRef" href="#bib0330"><span class="elsevierStyleSup">66</span></a></p><p id="par0105" class="elsevierStylePara elsevierViewall">On the other hand&#44; it is reasonable to think that perception of melodic contour in amusic patients may also affect the intonation &#40;prosody&#41; of speech&#46;<a class="elsevierStyleCrossRef" href="#bib0335"><span class="elsevierStyleSup">67</span></a> However&#44; some studies show that 2 perceptual processes are at work&#58; one for singing intonation and another for speaking intonation&#46; Patel argues that &#8216;melodic contour deafness&#8217; is not exclusive to music&#44; as it also affects spoken language&#46;<a class="elsevierStyleCrossRef" href="#bib0340"><span class="elsevierStyleSup">68</span></a> Other studies have shown that musical perception depends on the same cognitive processes needed for spatial processing&#46; Researchers have described cases of amusic patients with spatial impairment&#44; which were believed to be related to poor mental representation of pitch intervals&#46;<a class="elsevierStyleCrossRef" href="#bib0345"><span class="elsevierStyleSup">69</span></a></p><p id="par0110" class="elsevierStylePara elsevierViewall">We often hear tone-deaf subjects say&#44; &#8220;I can&#8217;t play music since my ear is not good&#44; but I love it&#8221;&#46; These people are unable to sing in tune and they cannot tell when others are off-pitch&#44; but they do enjoy music&#46; Our opinion is that they should not be considered amusic in the strict sense of the term&#46; Such individuals are probably lacking in musical education or exposure to music&#46; Although their musical abilities remain intact&#44; they are inactive&#46; Alternatively&#44; these individuals may be considered to have a &#8216;tolerant&#8217; form of amusia&#44; which may improve with the help of directed music training&#46; Music teachers often improve their students&#8217; musical abilities&#44; since the ear for music can become more fine-tuned<a class="elsevierStyleCrossRef" href="#bib0350"><span class="elsevierStyleSup">70</span></a> by the repetition of specific musical tasks which discriminate pitches&#44; chords&#44; intervals&#44; rhythms&#44; tonalities&#44; and melodies&#46; These tasks are activated when we play an instrument or attend a concert&#44; for example&#46; In addition&#44; neuroimaging studies have found neuroplasticity in the musical pathways&#46; This phenomenon is related to more ample musical experience&#44; acquired by either playing or listening to music constantly &#40;experience-based neuroplasticity&#41;&#46;<a class="elsevierStyleCrossRefs" href="#bib0355"><span class="elsevierStyleSup">71&#8211;73</span></a> This is why some authors suggest that neuronal organisation in subjects with congenital amusia is not only endogenous&#44; but also related to limited exposure to music&#46; Amusic subjects are less likely to listen to music since it brings no pleasure&#46; Therefore&#44; avoiding exposure to music over the long term may lead to a decrease in the plasticity of frontotemporal connections &#40;learning non-use&#41;&#46; It is fundamental that we employ neuroimaging to study the neuroplasticity of the musical networks during directed musical tasks&#46; This may lead to the discovery of rehabilitation techniques for amusic patients&#46; In 2008&#44; Weill-Chounlamountry et al&#46;<a class="elsevierStyleCrossRef" href="#bib0370"><span class="elsevierStyleSup">74</span></a> developed the first rehabilitation therapy for amusia&#46; Their patient had suffered a cerebral infarction which caused tone deafness by impairing his pitch discrimination and therefore melody discrimination&#44; but which did not affect his sense of rhythm&#46; Researchers employed a computer programme that administered selective rehabilitation methods focusing solely on melody discrimination&#46; This technique improved the patient&#39;s results on post-therapy MBEA tests&#46; In addition&#44; music plays an important role in correcting other cognitive deficits &#40;melodic intonation therapy in patients with aphasia&#41;&#46;<a class="elsevierStyleCrossRefs" href="#bib0375"><span class="elsevierStyleSup">75&#44;76</span></a></p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Conclusions</span><p id="par0115" class="elsevierStylePara elsevierViewall">Although several different areas of the brain are involved in music processing&#44; more studies are needed in order to gain a better understanding of anatomical correlates&#46; Although we do possess a large body of knowledge about speech and its corresponding areas of the brain&#44; hemispheric specificity in music and brain regions involved in each of the components of music &#40;pitch&#44; rhythm&#44; timbre&#44; melody&#44; musical memory&#41; remain largely enigmatic&#46; Neuroimaging tests &#40;fMRI&#44; PET&#44; MEG&#41; in amusic patients and in subjects with deficits in specific music processes will add to our knowledge of musical networks and refine models of anatomical and functional correlates&#46; Congenital and acquired amusia may be more frequent than the literature suggests&#46; The scarcity of tools for neuropsychological diagnosis and patients&#8217; lack of awareness of their amusia may presumably explain the low rates of detection of these disorders&#46;</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Funding</span><p id="par0120" class="elsevierStylePara elsevierViewall">This study received no public or private financial support&#46;</p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Conflict of interest</span><p id="par0125" class="elsevierStylePara elsevierViewall">The authors have no conflict of interest to declare&#46;</p></span></span>"
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          "titulo" => "Music cognition model"
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          "titulo" => "Definition and types of amusia"
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          "titulo" => "Anatomical correlates of musical processing"
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          "titulo" => "Cognitive evaluation and rehabilitation for amusia"
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    "fechaRecibido" => "2011-02-15"
    "fechaAceptado" => "2011-04-07"
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            0 => "Amusia"
            1 => "Music cognition"
            2 => "Brain and music"
            3 => "Musical perception"
            4 => "Musical memory"
            5 => "Musical neuroscience"
            6 => "Musical rehabilitation"
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          "palabras" => array:7 [
            0 => "Amusia"
            1 => "Cognici&#243;n musical"
            2 => "Cerebro y m&#250;sica"
            3 => "Percepci&#243;n musical"
            4 => "Memoria musical"
            5 => "Neurociencia de la m&#250;sica"
            6 => "Rehabilitaci&#243;n y m&#250;sica"
          ]
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        "titulo" => "Abstract"
        "resumen" => "<span class="elsevierStyleSectionTitle">Introduction</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">The study of the neural networks involved in music processing has received less attention than work researching the brain&#39;s language networks&#46; For the last two decades there has been a growing interest in discovering the functional mechanisms of the musical brain and understanding those disorders in which brain regions linked with perception and production of music are damaged&#46;</p> <span class="elsevierStyleSectionTitle">Discussion</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Congenital and acquired musical deficits in their various forms &#40;perception&#44; execution&#44; music-memory&#41; are grouped together under the generic term amusia&#46; In this selective review we present the &#8220;cutting edge&#8221; studies on the cognitive and neural processes implicated in music and the various forms of amusia&#46;</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Musical processing requires a large cortico-subcortical network which is distributed throughout both cerebral hemispheres and the cerebellum&#46; The analysis of healthy subjects using functional neuroimaging and examination of selective deficits &#40;e&#46;g&#46;&#44; tone&#44; rhythm&#44; timbre&#44; melodic contours&#41; in patients will improve our knowledge of the mechanisms involved in musical processing and the latter&#39;s relationship with other cognitive processes&#46;</p>"
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        "resumen" => "<span class="elsevierStyleSectionTitle">Introducci&#243;n</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">El estudio de las redes neuronales implicadas en el procesamiento de la m&#250;sica ha recibido menos atenci&#243;n que la dispensada al lenguaje proposicional&#46; Desde hace dos d&#233;cadas existe un inter&#233;s creciente en conocer los mecanismos funcionales del cerebro musical y los trastornos que surgen del da&#241;o de las estructuras implicadas en la percepci&#243;n y producci&#243;n de la m&#250;sica&#46;</p> <span class="elsevierStyleSectionTitle">Desarrollo</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Los d&#233;ficits cong&#233;nitos y adquiridos del procesamiento musical en cualquiera de sus componentes &#40;percepci&#243;n&#44; ejecuci&#243;n&#44; memoria musical&#41; se engloban dentro del t&#233;rmino gen&#233;rico amusia&#46; En este trabajo se presenta una revisi&#243;n selectiva del &#171;estado-del-arte&#187; de los procesos cognitivos y neurales implicados en la m&#250;sica y los diferentes tipos de amusias&#46;</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">El procesamiento musical depende de una amplia red neural c&#243;rtico-subcortical distribuida en ambos hemisferios cerebrales y cerebelo&#46; El an&#225;lisis de sujetos sanos con neuroimagen funcional y de los d&#233;ficits selectivos en los componentes musicales &#40;p&#46; ej&#46;&#44; tono&#44; ritmo&#44; timbre&#44; contorno mel&#243;dico&#41; en pacientes con amusia mejorar&#225;n nuestro conocimiento acerca de los mecanismos implicados en el procesamiento musical y su relaci&#243;n con otros procesos cognitivos&#46;</p>"
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        "nota" => "<p class="elsevierStyleNotepara">Please cite this article as&#58; Garc&#237;a-Casares N&#44; et al&#46; Modelo de cognici&#243;n musical y amusia&#46; Neurolog&#237;a&#46; 2013&#59;28&#58;179&#8211;86&#46;</p>"
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          "en" => "<p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Anatomical locations and significant deficits in cases of acquired amusia Axial MRI &#40;MRIcron&#58; x 91&#44; y 126&#44; z 83&#41;&#46;</p>"
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Age&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>&#8804;50 years&#58; 18&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>&#62;50 years&#58; 35&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Sex&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Men&#58; 17&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Women&#58; 36&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Dominant hand</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Right 48&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">Professional musician</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Yes 25&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>No 28&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Hemisphere of the lesion</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Yes&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">Pitch discrimination 29Rhythm discrimination 22Melody recognition 20Timbre discrimination 15Singing 12Playing instruments 10Emotional connection to music 9Reading music 8Writing music 9Voice discrimination 3Environmental sound discrimination 4&nbsp;\t\t\t\t\t\t\n
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                      "titulo" => "Music and the bra&#58; studies in the neurology of music"
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                            0 => "T&#46;D&#46; Griffiths"
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                        "titulo" => "The biological foundations of music"
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                          "autores" => array:3 [
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Article information

ISSN: 21735808
Original language: English

DOI:10.1016/j.nrleng.2011.04.009

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Year/Month	Html	Pdf	Total

2024 November	10	0	10
2024 October	88	7	95
2024 September	103	8	111
2024 August	51	11	62
2024 July	66	7	73
2024 June	66	7	73
2024 May	66	10	76
2024 April	49	5	54
2024 March	53	9	62
2024 February	61	3	64
2024 January	76	7	83
2023 December	95	12	107
2023 November	87	13	100
2023 October	95	14	109
2023 September	40	7	47
2023 August	41	5	46
2023 July	61	12	73
2023 June	57	3	60
2023 May	104	12	116
2023 April	103	13	116
2023 March	55	28	83
2023 February	55	4	59
2023 January	57	10	67
2022 December	39	18	57
2022 November	59	11	70
2022 October	44	57	101
2022 September	35	21	56
2022 August	32	15	47
2022 July	34	10	44
2022 June	32	9	41
2022 May	40	17	57
2022 April	52	21	73
2022 March	57	7	64
2022 February	56	12	68
2022 January	91	15	106
2021 December	97	15	112
2021 November	44	11	55
2021 October	269	17	286
2021 September	68	30	98
2021 August	52	8	60
2021 July	53	25	78
2021 June	52	23	75
2021 May	52	32	84
2021 April	176	36	212
2021 March	146	20	166
2021 February	103	27	130
2021 January	95	17	112
2020 December	72	18	90
2020 November	70	23	93
2020 October	75	14	89
2020 September	35	10	45
2020 August	46	9	55
2020 July	45	13	58
2020 June	60	12	72
2020 May	46	12	58
2020 April	59	10	69
2020 March	57	16	73
2020 February	42	8	50
2020 January	53	9	62
2019 December	87	13	100
2019 November	19	6	25
2019 October	34	12	46
2019 September	12	0	12
2019 August	20	0	20
2019 July	17	12	29
2019 June	46	27	73
2019 May	89	56	145
2019 April	53	12	65
2019 March	26	10	36
2019 February	28	7	35
2019 January	21	9	30
2018 December	21	6	27
2018 November	49	9	58
2018 October	38	17	55
2018 September	52	9	61
2018 August	24	3	27
2018 July	14	3	17
2018 June	20	6	26
2018 May	23	5	28
2018 April	22	9	31
2018 March	14	1	15
2018 February	13	5	18
2018 January	17	4	21
2017 December	17	6	23
2017 November	25	5	30
2017 October	16	11	27
2017 September	25	2	27
2017 August	16	8	24
2017 July	28	8	36
2017 June	32	5	37
2017 May	32	7	39
2017 April	26	5	31
2017 March	19	35	54
2017 February	55	3	58
2017 January	44	6	50
2016 December	40	12	52
2016 November	62	12	74
2016 October	108	12	120
2016 September	152	10	162
2016 August	63	6	69
2016 July	46	5	51
2016 June	40	15	55
2016 May	52	20	72
2016 April	66	18	84
2016 March	40	29	69
2016 February	34	16	50
2016 January	19	17	36
2015 December	43	19	62
2015 November	37	17	54
2015 October	51	24	75
2015 September	36	17	53
2015 August	44	6	50
2015 July	25	12	37
2015 June	23	11	34
2015 May	34	23	57
2015 April	24	15	39
2015 March	34	7	41
2015 February	18	12	30
2015 January	29	13	42
2014 December	37	13	50
2014 November	30	6	36
2014 October	33	9	42
2014 September	22	5	27
2014 August	34	5	39
2014 July	40	7	47
2014 June	21	7	28
2014 May	21	5	26
2014 April	13	7	20
2014 March	28	10	38
2014 February	13	6	19
2014 January	18	11	29
2013 December	40	14	54
2013 November	28	5	33
2013 October	80	10	90
2013 September	43	10	53
2013 August	51	7	58
2013 July	28	3	31

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