Amusia and stroke

Although a complete musical anti-talent myself, that doesn’t prohibit me from fully enjoying the works of the masters in the art. When my family is out of earshot, I even bellow – because it cannot be called music – from the top of my lungs alongside the most famous tenors ever recorded. A couple of days ago I loaded one of my most eclectic playlists. While remembering my younger days as an Iron Maiden concert goer (I never said I listen only to classical music :D) and screaming the “Fear of the Dark” chorus, I wondered what’s new on the front of music processing in the brain.

And I found an interesting recent paper about amusia. Amusia is, as those of you with ancient Greek proclivities might have surmised, a deficit in the perception of music, mainly the pitch but sometimes rhythm and other aspects of music. A small percentage of the population is born with it, but a whooping 35 to 69% of stroke survivors exhibit the disorder.

So Sihvonen et al. (2016) decided to take a closer look at this phenomenon with the help of 77 stroke patients. These patients had an MRI scan within the first 3 weeks following stroke and another one 6 months poststroke. They also completed a behavioral test for amusia within the first 3 weeks following stroke and again 3 months later. For reasons undisclosed, and thus raising my eyebrows, the behavioral assessment was not performed at 6 months poststroke, nor an MRI at the 3 months follow-up. It would be nice to have had behavioral assessment with brain images at the same time because a lot can happen in weeks, let alone months after a stroke.

Nevertheless, the authors used a novel way to look at the brain pictures, called voxel-based lesion-symptom mapping (VLSM). Well, is not really novel, it’s been around for 15 years or so. Basically, to ascertain the function of a brain region, researchers either get people with a specific brain lesion and then look for a behavioral deficit or get a symptom and then they look for a brain lesion. Both approaches have distinct advantages but also disadvantages (see Bates et al., 2003). To overcome the disadvantages of these methods, enter the scene VLSM, which is a mathematical/statistical gimmick that allows you to explore the relationship between brain and function without forming preconceived ideas, i.e. without forcing dichotomous categories. They also looked at voxel-based morphometry (VBM), which a fancy way of saying they looked to see if the grey and white matter differ over time in the brains of their subjects.

After much analyses, Sihvonen et al. (2016) conclude that the damage to the right hemisphere is more likely conducive to amusia, as opposed to aphasia which is due mainly to damage to the left hemisphere. More specifically,

“damage to the right temporal areas, insula, and putamen forms the crucial neural substrate for acquired amusia after stroke. Persistent amusia is associated with further [grey matter] atrophy in the right superior temporal gyrus (STG) and middle temporal gyrus (MTG), locating more anteriorly for rhythm amusia and more posteriorly for pitch amusia.”

The more we know, the better chances we have to improve treatments for people.

104-copy

unless you’re left-handed, then things are reversed.

References:

1. Sihvonen AJ, Ripollés P, Leo V, Rodríguez-Fornells A, Soinila S, & Särkämö T. (24 Aug 2016). Neural Basis of Acquired Amusia and Its Recovery after Stroke. Journal of Neuroscience, 36(34):8872-8881. PMID: 27559169, DOI: 10.1523/JNEUROSCI.0709-16.2016. ARTICLE  | FULLTEXT PDF

2.Bates E, Wilson SM, Saygin AP, Dick F, Sereno MI, Knight RT, & Dronkers NF (May 2003). Voxel-based lesion-symptom mapping. Nature Neuroscience, 6(5):448-50. PMID: 12704393, DOI: 10.1038/nn1050. ARTICLE

By Neuronicus, 9 November 2016

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The good and the bad of abstinence

The nucleus accumbens, a key region involved in reward processing and addiction. Credit: Zou et al. (2015)
The nucleus accumbens, a key region involved in reward processing and addiction. Credit: Zou et al. (2015)

Consumption of addictive drugs changes your brain and these changes underlie the consequent dependence. It is very difficult to quit, and certainly it is not a matter of lack of will power that the majority of drug users have such a great difficulty in trying to quit. But what happens to the brains of the lucky few who managed to kick the addiction out the window? Are their brains reverting to their pre-addiction states? As the paper below shows, sadly, no. But there is hope.

Zhou et al. ( 2015) used resting state fMRI (which means scanning your brain without requiring you to perform any task) to investigate the brains of 30 healthy controls and 30 heroin-addicts who were abstinent from the drug for more than 3 years. Specifically, they looked to see if the connectivity of certain brain regions involved in addiction is different after such a long abstinence time.

The bad news is that the abstinents still had some abnormal connectivity (for specialists: “stronger functional connectivity between the nucleus accumbens and the right ventromedial prefrontal cortex and relatively weaker connectivity between the nucleus accumbens and the left putamen, left precuneus, and supplementary motor area” p. 1697).

The good news: the longer the abstinence time, the greater the strength of the connection between nucleus accumbens and putamen (first structure involved in reward processing, the second in habit-learning), suggesting a partial neural recovery.

The study has some limitations: technical (did not control for heartbeat and respiration), methodological (most of the heroin abstinents were smokers, another addiction) and theoretical (one brain area does not support only one function, so its connectivity shouldn’t be over interpreted). With the caveat that the connectivity differences observed do not in any way point to a cause and effect relationship – that is we don’t know if these differences existed before the first heroin intake and caused it or they appeared after as a result of drug consumption, I think the paper is still is worth reading.

Reference: Zou F, Wu X, Zhai T, Lei Y, Shao Y, Jin X, Tan S, Wu B, Wang L, Yang Z (November 2015, Epub 17 Aug 2015). Abnormal resting-state functional connectivity of the nucleus accumbens in multi-year abstinent heroin addicts. Journal of Neuroscience Research, 93(11):1693-702. doi: 10.1002/jnr.23608. Article | FREE PDF

By Neuronicus, 9 October 2015