From amusic to musical?--Improving pitch memory in congenital amusia with transcranial alternating current stimulation

Do developmental dyslexia and congenital amusia share underlying impairments?

Developmental dyslexia and congenital amusia have common characteristics. Yet, their possible association in some individuals has been addressed only scarcely. Recently, two converging studies reported a sizable comorbidity rate between these two neurodevelopmental disorders (Couvignou et al., Cognitive Neuropsychology 2019; Couvignou & Kolinsky, Neuropsychologia 2021). However, the reason for their association remains unclear. Here, we investigate the hypothesis of shared underlying impairments between dyslexia and amusia. Fifteen dyslexic children with amusia (DYS+A), 15 dyslexic children without amusia (DYS-A), and two groups of 25 typically developing children matched on either chronological age (CA) or reading level (RL) were assessed with a behavioral battery aiming to investigate phonological and pitch processing capacities at auditory memory, perceptual awareness, and attentional levels. Overall, our results suggest that poor auditory serial-order memory increases susceptibility to comorbidity between dyslexia and amusia and may play a role in the development of the comorbid phenotype. In contrast, the impairments observed in the DYS+A children for auditory item memory, perceptual awareness, and attention might be a consequence of their reduced reading experience combined with weaker musical skills. Comparing DYS+A and DYS-A children suggests that the latter are more resourceful and/or have more effective compensatory strategies, or that their phenotype results from a different developmental trajectory. We will discuss the relevance of these findings for delving into the etiology of these two developmental disorders and address their implications for future research and practice.

Auditory cortex and beyond: Deficits in congenital amusia

Congenital amusia is a neuro-developmental disorder of music perception and production, with the observed deficits contrasting with the sophisticated music processing reported for the general population. Musical deficits within amusia have been hypothesized to arise from altered pitch processing, with impairments in pitch discrimination and, notably, short-term memory. We here review research investigating its behavioral and neural correlates, in particular the impairments at encoding, retention, and recollection of pitch information, as well as how these impairments extend to the processing of pitch cues in speech and emotion. The impairments have been related to altered brain responses in a distributed fronto-temporal network, which can be observed also at rest. Neuroimaging studies revealed changes in connectivity patterns within this network and beyond, shedding light on the brain dynamics underlying auditory cognition. Interestingly, some studies revealed spared implicit pitch processing in congenital amusia, showing the power of implicit cognition in the music domain. Building on these findings, together with audiovisual integration and other beneficial mechanisms, we outline perspectives for training and rehabilitation and the future directions of this research domain.

Working Memory and Transcranial-Alternating Current Stimulation-State of the Art: Findings, Missing, and Challenges

Working memory (WM) is a cognitive process that involves maintaining and manipulating information for a short period of time. WM is central to many cognitive processes and declines rapidly with age. Deficits in WM are seen in older adults and in patients with dementia, schizophrenia, major depression, mild cognitive impairment, Alzheimer's disease, etc. The frontal, parietal, and occipital cortices are significantly involved in WM processing and all brain oscillations are implicated in tackling WM tasks, particularly theta and gamma bands. The theta/gamma neural code hypothesis assumes that retained memory items are recorded via theta-nested gamma cycles. Neuronal oscillations can be manipulated by sensory, invasive- and non-invasive brain stimulations. Transcranial alternating-current stimulation (tACS) and repetitive transcranial magnetic stimulation (rTMS) are frequency-tuned non-invasive brain stimulation (NIBS) techniques that have been used to entrain endogenous oscillations in a frequency-specific manner. Compared to rTMS, tACS demonstrates superior cost, tolerability, portability, and safety profile, making it an attractive potential tool for improving cognitive performance. Although cognitive research with tACS is still in its infancy compared to rTMS, a number of studies have shown a promising WM enhancement effect, especially in the elderly and patients with cognitive deficits. This review focuses on the various methods and outcomes of tACS on WM in healthy and unhealthy human adults and highlights the established findings, unknowns, challenges, and perspectives important for translating laboratory tACS into realistic clinical settings. This will allow researchers to identify gaps in the literature and develop frequency-tuned tACS protocols with promising safety and efficacy outcomes. Therefore, research efforts in this direction should help to consider frequency-tuned tACS as a non-pharmacological tool of cognitive rehabilitation in physiological aging and patients with cognitive deficits.

Pitch and Rhythm Perception and Verbal Short-Term Memory in Acute Traumatic Brain Injury

Music perception deficits are common following acquired brain injury due to stroke, epilepsy surgeries, and aneurysmal clipping. Few studies have examined these deficits following traumatic brain injury (TBI), resulting in an under-diagnosis in this population. We aimed to (1) compare TBI patients to controls on pitch and rhythm perception during the acute phase; (2) determine whether pitch and rhythm perception disorders co-occur; (3) examine lateralization of injury in the context of pitch and rhythm perception; and (4) determine the relationship between verbal short-term memory (STM) and pitch and rhythm perception. Music perception was examined using the Scale and Rhythm tests of the Montreal Battery of Evaluation of Amusia, in association with CT scans to identify lesion laterality. Verbal short-term memory was examined using Digit Span Forward. TBI patients had greater impairment than controls, with 43% demonstrating deficits in pitch perception, and 40% in rhythm perception. Deficits were greater with right hemisphere damage than left. Pitch and rhythm deficits co-occurred 31% of the time, suggesting partly dissociable networks. There was a dissociation between performance on verbal STM and pitch and rhythm perception 39 to 42% of the time (respectively), with most individuals (92%) demonstrating intact verbal STM, with impaired pitch or rhythm perception. The clinical implications of music perception deficits following TBI are discussed.

Specialized neural dynamics for verbal and tonal memory: fMRI evidence in congenital amusia

Behavioral and neuropsychological studies have suggested that tonal and verbal short-term memory are supported by specialized neural networks. To date however, neuroimaging investigations have failed to confirm this hypothesis. In this study, we investigated the hypothesis of distinct neural resources for tonal and verbal memory by comparing typical nonmusician listeners to individuals with congenital amusia, who exhibit pitch memory impairments with preserved verbal memory. During fMRI, amusics and matched controls performed delayed-match-to-sample tasks with tones and words and perceptual control tasks with the same stimuli. For tonal maintenance, amusics showed decreased activity in the right auditory cortex, inferior frontal gyrus (IFG) and dorso-lateral-prefrontal cortex (DLPFC). Moreover, they exhibited reduced right-lateralized functional connectivity between the auditory cortex and the IFG during tonal encoding and between the IFG and the DLPFC during tonal maintenance. In contrasts, amusics showed no difference compared with the controls for verbal memory, with activation in the left IFG and left fronto-temporal connectivity. Critically, we observed a group-by-material interaction in right fronto-temporal regions: while amusics recruited these regions less strongly for tonal memory than verbal memory, control participants showed the reversed pattern (tonal > verbal). By benefitting from the rare condition of amusia, our findings suggest specialized cortical systems for tonal and verbal short-term memory in the human brain.

Roles of posterior parietal and dorsal premotor cortices in relative pitch processing: Comparing musical intervals to lexical tones

Humans use time-varying pitch patterns to convey information in music and speech. Recognition of musical melodies and lexical tones relies on relative pitch (RP), the ability to identify intervals between two pitches. RP processing in music is usually more fine-grained than that in tonal languages. In Western music, there are twelve pitch categories within an octave, whereas there are only three level (non-glide) lexical tones in Taiwanese (or Taiwanese Hokkien, a tonal language). The present study aimed at comparing the neural substrates underlying RP processing of musical melodic intervals with that of level lexical tones in Taiwanese. Functional magnetic resonance imaging data from fourteen participants with good RP were analyzed. The results showed that imagining the sounds of visually presented musical intervals was associated with enhanced activity in the central subregion of the right dorsal premotor cortex (dPMC), right posterior parietal cortex (PPC), and right dorsal precuneus compared to auditory imagery of visually presented Taiwanese bi-character words with level lexical tones. During the sound-congruence-judgement task (auditory imagery of musical intervals or bi-character words, and subsequently judging if the imagined sounds were melodically congruent with heard sounds), the contrast of the musical minus linguistic conditions yielded activity in the bilateral dPMC-PPC network and dorsal precuneus, with the dPMC activated in the rostral subregion. The central dPMC and PPC may mediate the attention-based maintenance of pitch intervals, whereas the dorsal precuneus may support attention control and the spatial/sensorimotor processing of the fine-grained pitch structures of music. When judging the congruence between the imagined and heard musical intervals, the bilateral rostral dPMC may play a role in attention control, working memory, evaluation of motor activities, and monitoring mechanisms. Based on the findings of this study and recent studies of amusia, we suggest that higher order cognitive operations are critical to the more fine-grained pitch processing of musical melodies compared to lexical tones.

The Nature and Nurture of Congenital Amusia: A Twin Case Study

In this article, we report the first documented case of congenital amusia in dizygotic twins. The female twin pair was 27 years old at the time of testing, with normal hearing and above average intelligence. Both had formal music lesson from the age of 8-12 and were exposed to music in their childhood. Using the Montreal Battery of Evaluation of Amusia (Peretz et al., 2003), one twin was diagnosed as amusic, with a pitch perception as well as a rhythm perception deficit, while the other twin had normal pitch and rhythm perception. We conducted a large battery of tests assessing the performance of the twins in music, pitch perception and memory, language perception and spatial processing. Both showed an identical albeit low pitch memory span of 3.5 tones and an impaired performance on a beat alignment task, yet the non-amusic twin outperformed the amusic twin in three other musical and all language related tasks. The twins also differed significantly in their performance on one of two spatial tasks (visualization), with the non-amusic twin outperforming the amusic twin (83% vs. 20% correct). The performance of the twins is also compared to normative samples of normal and amusic participants from other studies. This twin case study highlights that congenital amusia is not due to insufficient exposure to music in childhood: The exposure to music of the twin pair was as comparable as it can be for two individuals. This study also indicates that there is an association between amusia and a spatial processing deficit (see Douglas and Bilkey, 2007; contra Tillmann et al., 2010; Williamson et al., 2011) and that more research is needed in this area.

Driving working memory with frequency-tuned noninvasive brain stimulation

Frequency-tuned noninvasive brain stimulation is a recent approach in cognitive neuroscience that involves matching the frequency of transcranially applied electromagnetic fields to that of specific oscillatory components of the underlying neurophysiology. The objective of this method is to modulate ongoing/intrinsic brain oscillations, which correspond to rhythmic fluctuations of neural excitability, to causally change behavior. We review the impact of frequency-tuned noninvasive brain stimulation on the research field of human working memory. We argue that this is a powerful method to probe and understand the mechanisms of memory functions, targeting specifically task-related oscillatory dynamics, neuronal representations, and brain networks. We report the main behavioral and neurophysiological outcomes published to date, in particular, how functionally relevant oscillatory signatures in signal power and interregional connectivity yield causal changes of working memory abilities. We also present recent developments of the technique that aim to modulate cross-frequency coupling in polyrhythmic neural activity. Overall, the method has led to significant advances in our understanding of the mechanisms of systems neuroscience, and the role of brain oscillations in cognition and behavior. We also emphasize the translational impact of noninvasive brain stimulation techniques in the development of therapeutic approaches.

The Significance of the Right Dorsolateral Prefrontal Cortex for Pitch Memory in Non-musicians Depends on Baseline Pitch Memory Abilities

Pitch memory is a resource which is shared by music and language. Neuroimaging studies have shown that the right dorsolateral prefrontal cortex (DLPFC) is activated during pitch memory processes. The present study investigated the causal significance of this brain area for pitch memory in non-musicians by applying cathodal and sham transcranial direct current stimulation (tDCS) over the right DLPFC and examining the impact on offline pitch and visual memory span performances. On the overall sample (N = 22) no significant modulation effect of cathodal stimulation on the pitch span task was found. However, when dividing the sample by means of a median split of pre-test pitch memory abilities into a high and low performing group, a selective effect of significantly impaired pitch memory after cathodal tDCS in good performers was revealed. The visual control task was not affected by the stimulation in either group. The results support previous neuroimaging studies that the right DLPFC is involved in pitch memory processes in non-musicians and highlights the importance of baseline pitch memory abilities for the modulatory effect of tDCS.

Deficits of congenital amusia beyond pitch: Evidence from impaired categorical perception of vowels in Cantonese-speaking congenital amusics

Congenital amusia is a lifelong disorder of fine-grained pitch processing in music and speech. However, it remains unclear whether amusia is a pitch-specific deficit, or whether it affects frequency/spectral processing more broadly, such as the perception of formant frequency in vowels, apart from pitch. In this study, in order to illuminate the scope of the deficits, we compared the performance of 15 Cantonese-speaking amusics and 15 matched controls on the categorical perception of sound continua in four stimulus contexts: lexical tone, pure tone, vowel, and voice onset time (VOT). Whereas lexical tone, pure tone and vowel continua rely on frequency/spectral processing, the VOT continuum depends on duration/temporal processing. We found that the amusic participants performed similarly to controls in all stimulus contexts in the identification, in terms of the across-category boundary location and boundary width. However, the amusic participants performed systematically worse than controls in discriminating stimuli in those three contexts that depended on frequency/spectral processing (lexical tone, pure tone and vowel), whereas they performed normally when discriminating duration differences (VOT). These findings suggest that the deficit of amusia is probably not pitch specific, but affects frequency/spectral processing more broadly. Furthermore, there appeared to be differences in the impairment of frequency/spectral discrimination in speech and nonspeech contexts. The amusic participants exhibited less benefit in between-category discriminations than controls in speech contexts (lexical tone and vowel), suggesting reduced categorical perception; on the other hand, they performed inferiorly compared to controls across the board regardless of between- and within-category discriminations in nonspeech contexts (pure tone), suggesting impaired general auditory processing. These differences imply that the frequency/spectral-processing deficit might be manifested differentially in speech and nonspeech contexts in amusics—it is manifested as a deficit of higher-level phonological processing in speech sounds, and as a deficit of lower-level auditory processing in nonspeech sounds.

Transcranial electric stimulation for the investigation of speech perception and comprehension

Transcranial electric stimulation (tES), comprising transcranial direct current stimulation (tDCS) and transcranial alternating current stimulation (tACS), involves applying weak electrical current to the scalp, which can be used to modulate membrane potentials and thereby modify neural activity. Critically, behavioural or perceptual consequences of this modulation provide evidence for a causal role of neural activity in the stimulated brain region for the observed outcome. We present tES as a tool for the investigation of which neural responses are necessary for successful speech perception and comprehension. We summarise existing studies, along with challenges that need to be overcome, potential solutions, and future directions. We conclude that, although standardised stimulation parameters still need to be established, tES is a promising tool for revealing the neural basis of speech processing. Future research can use this method to explore the causal role of brain regions and neural processes for the perception and comprehension of speech.

Preserved appreciation of aesthetic elements of speech and music prosody in an amusic individual: A holistic approach

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An amusic individual was given novel tasks of speech and music prosody.

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Intact processing of holistic aesthetic aspects of prosody was demonstrated.

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Examination of speech and music prosodic phenomena adds to understanding amusia.

We present a follow-up study on the case of a Greek amusic adult, B.Z., whose impaired performance on scale, contour, interval, and meter was reported by Paraskevopoulos, Tsapkini, and Peretz in 2010, employing a culturally-tailored version of the Montreal Battery of Evaluation of Amusia. In the present study, we administered a novel set of perceptual judgement tasks designed to investigate the ability to appreciate holistic prosodic aspects of ‘expressiveness’ and emotion in phrase length music and speech stimuli. Our results show that, although diagnosed as a congenital amusic, B.Z. scored as well as healthy controls (N = 24) on judging ‘expressiveness’ and emotional prosody in both speech and music stimuli. These findings suggest that the ability to make perceptual judgements about such prosodic qualities may be preserved in individuals who demonstrate difficulties perceiving basic musical features such as melody or rhythm. B.Z.’s case yields new insights into amusia and the processing of speech and music prosody through a holistic approach. The employment of novel stimuli with relatively fewer non-naturalistic manipulations, as developed for this study, may be a useful tool for revealing unexplored aspects of music and speech cognition and offer the possibility to further the investigation of the perception of acoustic streams in more authentic auditory conditions.

Verbal and musical short-term memory: Variety of auditory disorders after stroke

Auditory cognitive deficits after stroke may concern language and/or music processing, resulting in aphasia and/or amusia. The aim of the present study was to assess the potential deficits of auditory short-term memory for verbal and musical material after stroke and their underlying cerebral correlates with a Voxel-based Lesion Symptom Mapping approach (VLSM). Patients with an ischemic stroke in the right (N=10) or left (N=10) middle cerebral artery territory and matched control participants (N=14) were tested with a detailed neuropsychological assessment including global cognitive functions, music perception and language tasks. All participants then performed verbal and musical auditory short-term memory (STM) tasks that were implemented in the same way for both materials. Participants had to indicate whether series of four words or four tones presented in pairs, were the same or different. To detect domain-general STM deficits, they also had to perform a visual STM task. Behavioral results showed that patients had lower performance for the STM tasks in comparison with control participants, regardless of the material (words, tones, visual) and the lesion side. The individual patient data showed a double dissociation between some patients exhibiting verbal deficits without musical deficits or the reverse. Exploratory VLSM analyses suggested that dorsal pathways are involved in verbal (phonetic), musical (melodic), and visual STM, while the ventral auditory pathway is involved in musical STM.

Differential effects of 10-Hz and 40-Hz transcranial alternating current stimulation (tACS) on endogenous versus exogenous attention

Previous electrophysiological studies implicate both alpha (8-12 Hz) and gamma (>30 Hz) neural oscillations in the mechanisms of selective attention. Here, participants preformed two separate visual attention tasks, one endogenous and one exogenous, while transcranial alternating current stimulation (tACS), at 10 Hz, 40 Hz, or sham, was applied to the right parietal lobe. Our results provide new evidence for the roles of gamma and alpha oscillations in voluntary versus involuntary shifts of attention. Gamma (40 Hz) stimulation resulted in improved disengagement from invalidly cued targets in the endogenous attention task, whereas alpha stimulation (10 Hz) had no effect on endogenous attention, but increased the exogenous cuing effect. These findings agree with previous studies suggesting that right inferior parietal regions may be especially important for the disengagement of attention, and go further to provide details about the specific type of oscillatory neural activity within that brain region that is differentially involved in endogenous versus exogenous attention. Our results also have potential implications for the plasticity and training of attention systems.

Abnormal topological organization of the white matter network in Mandarin speakers with congenital amusia

Congenital amusia is a neurogenetic disorder that mainly affects the processing of musical pitch. Brain imaging evidence indicates that it is associated with abnormal structural and functional connections in the fronto-temporal region. However, a holistic understanding of the anatomical topology underlying amusia is still lacking. Here, we used probabilistic diffusion tensor imaging tractography and graph theory to examine whole brain white matter structural connectivity in 31 Mandarin-speaking amusics and 24 age- and IQ-matched controls. Amusics showed significantly reduced global connectivity, as indicated by the abnormally decreased clustering coefficient (C_p) and increased normalized shortest path length (λ) compared to the controls. Moreover, amusics exhibited enhanced nodal strength in the right inferior parietal lobule relative to controls. The co-existence of the lexical tone deficits was associated with even more deteriorated global network efficiency in amusics, as suggested by the significant correlation between the increments in normalized shortest path length (λ) and the insensitivity in lexical tone perception. Our study is the first to reveal reduced global connectivity efficiency in amusics as well as an increase in the global connectivity cost due to the co-existed lexical tone deficits. Taken together these results provide a holistic perspective on the anatomical substrates underlying congenital amusia.

Modulating Human Auditory Processing by Transcranial Electrical Stimulation

Transcranial electrical stimulation (tES) has become a valuable research tool for the investigation of neurophysiological processes underlying human action and cognition. In recent years, striking evidence for the neuromodulatory effects of transcranial direct current stimulation, transcranial alternating current stimulation, and transcranial random noise stimulation has emerged. While the wealth of knowledge has been gained about tES in the motor domain and, to a lesser extent, about its ability to modulate human cognition, surprisingly little is known about its impact on perceptual processing, particularly in the auditory domain. Moreover, while only a few studies systematically investigated the impact of auditory tES, it has already been applied in a large number of clinical trials, leading to a remarkable imbalance between basic and clinical research on auditory tES. Here, we review the state of the art of tES application in the auditory domain focussing on the impact of neuromodulation on acoustic perception and its potential for clinical application in the treatment of auditory related disorders.