Congenital amusia: a cognitive disorder limited to resolved harmonics and with no peripheral basis

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.

The Perception of Lexical Tone and Intonation in Whispered Speech by Mandarin-Speaking Congenital Amusics

PURPOSE

A fundamental feature of human speech is variation, including the manner of phonation, as exemplified in the case of whispered speech. In this study, we employed whispered speech to examine an unresolved issue about congenital amusia, a neurodevelopmental disorder of musical pitch processing, which also affects speech pitch processing such as lexical tone and intonation perception. The controversy concerns whether amusia is a pitch-processing disorder or can affect speech processing beyond pitch.

METHOD

We examined lexical tone and intonation recognition in 19 Mandarin-speaking amusics and 19 matched controls in phonated and whispered speech, where fundamental frequency (f _o) information is either present or absent.

RESULTS

The results revealed that the performance of congenital amusics was inferior to that of controls in lexical tone identification in both phonated and whispered speech. These impairments were also detected in identifying intonation (statements/questions) in phonated and whispered modes. Across the experiments, regression models revealed that f _o and non-f _o (duration, intensity, and formant frequency) acoustic cues predicted tone and intonation recognition in phonated speech, whereas non-f _o cues predicted tone and intonation recognition in whispered speech. There were significant differences between amusics and controls in the use of both f _o and non-f _o cues.

CONCLUSION

The results provided the first evidence that the impairments of amusics in lexical tone and intonation identification prevail into whispered speech and support the hypothesis that the deficits of amusia extend beyond pitch processing.

SUPPLEMENTAL MATERIAL

https://doi.org/10.23641/asha.19302275.

Toward inclusive theories of the evolution of musicality

We compare and contrast the 60 commentaries by 109 authors on the pair of target articles by Mehr et al. and ourselves. The commentators largely reject Mehr et al.'s fundamental definition of music and their attempts to refute (1) our social bonding hypothesis, (2) byproduct hypotheses, and (3) sexual selection hypotheses for the evolution of musicality. Instead, the commentators generally support our more inclusive proposal that social bonding and credible signaling mechanisms complement one another in explaining cooperation within and competition between groups in a coevolutionary framework (albeit with some confusion regarding terminologies such as "byproduct" and "exaptation"). We discuss the proposed criticisms and extensions, with a focus on moving beyond adaptation/byproduct dichotomies and toward testing of cross-species, cross-cultural, and other empirical predictions.

Short- and long-term memory for pitch and non-pitch contours: Insights from congenital amusia

Congenital amusia is a neurodevelopmental disorder characterized by deficits in music perception, including discriminating and remembering melodies and melodic contours. As non-amusic listeners can perceive contours in dimensions other than pitch, such as loudness and brightness, our present study investigated whether amusics' pitch contour deficits also extend to these other auditory dimensions. Amusic and control participants performed an identification task for ten familiar melodies and a short-term memory task requiring the discrimination of changes in the contour of novel four-tone melodies. For both tasks, melodic contour was defined by pitch, brightness, or loudness. Amusic participants showed some ability to extract contours in all three dimensions. For familiar melodies, amusic participants showed impairment in all conditions, perhaps reflecting the fact that the long-term memory representations of the familiar melodies were defined in pitch. In the contour discrimination task with novel melodies, amusic participants exhibited less impairment for loudness-based melodies than for pitch- or brightness-based melodies, suggesting some specificity of the deficit for spectral changes, if not for pitch alone. The results suggest pitch and brightness may not be processed by the same mechanisms as loudness, and that short-term memory for loudness contours may be spared to some degree in congenital amusia.

Binaural localization of musical pitch using interaural time differences in congenital amusia

Naturally occurring sounds are routinely periodic. The ability to phase-lock to such periodicity facilitates pitch perception and interaural time differences (ITDs) determination in binaural localization. We examined whether deficient pitch processing in individuals with congenital amusia (tone deafness) is accompanied by impaired ability to lateralize musical pitch at auditory periphery and memorize the location of pitch at the working memory level. If common mechanisms subserve processing of temporal-fine-structure based pitch and ITDs, then deficient processing of one feature should impair performance on the other. Thus, we measured ITD discrimination thresholds using an adaptive-tracking procedure for lateralizing musical tone pairs separated by different semitone intervals. Amusic individuals exhibited normal ITD thresholds comparable to those of matched controls, which were not affected by concurrent pitch changes. For working memory tasks, the amusic group performed significantly worse than matched controls in probed pitch recall, irrespective of the complexity level of concurrent variations along the ITD dimension of the melodic sequence. Interestingly, despite normal peripheral ITD thresholds, amusic individuals performed worse than controls in recalling probed locations of tones within a sequence of musical notes originating from different ITD-simulated locations. Findings suggest that individuals with congenital amusia are unimpaired in temporal fine-structure encoding to determine the location of musical pitch based on binaural ITD information at the auditory periphery. However, working memory for a sequence of sounds' ITD-dependent spatial location is here shown to be impaired and dissociated from the pitch feature of sounds at the working memory level.

Learning for pitch and melody discrimination in congenital amusia

Congenital amusia is currently thought to be a life-long neurogenetic disorder in music perception, impervious to training in pitch or melody discrimination. This study provides an explicit test of whether amusic deficits can be reduced with training. Twenty amusics and 20 matched controls participated in four sessions of psychophysical training involving either pure-tone (500 Hz) pitch discrimination or a control task of lateralization (interaural level differences for bandpass white noise). Pure-tone pitch discrimination at low, medium, and high frequencies (500, 2000, and 8000 Hz) was measured before and after training (pretest and posttest) to determine the specificity of learning. Melody discrimination was also assessed before and after training using the full Montreal Battery of Evaluation of Amusia, the most widely used standardized test to diagnose amusia. Amusics performed more poorly than controls in pitch but not localization discrimination, but both groups improved with practice on the trained stimuli. Learning was broad, occurring across all three frequencies and melody discrimination for all groups, including those who trained on the non-pitch control task. Following training, 11 of 20 amusics no longer met the global diagnostic criteria for amusia. A separate group of untrained controls (n = 20), who also completed melody discrimination and pretest, improved by an equal amount as trained controls on all measures, suggesting that the bulk of learning for the control group occurred very rapidly from the pretest. Thirty-one trained participants (13 amusics) returned one year later to assess long-term maintenance of pitch and melody discrimination. On average, there was no change in performance between posttest and one-year follow-up, demonstrating that improvements on pitch- and melody-related tasks in amusics and controls can be maintained. The findings indicate that amusia is not always a life-long deficit when using the current standard diagnostic criteria.

Syntactic processing in music and language: Parallel abnormalities observed in congenital amusia

Evidence is accumulating that similar cognitive resources are engaged to process syntactic structure in music and language. Congenital amusia – a neurodevelopmental disorder that primarily affects music perception, including musical syntax – provides a special opportunity to understand the nature of this overlap. Using electroencephalography (EEG), we investigated whether individuals with congenital amusia have parallel deficits in processing language syntax in comparison to control participants. Twelve amusic participants (eight females) and 12 control participants (eight females) were presented melodies in one session, and spoken sentences in another session, both of which had syntactic-congruent and -incongruent stimuli. They were asked to complete a music-related and a language-related task that were irrelevant to the syntactic incongruities. Our results show that amusic participants exhibit impairments in the early stages of both music- and language-syntactic processing. Specifically, we found that two event-related potential (ERP) components – namely Early Right Anterior Negativity (ERAN) and Left Anterior Negativity (LAN), associated with music- and language-syntactic processing respectively, were absent in the amusia group. However, at later processing stages, amusics showed similar brain responses as controls to syntactic incongruities in both music and language. This was reflected in a normal N5 in response to melodies and a normal P600 to spoken sentences. Notably, amusics' parallel music- and language-syntactic impairments were not accompanied by deficits in semantic processing (indexed by normal N400 in response to semantic incongruities). Together, our findings provide further evidence for shared music and language syntactic processing, particularly at early stages of processing.

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Amusics displayed abnormal brain responses to music-syntactic irregularities.

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They also exhibited abnormal brain responses to language-syntactic irregularities.

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These impairments affect an early stage of syntactic processing not a later stage.

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Music and language involve similar cognitive mechanisms for processing syntax.

Not Cure But Heal: Music and Medicine

Do you know that our soul is composed of harmony? Leonardo Da Vinci Despite evidence for music-specific mechanisms at the level of pitch-pattern representations, the most fascinating aspect of music is its transmodality. Recent psychological and neuroscientific evidence suggest that music is unique in the coupling of perception, cognition, action and emotion. This potentially explains why music has been since time immemorial almost inextricably linked to healing processes and should continue to be.

Congenital amusics use a secondary pitch mechanism to identify lexical tones

Amusia is a pitch perception disorder associated with deficits in processing and production of both musical and lexical tones, which previous reports have suggested may be constrained to fine-grained pitch judgements. In the present study speakers of tone-languages, in which lexical tones are used to convey meaning, identified words present in chimera stimuli containing conflicting pitch-cues in the temporal fine-structure and temporal envelope, and which therefore conveyed two distinct utterances. Amusics were found to be more likely than controls to judge the word according to the envelope pitch-cues. This demonstrates that amusia is not associated with fine-grained pitch judgements alone, and is consistent with there being two distinct pitch mechanisms and with amusics having an atypical reliance on a secondary mechanism based upon envelope cues.

Pitch contour impairment in congenital amusia: New insights from the Self-paced Audio-visual Contour Task (SACT)

Individuals with congenital amusia usually exhibit impairments in melodic contour processing when asked to compare pairs of melodies that may or may not be identical to one another. However, it is unclear whether the impairment observed in contour processing is caused by an impairment of pitch discrimination, or is a consequence of poor pitch memory. To help resolve this ambiguity, we designed a novel Self-paced Audio-visual Contour Task (SACT) that evaluates sensitivity to contour while placing minimal burden on memory. In this task, participants control the pace of an auditory contour that is simultaneously accompanied by a visual contour, and they are asked to judge whether the two contours are congruent or incongruent. In Experiment 1, melodic contours varying in pitch were presented with a series of dots that varied in spatial height. Amusics exhibited reduced sensitivity to audio-visual congruency in comparison to control participants. To exclude the possibility that the impairment arises from a general deficit in cross-modal mapping, Experiment 2 examined sensitivity to cross-modal mapping for two other auditory dimensions: timbral brightness and loudness. Amusics and controls were significantly more sensitive to large than small contour changes, and to changes in loudness than changes in timbre. However, there were no group differences in cross-modal mapping, suggesting that individuals with congenital amusia can comprehend spatial representations of acoustic information. Taken together, the findings indicate that pitch contour processing in congenital amusia remains impaired even when pitch memory is relatively unburdened.

Auditory deficits in amusia extend beyond poor pitch perception

Congenital amusia is a music perception disorder believed to reflect a deficit in fine-grained pitch perception and/or short-term or working memory for pitch. Because most measures of pitch perception include memory and segmentation components, it has been difficult to determine the true extent of pitch processing deficits in amusia. It is also unclear whether pitch deficits persist at frequencies beyond the range of musical pitch. To address these questions, experiments were conducted with amusics and matched controls, manipulating both the stimuli and the task demands. First, we assessed pitch discrimination at low (500Hz and 2000Hz) and high (8000Hz) frequencies using a three-interval forced-choice task. Amusics exhibited deficits even at the highest frequency, which lies beyond the existence region of musical pitch. Next, we assessed the extent to which frequency coding deficits persist in one- and two-interval frequency-modulation (FM) and amplitude-modulation (AM) detection tasks at 500Hz at slow (fm=4Hz) and fast (fm=20Hz) modulation rates. Amusics still exhibited deficits in one-interval FM detection tasks that should not involve memory or segmentation. Surprisingly, amusics were also impaired on AM detection, which should not involve pitch processing. Finally, direct comparisons between the detection of continuous and discrete FM demonstrated that amusics suffer deficits in both coding and segmenting pitch information. Our results reveal auditory deficits in amusia extending beyond pitch perception that are subtle when controlling for memory and segmentation, and are likely exacerbated in more complex contexts such as musical listening.

Pitch-Responsive Cortical Regions in Congenital Amusia

Congenital amusia is a lifelong deficit in music perception thought to reflect an underlying impairment in the perception and memory of pitch. The neural basis of amusic impairments is actively debated. Some prior studies have suggested that amusia stems from impaired connectivity between auditory and frontal cortex. However, it remains possible that impairments in pitch coding within auditory cortex also contribute to the disorder, in part because prior studies have not measured responses from the cortical regions most implicated in pitch perception in normal individuals. We addressed this question by measuring fMRI responses in 11 subjects with amusia and 11 age- and education-matched controls to a stimulus contrast that reliably identifies pitch-responsive regions in normal individuals: harmonic tones versus frequency-matched noise. Our findings demonstrate that amusic individuals with a substantial pitch perception deficit exhibit clusters of pitch-responsive voxels that are comparable in extent, selectivity, and anatomical location to those of control participants. We discuss possible explanations for why amusics might be impaired at perceiving pitch relations despite exhibiting normal fMRI responses to pitch in their auditory cortex: (1) individual neurons within the pitch-responsive region might exhibit abnormal tuning or temporal coding not detectable with fMRI, (2) anatomical tracts that link pitch-responsive regions to other brain areas (e.g., frontal cortex) might be altered, and (3) cortical regions outside of pitch-responsive cortex might be abnormal. The ability to identify pitch-responsive regions in individual amusic subjects will make it possible to ask more precise questions about their role in amusia in future work.

Impaired encoding of rapid pitch information underlies perception and memory deficits in congenital amusia

Recent theories suggest that the basis of neurodevelopmental auditory disorders such as dyslexia or specific language impairment might be a low-level sensory dysfunction. In the present study we test this hypothesis in congenital amusia, a neurodevelopmental disorder characterized by severe deficits in the processing of pitch-based material. We manipulated the temporal characteristics of auditory stimuli and investigated the influence of the time given to encode pitch information on participants' performance in discrimination and short-term memory. Our results show that amusics' performance in such tasks scales with the duration available to encode acoustic information. This suggests that in auditory neuro-developmental disorders, abnormalities in early steps of the auditory processing can underlie the high-level deficits (here musical disabilities). Observing that the slowing down of temporal dynamics improves amusics' pitch abilities allows considering this approach as a potential tool for remediation in developmental auditory disorders.

Sound frequency affects speech emotion perception: results from congenital amusia

Congenital amusics, or "tone-deaf" individuals, show difficulty in perceiving and producing small pitch differences. While amusia has marked effects on music perception, its impact on speech perception is less clear. Here we test the hypothesis that individual differences in pitch perception affect judgment of emotion in speech, by applying low-pass filters to spoken statements of emotional speech. A norming study was first conducted on Mechanical Turk to ensure that the intended emotions from the Macquarie Battery for Evaluation of Prosody were reliably identifiable by US English speakers. The most reliably identified emotional speech samples were used in Experiment 1, in which subjects performed a psychophysical pitch discrimination task, and an emotion identification task under low-pass and unfiltered speech conditions. Results showed a significant correlation between pitch-discrimination threshold and emotion identification accuracy for low-pass filtered speech, with amusics (defined here as those with a pitch discrimination threshold >16 Hz) performing worse than controls. This relationship with pitch discrimination was not seen in unfiltered speech conditions. Given the dissociation between low-pass filtered and unfiltered speech conditions, we inferred that amusics may be compensating for poorer pitch perception by using speech cues that are filtered out in this manipulation. To assess this potential compensation, Experiment 2 was conducted using high-pass filtered speech samples intended to isolate non-pitch cues. No significant correlation was found between pitch discrimination and emotion identification accuracy for high-pass filtered speech. Results from these experiments suggest an influence of low frequency information in identifying emotional content of speech.

Brainstem encoding of speech and musical stimuli in congenital amusia: evidence from Cantonese speakers

Congenital amusia is a neurodevelopmental disorder of musical processing that also impacts subtle aspects of speech processing. It remains debated at what stage(s) of auditory processing deficits in amusia arise. In this study, we investigated whether amusia originates from impaired subcortical encoding of speech (in quiet and noise) and musical sounds in the brainstem. Fourteen Cantonese-speaking amusics and 14 matched controls passively listened to six Cantonese lexical tones in quiet, two Cantonese tones in noise (signal-to-noise ratios at 0 and 20 dB), and two cello tones in quiet while their frequency-following responses (FFRs) to these tones were recorded. All participants also completed a behavioral lexical tone identification task. The results indicated normal brainstem encoding of pitch in speech (in quiet and noise) and musical stimuli in amusics relative to controls, as measured by FFR pitch strength, pitch error, and stimulus-to-response correlation. There was also no group difference in neural conduction time or FFR amplitudes. Both groups demonstrated better FFRs to speech (in quiet and noise) than to musical stimuli. However, a significant group difference was observed for tone identification, with amusics showing significantly lower accuracy than controls. Analysis of the tone confusion matrices suggested that amusics were more likely than controls to confuse between tones that shared similar acoustic features. Interestingly, this deficit in lexical tone identification was not coupled with brainstem abnormality for either speech or musical stimuli. Together, our results suggest that the amusic brainstem is not functioning abnormally, although higher-order linguistic pitch processing is impaired in amusia. This finding has significant implications for theories of central auditory processing, requiring further investigations into how different stages of auditory processing interact in the human brain.