Musical memory in a patient with severe anterograde amnesia

Beyond the ears: A review exploring the interconnected brain behind the hierarchical memory of music

Music is a ubiquitous element of daily life. Understanding how music memory is represented and expressed in the brain is key to understanding how music can influence human daily cognitive tasks. Current music-memory literature is built on data from very heterogeneous tasks for measuring memory, and the neural correlates appear to differ depending on different forms of memory function targeted. Such heterogeneity leaves many exceptions and conflicts in the data underexplained (e.g., hippocampal involvement in music memory is debated). This review provides an overview of existing neuroimaging results from music-memory related studies and concludes that although music is a special class of event in our lives, the memory systems behind it do in fact share neural mechanisms with memories from other modalities. We suggest that dividing music memory into different levels of a hierarchy (structural level and semantic level) helps understand overlap and divergence in neural networks involved. This is grounded in the fact that memorizing a piece of music recruits brain clusters that separately support functions including-but not limited to-syntax storage and retrieval, temporal processing, prediction versus reality comparison, stimulus feature integration, personal memory associations, and emotion perception. The cross-talk between frontal-parietal music structural processing centers and the subcortical emotion and context encoding areas explains why music is not only so easily memorable but can also serve as strong contextual information for encoding and retrieving nonmusic information in our lives.

The hearing hippocampus

The hippocampus has a well-established role in spatial and episodic memory but a broader function has been proposed including aspects of perception and relational processing. Neural bases of sound analysis have been described in the pathway to auditory cortex, but wider networks supporting auditory cognition are still being established. We review what is known about the role of the hippocampus in processing auditory information, and how the hippocampus itself is shaped by sound. In examining imaging, recording, and lesion studies in species from rodents to humans, we uncover a hierarchy of hippocampal responses to sound including during passive exposure, active listening, and the learning of associations between sounds and other stimuli. We describe how the hippocampus' connectivity and computational architecture allow it to track and manipulate auditory information - whether in the form of speech, music, or environmental, emotional, or phantom sounds. Functional and structural correlates of auditory experience are also identified. The extent of auditory-hippocampal interactions is consistent with the view that the hippocampus makes broad contributions to perception and cognition, beyond spatial and episodic memory. More deeply understanding these interactions may unlock applications including entraining hippocampal rhythms to support cognition, and intervening in links between hearing loss and dementia.

Amygdala but not hippocampal damage associated with smaller social network size

Social network size has been associated with complex socio-cognitive processes (e.g., memory, perspective taking). Supporting this idea, recent neuroimaging studies in healthy adults have reported a relationship between social network size and brain volumes in regions related to memory and social cognition (e.g., hippocampus, amygdala). Lesion-deficit studies in neurological patients are rare and have been inconclusive due to differences in participant sampling and measurement. The present study uses a multiple case study approach. We investigated patients with focal damage to the hippocampus and/or amygdala (two neural structures thought to be critical for social networks), and examined the patients' social network size, loneliness, and life satisfaction relative to a non-injured comparison group. Patients with amygdalar damage had smaller social networks and reported higher levels of loneliness and lower life satisfaction, on average, than comparison participants. Patients with damage to the hippocampus reported more friends than the comparison participants, but did not differ in their ratings of loneliness or life satisfaction. This lesion study offers new evidence that the amygdala is critical for social networks, life satisfaction, and reduced loneliness.

Who Are You? The Study of Personality in Patients With Anterograde Amnesia

Little is known about the role of declarative memory in the ongoing perception of one's personality. Seven individuals who developed a rare and severe type of anterograde amnesia following damage to their medial temporal lobes were identified from our neurological patient registry. We examined the stability of their personality ratings on the Big Five Inventory over five retest periods and assessed the accuracy of their ratings via analyses of self-caregiver agreement. The patients portrayed a stable sense of self over the course of 1 year. However, their self-ratings differed from those provided by the caregivers. Intriguingly, these discrepancies diminished when caregivers retrospectively rated the patients' personalities prior to their brain injury, suggesting that patients' perceptions of themselves were stuck in the past. We interpret our findings to indicate that the ability to form new declarative memories is not required for maintaining a stable sense of self but may be important for updating one's sense of self over time.

Induction of BDNF Expression in Layer II/III and Layer V Neurons of the Motor Cortex Is Essential for Motor Learning

Motor learning depends on synaptic plasticity between corticostriatal projections and striatal medium spiny neurons. Retrograde tracing from the dorsolateral striatum reveals that both layer II/III and V neurons in the motor cortex express BDNF as a potential regulator of plasticity in corticostriatal projections in male and female mice. The number of these BDNF-expressing cortical neurons and levels of BDNF protein are highest in juvenile mice when adult motor patterns are shaped, while BDNF levels in the adult are low. When mice are trained by physical exercise in the adult, BDNF expression in motor cortex is reinduced, especially in layer II/III projection neurons. Reduced expression of cortical BDNF in 3-month-old mice results in impaired motor learning while space memory is preserved. These findings suggest that activity regulates BDNF expression differentially in layers II/III and V striatal afferents from motor cortex and that cortical BDNF is essential for motor learning.

SIGNIFICANCE STATEMENT Motor learning in mice depends on corticostriatal BDNF supply, and regulation of BDNF expression during motor learning is highest in corticostriatal projection neurons in cortical layer II/III.

Music training is neuroprotective for verbal cognition in focal epilepsy

Focal epilepsy is a unilateral brain network disorder, providing an ideal neuropathological model with which to study the effects of focal neural disruption on a range of cognitive processes. While language and memory functions have been extensively investigated in focal epilepsy, music cognition has received less attention, particularly in patients with music training or expertise. This represents a critical gap in the literature. A better understanding of the effects of epilepsy on music cognition may provide greater insight into the mechanisms behind disease- and training-related neuroplasticity, which may have implications for clinical practice. In this cross-sectional study, we comprehensively profiled music and non-music cognition in 107 participants; musicians with focal epilepsy (n = 35), non-musicians with focal epilepsy (n = 39), and healthy control musicians and non-musicians (n = 33). Parametric group comparisons revealed a specific impairment in verbal cognition in non-musicians with epilepsy but not musicians with epilepsy, compared to healthy musicians and non-musicians (P = 0.029). This suggests a possible neuroprotective effect of music training against the cognitive sequelae of focal epilepsy, and implicates potential training-related cognitive transfer that may be underpinned by enhancement of auditory processes primarily supported by temporo-frontal networks. Furthermore, our results showed that musicians with an earlier age of onset of music training performed better on a composite score of melodic learning and memory compared to non-musicians (P = 0.037), while late-onset musicians did not differ from non-musicians. For most composite scores of music cognition, although no significant group differences were observed, a similar trend was apparent. We discuss these key findings in the context of a proposed model of three interacting dimensions (disease status, music expertise, and cognitive domain), and their implications for clinical practice, music education, and music neuroscience research.

Musical memory and hippocampus revisited: Evidence from a musical layperson with highly selective hippocampal damage

The role of the human hippocampus for musical memory is still unclear. While imaging studies in healthy humans have repeatedly shown hippocampal activation in musical memory tasks, studies in musicians with chronic bilateral medial temporal lobe damage and in non-musicians suffering from neuro-degenerative diseases suggest that musical memory may at least partly be independent of hippocampal integrity. Here, we report on a musical layperson who acutely developed an amnesic syndrome in the context of autoimmune encephalitis. Structural and resting state functional MRI revealed exceptionally selective bilateral lesions of the hippocampi and altered functional connectivity with retrosplenial cortex and precuneus. Neuropsychological testing showed a severe global amnesic syndrome. Perception and processing of scales, melodic contours, intervals, rhythms and meter were unaffected. Most notably, the patient performed completely normally on tests of recognition memory for unfamiliar melodies and excerpts of complex musical material, while recognition memory for visual and verbal information was severely impaired. Likewise, emotional evaluation of musical excerpts did not differ from controls. We infer that integrity of musical processing and recognition memory in patients with hippocampal dysfunction does not result from training-induced or post-lesional brain plasticity, but rather reflects integrity of brain networks outside the hippocampi and presumably also outside retrosplenial cortex and precuneus. Our findings suggest major differences in the neural substrates of musical and non-musical recognition memory.

The left temporal pole is a convergence region mediating the relation between names and semantic knowledge for unique entities: Further evidence from a "recognition-from-name" study in neurological patients

Prior research has implicated the left temporal pole (LTP) as a critical region for naming semantically unique items, including famous faces, landmarks, and musical melodies. Most studies have used a confrontation naming paradigm, where a participant is presented with a stimulus and asked to retrieve its name. We have proposed previously that the LTP functions as a two-way, bidirectional convergence region brokering between conceptual knowledge and proper names for unique entities. Under this hypothesis, damage to the LTP should result in a "two way" impairment: (1) defective proper name retrieval when presented with a unique stimulus (as shown in prior work); and (2) defective concept retrieval when presented with a proper name. Here, we directly tested the second prediction using a "recognition-from-name" paradigm. Participants were patients with LTP damage, brain-damaged comparisons with damage outside the LTP, and healthy comparisons. Participants were presented with names of famous persons (e.g., "Marilyn Monroe"), landmarks (e.g., "Leaning Tower of Pisa"), or melodies (e.g., "Rudolph the Red-Nosed Reindeer") and were asked to provide conceptual knowledge about each. We found that individuals with damage to the LTP were significantly impaired at conceptual knowledge retrieval when given names of famous people and landmarks (but this finding did not hold for melodies). This outcome supports the theory that the LTP is a bidirectional convergence region for proper naming, but suggests that melody retrieval may rely on processes different from those supported by the LTP.

Golden oldies and silver brains: Deficits, preservation, learning, and rehabilitation effects of music in ageing-related neurological disorders

During the last decades, there have been major advances in mapping the brain regions that underlie our ability to perceive, experience, and produce music and how musical training can shape the structure and function of the brain. This progress has fueled and renewed clinical interest towards uncovering the neural basis for the impaired or preserved processing of music in different neurological disorders and how music-based interventions can be used in their rehabilitation and care. This article reviews our contribution to and the state-of-the-art of this field. We will provide a short overview outlining the key brain networks that participate in the processing of music and singing in the healthy brain and then present recent findings on the following key music-related research topics in neurological disorders: (i) the neural architecture underlying deficient processing of music (amusia), (ii) the preservation of singing in aphasia and music-evoked emotions and memories in Alzheimer's disease, (iii) the mnemonic impact of songs as a verbal learning tool, and (iv) the cognitive, emotional, and neural efficacy of music-based interventions and activities in the rehabilitation and care of major ageing-related neurological illnesses (stroke, Alzheimer's disease, and Parkinson's disease).

Hippocampus contributes to the maintenance but not the quality of visual information over time

The hippocampus has recently been implicated in the brief representation of visual information, but its specific role is not well understood. We investigated this role using a paradigm that distinguishes quantity and quality of visual memory as described in a previous study. We found that amnesic patients with bilateral hippocampal damage (N = 5) were less likely to remember test stimuli than comparison participants despite a brief maintenance interval (900 msec). However, estimates of memory quality were similar for all groups. Our findings suggest that the hippocampus contributes to brief maintenance of visual information but does not contribute to the quality of that information.

New learning of music after bilateral medial temporal lobe damage: evidence from an amnesic patient

Damage to the hippocampus impairs the ability to acquire new declarative memories, but not the ability to learn simple motor tasks. An unresolved question is whether hippocampal damage affects learning for music performance, which requires motor processes, but in a cognitively complex context. We studied learning of novel musical pieces by sight-reading in a newly identified amnesic, LSJ, who was a skilled amateur violist prior to contracting herpes simplex encephalitis. LSJ has suffered virtually complete destruction of the hippocampus bilaterally, as well as extensive damage to other medial temporal lobe structures and the left anterior temporal lobe. Because of LSJ's rare combination of musical training and near-complete hippocampal destruction, her case provides a unique opportunity to investigate the role of the hippocampus for complex motor learning processes specifically related to music performance. Three novel pieces of viola music were composed and closely matched for factors contributing to a piece's musical complexity. LSJ practiced playing two of the pieces, one in each of the two sessions during the same day. Relative to a third unpracticed control piece, LSJ showed significant pre- to post-training improvement for the two practiced pieces. Learning effects were observed both with detailed analyses of correctly played notes, and with subjective whole-piece performance evaluations by string instrument players. The learning effects were evident immediately after practice and 14 days later. The observed learning stands in sharp contrast to LSJ's complete lack of awareness that the same pieces were being presented repeatedly, and to the profound impairments she exhibits in other learning tasks. Although learning in simple motor tasks has been previously observed in amnesic patients, our results demonstrate that non-hippocampal structures can support complex learning of novel musical sequences for music performance.

Not so fast: hippocampal amnesia slows word learning despite successful fast mapping

The human hippocampus is widely believed to be necessary for the rapid acquisition of new declarative relational memories. However, processes supporting on-line inferential word use ("fast mapping") may also exercise a dissociable learning mechanism and permit rapid word learning without the hippocampus (Sharon et al. (2011) Proc Natl Acad Sci USA 108:1146-1151). We investigated fast mapping in severely amnesic patients with hippocampal damage (N = 4), mildly amnesic patients (N = 6), and healthy comparison participants (N = 10) using on-line measures (eye movements) that reflected ongoing processing. All participants studied unique word-picture associations in two encoding conditions. In the explicit-encoding condition, uncommon items were paired with their names (e.g., "This is a numbat."). In the fast mapping study condition, participants heard an instruction using a novel word (e.g., "Click on the numbat.") while two items were presented (an uncommon target such as a numbat, and a common distracter such as a dog). All groups performed fast mapping well at study, and on-line eye movement measures did not reveal group differences. However, while comparison participants showed robust word learning irrespective of encoding condition, severely amnesic patients showed no evidence of learning after fast mapping or explicit encoding on any behavioral or eye-movement measure. Mildly amnesic patients showed some learning, but performance was unaffected by encoding condition. The findings are consistent with the following propositions: the hippocampus is not essential for on-line fast mapping of novel words; but is necessary for the rapid learning of arbitrary relational information irrespective of encoding conditions.

Memory for items and relationships among items embedded in realistic scenes: disproportionate relational memory impairments in amnesia

OBJECTIVE

The objective of this study was to examine the dependence of item memory and relational memory on medial temporal lobe (MTL) structures. Patients with amnesia, who either had extensive MTL damage or damage that was relatively restricted to the hippocampus, were tested, as was a matched comparison group. Disproportionate relational memory impairments were predicted for both patient groups, and those with extensive MTL damage were also expected to have impaired item memory.

METHOD

Participants studied scenes, and were tested with interleaved 2-alternative forced-choice probe trials. Probe trials were either presented immediately after the corresponding study trial (Lag 1), 5 trials later (Lag 5), or 9 trials later (Lag 9) and consisted of the studied scene along with a manipulated version of that scene in which 1 item was replaced with a different exemplar (item memory test) or was moved to a new location (relational memory test). Participants were to identify the exact match of the studied scene.

RESULTS

As predicted, patients were disproportionately impaired on the test of relational memory. Item memory performance was marginally poorer among patients with extensive MTL damage, but both groups were impaired relative to matched comparison participants. Impaired performance was evident at all lags, including the shortest possible lag (Lag 1).

CONCLUSIONS

The results are consistent with the proposed role of the hippocampus in relational memory binding and representation, even at short delays, and suggest that the hippocampus may also contribute to successful item memory when items are embedded in complex scenes.

Music mnemonics aid Verbal Memory and Induce Learning - Related Brain Plasticity in Multiple Sclerosis

Recent research on music and brain function has suggested that the temporal pattern structure in music and rhythm can enhance cognitive functions. To further elucidate this question specifically for memory, we investigated if a musical template can enhance verbal learning in patients with multiple sclerosis (MS) and if music-assisted learning will also influence short-term, system-level brain plasticity. We measured systems-level brain activity with oscillatory network synchronization during music-assisted learning. Specifically, we measured the spectral power of 128-channel electroencephalogram (EEG) in alpha and beta frequency bands in 54 patients with MS. The study sample was randomly divided into two groups, either hearing a spoken or a musical (sung) presentation of Rey's auditory verbal learning test. We defined the "learning-related synchronization" (LRS) as the percent change in EEG spectral power from the first time the word was presented to the average of the subsequent word encoding trials. LRS differed significantly between the music and the spoken conditions in low alpha and upper beta bands. Patients in the music condition showed overall better word memory and better word order memory and stronger bilateral frontal alpha LRS than patients in the spoken condition. The evidence suggests that a musical mnemonic recruits stronger oscillatory network synchronization in prefrontal areas in MS patients during word learning. It is suggested that the temporal structure implicit in musical stimuli enhances "deep encoding" during verbal learning and sharpens the timing of neural dynamics in brain networks degraded by demyelination in MS.

Spatial reconstruction by patients with hippocampal damage is dominated by relational memory errors

Hippocampal damage causes profound yet circumscribed memory impairment across diverse stimulus types and testing formats. Here, within a single test format involving a single class of stimuli, we identified different performance errors to better characterize the specifics of the underlying deficit. The task involved study and reconstruction of object arrays across brief retention intervals. The most striking feature of patients' with hippocampal damage performance was that they tended to reverse the relative positions of item pairs within arrays of any size, effectively "swapping" pairs of objects. These "swap errors" were the primary error type in amnesia, almost never occurred in healthy comparison participants, and actually contributed to poor performance on more traditional metrics (such as distance between studied and reconstructed location). Patients made swap errors even in trials involving only a single pair of objects. The selectivity and severity of this particular deficit creates serious challenges for theories of memory and hippocampus.