1
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Trimble MR, Hesdorffer D, Hećimović H, Osborne N. Personalised music as a treatment for epilepsy. Epilepsy Behav 2024; 156:109829. [PMID: 38761451 DOI: 10.1016/j.yebeh.2024.109829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Revised: 04/29/2024] [Accepted: 05/06/2024] [Indexed: 05/20/2024]
Abstract
In this paper we look at non-pharmaceutical treatments for intractable epilepsy based on neurophysiological methods especially with EEG analysis. In summary, there are a number of limbic and thalamo-cortical related structures involved in the processing of musical emotion (exposure), including the amygdala (arousal, expression of mood, fear), hippocampus (memory, regulation of HPA axis, stress), parahippocampal gyrus (recognition, memory retrieval), insula (valence), temporal poles (connectivity), ventral striatum (expectation and experience of reward), orbitofrontal cortex (valence) and cingulate cortex (autonomic regulation). One method is to audify (a form of sonification) EEG activity to find music by feedback to entrain abnormal EEG activity. We discuss various methods and our use of X-System (https://www.x-system.co.uk/) which is a computational model of the musical brain capable of predicting the neurophysiological effects of music. It models structures and pathways related to responses to music, including the cochlea, brain stem, auditory and motor cortex, as well as basal ganglia, cerebellum and limbic structures. It can predict autonomic and endocrine activity as well as the substrates of electrical activity to select music which can regularise EEG abnormalities to decrease epileptic activity and seizures, especially in those unresponsive to antiepileptic medication or invasive treatments.
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Affiliation(s)
- M R Trimble
- University College London, Institute for Neurology, London, UK.
| | - D Hesdorffer
- GH Sergievsky Center and Department of Epidemiology, Columbia University, New York, NY 10032, USA
| | - H Hećimović
- University North, Varaždin, Croatia; Neurocenter, Zagreb, Croatia
| | - N Osborne
- Reid School of Music, University of Edinburgh, Edinburgh, Scotland, UK
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2
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Evers S. The description of epileptic seizures in the classical opera. Seizure 2024; 118:117-122. [PMID: 38688042 DOI: 10.1016/j.seizure.2024.04.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Revised: 04/19/2024] [Accepted: 04/20/2024] [Indexed: 05/02/2024] Open
Abstract
Epilepsy or epileptic seizures have only rarely been described in the classical opera. Four operas were detected, in which epileptic seizures are described also by musical means. Three of them ("Der Golem" by Eugen d'Albert; "Idiot" by Mieczyslaw Weinberg; "Otello" by Giuseppe Verdi) describe a generalized tonic-clonic epileptic seizure by a descending chromatic scale. One opera ("The turn of the screw" by Benjamin Britten) describes temporal lobe seizures by overtone music played by the instrument celesta.
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Affiliation(s)
- Stefan Evers
- Department of Neurology, Krankenhaus Lindenbrunn, Coppenbrügge, Germany; Faculty of Medicine, University of Münster, Germany.
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3
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Bonakdarpour B, Zhou G, Huang D, Vidano CT, Schuele S, Zelano C, Takarabe C. Calming effect of Clinically Designed Improvisatory Music for patients admitted to the epilepsy monitoring unit during the COVID-19 pandemic: a pilot study. Front Neurol 2023; 14:1206171. [PMID: 37731858 PMCID: PMC10507627 DOI: 10.3389/fneur.2023.1206171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2023] [Accepted: 08/04/2023] [Indexed: 09/22/2023] Open
Abstract
Background Epilepsy monitoring requires simulating seizure-inducing conditions which frequently causes discomfort to epilepsy monitoring unit (EMU) patients. COVID-19 hospital restrictions added another layer of stress during hospital admissions. The purpose of this pilot study was to provide evidence that live virtual Clinically Designed Improvisatory Music (CDIM) brings relief to EMU patients for their psychological distress. Methods Five persons with epilepsy (PWEs) in the EMU during the COVID-19 lockdown participated in the study (average age ± SD = 30.2 ± 6 years). Continuous electroencephalogram (EEG) and electrocardiogram (EKG) were obtained before, during, and after live virtual CDIM. CDIM consisted of 40 minutes of calming music played by a certified clinical music practitioner (CMP) on viola. Post-intervention surveys assessed patients' emotional state on a 1-10 Likert scale. Alpha/beta power spectral density ratio was calculated for each subject across the brain and was evaluated using one-way repeated analysis of variance, comparing 20 minutes before, during, and 20 minutes after CDIM. Post-hoc analysis was performed using paired t-test at the whole brain level and regions with peak changes. Results Patients reported enhanced emotional state (9 ± 1.26), decrease in tension (9.6 ± 0.49), decreased restlessness (8.6 ± 0.80), increased pleasure (9.2 ± 0.98), and likelihood to recommend (10 ± 0) on a 10-point Likert scale. Based on one-way repeated analysis of variance, alpha/beta ratio increased at whole-brain analysis (F3,12 = 5.01, P = 0.018) with a peak in midline (F3,12 = 6.63, P = 0.0068 for Cz) and anterior medial frontal region (F3,12 = 6.45, P = 0.0076 for Fz) during CDIM and showed a trend to remain increased post-intervention. Conclusion In this pilot study, we found positive effects of CDIM as reported by patients, and an increased alpha/beta ratio with meaningful electroencephalographic correlates due to the calming effects in response to CDIM. Our study provides proof of concept that live virtual CDIM offered demonstrable comfort with biologic correlations for patients admitted in the EMU during the COVID-19 pandemic.
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Affiliation(s)
- Borna Bonakdarpour
- Department of Neurology, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
- Feinberg School of Medicine, Mesulam Center for Cognitive Neurology and Alzheimer’s Disease, Northwestern University, Chicago, IL, United States
| | - Guangyu Zhou
- Department of Neurology, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - Daniel Huang
- Department of Neurology, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
- Feinberg School of Medicine, Mesulam Center for Cognitive Neurology and Alzheimer’s Disease, Northwestern University, Chicago, IL, United States
| | - Catherine T. Vidano
- Feinberg School of Medicine, Mesulam Center for Cognitive Neurology and Alzheimer’s Disease, Northwestern University, Chicago, IL, United States
| | - Stephan Schuele
- Department of Neurology, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - Christina Zelano
- Department of Neurology, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - Clara Takarabe
- Department of Neurology, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
- Feinberg School of Medicine, Mesulam Center for Cognitive Neurology and Alzheimer’s Disease, Northwestern University, Chicago, IL, United States
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4
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Li Z, Chen L, Xu C, Chen Z, Wang Y. Non-invasive sensory neuromodulation in epilepsy: Updates and future perspectives. Neurobiol Dis 2023; 179:106049. [PMID: 36813206 DOI: 10.1016/j.nbd.2023.106049] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Revised: 02/15/2023] [Accepted: 02/16/2023] [Indexed: 02/22/2023] Open
Abstract
Epilepsy, one of the most common neurological disorders, often is not well controlled by current pharmacological and surgical treatments. Sensory neuromodulation, including multi-sensory stimulation, auditory stimulation, olfactory stimulation, is a kind of novel noninvasive mind-body intervention and receives continued attention as complementary safe treatment of epilepsy. In this review, we summarize the recent advances of sensory neuromodulation, including enriched environment therapy, music therapy, olfactory therapy, other mind-body interventions, for the treatment of epilepsy based on the evidence from both clinical and preclinical studies. We also discuss their possible anti-epileptic mechanisms on neural circuit level and propose perspectives on possible research directions for future studies.
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Affiliation(s)
- Zhongxia Li
- Key Laboratory of Neuropharmacology and Translational Medicine of Zhejiang Province, School of Pharmaceutical Sciences, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China; Zhejiang Rehabilitation Medical Center Department, The Third Affiliated Hospital, Zhejiang Chinese Medical University, Hangzhou, China
| | - Liying Chen
- Department of Pharmacy, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Cenglin Xu
- Key Laboratory of Neuropharmacology and Translational Medicine of Zhejiang Province, School of Pharmaceutical Sciences, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Zhong Chen
- Key Laboratory of Neuropharmacology and Translational Medicine of Zhejiang Province, School of Pharmaceutical Sciences, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Yi Wang
- Key Laboratory of Neuropharmacology and Translational Medicine of Zhejiang Province, School of Pharmaceutical Sciences, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China; Zhejiang Rehabilitation Medical Center Department, The Third Affiliated Hospital, Zhejiang Chinese Medical University, Hangzhou, China.
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5
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Bratu IF, Nica AE, Oane I, Daneasa A, Stoica S, Barborica A, Mindruta I. Musicogenic seizures in temporal lobe epilepsy: Case reports based on ictal source localization analysis. Front Neurol 2023; 14:1072075. [PMID: 36891471 PMCID: PMC9987853 DOI: 10.3389/fneur.2023.1072075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Accepted: 01/17/2023] [Indexed: 02/22/2023] Open
Abstract
Musicogenic epilepsy is a rare form of reflex epilepsy in which seizures are provoked by music. Different musicogenic stimuli have been identified: pleasant/unpleasant music or specific musical patterns. Several etiologies have been uncovered, such as focal cortical dysplasia, autoimmune encephalitis, tumors, or unspecific gliosis. In this article, we report two patients with musicogenic seizures. The first patient was diagnosed with structural temporal lobe epilepsy. Her seizures were elicited by music that she liked. Interictal and ictal video-electroencephalography (video-EEG) and signal analysis using independent component analysis revealed the right temporal lobe seizure onset extending over the neocortical regions. The patient underwent right temporal lobectomy (including the amygdala, the head, and the body of the hippocampus) and faced an Engel IA outcome 3 years post-surgery. The second patient was diagnosed with autoimmune temporal lobe epilepsy (GAD-65 antibodies). Her seizures were triggered by contemporary hit radio songs without any personal emotional significance. Interictal and ictal video-electroencephalography (video-EEG) and independent component analysis highlighted the left temporal lobe seizure onset extending over the neocortical regions. Intravenous immunoglobulin therapy was initiated, and the patient became seizure-free at 1 year. In conclusion, musicogenic seizures may be elicited by various auditory stimuli, the presence or absence of an emotional component offering an additional clue for the underlying network pathophysiology. Furthermore, in such cases, the use of independent component analysis of the scalp EEG signals proves useful in revealing the location of the seizure generator, and our findings point toward the temporal lobe, both mesial and neocortical regions.
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Affiliation(s)
- Ionut-Flavius Bratu
- Epilepsy Monitoring Unit, Neurology Department, University Emergency Hospital Bucharest, Bucharest, Romania
| | - Adriana Elena Nica
- Intensive Care Unit, University Emergency Hospital Bucharest, Bucharest, Romania
| | - Irina Oane
- Epilepsy Monitoring Unit, Neurology Department, University Emergency Hospital Bucharest, Bucharest, Romania
| | - Andrei Daneasa
- Epilepsy Monitoring Unit, Neurology Department, University Emergency Hospital Bucharest, Bucharest, Romania
| | - Sergiu Stoica
- Neurosurgery Department, Brain Institute, Monza Hospital, Bucharest, Romania
| | | | - Ioana Mindruta
- Epilepsy Monitoring Unit, Neurology Department, University Emergency Hospital Bucharest, Bucharest, Romania.,Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
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6
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Wired for sound: The effect of sound on the epileptic brain. Seizure 2022; 102:22-31. [PMID: 36179456 DOI: 10.1016/j.seizure.2022.09.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 09/08/2022] [Accepted: 09/23/2022] [Indexed: 11/22/2022] Open
Abstract
Sound waves are all around us resonating at audible and inaudible frequencies. Our ability to hear is crucial in providing information and enabling interaction with our environment. The human brain generates neural oscillations or brainwaves through synchronised electrical impulses. In epilepsy these brainwaves can change and form rhythmic bursts of abnormal activity outwardly appearing as seizures. When two waveforms meet, they can superimpose onto one another forming constructive, destructive or mixed interference. The effects of audible soundwaves on epileptic brainwaves has been largely explored with music. The Mozart Sonata for Two Pianos in D major, K. 448 has been examined in a number of studies where significant clinical and methodological heterogeneity exists. These studies report variable reductions in seizures and interictal epileptiform discharges. Treatment effects of Mozart Piano Sonata in C Major, K.545 and other composer interventions have been examined with some musical exposures, for example Hayden's Symphony No. 94 appearing pro-epileptic. The underlying anti-epileptic mechanism of Mozart music is currently unknown, but interesting research is moving away from dopamine reward system theories to computational analysis of specific auditory parameters. In the last decade several studies have examined inaudible low intensity focused ultrasound as a neuro-modulatory intervention in focal epilepsy. Whilst acute and chronic epilepsy rodent model studies have consistently demonstrated an anti-epileptic treatment effect this is yet to be reported within large scale human trials. Inaudible infrasound is of concern since at present there are no reported studies on the effects of exposure to infrasound on epilepsy. Understanding the impact of infrasound on epilepsy is critical in an era where sustainable energies are likely to increase exposure.
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7
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Park C, Sinha SR, Southwell DG. Laser ablative treatment of musicogenic epilepsy arising from dominant mesial temporal lobe: illustrative case. JOURNAL OF NEUROSURGERY: CASE LESSONS 2022; 3:CASE2295. [PMID: 35733825 PMCID: PMC9204930 DOI: 10.3171/case2295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Accepted: 04/15/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND Musicogenic epilepsy (ME) is a rare reflex epilepsy in which seizures are triggered by musical stimuli. Prior descriptions of ME have suggested localization to the nondominant temporal lobe, primarily in neocortex. Although resection has been described as a treatment for ME, other surgical modalities, such as laser ablation, may effectively disrupt seizure networks in ME while incurring comparatively lower risks of morbidity. The authors described the use of laser ablation to treat ME arising from the dominant mesial temporal structures. OBSERVATIONS A 37-year-old woman with a 15-year history of drug-resistant ME was referred for surgical evaluation. Her seizures were triggered by specific musical content and involved behavioral arrest, repetitive swallowing motions, and word incomprehension. Diagnostic studies, including magnetic resonance imaging, single-photon emission computed tomography, magnetoencephalography, Wada testing, and stereoelectroencephalography, indicated seizure onset in the left (dominant) mesial temporal lobe. Laser interstitial thermal therapy was used to ablate the left mesial seizure onset zone. The patient was discharged on postoperative day two. At 18-month follow-up, she was seizure-free with no posttreatment neurological deficits. LESSONS Laser ablation can be an effective treatment option for well-localized forms of ME, particularly when seizures originate from the dominant mesial temporal lobe.
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Affiliation(s)
| | - Saurabh R. Sinha
- Neurology, Duke University Medical Center, Durham, North Carolina
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8
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Chuvakova LN, Funikov SY, Rezvykh AP, Davletshin AI, Evgen'ev MB, Litvinova SA, Fedotova IB, Poletaeva II, Garbuz DG. Transcriptome of the Krushinsky-Molodkina Audiogenic Rat Strain and Identification of Possible Audiogenic Epilepsy-Associated Genes. Front Mol Neurosci 2021; 14:738930. [PMID: 34803604 PMCID: PMC8600260 DOI: 10.3389/fnmol.2021.738930] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Accepted: 10/07/2021] [Indexed: 12/13/2022] Open
Abstract
Audiogenic epilepsy (AE), inherent to several rodent strains is widely studied as a model of generalized convulsive epilepsy. The molecular mechanisms that determine the manifestation of AE are not well understood. In the present work, we compared transcriptomes from the corpora quadrigemina in the midbrain zone, which are crucial for AE development, to identify genes associated with the AE phenotype. Three rat strains without sound exposure were compared: Krushinsky-Molodkina (KM) strain (100% AE-prone); Wistar outbred rat strain (non-AE prone) and “0” strain (partially AE-prone), selected from F2 KM × Wistar hybrids for their lack of AE. The findings showed that the KM strain gene expression profile exhibited a number of characteristics that differed from those of the Wistar and “0” strain profiles. In particular, the KM rats showed increased expression of a number of genes involved in the positive regulation of the MAPK signaling cascade and genes involved in the positive regulation of apoptotic processes. Another characteristic of the KM strain which differed from that of the Wistar and “0” rats was a multi-fold increase in the expression level of the Ttr gene and a significant decrease in the expression of the Msh3 gene. Decreased expression of a number of oxidative phosphorylation-related genes and a few other genes was also identified in the KM strain. Our data confirm the complex multigenic nature of AE inheritance in rodents. A comparison with data obtained from other independently selected AE-prone rodent strains suggests some common causes for the formation of the audiogenic phenotype.
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Affiliation(s)
- Lyubov N Chuvakova
- Engelhardt Institute of Molecular Biology, Russian Academy of Sciences, Moscow, Russia
| | - Sergei Yu Funikov
- Engelhardt Institute of Molecular Biology, Russian Academy of Sciences, Moscow, Russia
| | - Alexander P Rezvykh
- Engelhardt Institute of Molecular Biology, Russian Academy of Sciences, Moscow, Russia.,Moscow Institute of Physics and Technology, Dolgoprudny, Russia
| | - Artem I Davletshin
- Engelhardt Institute of Molecular Biology, Russian Academy of Sciences, Moscow, Russia
| | - Michael B Evgen'ev
- Engelhardt Institute of Molecular Biology, Russian Academy of Sciences, Moscow, Russia
| | | | | | | | - David G Garbuz
- Engelhardt Institute of Molecular Biology, Russian Academy of Sciences, Moscow, Russia
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9
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Musical components important for the Mozart K448 effect in epilepsy. Sci Rep 2021; 11:16490. [PMID: 34531410 PMCID: PMC8446029 DOI: 10.1038/s41598-021-95922-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Accepted: 07/28/2021] [Indexed: 11/08/2022] Open
Abstract
There is growing evidence for the efficacy of music, specifically Mozart’s Sonata for Two Pianos in D Major (K448), at reducing ictal and interictal epileptiform activity. Nonetheless, little is known about the mechanism underlying this beneficial “Mozart K448 effect” for persons with epilepsy. Here, we measured the influence that K448 had on intracranial interictal epileptiform discharges (IEDs) in sixteen subjects undergoing intracranial monitoring for refractory focal epilepsy. We found reduced IEDs during the original version of K448 after at least 30-s of exposure. Nonsignificant IED rate reductions were witnessed in all brain regions apart from the bilateral frontal cortices, where we observed increased frontal theta power during transitions from prolonged musical segments. All other presented musical stimuli were associated with nonsignificant IED alterations. These results suggest that the “Mozart K448 effect” is dependent on the duration of exposure and may preferentially modulate activity in frontal emotional networks, providing insight into the mechanism underlying this response. Our findings encourage the continued evaluation of Mozart’s K448 as a noninvasive, non-pharmacological intervention for refractory epilepsy.
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10
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Rafiee M, Istasy M, Valiante TA. Music in epilepsy: Predicting the effects of the unpredictable. Epilepsy Behav 2021; 122:108164. [PMID: 34256336 DOI: 10.1016/j.yebeh.2021.108164] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Revised: 06/07/2021] [Accepted: 06/08/2021] [Indexed: 01/08/2023]
Abstract
Epilepsy is the most common serious neurological disorder in the world. Despite medical and surgical treatment, many individuals continue to have seizures, suggesting adjunctive management strategies are required. Promising effects of daily listening to Mozart K.448 on reducing seizure frequency in individuals with epilepsy have been demonstrated. In our recent randomized control study, we reported the positive effect of daily listening to Mozart K.448 on reducing seizures compared to daily listening to a control piece with an identical power spectrum to the Mozart piece yet devoid of rhythmic structure. Despite the promising effect of listening to Mozart K.448 on reducing seizure in individuals with epilepsy, the mechanism(s) underlying such an effect is largely unknown. In this paper, we specifically review how auditory stimulation alters brain dynamics, in addition to computational approaches to define the structural features of classical music, to then propose a plausible mechanism for the underlying anti-convulsant effects of listening to Mozart K.448. We review the evidence demonstrating that some Mozart pieces in addition to compositions from other composers such as Joplin contain less predictable rhythmic structure in comparison with other composers such as Beethoven. We propose through both entrainment and 1/f resonance mechanisms that listening to musical pieces containing the least predictable rhythmic structure, might reduce the self similarity of brain activity which in turn modulates low frequency power, situating the brain in a more "noise like" state and away from brain dynamics that can lead to seizures.
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Affiliation(s)
| | - Marco Istasy
- Krembil Brain Institute, Toronto, ON, Canada; Department of Human Biology, Faculty of Arts and Science, University of Toronto, ON, Canada
| | - Taufik A Valiante
- Krembil Brain Institute, Toronto, ON, Canada; Division of Neurosurgery, Department of Surgery, University of Toronto, Toronto ON, Canada; Institute Biomedical Engineering, and Electrical and Computer Engineering, University of Toronto, Toronto, ON, Canada; Institute of Medical Science, Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
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11
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Štillová K, Kiska T, Koriťáková E, Strýček O, Mekyska J, Chrastina J, Rektor I. Mozart effect in epilepsy: Why is Mozart better than Haydn? Acoustic qualities-based analysis of stereoelectroencephalography. Eur J Neurol 2021; 28:1463-1469. [PMID: 33527581 DOI: 10.1111/ene.14758] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Revised: 12/12/2020] [Accepted: 01/26/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND PURPOSE We aimed to confirm the Mozart effect in epileptic patients using intracerebral electroencephalography recordings and the hypothesis that the reduction of epileptiform discharges (EDs) can be explained by the music's acoustic properties. METHODS Eighteen epilepsy surgery candidates were implanted with depth electrodes in the temporal medial and lateral cortex. Patients listened to the first movement of Mozart's Sonata for Two Pianos K. 448 and to the first movement of Haydn's Symphony No. 94. Musical features from each composition with respect to rhythm, melody, and harmony were analyzed. RESULTS Epileptiform discharges in intracerebral electroencephalography were reduced by Mozart's music. Listening to Haydn's music led to reduced EDs only in women; in men, the EDs increased. The acoustic analysis revealed that nondissonant music with a harmonic spectrum and decreasing tempo with significant high-frequency parts has a reducing effect on EDs in men. To reduce EDs in women, the music should additionally be gradually less dynamic in terms of loudness. Finally, we were able to demonstrate that these acoustic characteristics are more dominant in Mozart's music than in Haydn's music. CONCLUSIONS We confirmed the reduction of intracerebral EDs while listening to classical music. An analysis of the musical features revealed that the acoustic characteristics of music are responsible for suppressing brain epileptic activity. Based on our study, we suggest studying the use of musical pieces with well-defined acoustic properties as an alternative noninvasive method to reduce epileptic activity in patients with epilepsy.
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Affiliation(s)
- Klára Štillová
- Central European Institute of Technology-CEITEC, Masaryk University, Brno, Czech Republic.,Epilepsy Centre and Department of Neurology, Faculty of Medicine, St. Anne's University Hospital, Masaryk University, Brno, Czech Republic
| | - Tomáš Kiska
- Central European Institute of Technology-CEITEC, Masaryk University, Brno, Czech Republic.,Department of Telecommunications, Faculty of Electrical Engineering and Communication, Brno University of Technology, Brno, Czech Republic
| | - Eva Koriťáková
- Institute of Biostatistics and Analyses, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Ondřej Strýček
- Central European Institute of Technology-CEITEC, Masaryk University, Brno, Czech Republic.,Epilepsy Centre and Department of Neurology, Faculty of Medicine, St. Anne's University Hospital, Masaryk University, Brno, Czech Republic
| | - Jiří Mekyska
- Department of Telecommunications, Faculty of Electrical Engineering and Communication, Brno University of Technology, Brno, Czech Republic
| | - Jan Chrastina
- Central European Institute of Technology-CEITEC, Masaryk University, Brno, Czech Republic.,Department of Neurosurgery, Faculty of Medicine, St. Anne's University Hospital, Masaryk University, Brno, Czech Republic
| | - Ivan Rektor
- Central European Institute of Technology-CEITEC, Masaryk University, Brno, Czech Republic.,Epilepsy Centre and Department of Neurology, Faculty of Medicine, St. Anne's University Hospital, Masaryk University, Brno, Czech Republic
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12
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Rini J, Ochoa J. Mapping musical automatism: Further insights from epileptic high-frequency oscillation analysis. NEUROLOGY AND CLINICAL NEUROSCIENCE 2020; 8:177-182. [PMID: 33425352 PMCID: PMC7793560 DOI: 10.1111/ncn3.12375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Accepted: 02/19/2020] [Indexed: 06/12/2023]
Abstract
As ictal semiology is increasingly understood to arise from epileptogenic networks, high-frequency oscillation propagation patterns are helping elucidate networks relevant for surgical planning. Musical automatisms, a well-documented but very rare phenomenon of epilepsy, have yet to be examined as a manifestation of high-frequency propagation in the public literature. In our current study, we report a rare case intractable epilepsy with ictal humming whose epileptogenic zone was associated with the non-dominant left anterior medial temporal region. Mapping our case's ictal semiology and high-frequency propagation pattern both facilitated treatment and further supports prior observations that the rare phenomena of musical automatisms localize to a non-dominant frontal-temporal network rather than a specific cortical territory.
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Affiliation(s)
- James Rini
- Behavioral Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco, CA, USA
| | - Juan Ochoa
- Department of Neurology, University of South Alabama Medical Center, Mobile, AL, USA
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13
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Alqahtani F, Imran I, Pervaiz H, Ashraf W, Perveen N, Rasool MF, Alasmari AF, Alharbi M, Samad N, Alqarni SA, Al-Rejaie SS, Alanazi MM. Non-pharmacological Interventions for Intractable Epilepsy. Saudi Pharm J 2020; 28:951-962. [PMID: 32792840 PMCID: PMC7414058 DOI: 10.1016/j.jsps.2020.06.016] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Accepted: 06/23/2020] [Indexed: 12/20/2022] Open
Abstract
In 30% of epileptic individuals, intractable epilepsy represents a problem for the management of seizures and severely affects the patient's quality of life due to pharmacoresistance with commonly used antiseizure drugs (ASDs). Surgery is not the best option for all resistant patients due to its post-surgical consequences. Therefore, several alternative or complementary therapies have scientifically proven significant therapeutic potential for the management of seizures in intractable epilepsy patients with seizure-free occurrences. Various non-pharmacological interventions include metabolic therapy, brain stimulation therapy, and complementary therapy. Metabolic therapy works out by altering the energy metabolites and include the ketogenic diets (KD) (that is restricted in carbohydrates and mimics the metabolic state of the body as produced during fasting and exerts its antiepileptic effect) and anaplerotic diet (which revives the level of TCA cycle intermediates and this is responsible for its effect). Neuromodulation therapy includes vagus nerve stimulation (VNS), responsive neurostimulation therapy (RNS) and transcranial magnetic stimulation therapy (TMS). Complementary therapies such as biofeedback and music therapy have demonstrated promising results in pharmacoresistant epilepsies. The current emphasis of the review article is to explore the different integrated mechanisms of various treatments for adequate seizure control, and their limitations, and supportive pieces of evidence that show the efficacy and tolerability of these non-pharmacological options.
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Key Words
- ASDs, Antiepileptic drugs
- ATP, Adenosine triphosphate
- Anaplerotic diet
- BBB, Blood-brain barrier
- CKD, Classic ketogenic diet
- CSF, Cerebrospinal fluid
- EEG, Electroencephalography
- EMG, Electromyography
- GABA, Gamma-aminobutyric acid
- Intractable epilepsy
- KB, Ketone bodies
- KD, Ketogenic diet
- Ketogenic diet
- LC, Locus coeruleus
- LCFA, Long-chain fatty acids
- MAD, Modified Atkin's diet
- MCT, Medium-chain triglyceride
- MEP, Maximal evoked potential
- Music therapy
- NTS, Nucleus tractus solitaries
- PPAR, Peroxisome proliferator-activated receptor
- PUFAs, Polyunsaturated fatty acids
- RNS, Responsive neurostimulation
- ROS, reactive oxygen species
- SMR, Sensorimotor rhythm
- TCA, Tricarboxylic acid cycle
- TMS, Transcranial magnetic stimulation
- Transcranial magnetic stimulation Biofeedback therapy
- VNS, Vagus nerve stimulation
- Vagus nerve stimulation
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Affiliation(s)
- Faleh Alqahtani
- Department of Pharmacology and Toxicology, College of Pharmacy, King Saud University, Riyadh 11451, Saudi Arabia
| | - Imran Imran
- Department of Pharmacology, Faculty of Pharmacy, Bahauddin Zakariya University, Multan 60800, Pakistan
| | - Hafsa Pervaiz
- Department of Pharmacology, Faculty of Pharmacy, Bahauddin Zakariya University, Multan 60800, Pakistan
| | - Waseem Ashraf
- Department of Pharmacology, Faculty of Pharmacy, Bahauddin Zakariya University, Multan 60800, Pakistan
| | - Nadia Perveen
- Department of Pharmacology, Faculty of Pharmacy, Bahauddin Zakariya University, Multan 60800, Pakistan
| | - Muhammad Fawad Rasool
- Department of Pharmacy Practice, Faculty of Pharmacy, Bahauddin Zakariya University, Multan 60800, Pakistan
| | - Abdullah F Alasmari
- Department of Pharmacology and Toxicology, College of Pharmacy, King Saud University, Riyadh 11451, Saudi Arabia
| | - Metab Alharbi
- Department of Pharmacology and Toxicology, College of Pharmacy, King Saud University, Riyadh 11451, Saudi Arabia
| | - Noreen Samad
- Department of Biochemistry, Faculty of Science, Bahauddin Zakariya University, Multan 60800, Pakistan
| | - Saleh Abdullah Alqarni
- Department of Pharmacology and Toxicology, College of Pharmacy, King Saud University, Riyadh 11451, Saudi Arabia
| | - Salim S Al-Rejaie
- Department of Pharmacology and Toxicology, College of Pharmacy, King Saud University, Riyadh 11451, Saudi Arabia
| | - Mohammed Mufadhe Alanazi
- Department of Pharmacology and Toxicology, College of Pharmacy, King Saud University, Riyadh 11451, Saudi Arabia
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Rafiee M, Patel K, Groppe DM, Andrade DM, Bercovici E, Bui E, Carlen PL, Reid A, Tai P, Weaver D, Wennberg R, Valiante TA. Daily listening to Mozart reduces seizures in individuals with epilepsy: A randomized control study. Epilepsia Open 2020; 5:285-294. [PMID: 32524054 PMCID: PMC7278546 DOI: 10.1002/epi4.12400] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2020] [Revised: 05/02/2020] [Accepted: 05/03/2020] [Indexed: 11/06/2022] Open
Abstract
Objective Epilepsy is one of the most common neurological disorders . Many individuals continue to have seizures despite medical and surgical treatments, suggesting adjunctive management strategies are required. Promising effects of daily listening to Mozart on reducing seizure frequency in individuals with epilepsy have been demonstrated over the last 20 years, but not in a rigorously controlled manner. In this study, we compared the effect on seizure frequency of daily listening to either Mozart K.448 or a spectrally similar, yet non‐rhythmic control piece. We hypothesized that there would be no difference in seizure counts when participants listened to Mozart K.448 vs when they listened to the control piece. Methods We employed a randomized crossover design, in which each participant was exposed to both three months of daily listening to the first six minutes of Sonata for two pianos in D major by Mozart (Mozart K.448; treatment period) and three months of daily listening to phase‐scrambled version (control period). There was a three‐month baseline and a three‐month follow‐up period before and after the six‐month listening period, respectively. Change in seizure counts obtained from the seizure diaries was considered as the main study outcome. Results Using three methodologies to investigate the existence of the treatment effect (paired t test, estimation statistics and plots, and Cohen's d), our results revealed a reduction in seizure counts during the treatment period, which was not observed for the control period (P‐value < .001). Significance Using a spectrally similar control piece, our study advances previous reports that were limited by a “no music” control condition. Daily listening to Mozart K.448 was associated with reducing seizure frequency in adult individuals with epilepsy. These results suggest that daily Mozart listening may be considered as an adjunctive therapeutic option to reduce seizure burden in individuals with epilepsy.
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Affiliation(s)
| | - Kramay Patel
- Krembil Brain Institute Toronto ON Canada.,Institute of Biomaterials and Biomedical Engineering, and Electrical and Computer Engineering University of Toronto Toronto ON Canada
| | | | - Danielle M Andrade
- Krembil Brain Institute Toronto ON Canada.,Division of Neurology Department of Medicine University of Toronto Toronto ON Canada
| | - Eduard Bercovici
- Krembil Brain Institute Toronto ON Canada.,Division of Neurology Department of Medicine University of Toronto Toronto ON Canada
| | - Esther Bui
- Krembil Brain Institute Toronto ON Canada.,Division of Neurology Department of Medicine University of Toronto Toronto ON Canada
| | - Peter L Carlen
- Krembil Brain Institute Toronto ON Canada.,Institute of Biomaterials and Biomedical Engineering, and Electrical and Computer Engineering University of Toronto Toronto ON Canada.,Division of Neurology Department of Medicine University of Toronto Toronto ON Canada.,Department of Physiology University of Toronto Toronto ON Canada.,Division of Neurosurgery Department of Surgery University of Toronto Toronto ON Canada
| | - Aylin Reid
- Krembil Brain Institute Toronto ON Canada.,Division of Neurology Department of Medicine University of Toronto Toronto ON Canada
| | - Peter Tai
- Krembil Brain Institute Toronto ON Canada.,Division of Neurology Department of Medicine University of Toronto Toronto ON Canada
| | - Donald Weaver
- Krembil Brain Institute Toronto ON Canada.,Division of Neurology Department of Medicine University of Toronto Toronto ON Canada.,Department of Chemistry University of Toronto Toronto ON Canada
| | - Richard Wennberg
- Krembil Brain Institute Toronto ON Canada.,Division of Neurology Department of Medicine University of Toronto Toronto ON Canada
| | - Taufik A Valiante
- Krembil Brain Institute Toronto ON Canada.,Institute of Biomaterials and Biomedical Engineering, and Electrical and Computer Engineering University of Toronto Toronto ON Canada.,Division of Neurosurgery Department of Surgery University of Toronto Toronto ON Canada.,Institute of Medical Science Faculty of Medicine University of Toronto Toronto ON Canada
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15
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Sesso G, Sicca F. Safe and sound: Meta-analyzing the Mozart effect on epilepsy. Clin Neurophysiol 2020; 131:1610-1620. [PMID: 32449680 DOI: 10.1016/j.clinph.2020.03.039] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Revised: 03/11/2020] [Accepted: 03/28/2020] [Indexed: 12/22/2022]
Abstract
OBJECTIVE The use of music-based neuro-stimulation for treating seizures and interictal epileptiform discharges (IED) (the so-called "Mozart effect") remains a controversial issue. We have conducted an updated meta-analysis in order to systematically review literature evidence and provide further insights about the role of the Mozart effect in epilepsy. METHODS Following the "Preferred Reporting Items for Systematic Reviews and Meta-Analyses" (PRISMA) guidelines, we searched three bibliographic databases from their date of inception to January 2020. Nine meta-analyses were performed according to both music stimulation protocols and outcome measures. We applied the Cochrane Q-test and the I2-index for heterogeneity evaluation, and either fixed-effect or random-effect models to compute mean differences and pool data. RESULTS Of 147 abstracts, 12 studies were included and grouped according to stimulation protocols and outcome measures. The nine meta-analyses showed significant reductions in seizures and IED frequencies after long-term music treatment, and in IED frequency during and after a single music stimulus. CONCLUSIONS Music-based neurostimulation may improve the clinical outcome of individuals with epilepsy, by reducing the frequency of seizures and IED. Further and stronger evidence will allow defining its potential in the different forms of epilepsy, and the most effective stimulation protocols. SIGNIFICANCE Music therapy should be considered as a complementary, non-invasive approach for treating epilepsy and epileptiform discharges.
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Affiliation(s)
- Gianluca Sesso
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Federico Sicca
- EPILAB - Epilepsy and Clinical Neurophysiology Laboratory, Department of Developmental Neuroscience, IRCCS Stella Maris Foundation, Pisa, Italy.
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16
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Le Daré B, Triquet L, Degremont A, Charbonnel H, Default A, Osmont MN, Picard S, Gentilhomme G, Bellissant E, Scailteux LM, Polard E. [Pitch perception modification due to antiepileptics: A literature and pharmacovigilance databases review]. Therapie 2020; 75:599-604. [PMID: 32204934 DOI: 10.1016/j.therap.2020.02.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Revised: 12/09/2019] [Accepted: 02/14/2020] [Indexed: 10/24/2022]
Abstract
Pitch perception modifications are among the little-known adverse effects observed with antiepileptics, mainly affecting patients treated with carbamazepine (CBZ). Here, we describe an original French case of pitch perception modification due to CBZ resulting in perfect pitch loss. We also reviewed the literature as well as French and world health organisation global pharmacovigilance database. The case report concerns a 22-year-old patient with perfect pitch with untreated left temporal partial epilepsy. Following a generalized seizure, the introduction of CBZ prolonged release (200mg twice a day) is decided. As soon as CBZ is introduced, the patient notices a change in pitch perception, about a semitone lower. This adverse effect persisted despite a gradual decrease in doses. The patient reported a total recovery of his perfect pitch when CBZ stopped completely 11 years later. In the French pharmacovigilance database, only one other case of pitch perception modification under CBZ was recorded (no cases were found with oxcarbazepine, lacosamide, sodium valproate, lamotrigine, levetiracetam, phenobarbital, phenytoin, primidone, ethosuximide, vigabatrine, felbamate, gabapentin, tiagabine and topiramate). In the literature, 27 cases of pitch perception modification have been published with CBZ, 1 case with oxcarbazepine and 1 case with lacosamide. Pitch perception modification is a very rare adverse effect of CBZ, oxcarbazepine and lacosamide, identified in the literature mainly in the Japanese population, in experienced musicians. A rapid onset after the introduction of treatment, a complete resolution of symptoms, in most cases upon discontinuation of treatment, is observed, with no sequelae reported. Due to the impact on quality of life, especially in patients whose profession is related to music, knowledge of this adverse event seems important to evoke this diagnosis.
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Affiliation(s)
- Brendan Le Daré
- Centre régional de pharmacovigilance, pharmacoépidémiologie et information sur le médicament, hôpital universitaire de Rennes, CHU de Rennes, 2, rue Henri-Le Guilloux, 35000 Rennes, France.
| | - Louise Triquet
- Centre régional de pharmacovigilance, pharmacoépidémiologie et information sur le médicament, hôpital universitaire de Rennes, CHU de Rennes, 2, rue Henri-Le Guilloux, 35000 Rennes, France
| | - Adeline Degremont
- Centre régional de pharmacovigilance, pharmacoépidémiologie et information sur le médicament, hôpital universitaire de Rennes, CHU de Rennes, 2, rue Henri-Le Guilloux, 35000 Rennes, France
| | | | - Anne Default
- Centre régional de pharmacovigilance Marseille-Provence-Corse, hôpital Sainte-Marguerite, Assistance publique-Hôpitaux de Marseille, 130005 Marseille, France
| | - Marie-Noëlle Osmont
- Centre régional de pharmacovigilance, pharmacoépidémiologie et information sur le médicament, hôpital universitaire de Rennes, CHU de Rennes, 2, rue Henri-Le Guilloux, 35000 Rennes, France
| | - Sylvie Picard
- Centre régional de pharmacovigilance, pharmacoépidémiologie et information sur le médicament, hôpital universitaire de Rennes, CHU de Rennes, 2, rue Henri-Le Guilloux, 35000 Rennes, France
| | - Guillaume Gentilhomme
- Centre régional de pharmacovigilance, pharmacoépidémiologie et information sur le médicament, hôpital universitaire de Rennes, CHU de Rennes, 2, rue Henri-Le Guilloux, 35000 Rennes, France
| | - Eric Bellissant
- Centre régional de pharmacovigilance, pharmacoépidémiologie et information sur le médicament, hôpital universitaire de Rennes, CHU de Rennes, 2, rue Henri-Le Guilloux, 35000 Rennes, France
| | - Lucie-Marie Scailteux
- Centre régional de pharmacovigilance, pharmacoépidémiologie et information sur le médicament, hôpital universitaire de Rennes, CHU de Rennes, 2, rue Henri-Le Guilloux, 35000 Rennes, France
| | - Elisabeth Polard
- Centre régional de pharmacovigilance, pharmacoépidémiologie et information sur le médicament, hôpital universitaire de Rennes, CHU de Rennes, 2, rue Henri-Le Guilloux, 35000 Rennes, France
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18
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Pelliccia V, Villani F, Gozzo F, Gnatkovsky V, Cardinale F, Tassi L. Musicogenic epilepsy: A Stereo-electroencephalography study. Cortex 2019; 120:582-587. [PMID: 30837152 DOI: 10.1016/j.cortex.2019.02.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2018] [Revised: 12/02/2018] [Accepted: 02/05/2019] [Indexed: 11/30/2022]
Abstract
Musicogenic epilepsy is rare focal epilepsy in which seizures are triggered by music. Both spontaneous and reflexes seizures may occur. To date there are limited data about this epilepsy, particularly about its etiopathogenesis. We report the clinical, neurophysiological and imaging data about musicogenic epilepsy in a patient who underwent Stereo-electroencephalography (SEEG) study. A 27 year-old right-handed woman suffering from drug-resistant epilepsy since the age of 17 years, was evaluated for surgery. She had weekly seizures characterized by an unpleasant ascending gastric sensation, tachycardia, occasionally late oro-alimentary automatisms, déjà-vu and vomiting. Only during longer seizures a partial loss of awareness was reported. Interestingly, familiar songs triggered seizures. Rarely, she had spontaneous seizures with the same features. The ictal EEG onset appeared to be right temporal, but there was seizure propagation to suprasylvian areas. Brain MRI was negative. A SEEG implantation was performed to study the right temporo-perisylvian regions. SEEG data clearly indicated the antero-mesial temporal regions as origin of the seizures, without any spread to other close or distant cortical areas. Right temporal antero-mesial resection was performed 24 months ago and the patient is seizure-free since surgery. Neuropathology was uninformative. SEEG data highlighted the hypothesis regarding a temporo-mesial emotional-mnesic network triggered by particular music with an affective component for the patient. The primary auditory cortex and lateral mid-posterior temporal and extratemporal cortices were not involved. Different triggers as mentally singing and hearing the music can induce seizure as well as electrical stimulation in the mesial temporal structures.
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Affiliation(s)
| | - Flavio Villani
- Epilepsy Unit, Fondazione IRCCS, Istituto Neurologico C. Besta, Milano, Italy
| | - Francesca Gozzo
- C. Munari Epilepsy Surgery Centre, Ospedale Niguarda, Milano, Italy
| | - Vadym Gnatkovsky
- Epilepsy Unit, Fondazione IRCCS, Istituto Neurologico C. Besta, Milano, Italy
| | | | - Laura Tassi
- C. Munari Epilepsy Surgery Centre, Ospedale Niguarda, Milano, Italy.
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19
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Arias M. Neurology of ecstatic religious and similar experiences: ecstatic, orgasmic, and musicogenic seizures. Stendhal syndrome and autoscopic phenomena. NEUROLOGÍA (ENGLISH EDITION) 2019. [DOI: 10.1016/j.nrleng.2016.04.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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20
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Tseng WEJ, Lim SN, Chen LA, Jou SB, Hsieh HY, Cheng MY, Chang CW, Li HT, Chiang HI, Wu T. Correlation of vocals and lyrics with left temporal musicogenic epilepsy. Ann N Y Acad Sci 2018; 1423:188-197. [PMID: 29542128 DOI: 10.1111/nyas.13594] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2017] [Revised: 11/19/2017] [Accepted: 12/11/2017] [Indexed: 01/10/2023]
Abstract
Whether the cognitive processing of music and speech relies on shared or distinct neuronal mechanisms remains unclear. Music and language processing in the brain are right and left temporal functions, respectively. We studied patients with musicogenic epilepsy (ME) that was specifically triggered by popular songs to analyze brain hyperexcitability triggered by specific stimuli. The study included two men and one woman (all right-handed, aged 35-55 years). The patients had sound-triggered left temporal ME in response to popular songs with vocals, but not to instrumental, classical, or nonvocal piano solo versions of the same song. Sentimental lyrics, high-pitched singing, specificity/familiarity, and singing in the native language were the most significant triggering factors. We found that recognition of the human voice and analysis of lyrics are important causal factors in left temporal ME and provide observational evidence that sounds with speech structure are predominantly processed in the left temporal lobe. A literature review indicated that language-associated stimuli triggered ME in the left temporal epileptogenic zone at a nearly twofold higher rate compared with the right temporal region. Further research on ME may enhance understanding of the cognitive neuroscience of music.
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Affiliation(s)
- Wei-En J Tseng
- Department of Neurology, Section of Epilepsy, Chang Gung Memorial Hospital, Linkou Medical Center and Chang Gung University College of Medicine, Taoyuan, Taiwan
- Program in Biomedical Engineering, Chang Gung University, Taoyuan, Taiwan
| | - Siew-Na Lim
- Department of Neurology, Section of Epilepsy, Chang Gung Memorial Hospital, Linkou Medical Center and Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Lu-An Chen
- Department of Neurology, Mackay Memorial Hospital, Taipei, Taiwan
| | - Shuo-Bin Jou
- Department of Neurology, Mackay Memorial Hospital, Taipei, Taiwan
| | - Hsiang-Yao Hsieh
- Department of Neurology, Section of Epilepsy, Chang Gung Memorial Hospital, Linkou Medical Center and Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Mei-Yun Cheng
- Department of Neurology, Section of Epilepsy, Chang Gung Memorial Hospital, Linkou Medical Center and Chang Gung University College of Medicine, Taoyuan, Taiwan
- Institute of Molecular Medicine, National Tsing Hua University, Hsinchu, Taiwan
| | - Chun-Wei Chang
- Department of Neurology, Section of Epilepsy, Chang Gung Memorial Hospital, Linkou Medical Center and Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Han-Tao Li
- Department of Neurology, Section of Epilepsy, Chang Gung Memorial Hospital, Linkou Medical Center and Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Hsing-I Chiang
- Department of Neurology, Section of Epilepsy, Chang Gung Memorial Hospital, Linkou Medical Center and Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Tony Wu
- Department of Neurology, Section of Epilepsy, Chang Gung Memorial Hospital, Linkou Medical Center and Chang Gung University College of Medicine, Taoyuan, Taiwan
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Nagahama Y, Kovach CK, Ciliberto M, Joshi C, Rhone AE, Vesole A, Gander PE, Nourski KV, Oya H, Howard MA, Kawasaki H, Dlouhy BJ. Localization of musicogenic epilepsy to Heschl's gyrus and superior temporal plane: case report. J Neurosurg 2017; 129:157-164. [PMID: 28946181 DOI: 10.3171/2017.3.jns162559] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Musicogenic epilepsy (ME) is an extremely rare form of the disorder that is provoked by listening to or playing music, and it has been localized to the temporal lobe. The number of reported cases of ME in which intracranial electroencephalography (iEEG) has been used for seizure focus localization is extremely small, especially with coverage of the superior temporal plane (STP) and specifically, Heschl's gyrus (HG). The authors describe the case of a 17-year-old boy with a history of medically intractable ME who underwent iEEG monitoring that involved significant frontotemporal coverage as well as coverage of the STP with an HG depth electrode anteriorly and a planum temporale depth electrode posteriorly. Five seizures occurred during the monitoring period, and a seizure onset zone was localized to HG and the STP. The patient subsequently underwent right temporal neocortical resection, involving the STP and including HG, with preservation of the mesial temporal structures. The patient remains seizure free 1 year postoperatively. To the authors' knowledge, this is the first reported case of ME in which the seizure focus has been localized to HG and the STP with iEEG monitoring. The authors review the literature on iEEG findings in ME, explain their approach to HG depth electrode placement, and discuss the utility of STP depth electrodes in temporal lobe epilepsy.
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Affiliation(s)
| | | | | | | | | | - Adam Vesole
- 3Carver College of Medicine, University of Iowa Hospitals and Clinics; and
| | | | | | | | - Matthew A Howard
- Departments of1Neurosurgery and.,4Pappajohn Biomedical Institute, University of Iowa Carver College of Medicine, Iowa City, Iowa
| | | | - Brian J Dlouhy
- Departments of1Neurosurgery and.,4Pappajohn Biomedical Institute, University of Iowa Carver College of Medicine, Iowa City, Iowa
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BOŞNAK MEHMET, KURT AKİFHAKAN, YAMAN SELMA. BEYNİMİZİN MÜZİK FİZYOLOJİSİ. KAHRAMANMARAŞ SÜTÇÜ İMAM ÜNIVERSITESI TIP FAKÜLTESI DERGISI 2017. [DOI: 10.17517/ksutfd.296621] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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24
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Neurology of ecstatic religious and similar experiences: Ecstatic, orgasmic, and musicogenic seizures. Stendhal syndrome and autoscopic phenomena. Neurologia 2016; 34:55-61. [PMID: 27340019 DOI: 10.1016/j.nrl.2016.04.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2016] [Revised: 04/11/2016] [Accepted: 04/20/2016] [Indexed: 11/23/2022] Open
Abstract
All human experiences, including mystical and religious ones, are the result of brain functional activity. Thanks to the study of cases of ecstatic epilepsy with structural (MRI) and functional neuroimaging (fMRI, PET, SPECT) and neurophysiological technologies (recording and stimulation with intracranial electrodes), we now have a better knowledge of certain mental states which involve pleasant and affective symptoms and clarity of mind. These ecstatic experiences are thought to be caused by the activation of the anterior insular cortex and some neuronal networks (basically related to mirror neurons and salience) participating in introspection, social cognition, memory, and emotional processes. Thus, neuroscience could explain in a retrospective way some facts surrounding the situations of such relevant figures as Paul the Apostle, Teresa de Cepeda y Ahumada, and Dostoevsky, whose origin was previously considered paranormal or supernatural. Ecstatic epilepsy shares symptoms and mechanisms with orgasmic epilepsy (spontaneous orgasms in the course of epileptic seizures), musicogenic epilepsy (epileptic seizures triggered by listening to a certain musical piece), and also with Stendhal syndrome (neuropsychiatric disturbances caused when an individual is exposed to large amounts of art) and some autoscopic phenomena (out-of-body experiences that occasionally take place in imminent death situations). In all these events, there are pleasant and affective symptoms which have a great impact on patients.
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Lin K, Guaranha M, Wolf P. Reflex epileptic mechanisms in ictogenesis and therapeutic consequences. Expert Rev Neurother 2016; 16:573-85. [PMID: 26999567 DOI: 10.1586/14737175.2016.1169174] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Recent studies of reflex epileptic mechanisms in human epilepsy using advanced methods of neurophysiology and functional neuroimaging have contributed much to elucidate pathophysiological processes of seizure generation. Whereas in lesional focal epilepsies reflex mechanisms usually relate directly to the anatomical focus, in system epilepsies they have helped to define which functional anatomical systems serving physiological function are recruited by the ictogenic mechanisms. Reflex epileptic seizures can often be prevented by avoidance or modification of triggers or by prophylactic benzodiazepine administration. Surgical options apply to focal cases. According to restricted experiences with pharmacotherapy, without controlled studies and little information on new AEDs, reflex seizures in system epilepsies appear to respond best to valproic acid and in focal epilepsies, to carbamazepine.
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Affiliation(s)
- Katia Lin
- a Serviço de Neurologia, Departamento de Clínica Médica , Hospital Universitário, Universidade Federal de Santa Catarina (UFSC) , Florianópolis , SC , Brazil
| | - Mirian Guaranha
- b Hospital São Paulo , Universidade Federal de São Paulo , São Paulo , Brazil
| | - Peter Wolf
- a Serviço de Neurologia, Departamento de Clínica Médica , Hospital Universitário, Universidade Federal de Santa Catarina (UFSC) , Florianópolis , SC , Brazil.,c Danish Epilepsy Centre , Dianalund , Denmark
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Exposure to Mozart music reduces cognitive impairment in pilocarpine-induced status epilepticus rats. Cogn Neurodyn 2015; 10:23-30. [PMID: 26834859 DOI: 10.1007/s11571-015-9361-1] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2015] [Revised: 10/06/2015] [Accepted: 10/13/2015] [Indexed: 10/22/2022] Open
Abstract
Patients with temporal lobe epilepsy (TLE) often display cognitive deficits. However, current epilepsy therapeutic interventions mainly aim at how to reduce the frequency and degree of epileptic seizures. Recovery of cognitive impairment is not attended enough, resulting in the lack of effective approaches in this respect. In the pilocarpine-induced temporal lobe epilepsy rat model, memory impairment has been classically reported. Here we evaluated spatial cognition changes at different epileptogenesis stages in rats of this model and explored the effects of long-term Mozart music exposure on the recovery of cognitive ability. Our results showed that pilocarpine rats suffered persisting cognitive impairment during epileptogenesis. Interestingly, we found that Mozart music exposure can significantly enhance cognitive ability in epileptic rats, and music intervention may be more effective for improving cognitive function during the early stages after Status epilepticus. These findings strongly suggest that Mozart music may help to promote the recovery of cognitive damage due to seizure activities, which provides a novel intervention strategy to diminish cognitive deficits in TLE patients.
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Coppola G, Toro A, Operto FF, Ferrarioli G, Pisano S, Viggiano A, Verrotti A. Mozart's music in children with drug-refractory epileptic encephalopathies. Epilepsy Behav 2015; 50:18-22. [PMID: 26093514 DOI: 10.1016/j.yebeh.2015.05.038] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2015] [Revised: 05/22/2015] [Accepted: 05/26/2015] [Indexed: 01/26/2023]
Abstract
Mozart's sonata for two pianos in D major, K448, has been shown to decrease interictal EEG discharges and recurrence of clinical seizures in both adults and young patients. In this prospective, open-label study, we evaluated the effect of listening to a set of Mozart's compositions, according to the Tomatis method, on sleep quality and behavioral disorders, including auto-/hetero-aggression, irritability, and hyperactivity, in a group of children and adolescents with drug-resistant epilepsy. The study group was composed of 11 outpatients (7 males and 4 females), between 1.5years and 21years of age (mean age: 11.9years), all suffering from drug-resistant epileptic encephalopathy (n=11). All of them had a severe/profound intellectual disability associated with cerebral palsy. During the study period, each patient had to listen to a set of Mozart's compositions 2h per day for fifteen days for a total of 30h, which could be distributed over the day depending on the habits and compliance of each patient. The music was filtered by a device preferably delivering higher sound frequencies (>3000Hz) according to the Tomatis principles. The antiepileptic drug therapy remained unchanged throughout the study period. During the 15-day music therapy, 2 out of 11 patients had a reduction of 50-75% in seizure recurrence, and 3 out of 12 patients had a reduction of 75-89%. Overall, 5 (45.4%) out of 11 patients had a ≥50% reduction in the total number of seizures, while the percentage decrease of the total seizure number (11/11) compared with baseline was -51.5% during the 15-day music therapy and -20.7% in the two weeks after the end of treatment. All responders also had an improvement in nighttime sleep and daytime behavior.
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Affiliation(s)
- Giangennaro Coppola
- Clinic of Child and Adolescent Neuropsychiatry, Department of Medicine and Surgery, S. Giovanni di Dio and Ruggi d'Aragona Hospital, University of Salerno, Italy.
| | - Annacarmela Toro
- Clinic of Child and Adolescent Neuropsychiatry, Department of Medicine and Surgery, S. Giovanni di Dio and Ruggi d'Aragona Hospital, University of Salerno, Italy
| | - Francesca Felicia Operto
- Clinic of Child and Adolescent Neuropsychiatry, Department of Medicine and Surgery, S. Giovanni di Dio and Ruggi d'Aragona Hospital, University of Salerno, Italy
| | - Giuseppe Ferrarioli
- Clinic of Child and Adolescent Neuropsychiatry, Department of Medicine and Surgery, S. Giovanni di Dio and Ruggi d'Aragona Hospital, University of Salerno, Italy
| | - Simone Pisano
- Clinic of Child and Adolescent Neuropsychiatry, Department of Medicine and Surgery, S. Giovanni di Dio and Ruggi d'Aragona Hospital, University of Salerno, Italy
| | - Andrea Viggiano
- Clinic of Child and Adolescent Neuropsychiatry, Department of Medicine and Surgery, S. Giovanni di Dio and Ruggi d'Aragona Hospital, University of Salerno, Italy
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28
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Liao H, Jiang G, Wang X. Music therapy as a non-pharmacological treatment for epilepsy. Expert Rev Neurother 2015. [DOI: 10.1586/14737175.2015.1071191] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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29
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Abstract
Reflex epilepsies can be provoked by various types of external stimuli, but triggered by smell is rare in the literature. In this case report, we present a patient whose reflex epilepsy is triggered by smell. Physical examination findings and electrophysiologic studies of the patient are discussed.
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Affiliation(s)
- Faik Ilik
- Elbistan State Hospital, Kahramanmaras, Turkey
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30
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31
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Omigie D, Samson S. A Protective Effect of Musical Expertise on Cognitive Outcome Following Brain Damage? Neuropsychol Rev 2014; 24:445-60. [DOI: 10.1007/s11065-014-9274-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2014] [Accepted: 10/22/2014] [Indexed: 11/24/2022]
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32
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Papp G, Kovac S, Frese A, Evers S. The impact of temporal lobe epilepsy on musical ability. Seizure 2014; 23:533-6. [DOI: 10.1016/j.seizure.2014.03.018] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2013] [Revised: 03/28/2014] [Accepted: 03/29/2014] [Indexed: 10/25/2022] Open
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33
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Raglio A, Farina E, Giovagnoli AR. Can music therapy alleviate psychological, cognitive, and behavioral impairment in epilepsy? Epilepsy Behav 2014; 31:7-8. [PMID: 24287099 DOI: 10.1016/j.yebeh.2013.10.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2013] [Accepted: 10/08/2013] [Indexed: 11/19/2022]
Affiliation(s)
- A Raglio
- Sospiro Foundation, Piazza Libertà 2, Sospiro, Cremona 26048, Italy; Department of Biomedical and Specialistic Surgical Sciences, Section of Neurology, University of Ferrara, Via Aldo Moro 8, 44124 Cona, Ferrara, Italy.
| | - E Farina
- S. Maria Nascente I.R.C.C.S., Don Gnocchi Foundation, Via Capecelatro 66, Milano 20148, Italy.
| | - A R Giovagnoli
- Department of Diagnostics and Applied Technology, Fondazione I.R.C.C.S. Istituto Neurologico C. Besta, Via Celoria 11, Milano 20133, Italy.
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34
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The Effects of Mozart’s Music on Interictal Activity in Epileptic Patients: Systematic Review and Meta-analysis of the Literature. Curr Neurol Neurosci Rep 2013; 14:420. [DOI: 10.1007/s11910-013-0420-x] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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