Musical Hallucinations in Chronic Pain: The Anterior Cingulate Cortex Regulates Internally Generated Percepts

Complex auditory musical hallucinations with ambivalent feelings

A 78-year-old woman with hypertension, diabetes mellitus type 2 and bilateral sensorineural hearing loss was referenced to geriatric psychiatry consultation. She presented cognitive dysfunction, erotomanic delusion and complex musical hallucinations (MH), described as hearing her neighbour singing a familiar church song along with bells in the background, making comments and talking to her. A computed tomography (CT) of the brain detected small right nucleocapsular and bilateral external capsules hypodensities of presumed vascular aetiology during hospitalisation. MH are a rare phenomenon with heterogeneous aetiology. Most frequently, the cause is hearing impairment; other causes include social isolation, cognitive dysfunction, vascular risk factors and medication. Studies suggest that some brain areas related to musical memory circuitry might be related and not fully mapped. Auditory verbal hallucinations with a voice that either comments, talks or sings to the patient have never been described in the literature, making this clinical case attractive.

The Benefits of Music Listening for Induced State Anxiety: Behavioral and Physiological Evidence

BACKGROUND

Some clinical studies have indicated that neutral and happy music may relieve state anxiety. However, the brain mechanisms by which these effective interventions in music impact state anxiety remain unknown.

METHODS

In this study, we selected music with clinical effects for therapy, and 62 subjects were included using the evoked anxiety paradigm. After evoking anxiety with a visual stimulus, all subjects were randomly divided into three groups (listening to happy music, neutral music and a blank stimulus), and EEG signals were acquired.

RESULTS

We found that different emotional types of music might have different mechanisms in state anxiety interventions. Neutral music had the effect of alleviating state anxiety. The brain mechanisms supported that neutral music ameliorating state anxiety was associated with decreased power spectral density of the occipital lobe and increased brain functional connectivity between the occipital lobe and frontal lobe. Happy music also had the effect of alleviating state anxiety, and the brain mechanism was associated with enhanced brain functional connectivity between the occipital lobe and right temporal lobe.

CONCLUSIONS

This study may be important for a deep understanding of the mechanisms associated with state anxiety music interventions and may further contribute to future clinical treatment using nonpharmaceutical interventions.