The impact of mild cognitive impairment on musical ability

ZUSAMMENFASSUNG

Hintergrund: Patienten mit einer Alzheimer-Erkrankung zeigen Beeinträchtigungen kognitiver Prozesse einschließlich der Verarbeitung musikalischer Reize. Wir haben untersucht, ob der Rückgang der musikalischen Verarbeitung schon im Stadium der mild cognitive impairment (MCI) beginnt.

Methodik: Wir haben 18 Patienten mit MCI und ohne eine andere neurologische oder psychiatrische Erkrankung eingeschlossen. Es wurde ein selbst entwickelter Musikalitätstest angewendet, der folgende Fähigkeiten misst: Identifikation von Melodien; Tonhöhenerkennung; Rhythmuserkennung; emotionaler Ausdruck der Musik. Zusätzlich haben wir Marker einer dementiellen Entwicklung im Liquor bestimmt. Wir haben die Ergebnisse der Patienten verglichen mit den Ergebnissen einer nach Alter und Geschlecht parallelisierten gesunden Vergleichsgruppe. Alle Patienten und Kontrollen hatten keine spezifische musikalische Ausbildung.

Ergebnisse: Patienten mit MCI zeigten signifikant niedrigere Ergebnisse beim Rhythmus, Metrum und emotionalen Subtests und im gesamten Test-Score. Der Gesamt-Score war invers korreliert mit dem Level von Gesamt-Tau im Liquor.

Diskussion: Unsere Daten deuten darauf hin, dass einige Domänen der Musikalität bei Patienten mit MCI signifikant beeinträchtigt sind. Dies bedeutet jedoch nicht notwendigerweise, dass die Produktion von und die Freude an Musik beeinträchtigt sind. Dennoch sollte die Beeinträchtigung von Teilen der Musikalität beim Einsatz von Musiktherapie bei diesen Patienten berücksichtigt werden.

ABSTRACT

Background: Patients with Alzheimer’s disease show impairment of cognitive processing including processing of musical stimuli. We aimed to evaluate whether the decline of musical processing already commences in patients with mild cognitive impairment (MCI).

Methods: We enrolled 18 patients with MCI and without any other neurological or psychiatric disorder. We applied a self developed test of musical ability which evaluates the ability to identify melodies, pitch, rhythm, and emotional content of music. In addition, markers of dementia were measured in the cerebrospinal fluid. We compared the results of the patients to the results of age and sex matched healthy control subjects. All patients and subjects were without specific musical training.

Results: Patients with MCI showed a significantly lower score in the rhythm, metrum, and emotion subtests and in the total test. The total test score was inversely correlated with the level of total tau in the cerebrospinal fluid.

Conclusions: Our data suggest that some domains of musical ability are significantly impaired in patients with MCI. This does not necessarily mean that producing, enjoying, or listening to music is affected. However, it should be noted in the music therapy setting that processing of musical stimuli can be reduced in these patients.

Schlüsselwörter

Musikalität - leichte kognitive Dysfunktion - Alzheimer-Erkrankung

Keywords

Musical ability - mild cognitive impairment - Alzheimer’s disease

• References

• 1 Peretz I, Zatorre RJ. Brain organization for music processing. Annu Rev Psychol 2005; 56: 89-114
• 2 Baird A, Samson S. Memory for music in Alzheimer’s disease: unforgettable?. Neuropsychol Rev 2009; 19: 85-101
• 3 Guetin S, Charras K, Berard A. et al An overview of the use of music therapy in the context of Alzheimer’s disease: a report of a French expert group. Dementia 2013; 12: 619-634
• 4 Cooper C, Sommerlad A, Lyketsos CG. et al Modifiable predictors of dementia in mild cognitive impairment: a systematic review and meta-analysis. Am J Psychiatry 2015; 172: 323-334
• 5 Gauthier S, Reisberg B, Zaudig M. et al International Psychogeriatric Association Expert Conference on mild cognitive impairment. Lancet 2006; 367: 1262-1270
• 6 Reisberg B, Ferris SH, De Leon MJ. et al The global deterioration scale for assessment of primary degenerative dementia. Am J Psychiatry 1982; 139: 1136-1139
• 7 Petersen RC, Smith GE, Waring SC. et al Mild cognitive impairment: clinical characterization and outcome. Arch Neurol 1999; 56: 303-308
• 8 Petersen RC, Caracciolo B, Brayne C. et al Mild cognitive impairment: a concept in evolution. J Intern Med 2014; 275: 214-228
• 9 Johnson JK, Chang CC, Brambati SM. et al Music recognition in frontotemporal lobar degeneration and Alzheimer disease. Cogn Behav Neurol 2011; 24: 74-84
• 10 Folstein MF, Folstein SE, McHugh PR. “Mini-mental state”. A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 1975; 12: 189-198
• 11 Lorenz C. In Entwicklung eines klinischen Musikalitätstests: Normwerte, klinischer Einsatz und Vergleich von Patienten mit Hirninfarkten. Med Diss Münster 2000
• 12 Aldridge D. Music therapy research and practice in medicine: From out of the silence. London: Jessica Kinglsey Publishers; 1996
• 13 Schuppert M, Münte TF, Wieringa BM. et al Receptive amusia: evidence for cross-hemispheric neural networks underlying music processing strategies. Brain 2000; 123: 546-559
• 14 Kohlmetz C, Altenmüller E, Schuppert M. et al Deficit in automatic sound-change detection may underlie some music perception deficits after acute hemispheric stroke. Neuropsychologia 2001; 39: 1121-1124
• 15 Särkämö T, Tervaniemi M, Soinila S. et al Cognitive deficits associated with acquired amusia after stroke: a neuropsychological follow-up study. Neuropsychologia 2009; 47: 2642-2651
• 16 Papp G, Kovac S, Frese A. et al The impact of temporal lobe epilepsy on musical ability. Seizure 2014; 23: 533-536
• 17 Reker P, Domschke K, Zwanzger P. et al The impact of depression on musical ability. J Affect Disord 2014; 156: 150-155
• 18 Polk M, Kertesz A. Music and language in degenerative disease of the brain. Brain Cogn 1993; 22: 98-117
• 19 Alescio-Lautier B, Michel BF, Herrera C. et al Visual and visuospatial short-term memory in mild cognitive impairment and Alzheimer disease: role of attention. Neuropsychologia 2007; 45: 1948-1960
• 20 Yakhia M, Konig A, van der Flier WM. et al Actigraphic motor activity in mild cognitive impairment patients carrying out short functional activity tasks: comparison between mild cognitive impairment with and without depressive symptoms. J Alzheimers Dis 2014; 40: 869-875
• 21 Hsieh S, Hornberger M, Piguet O. et al Brain correlates of musical and facial emotion recognition: evidence from the dementias. Neuropsychologia 2012; 50: 1814-1822
• 22 Vanstone AD, Cuddy LL. Musical memory in Alzheimer disease. Neuropsychol Dev Cogn B Aging Neuropsychol Cogn 2010; 17: 108-128
• 23 Azermai M. Dealing with behavioral and psychological symptoms of dementia: a general overview. Psychol Res Behav Manag 2015; 8: 181-185
• 24 McDermott O, Orrell M, Ridder HM. The importance of music for people with dementia: the perspectives of people with dementia, family carers, staff and music therapists. Aging Ment Health 2014; 18: 706-716
• 25 Chang YS, Chu H, Yang CY. et al The efficacy of music therapy for people with dementia: A meta-analysis of randomised controlled trials. J Clin Nurs 2015; 24: 3425-3440
• 26 Ménard MC, Belleville S. Musical and verbal memory in Alzheimer’s disease: a study of long-term and short-term memory. Brain Cogn 2009; 71: 38-45
• 27 Thomann PA, Kaiser E, Schönknecht P. et al Association of total tau and phosphorylated tau 181 protein levels in cerebrospinal fluid with cerebral atrophy in mild cognitive impairment and Alzheimer disease. J Psychiatry Neurosci 2009; 34: 136-142
• 28 Blennow K, Hampel H, Weiner M. et al Cerebrospinal fluid and plasma biomarkers in Alzheimer disease. Nat Rev Neurol 2010; 6: 131-144
• 29 Price JL, Morris JC. Tangles and plaques in nondemented aging and “preclinical” Alzheimer’s disease. Ann Neurol 1999; 45: 358-368
• 30 Price JL, McKeel Jr DW, Buckles VD. et al Neuropathology of nondemented aging: presumptive evidence for preclinical Alzheimer disease. Neurobiol Aging 2009; 30: 1026-1036
• 31 Schönknecht P, Pantel J, Kaiser E. et al Increased tau protein differentiates mild cognitive impairment from geriatric depression and predicts conversion to dementia. Neurosci Lett 2007; 416: 39-42
• 32 Hansson O, Zetterberg H, Buchhave P, Londos E, Blennow K, Minthon L. Association between CSF biomarkers and incipient Alzheimer’s disease in patients with mild cognitive impairment: a follow-up study. Lancet Neurol 2006; 5: 228-234
• 33 Mattsson N, Zetterberg H, Hansson O. et al CSF biomarkers and incipient Alzheimer disease in patients with mild cognitive impairment. JAMA 2009; 302: 385-393
• 34 Olsson B, Lautner R, Andreasson U. et al CSF and blood biomarkers for the diagnosis of Alzheimer’s disease: a systematic review and meta-analysis. Lancet Neurol 2016; 15: 673-684
• 35 Schinka JA, Loewenstein DA, Raj A. et al Defining mild cognitive impairment: impact of varying decision criteria on neuropsychological diagnostic frequencies and correlates. Am J Geriatr Psychiatry 2010; 18: 684-691
• 36 Chertkow H, Feldman HH, Jacova C. et al Definitions of dementia and predementia states in Alzheimer’s disease and vascular cognitive impairment: consensus from the Canadian conference on diagnosis of dementia. Alzheimers Res Ther 2013; 5 (Suppl. 01) S2