Paper 1:

J Clin Exp Neuropsychol. 2017 Feb;39(1):9-21.

Does music training facilitate the mnemonic effect of song? An exploration of musicians and nonmusicians with and without Alzheimer’s dementia.

Baird A1,2, Samson S3,4, Miller L1,5, Chalmers K6.

1 ARC Centre of Excellence in Cognition and its Disorders , Sydney , NSW , Australia.
2 Psychology Department , Macquarie University , Sydney , NSW , Australia.
3 Neuropsychology: Audition, Cognition, Action, Laboratory PSITEC (EA 4072) , University of Lille , Lille , France.
4 La Pitié-Salpêtrière Hospital , Paris , France.
5 Neuropsychology Department , Royal Prince Alfred Hospital and Central Medical School, University of Sydney , Sydney , NSW , Australia.
6 School of Psychology , University of Newcastle , Newcastle , NSW , Australia.

 

Abstract

INTRODUCTION:

The efficacy of using sung words as a mnemonic device for verbal memory has been documented in persons with probable Alzheimer’s dementia (AD), but it is not yet known whether this effect is related to music training. Given that music training can enhance cognitive functioning, we explored the effects of music training and modality (sung vs. spoken) on verbal memory in persons with and without AD.

METHOD:

We used a mixed factorial design to compare learning (5 trials), delayed recall (30-min and, 24-hour), and recognition of sung versus spoken information in 22 healthy elderly (15 musicians), and 11 people with AD (5 musicians).

RESULTS:

Musicians with AD showed better total learning (over 5 trials) of sung information than nonmusicians with AD. There were no significant differences in delayed recall and recognition accuracy (of either modality) between musicians with and without AD, suggesting that music training may facilitate memory function in AD. Analysis of individual performances showed that two of the five musicians with AD were able to recall some information on delayed recall, whereas the nonmusicians with AD recalled no information on delay. The only significant finding in regard to modality (sung vs. spoken) was that total learning was significantly worse for sung than spoken information for nonmusicians with AD. This may be due to the need to recode information presented in song into spoken recall, which may be more cognitively demanding for this group.

CONCLUSIONS:

This is the first study to demonstrate that music training modulates memory of sung and spoken information in AD. The mechanism underlying these results is unclear, but may be due to music training, higher cognitive abilities, or both. Our findings highlight the need for further research into the potentially protective effect of music training on cognitive abilities in our aging population.

KEYWORDS: Alzheimer’s dementia; Cognition; Memory; Music; Musician; Song

PMID: 27309634

 

Paper 2:

Neurocase. 2017 Feb;23(1):36-40. doi: 10.1080/13554794.2017.1287278.

A nonmusician with severe Alzheimer’s dementia learns a new song.

Baird A1, Umbach H1, Thompson WF1.

Australian Research Council Centre of Excellence in Cognition and its Disorders and Psychology Department , Macquarie University , Sydney , Australia.
Abstract

The hallmark symptom of Alzheimer’s Dementia (AD) is impaired memory, but memory for familiar music can be preserved. We explored whether a non-musician with severe AD could learn a new song. A 91 year old woman (NC) with severe AD was taught an unfamiliar song. We assessed her delayed song recall (24 hours and 2 weeks), music cognition, two word recall (presented within a familiar song lyric, a famous proverb, or as a word stem completion task), and lyrics and proverb completion. NC’s music cognition (pitch and rhythm perception, recognition of familiar music, completion of lyrics) was relatively preserved. She recalled 0/2 words presented in song lyrics or proverbs, but 2/2 word stems, suggesting intact implicit memory function. She could sing along to the newly learnt song on immediate and delayed recall (24 hours and 2 weeks later), and with intermittent prompting could sing it alone. This is the first detailed study of preserved ability to learn a new song in a non-musician with severe AD, and contributes to observations of relatively preserved musical abilities in people with dementia.

KEYWORDS: Alzheimer’s Dementia; Music; memory; singing

PMID: 28376689

 

Supplement:

Our population is ageing and there is a corresponding increase in the incidence of dementia. In 2015 it was estimated to affect 46.8 million people worldwide. Memory impairment is the hallmark symptom of the most common type of dementia, Alzheimer’s Dementia (AD). There is currently no cure for AD. Drug treatments are available to slow the progression of the disease, but the efficacy varies. In recent years there has been a renewed interest in non-pharmacological treatments for dementia. Music is one of the most effective non-pharmacological treatments for various symptoms of dementia, reducing agitation, lifting mood and enhancing memory function. Although individuals with AD have severely impaired memory function in most areas of their lives, memory for familiar music can be spared. This phenomenon was first reported in a seminal case study of a woman with severe AD who showed intact recognition of famous tunes (Cuddy & Duffin, 2005). Music evoked autobiographical memories (MEAMs) or personal memories triggered by music are also preserved in people with AD. Even more surprising, some musicians with AD can retain the ability to play their musical instrument and even learn and recall new tunes, even in the severe stage (see Baird & Samson, 2015 for a review). These observations suggest that memory for music is more resistant to brain disease than memory for other types of stimuli, such as verbal or visual. In keeping with previous memory research, Baird and Samson (2009) proposed that different types of musical memory exist and can be differentially spared or impaired in AD. For example, spared ability to recognise familiar tunes and to play a musical instrument suggests intact sematic and procedural musical memory respectively, while impaired ability to identify new or old tunes presented within an experimental session suggest that episodic musical memory is typically impaired. These different types of musical memory are mediated by different neural networks. Neuroimaging studies have found that the frontal regions of the brain mediate memory for familiar music and MEAMs, and these regions are typically spared of the pathology of AD, enabling the longstanding integrity of these musical abilities (e.g. Jacobsen et al., 2015).

 

The previous case studies of learning and recalling new music have all been in musicians with AD. We were interested to see if a non-musician with AD could learn and recall a new song (Baird, Umbach & Thompson, 2017). Our case study of NC, a woman with severe AD who always enjoyed singing but had no formal music training, showed that she was able to learn a new tune and recall it two weeks later. This was in striking contrast to her inability to recall meeting the researcher, or to recall three words after a 2 minute delay. This demonstrates that the process of learning and recalling musical information is unique regardless of any formal music training. The mechanisms underlying this spared memory ability are likely to be multifactorial, and relate to both the nature of music, specifically its various features (Thompson & Schlaug, 2015), such as its tendency to trigger emotional and physical reactions, and the neural correlates mediating music learning and memory. Of note, NC showed a high level of responsiveness to music and had a lifelong engagement with music, and it is likely that this contributed to her ability to learn new music.  It is unknown if this preserved new music learning ability is a feature of all people with AD, or only those with high levels of music engagement and responsiveness, as in NC, and this requires further investigation.

 

The findings of spared music abilities in people with AD raises an intriguing question. Can these preserved abilities be harnessed to enhance memory function? The promising potential for music to boost verbal memory in people with AD has been demonstrated by some studies which have shown that information that is presented as lyrics in a song is better recognised and recalled than when it is spoken (Simmons-Stern, Budson & Ally, 2010; Moussard et al., 2012). We investigated if this memory enhancing effect of song was modulated by music training in people with or without AD (Baird et al., 2017). That is, is the memory enhancing effect of song on verbal information more likely to be shown by musicians, or can it also be found in people who have no music training? We used ecologically valid verbal information and a memory task that was typical of the memory demands of everyday life (recall rather than recognition). Information was presented to participants in spoken form, or as lyrics to a well-known Australian tune (Waltzing Matilda). Participants heard the information up to 5 times and were asked to recall it each time, and then after a half hour and 24 hour delay. Here is the information that had to be learnt and recalled, with the information about the male either sung or spoken, and vice versa for the female.

 

On Monday at 9 o’clock he took an aspirin. On Wednesday at 6:30 he made a phone call.

On Friday at 5:30 she posted a letter. On Sunday at 11 o’clock she went bowling.

 

This memory task was very challenging task for the people with AD who had no music training. These non-musicians with AD were unable to recall any information (spoken or sung) after a delay. They also found it much harder to learn the sung information compared with the spoken information. This may be due to the need to recode the sung information into spoken recall which is likely to have been more challenging for them given their lack of music training. In contrast, the musicians with AD showed better learning of the sung verbal information overall (over the 5 trials) compared with the non-musicians with AD. Some musicians with AD were able to learn and recall the information as well as healthy elderly people. In other words, music training appears to have facilitated their memory function. It is unclear whether this is due to the higher cognitive abilities of the musicians or their music training. Overall, our findings show that music training does impact on the learning and recall of spoken and sung information in people with AD. These results contribute to the accumulating evidence of the protective effect of music training on cognitive abilities in the elderly (Hanna-Pladdy & Gajewski, 2012).

 

In summary, our two papers highlight the unique relationship between music and memory in people with AD. Given our ageing population and increasing incidence of dementia, further research is needed to explore the mechanisms underlying the memory enhancing effects of music, and the positive impact of music training on the ageing brain.

 

References

  • Baird A, Umbach H. & Thompson W. A non-musician with severe Alzheimer’s Dementia learns a new song. (2017). Neurocase, 23, 36-40.
  • Baird A, Samson S, Miller L & Chalmers K (2017). Does music training facilitate the mnemonic effect of song? An exploration of musicians and non-musicians with and without Alzheimer’s Dementia. Journal of Clinical and Experimental Neuropsychology, 39, 9-21.
  • Baird A. & Samson, S. (2009). Memory for music in Alzheimer’s disease: Unforgettable? Neuropsychology Review, 19, 85-101.
  • Baird A. & Samson S. (2015). Music and dementia. In E. Altenmüller, F. Boller & S. Finger (Ed.), Music, Neurology, and Neuroscience: History and Modern Perspectives. Progress in Brain Research Series London, UK: Elsevier.
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  • Jacobsen J-H, Stelzer J, Fritz TH, Chetelat G, Joie RL & Turner R. (2015). Why musical memory can be preserved in advanced Alzheimer’s Disease. Brain, 138, 2438-2450.
  • Moussard, A., Bigand, E., Belleville, S., & Peretz, I. (2012). Music as an aid to learn new verbal information in Alzheimer’s disease. Music Perception, 29, 521-531.
  • Simmons-Stern, N. R., Budson, A. E., & Ally, B. A. (2010). Music as a memory enhancer in patients with Alzheimer’s disease, Neuropsychologia, 48, 3164-3167.
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