[Paleopsych] NYT: Neuron Network Goes Awry, and Brain Becomes an IPod

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Neuron Network Goes Awry, and Brain Becomes an IPod
http://www.nytimes.com/2005/07/12/health/psychology/12musi.html

    By [3]CARL ZIMMER

    Seven years ago Reginald King was lying in a hospital bed recovering
    from bypass surgery when he first heard the music.

    It began with a pop tune, and others followed. Mr. King heard
    everything from cabaret songs to Christmas carols. "I asked the nurses
    if they could hear the music, and they said no," said Mr. King, a
    retired sales manager in Cardiff, Wales.

    "I got so frustrated," he said. "They didn't know what I was talking
    about and said it must be something wrong with my head. And it's been
    like that ever since."

    Each day, the music returns. "They're all songs I've heard during my
    lifetime," said Mr. King, 83. "One would come on, and then it would
    run into another one, and that's how it goes on in my head. It's
    driving me bonkers, to be quite honest."

    Last year, Mr. King was referred to Dr. Victor Aziz, a psychiatrist at
    St. Cadoc's Hospital in Wales. Dr. Aziz explained to him that there
    was a name for his experience: musical hallucinations.

    Dr. Aziz belongs to a small circle of psychiatrists and neurologists
    who are investigating this condition. They suspect that the
    hallucinations experienced by Mr. King and others are a result of
    malfunctioning brain networks that normally allow us to perceive
    music.

    They also suspect that many cases of musical hallucinations go
    undiagnosed.

    "You just need to look for it," Dr. Aziz said. And based on his
    studies of the hallucinations, he suspects that in the next few
    decades, they will be far more common.

    Musical hallucinations were invading people's minds long before they
    were recognized as a medical condition. "Plenty of musical composers
    have had musical hallucinations," Dr. Aziz said.

    Toward the end of his life, for instance, Robert Schumann wrote down
    the music he hallucinated; legend has it that he said he was taking
    dictation from Schubert's ghost.

    While doctors have known about musical hallucinations for over a
    century, they have rarely studied it systematically. That has changed
    in recent years. In the July issue of the journal Psychopathology, Dr.
    Aziz and his colleague Dr. Nick Warner will publish an analysis of 30
    cases of musical hallucination they have seen over 15 years in South
    Wales. It is the largest case-series ever published for musical
    hallucinations.

    "We were trying to collect as much information about their day-to-day
    lives as we could," Dr. Aziz said. "We were asking a lot of the
    questions that weren't answered in previous research. What do they
    hear, for example? Is it nearby or is it at a long distance?"

    Dr. Aziz and Dr. Warner found that in two-thirds of the cases, musical
    hallucinations were the only mental disturbance experienced by the
    patients. A third were deaf or hard of hearing. Women tended to suffer
    musical hallucinations more than men, and the average patient was 78
    years old.

    Mr. King's experience was typical for people experiencing musical
    hallucinations. Patients reported hearing a wide variety of songs,
    among them "Don't Cry for Me Argentina" and "Three Blind Mice."

    In two-thirds of the cases, the music was religious; six people
    reporting hearing the hymn "Abide With Me."

    Dr. Aziz believes that people tend to hear songs they have heard
    repeatedly or that are emotionally significant to them. "There is a
    meaning behind these things," he said.

    His study also shows that these hallucinations are different from the
    auditory hallucinations of people with schizophrenia. Such people
    often hear inner voices. Patients like Mr. King hear only music.

    The results support recent work by neuroscientists indicating that our
    brains use special networks of neurons to perceive music. When sounds
    first enter the brain, they activate a region near the ears called the
    primary auditory cortex that starts processing sounds at their most
    basic level. The auditory cortex then passes on signals of its own to
    other regions, which can recognize more complex features of music,
    like rhythm, key changes and melody.

    Neuroscientists have been able to identify some of these regions with
    brain scans, and to compare the way people respond to musical and
    nonmusical sounds.

    Only a handful of brain scans have been made of people with musical
    hallucinations. Dr. Tim Griffiths, a neurologist at the University of
    Newcastle Upon Tyne in England, performed one of these studies on six
    elderly patients who developed musical hallucinations after becoming
    partly deaf.

    Dr. Griffiths used a scanning technique known as PET, which involves
    injecting radioactive markers into the bloodstream. Each time he
    scanned his subjects' brains, he asked them whether they had
    experienced musical hallucinations. If they had, he asked them to rate
    the intensity on a scale from one to seven.

    Dr. Griffiths discovered a network of regions in the brain that became
    more active as the hallucinations became more intense. "What strikes
    me is that you see a very similar pattern in normal people who are
    listening to music," he said.

    The main difference is that musical hallucinations don't activate the
    primary auditory cortex, the first stop for sound in the brain. When
    Dr. Griffith's subjects hallucinated, they used only the parts of the
    brain that are responsible for turning simple sounds into complex
    music.

    These music-processing regions may be continually looking for signals
    in the brain that they can interpret, Dr. Griffiths suggested. When no
    sound is coming from the ears, the brain may still generate
    occasional, random impulses that the music-processing regions
    interpret as sound. They then try to match these impulses to memories
    of music, turning a few notes into a familiar melody.

    For most people, these spontaneous signals may produce nothing more
    than a song that is hard to get out of the head. But the constant
    stream of information coming in from the ears suppresses the false
    music.

    Dr. Griffith proposes that deafness cuts off this information stream.
    And in a few deaf people the music-seeking circuits go into overdrive.
    They hear music all the time, and not just the vague murmurs of a
    stuck tune. It becomes as real as any normal perception.

    "What we're seeing is an amplification of a normal mechanism that's in
    everyone," Dr. Griffiths said.

    It is also possible for people who are not deaf to experience musical
    hallucinations. Epileptic seizures, certain medications and Lyme
    disease are a few of the factors that may set them off.

    Dr. Aziz also noted that two-thirds of his subjects were living alone,
    and thus were not getting much stimulation. One patient experienced
    fewer musical hallucinations when Dr. Aziz had her put in a nursing
    home, he said, "because then she was talking to people, she was
    active."

    There is no standard procedure for treating musical hallucinations.
    Some doctors try antipsychotic drugs, and some use cognitive
    behavioral therapy to help patients understand what's going on in
    their brains. "Sometimes simple things can be the cure," Dr. Aziz
    said. "Turning on the radio may be more important than giving
    medication."

    Despite these treatments, many people with musical hallucinations find
    little relief. "I'm just living with it," Mr. King said. "I wish there
    was something I could do.

    "I do silly things like talking to myself, hoping that when I stop
    talking, the tune will stop. But it doesn't work that way."

    More studies may help researchers find new treatments. Prof. Diana
    Deutsch, a psychologist at the University of California, San Diego, is
    planning a new scanning study of musical hallucination on people who
    are not deaf, using functional M.R.I. Unlike the PET scanning used by
    Dr. Griffiths, functional M.R.I. is powerful enough to catch
    second-by-second changes in brain activity.

    "It might be awhile before we have results, but it's certainly
    something I'm very excited about," Dr. Deutsch said. "We'll see where
    it takes us."

    Dr. Aziz also believes that it is necessary to get a better sense of
    how many people hear musical hallucinations. Like Mr. King, many
    people have had their experiences dismissed by doctors.

    Dr. Aziz said that ever since he began presenting his results at
    medical conferences last year, a growing number of patients have been
    referred to him.

    "In 15 years I got 30 patients," he said, "and in less than a year
    I've had 5. It just tells you people are more aware of it."

    Dr. Aziz suspects that musical hallucinations will become more common
    in the future. People today are awash in music from radios,
    televisions, elevators and supermarkets. It is possible that the
    pervasiveness of music may lead to more hallucinations. The types of
    hallucinations may also change as people experience different kinds of
    songs.

    "We have speculated that people will hear more pop and classical music
    than they do now," said Dr. Aziz. "I hope I live long enough to find
    out myself in 20 years' time."