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Editorial
The 1972 Danube Symposium on the neurology of music prompted Macdonald Critchley and Ronald Henson to edit the volume that appeared in 1977 as ‘Music and the Brain’. One contributor had a musical training; the rest were amateurs. Dr Geoffrey Bush ironed out musical bêtises. Sir Michael Tippett wrote the preface. Resistant to any cool scientific analysis of ‘what is music?’, Sir Michael ruminates that this is no more tractable a question than ‘what is memory?’. Music combines activation of the nervous system to produce the affect, and the psyche to create a dream-like state: ‘the knowledge . . . (entering) my music by an alchemy which transmutes the experience of reading into metaphor . . . "divine madness" to use Plato's jargon’ . . . and, from (WB) Yeats, ‘Music, to calm, perhaps, That dolphin-torn, that gong-tormented sea’.A note appended to the reprinted version (1904) of Sir William Gowers's 1896 Bradshaw Lecture on ‘Subjective sensations of sound’ discusses ‘the designation of musical notes in science and medicine.’ Gowers considers that the system for convenient and accurate musical notation, systematized by Hermann von Helmholtz (1821–1894) ‘has no rational foundation . . . (bringing) the necessary consequence (that) error and confusion are met with as frequently as precision’. Since the eighth note in sequence is in unison with the first, Gowers subscribes to the view that music should be ordered in ‘septaves’ not ‘octaves’ (taking as his authority a rare little book, ‘The Art of Tuning’ published in 1806 by Earl Stanhope, and to be found in the library of the Athenaeum Club in London). Furthermore, the system of using the letter C as keynote, with other distinguishing marks to denote separate octaves, has added to the confusion of notation, as repeatedly exemplified in both the scientific and medical literature. Gowers is tetchy for the reason that ambiguities of musical notation had made nonsense of the German translation of his case report describing a patient with deafness whose range of hearing narrowed to the two Es of the treble clef. He voiced his irritation in the issue of Musical News for January 24, 1903; and the novel system for notation that he there proposed (including preference for determining pitch using the whistle designed by Francis Galton rather than the more conventional tuning fork) evidently found favour with one correspondent, Dr Shinn of the Guildhall School of Music.
But music and memory move on, and errors of musical notation happen, as papers in the present issue reveal. In a remarkable account, Ian McDonald (former editor of Brain) brings his special knowledge of neurology and musicianship to a personal account of ‘amusia with recovery’ due to the small stroke he suffered in October 2004 (page 2554). Recognition came slowly. At first, many friends trained in neurology attributed the difficulties he now describes to professorial foibles and mild eccentricity, until the evidence became irrefutable during a major lecture delivered to the Royal College of Physicians of London 
6 weeks after the event. One of our reviewers, Jason Warren, comments: ‘the musical deficits can be interpreted in terms of more general functions of the non-dominant parietal lobe, and the discrete nature of the lesion provides a window on the role of this brain region in music processing. Musical notation (unlike most text) must be read vertically as well as horizontally: this spatial transformation of a specialized script is likely to depend on cooperation between the cerebral hemispheres and, more specifically, on transformational mapping processes in the parietal lobes. This case shows that a lesion of the non-dominant hemisphere is sufficient to produce musical alexia, complementing previous reports of impaired music reading after dominant hemisphere lesions. Disordered perception of the temporal dimensions of music (rhythm and metre) may be functionally aligned with deficits affecting other aspects of time sense following non-dominant parietal lobe damage, of particular relevance to the perception of higher-order time structure. The altered affective response to music hints at a cognitive level of musical emotion processing that may also depend on the abstraction of complex structural features by mechanisms in the parietal lobe.’
As one who has interpreted so ably disturbances of higher cerebral function for a wider audience, Oliver Sacks considers Professor McDonald's personal account to be ‘quite amazing in its candour and depth, its narrative force and its self analysis . . . how rare, and how precious, such accounts are, especially when they come from physician-patients’. Our readers will share that judgement and appreciate the intellectual motive that has made an account of this intensely personal episode more generally available. In his own contribution to this issue (page 2528), Oliver Sacks, explores the role of music for the individual and for society, the relationship of beat and rhythm to motor control in health and disease, the emotional valence of music, and its intrusions in the context of neurological disease as hallucinations and the triggers for epilepsy—in short, the ‘power of music’. Wearing his neurological ‘hat’, as professor in neurology at Albert Einstein College of Medicine, New York, Dr Sacks is well qualified to comment. But the contributions go much further; for, in his writings, Oliver Sacks has not merely served the public understanding of science but lifted this to a new cultural dimension, allowing the general reader access to the astonishing features of brain disease and extending a genre established by other medico-literary luminaries such as Aleksandr Romanovich Luria—‘The Mind of a Mnemonist’ (1968) and ‘The Man with a Shattered World’ (1972) offering accounts of altered brain function for the general reader that whet the appetite for ‘The Man Who Mistook His Wife for a Hat’ (1985) and ‘An Anthropologist on Mars’ (1995).
As violinist and singer, respectively, Klaus Toyka and Hans-Joachim Freund also combine expertise in clinical neuroscience with superior musical abilities. They review ‘Music, Motor Control and the Brain’ edited by Eckart Altenmüller, Mario Wiesendanger and Jürg Kesselring, revisiting topics on which Macdonald Critchley himself wrote in 1977 (page 2794). This volume is also based on a conference (held at the Monte Verita in Switzerland, during 2002), and with an emphasis on the psychology and motor aspects of musical performance, in health and in the context of musicians' cramps and stage-fright. Professors Toyka and Freund address issues that resurface in our other articles: the need for and the neuroscience of musical practice, training in childhood, song memory and choral performance, and aspects of cortical function and motor control that link technical proficiency to emotional expression. In drawing together the neuroscience of music, and the basis for its expression at the highest levels of human achievement, they follow Sir Michael Tippett in concluding that the symbolic aspects do not yield to mere description—the core being intrinsic to the ‘language’ of the work.
We publish five other articles on music and the brain. Krista Hyde and colleagues from Montreal (Canada) and Newcastle (UK) take forward the suggestion that tone-deafness (congenital amusia) arises from inability to process pitch, correlating this functional deficit in two cohorts of cases and controls with structural abnormalities that suggest altered connectivity between the right inferior frontal gyrus and the ipsilateral auditory cortex (page 2562). Takako Fujioka and colleagues from the University of Toronto and McMaster University (Canada), Okazaki (Japan), and the University of Münster (Germany) show differences in the timing of left hemisphere auditory evoked fields detected by magnetoencephalography in children trained to play the violin using the Suzuki method, compared with noise, suggesting that training establishes a neural network associated with sound categorization that is influenced by early musical learning (page 2593). Isabelle Peretz and a group from the University of Montreal (Canada), the Hôpital-Salpêtrière (Paris) and the University of Lille (France), and California Institute of Technology (USA) contrast these euphonious paediatric experiences with the random clatter of children bashing the piano keys: they refine the brain region required specifically to appreciate unpleasant music, compared with consonant sounds of varying emotional contents, to the right or left parahippocampal cortex; and with the retained ability to perceive the accuracy of that music (page 2585). Together, the findings suggest complementary roles for the parahippocampus and the amygdala in responding to dissonance. Isabelle Peretz, Amélie Racette and Céline Bard from Montreal (Canada) return to the dogma that sung and spoken language can be dissociated: no differences are found for well-rehearsed or novel lyrics and prose sequences amongst aphasic patients with left hemisphere lesions, in speech or singing alone, whereas marked improvements are associated with choral singing. Perhaps, singing-along in harmony with others, at least in French, offers a useful rehabilitation strategy for aphasics (page 2571). Lauren Stewart, Katharina von Kriegstein, Jason Warren and Timothy Griffiths from Newcastle upon Tyne and the Institute of Neurology, London (UK), review the basic and clinical science evidence for the many cognitive processes involved in musical listening and develop a system for assessing the perceptual and cognitive analysis of its emotional content, relevant both to congenital and acquired disorders of musical appreciation, and to musical hallucinations (page 2533). They show, in a way that Sir Michael Tippett would now have to concede, that the neuroscience of music, no less than that of memory, has indeed advanced in the 29 years since Macdonald Critchley and Ronald Henson first tackled the subject.
Meanwhile, Brain was not neglecting progress as it occurred in understanding the subject. Many issues that resurface in the octet of articles on music and the brain, here published, resonate with an earlier report of two cases and extensive analysis of the previous literature. In ‘From the Archives’, we review ‘Music and Language: Musical Alexia and Agraphia’ by John C.M. Brust (Brain 1980: 103; 367–392).
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