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Brain, Vol. 123, No. 9, 1926-1938, September 2000
© 2000 Oxford University Press

Patterns of music agnosia associated with middle cerebral artery infarcts

Julie Ayotte1,2, Isabelle Peretz1,2, Isabelle Rousseau3, Céline Bard3 and Michel Bojanowski4

1 Department of Psychology, University of Montreal, 2 Research Center of the University Institute of Geriatrics of Montreal, 3 Department of Radiology and 4 Department of Neurosurgery, Centre hospitalier Universitaire de Montréal, Montreal, Canada

Correspondence to: Isabelle Peretz, Département de Psychologie, Université de Montréal, C.P. 6128, succ. Centre-ville, Montréal (Qué) H3C 3J7 Canada E-mail: Isabelle.Peretz{at}umontreal.ca

The objective of the study is to evaluate if the rupture of an aneurysm located on the middle cerebral artery (MCA) results in disorders of music recognition. To this aim, 20 patients having undergone brain surgery for the clipping of a unilateral left (LBS), right (RBS) or bilateral (BBS) aneurysm(s) of the MCA and 20 neurologically intact control subjects (NC) were evaluated with a series of tests assessing most of the abilities involved in music recognition. In general, the study shows that a ruptured aneurysm on the MCA that is repaired by brain surgery is very likely to produce deficits in the auditory processing of music. The incidence of such a deficit was not only very high but also selective. The results show that the LBS group was more impaired than the NC group in all three tasks involving musical long-term memory. The study also uncovered two new cases of apperceptive agnosia for music. These two patients (N.R. and R.C.) were diagnosed as such because both exhibit a clear deficit in each of the three music memory tasks and both are impaired in all discrimination tests involving musical perception. Interestingly, the lesions overlap in the right superior temporal lobe and in the right insula, making the two new cases very similar to an earlier case report. Altogether, the results are also consistent with the view that apperceptive agnosia results from damage to right hemispheric structures while associative agnosia results from damage to the left hemisphere.


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