Where words fail, music speaks: isolated memory processes in a musical patient with schizophrenia.
Where words fail, music speaks: isolated memory processes in a musical patient with schizophrenia.
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当语言无法表达时，音乐会说话：患有精神分裂症的音乐患者的孤立记忆过程。
DOI：
10.1016/j.schres.2009.02.015
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发表时间：
2009
影响因子：
4.5
通讯作者：
Elvevåg,Brita
中科院分区：
文献类型：
--
作者：
Skelley,ShaynaL;Miranda,RobbinA;Ullman,MichaelT;Apud,JoséA;Weinberger,DanielR;Elvevåg,Brita
加工规则支配的知识招募扎根于额叶/基底节回路的程序性记忆系统，而加工记忆的特质知识依赖于涉及陈述性记忆的颞叶区域(Ullman，2001)。这些或相关的系统可能是语言和音乐中基于规则和记忆的过程的基础(Langheim等人，2002；Patel，2003；Miranda和Ullman，2007)。Miranda和Ullman(2007)发现，“走调”音符--在熟悉和陌生的旋律中构成了对音乐调性规则的违反--引起了对语言中违反语法规则的类似的神经反应，而在熟悉的旋律中意外的“走调”音符引发了与词汇-语义加工相关的大脑活动模式。需要检测违规的任务可以揭示患者的假定缺陷是否与处理基于规则的(程序性)或记忆的(陈述性)知识有关。我们在一名31岁的个体中探索了这些不同的音乐记忆过程，他具有显著的音乐天赋，背景是由于精神分裂症而导致的广泛的认知障碍和精神病症状(听觉和视觉幻觉、思维广播和偏执)。患者接受阿立哌唑、氯氮平、锂和舍曲林治疗。广泛的神经心理测试--作为“CBDB/NIH兄弟研究”的一部分--显示在包括智力在内的大多数领域的表现都低于30%。
Processing rule-governed knowledge recruits the procedural memory system rooted in frontal/basal-ganglia circuits, whereas processing memorized idiosyncratic knowledge depends on temporal lobe regions involved in declarative memory (Ullman, 2001). These or related systems likely underlie rule-and memory-based processes in both language and music (Langheim et al., 2002; Patel, 2003; Miranda and Ullman, 2007). Miranda and Ullman (2007) found that “out-of-key” notes–constituting violations of musical tonality rules in familiar and unfamiliar melodies–elicited similar neural responses to grammar rule violations in language, whereas unexpected “in-key” notes in familiar melodies elicited a pattern of brain activity associated with lexical–semantic processing. Tasks requiring detection of violations can reveal whether putative deficits in patients are associated with processing rule-based (procedural) or memorized (declarative) knowledge.We explored these distinct music memory processes in a 31-year-old individual with noteworthy musical aptitude against a backdrop of widespread cognitive impairment and psychotic symptoms (auditory and visual hallucinations, thought broadcasting, and paranoia) due to schizophrenia. The patient was treated with aripiprazole, clozapine, lithium, and sertraline. Extensive neuropsychological testing–as part of the “CBDB/NIH Sibling Study”–revealed performance under the 30th percentile in most domains, including intelligence,