Musical practice and cognitive aging: two cross-sectional studies point to phonemic fluency as a potential candidate for a use-dependent adaptation

Because of permanent use-dependent brain plasticity, all lifelong individuals' experiences are believed to influence the cognitive aging quality. In older individuals, both former and current musical practices have been associated with better verbal skills, visual memory, processing speed, and planning function. This work sought for an interaction between musical practice and cognitive aging by comparing musician and non-musician individuals for two lifetime periods (middle and late adulthood). Long-term memory, auditory-verbal short-term memory, processing speed, non-verbal reasoning, and verbal fluencies were assessed. In Study 1, measures of processing speed and auditory-verbal short-term memory were significantly better performed by musicians compared with controls, but both groups displayed the same age-related differences. For verbal fluencies, musicians scored higher than controls and displayed different age effects. In Study 2, we found that lifetime period at training onset (childhood vs. adulthood) was associated with phonemic, but not semantic, fluency performances (musicians who had started to practice in adulthood did not perform better on phonemic fluency than non-musicians). Current frequency of training did not account for musicians' scores on either of these two measures. These patterns of results are discussed by setting the hypothesis of a transformative effect of musical practice against a non-causal explanation

Musical experience prior to traumatic exposure as a resilience factor: a conceptual analysis

Resilience mechanisms can be dynamically triggered throughout the lifecourse by resilience factors in order to prevent individuals from developing stress-related pathologies such as posttraumatic stress disorder (PTSD). Some interventional studies have suggested that listening to music and musical practice after experiencing a traumatic event decrease the intensity of PTSD, but surprisingly, no study to our knowledge has explored musical experience as a potential resilience factor before the potential occurrence of a traumatic event. In the present conceptual analysis, we sought to summarize what is known about the concept of resilience and how musical experience could trigger two key mechanisms altered in PTSD: emotion regulation and cognitive control. Our hypothesis is that the stimulation of these two mechanisms by musical experience during the pre-traumatic period could help protect against the symptoms of emotional dysregulation and intrusions present in PTSD. We then developed a new framework to guide future research aimed at isolating and investigating the protective role of musical experience regarding the development of PTSD in response to trauma. The clinical application of this type of research could be to develop pre-trauma training that promotes emotional regulation and cognitive control, aimed at populations at risk of developing PTSD such as healthcare workers, police officers, and military staffs

Boosting Autobiographical Memory and the Sense of Identity of Alzheimer Patients Through Repeated Reminiscence Workshops?

peer reviewedDespite severe amnesia, some studies showed that Alzheimer Disease (AD) patients with moderate to severe dementia keep a consistent, but impoverished representation of themselves, showing preservation of the sense of identity even at severe stages of the illness. Some studies suggest that listening to music can facilitate the reminiscence of autobiographical memories and that stimulating autobiographical memory would be relevant to support the self of these patients. Consequently, we hypothesized that repeated participation to reminiscence workshops, using excerpts of familiar songs as prompts would participate to the enrichment of autobiographical memories, self-representation and sense of identity. We included a group of 20 AD patients with severe dementia residing in nursing homes. Their performances were compared to a control group of 20 matched (age, education, mood) healthy residents living in the same institutions. The experiment was conducted in three phases over a 2-week period. On phase 1, an individual assessment of sense of identity was proposed to each participant. On phase 2, participants joined musical reminiscence workshops (six sessions over 2 weeks for AD patients and 3 sessions over a week for controls). During the third phase (12 days after the first assessment), individual evaluation of autobiographical memory and a second assessment of sense of identity were proposed. Our results showed that, despite their massive amnesia syndrome, autobiographical memories of AD reached at the end of the 2 weeks the number and quality of those of matched controls. Moreover, we confirmed a continuity of self-representation in AD patients with a stable profile of the answers between the first and second individual assessments of sense of identity. However, the increase in number and episodic quality of autobiographical memories was not accompanied by an enrichment of the sense of identity. In a complementary study, new patients participated in the same paradigm, but using movie extracts as prompts, and showed very similar effects. We discuss all of these results with regard to the literature showing the significant impact of repetition on the reactivation of memory traces even in very amnestic AD patients at severe stages of the disease

Recognition-based memory through familiarity assessment in severe Alzheimer’s disease

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Dementia beyond 2025: knowledge and uncertainties

International audienceGiven that there may well be no significant advances in drug development before 2025, prevention of dementia/AD through the management of vascular and lifestyle-related risk factors may be a more realistic goal than treatment. Level of education and cognitive reserve assessment in neuropsychological testing deserve attention, as well as cultural, social and economic aspects of caregiving. Assistive technologies for dementia care remain complex. Serious games are emerging as virtual educational and pleasurable tools, designed for individual and cooperative skill-building. Public policies are likely to pursue improving awareness and understanding of dementia; providing good quality early diagnosis and intervention for all; improving quality of care from diagnosis to the end of life, using clinical and economic endpoints; delivering dementia strategies quicker, with an impact on more people. Dementia should remain presented as a stand-alone concept, distinct from frailty or loss of autonomy. The basic science of sensory impairment and social engagement in people with dementia needs to be developed. E-learning and serious games programmes may enhance public and professional education. Faced with funding shortage, new professional dynamics and economic models may emerge through coordinated, flexible research networks. Psychosocial research could be viewed as an investment in quality of care, rather than an academic achievement in a few centres of excellence. This would help provide a competitive advantage to the best operators. Stemming from care needs, a logical, systems approach to dementia care environment through organizational, architectural and psychosocial interventions may be developed, to help reduce symptoms in people with dementia and enhance quality of life. Dementia-friendly environments, culture and domesticity are key factors for such interventions

When Music and Long-Term Memory Interact: Effects of Musical Expertise on Functional and Structural Plasticity in the Hippocampus

The development of musical skills by musicians results in specific structural and functional modifications in the brain. Surprisingly, no functional magnetic resonance imaging (fMRI) study has investigated the impact of musical training on brain function during long-term memory retrieval, a faculty particularly important in music. Thus, using fMRI, we examined for the first time this process during a musical familiarity task (i.e., semantic memory for music). Musical expertise induced supplementary activations in the hippocampus, medial frontal gyrus, and superior temporal areas on both sides, suggesting a constant interaction between episodic and semantic memory during this task in musicians. In addition, a voxel-based morphometry (VBM) investigation was performed within these areas and revealed that gray matter density of the hippocampus was higher in musicians than in nonmusicians. Our data indicate that musical expertise critically modifies long-term memory processes and induces structural and functional plasticity in the hippocampus

La mémoire sémantique musicale : apport des données de la neuropsychologie clinique et de la neuro-imagerie fonctionnelle

International audienceNeuropsychological clinical dissociations between musical and linguistic skills in brain damage patients suggest the view of an autonomous musical semantic memory. On the basis of these clinical observations, Isabelle Peretz et al. propose the existence of a pure musical lexicon. However, the nature and the organization of musical semantic representations always drive many debates. Does musical knowledge’s constitute a particular semantic category (like faces), are they purely perceptual representations, and let us must rather speak about musical perceptual memory or musical semantic memory? Moreover, the data resulting from the functional neuroimaging not always clearly highlight a neural specificity during recovery of musical knowledge, and sometimes more support the assumption of a broad covering between verbal and musical semantic memory. We summon up here some clinical observations and functional neuroimaging results allowing to clarify this issue. From these data, and notably our own neuroimaging and Alzheimer Patient’s clinical works, we try to reconcile the apparent discrepancies and to consider the various components of musical semantic memory concept. To summarize, it seems that perceptual level of musical representations are largely sustained by a right temporo-frontal neural network, whereas linguistic and personal autobiographic musical semantic associations are largely driven by a left counterpart temporo-frontal network. These two levels of musical semantic representations, sustained in a bilateral neural distributed network, notably give enlightenment to the remarkable maintenance of musical knowledge’s in long-term memory for brain damage patients.Les observations de dissociations entre les habiletés musicales et langagières chez des patients cérébrolésés suggèrent la possibilité d’une mémoire sémantique musicale autonome. Sur la base de ces observations cliniques, l’existence d’un lexique musical pur est ainsi proposée par Isabelle Peretz et al. Cependant, le format et l’organisation des représentations sémantiques musicales suscitent de nombreux débats. Les connaissances musicales constituent-elles une catégorie sémantique particulière (à l’image des visages), ou s’agit-il de représentations purement perceptives ? Devons-nous plutôt parler de mémoire perceptive musicale ou de mémoire sémantique musicale ? De plus, les données issues de la neuro-imagerie cérébrale fonctionnelle ne mettent pas toujours en évidence une spécificité neurale dans la récupération de connaissances musicales et vont parfois plus dans le sens d’une hypothèse d’un large recouvrement entre mémoire sémantique verbale et musicale. Nous reprenons ici un certain nombre d’observations cliniques et de résultats de neuro-imagerie fonctionnelle permettant d’éclairer cette question. À partir de ces données, et notamment de nos propres recherches en neuro-imagerie, chez des patients atteints de maladie d’Alzheimer, nous tentons de concilier les divergences apparentes et d’envisager les différentes facettes du concept de mémoire sémantique musicale

Emotional power of music in patients with memory disorders: clinical implications of cognitive neuroscience.

International audienceBy adapting methods of cognitive psychology to neuropsychology, we examined memory and familiarity abilities in music in relation to emotion. First we present data illustrating how the emotional content of stimuli influences memory for music. Second, we discuss recent findings obtained in patients with two different brain disorders (medically intractable epilepsy and Alzheimer's disease) that show relatively spared memory performance for music, despite severe verbal memory disorders. Studies on musical memory and its relation to emotion open up paths for new strategies in cognitive rehabilitation and reinstate the importance of examining interactions between cognitive and clinical neurosciences

La mémoire musicale a long terme au cours de l'évolution de la maladie d'Alzheimer

International audienceIn Alzheimer patients with a solid musical background, isolated case-reports have reported the maintenance of remarkable musical abilities despite clear difficulties in their verbal memory and linguistic functions. These reports have encouraged a number of scientists to undertake more systematic studies which would allow a rigorous approach to the analysis of musical memory in Alzheimer patients with no formal musical background. Although restricted in number, the latest data are controversial regarding preserved musical capacities in Alzheimer patients. Our current review of the literature addresses this topic and advances the hypothesis that the processes of musical memory are function of illness progression. In the earlier stages, the majority of evaluations concerned musical episodic memory and suggested a dysfunction of this memory whereas in the moderate and severe stages, musical semantic memory and implicit learning are the majority of investigations and seemed more resistant to Alzheimer disease. In summary, our current review bring to understand the memory circuits involved and highlight the necessity to adapted the investigational tools employed to conform with the severity of the signs and symptoms of progressive Alzheimer disease in order to demonstrate the preserved musical capacities.Quelques cas cliniques présentés dans la littérature ont mis en évidence la préservation de remarquables capacités musicales chez des patients Alzheimer anciennement musiciens, cette préservation contrastant avec des difficultés mnésiques et langagières. Ces observations ont naturellement conduit les chercheurs à proposer des études plus systématiques permettant d’évaluer réellement les compétences en mémoire musicale de patients Alzheimer non-musiciens. Ces travaux, actuellement peu nombreux, ne semblent pas apporter des réponses claires quant à une préservation des capacités en mémoire musicale chez ces patients. La synthèse de la littérature que nous proposons ici nous permet de faire le point sur le sujet, et de proposer une explication possible aux divergences de résultats. Ainsi, de cette revue de la littérature, nous pouvons constater que les processus de mémoire évalués varient selon les stades de la maladie. Aux stades précoces, une évaluation majoritaire de la mémoire épisodique musicale est proposée et apparaît déficitaire chez ces patients alors qu’à partir des stades modérés de la maladie, les travaux axent leur évaluation sur la mémoire sémantique et les apprentissages implicites qui se révèlent résister plus longtemps à la pathologie. Ces résultats nous amènent à réfléchir sur les systèmes mnésiques engagés et sur l’importance, pour mettre en évidence des capacités musicales préservées, d’adapter les outils d’évaluation à la sévérité des troubles rencontrés au cours de la maladie

Helping caregivers of people with dementia: a need to renew theoretical frameworks in France

International audienceResearch and care have improved a lot for persons with dementia (PWD) in France. However, most studies are essentially descriptive, and very few researches have focused on theoretical framework that may help understand and help their caregivers (CG). Yet, some approaches exist, and have proven to be efficient in other countries. The main interest of such approaches is the possibility to match health professionals' conception of CG and their situation, and thus allowing to better describe their situation, their difficulties and their expectations, and thus offer a caring the closest possible from their needs. Four main approaches will be discussed : 1) stress coping, the most used model in CG's care that allows to assess the principal stressors in CG's role, and to figure out the best ways to cope with these; 2) person centered care, which claims that making the CG more competent in their role decreases their burden; 3) role transition theory for which the difficulties come from the fact that CG's role is mostly unexpected, and their way of embracing it modifies their perception of themselves and their relative with dementia; 4) senses framework characterizes CG and PWD through their relationship, and offers a vision that includes difficulties and ways to cope with them, as well as satisfactions they experiment in the caregiving relationship. We will see through these theoretical frameworks which elements are the most relevant to take into account, their similarities and differences as well as the possible applications for health practitioners