[Cognitive rehabilitation of amusia].
BACKGROUND
The cognitive model of music processing has a modular architecture with two main pathways (a melody pathway and a time pathway) for processing the musical "message" and thus enabling music recognition. It also features a music-specific module for tonal encoding of pitch which stands apart from all other known cognitive systems (including language processing). To the best of our knowledge, rehabilitation therapy for amusia has not yet been reported.


OBJECTIVE
We developed a therapeutic method (inspired by work on word deafness) in order to determine whether specific rehabilitation based on melody discrimination could prompt the regression of amusia.


METHODS
We report the case of a patient having developed receptive, acquired amusia four years previously. His tone deafness disorder was assessed using the Montreal Battery of Evaluation of Amusia (MBEA), which revealed impairment of the melody pathway but no deficiency in the time pathway. A computer-assisted rehabilitation method was implemented; it used melody discrimination tasks and an errorless learning paradigm with progressively fading visual cues.


RESULTS
After therapy, we noted an improvement in the overall MBEA score and its component subscores which could not be explained by spontaneous recovery (in view of the number of years since the neurological accident). The improvement was maintained at seven months post-therapy. Although post-therapy improvement in daily life was not systematically assessed, the patient started listening to his favourite music again.


CONCLUSIONS
Specific amusia therapy has shown efficacy.
Service de médecine physique et de réadaptation, groupe hospitalier Pitié-Salpêtrière, AP-HP, 47, boulevard de l'hôpital, 75651 Paris, France.
A
A
Weill-Chounlamountry
L
L
Soyez-Gayout
C
C
Tessier
P
P
Pradat-Diehl
D001299:Audiometry; D001308:Auditory Perceptual Disorders / Q000175:diagnosis / Q000209:etiology / Q000534:rehabilitation*; D003071:Cognition; D003638:Deafness / Q000175:diagnosis / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009146:Music; D010898:Pitch Perception; D020521:Stroke / Q000150:complications*