Auditory hedonic phenotypes in dementia: A behavioural and neuroanatomical analysis.
Patients with dementia may exhibit abnormally altered liking for environmental sounds and music but such altered auditory hedonic responses have not been studied systematically. Here we addressed this issue in a cohort of 73 patients representing major canonical dementia syndromes (behavioural variant frontotemporal dementia (bvFTD), semantic dementia (SD), progressive nonfluent aphasia (PNFA) amnestic Alzheimer's disease (AD)) using a semi-structured caregiver behavioural questionnaire and voxel-based morphometry (VBM) of patients' brain MR images. Behavioural responses signalling abnormal aversion to environmental sounds, aversion to music or heightened pleasure in music ('musicophilia') occurred in around half of the cohort but showed clear syndromic and genetic segregation, occurring in most patients with bvFTD but infrequently in PNFA and more commonly in association with MAPT than C9orf72 mutations. Aversion to sounds was the exclusive auditory phenotype in AD whereas more complex phenotypes including musicophilia were common in bvFTD and SD. Auditory hedonic alterations correlated with grey matter loss in a common, distributed, right-lateralised network including antero-mesial temporal lobe, insula, anterior cingulate and nucleus accumbens. Our findings suggest that abnormalities of auditory hedonic processing are a significant issue in common dementias. Sounds may constitute a novel probe of brain mechanisms for emotional salience coding that are targeted by neurodegenerative disease.
['Fletcher|Phillip D|PD|', 'Downey|Laura E|LE|', 'Golden|Hannah L|HL|', 'Clark|Camilla N|CN|', 'Slattery|Catherine F|CF|', 'Paterson|Ross W|RW|', 'Schott|Jonathan M|JM|', 'Rohrer|Jonathan D|JD|', 'Rossor|Martin N|MN|', 'Warren|Jason D|JD|']
D000339:Affect D000368:Aged D000369:Aged, 80 and over D000544:Alzheimer Disease D001307:Auditory Perception D001921:Brain D004644:Emotions D005260:Female D057180:Frontotemporal Dementia D006179:Gyrus Cinguli D006801:Humans D008279:Magnetic Resonance Imaging D008297:Male D008875:Middle Aged D009146:Music D009714:Nucleus Accumbens D010641:Phenotype D057178:Primary Progressive Nonfluent Aphasia D013702:Temporal Lobe
Environmental sounds Music Frontotemporal dementia Semantic dementia Alzheimer's disease VBM Musicophilia Affect Progressive aphasia Reward