Evaluation of the Musical Abilities in Aphasic Patients

Abstract

Individuals with acquired brain injury may present deficits across multiple cognitive domains, as lesions often extend beyond strict focal regions (Sihvonen et al., 2017). Aphasia following stroke has frequently been associated with impairments in musical abilities, commonly referred to as amusia (Peretz, Champod, & Hyde, 2003). Considering the possible overlap between neural networks involved in musical and linguistic processing (Patel, 2013), it becomes relevant to systematically investigate the profile of musical perception in this clinical population. The primary objective of the present study was to characterize musical perception abilities in individuals with aphasia acquired as a consequence of stroke, and secondarily, to explore their relationship with selected linguistic measures. Twenty adults aged between 50 and 78 years participated in the study, including 10 individuals with post-stroke aphasia and 10 neurologically healthy control participants matched for age. The linguistic abilities of the aphasia group were assessed using four subtests of the Boston Diagnostic Aphasia Examination (BDAE): the Word Discrimination task from the Auditory Comprehension subtest; the Word Repetition task and the High- and Low-Probability Sentences Repetition tasks from the Repetition subtests; and the Boston Cookie Theft Picture description task. Musical perception abilities were measured using the Montréal Battery of Evaluation of Amusia (MBEA), including the Scale, Contour, Interval, Rhythm, Meter, and Musical Memory subtests. Considering the linguistic tasks, individuals with aphasia showed preserved performance in the Word Discrimination task and reduced performance in the Word and Sentence Repetition tasks. Regarding musical perception, the aphasia group performed significantly worse than the control group in the Interval and Rhythm subtests of the MBEA, whereas no significant differences were observed between groups in the remaining subtests, including Musical Memory.  Although patients with aphasia demonstrated difficulties in audio-phonatory transcoding, fluent participants outperforming non-fluent participants in sentence repetition, all maintained functional and effective communication. However, the musical profile revealed marked heterogeneity, with significant impairments in the analytical components of Interval and Rhythm—often associated with left hemisphere lesions—while Musical Memory remained unexpectedly preserved compared to the control group. The findings of significant impairments in analytical aspects of musical perception in contrast with the stability of Musical Memory highlight the heterogeneity of musical perception abilities in aphasia and reinforce the inclusion of music-based assessments in clinical contexts, as they may provide relevant complementary information for planning music-based rehabilitation interventions.