Griffiths T D
Department of Neurology, Newcastle University,Newcastle-upon-Tyne, UK.
Brain. 2000 Oct;123 ( Pt 10):2065-76. doi: 10.1093/brain/123.10.2065.
Six subjects with musical hallucinations following acquired deafness are described. The subjects all experienced the condition in the absence of any other features to suggest epilepsy or psychosis. I propose a neuropsychological model for the condition consistent with detailed observation of the subjects' phenomenology. The model is based on spontaneous activity within a cognitive module for the analysis of temporal pattern in segmented sound. Functional imaging was carried out to test the hypothesis that musical hallucinosis is due to activity within such a module, for which the neural substrate is a distributed network distinct from the primary auditory cortex. PET was carried out on the six subjects to identify areas where brain activity increased as a function of the severity of the hallucination. In a group analysis, no effect was demonstrated in the primary auditory cortices. Clusters of correlated activity were demonstrated in the posterior temporal lobes, the right basal ganglia, the cerebellum and the inferior frontal cortices. This network is similar to that previously demonstrated during the normal perception and imagery of patterned-segmented sound, and is consistent with the proposed neuropsychological and neural mechanism.
本文描述了6例获得性耳聋后出现音乐幻觉的患者。这些患者均在无任何提示癫痫或精神病的其他特征的情况下出现了这种情况。我提出了一种与对患者现象学的详细观察相一致的该病症的神经心理学模型。该模型基于一个用于分析分段声音中时间模式的认知模块内的自发活动。进行了功能成像以检验音乐幻觉症是由于这样一个模块内的活动所致的假设，该模块的神经基质是一个与初级听觉皮层不同的分布式网络。对这6例患者进行了正电子发射断层扫描（PET），以确定脑活动随幻觉严重程度增加的区域。在组分析中，初级听觉皮层未显示出效应。在颞叶后部、右侧基底神经节、小脑和额下皮层发现了相关活动簇。该网络类似于先前在有模式分段声音的正常感知和想象过程中所显示的网络，并且与所提出的神经心理学和神经机制一致。
