Auditory Research Group, Medical School, Institute of Neuroscience, University of Newcastle-upon-Tyne, UK.
Clin Otolaryngol. 2009 Oct;34(5):423-30. doi: 10.1111/j.1749-4486.2009.02013.x.
Musical hallucination is the subjective experience of hearing music, or aspects of music, when none is being played, and as such is a disorder of the processing of complex sounds.
To determine the extent to which the otological system is responsible for musical hallucination, and to evaluate approaches to clinical management.
A review of all studies and literature reviews pertaining to musical hallucination, supplemented by inclusion of informative case reports.
A systematic search of multiple databases carried out on 22nd March 2009 was complemented by referral to the reference lists of included manuscripts.
Although not always troublesome in itself, musical hallucination can be a marker of underlying pathology in the ear or brain, or indicate obsessive-compulsive traits or social isolation, and is likely to be clinically underreported. Associations have been reported with hearing loss, female gender, social isolation and being over 60 years of age, although it is rare even in this group, and these may well not be independent risk factors. Robust comparative analysis of these factors with controls has yet to be undertaken. Underlying causes include neurovascular pathology, psychiatric disorders and opioid medications, however these are absent in the majority of cases.
This review supports the proposal that the otological system plays a role in the pathogenesis of musical hallucination. Hearing impairment may act as an initiating factor, and the primary dysfunction is overactivity of auditory association cortex, although an impairment of higher-level inhibition does also seem necessary. Once underlying sinister causes have been excluded, first line treatment should be explanation of the condition and optimisation of hearing. Medications have a role only in selected patient groups.
音乐幻觉是指当没有音乐播放时主观听到音乐或音乐某些方面的现象，因此是一种复杂声音处理障碍。
确定耳科系统在多大程度上对音乐幻觉负责，并评估其临床管理方法。
对所有与音乐幻觉相关的研究和文献综述进行的系统性回顾，并通过纳入有启发性的病例报告进行补充。
于 2009 年 3 月 22 日进行了多次数据库的系统检索，补充检索了纳入文献的参考文献列表。
尽管音乐幻觉本身并不总是造成困扰，但它可能是耳朵或大脑潜在病理的标志物，或者表明存在强迫症特征或社会孤立现象，并且可能在临床上被低估。已经报道了与听力损失、女性、社会孤立和年龄超过 60 岁有关的关联，尽管即使在这一人群中也很少见，并且这些可能并非独立的危险因素。尚未对这些因素与对照组进行稳健的比较分析。潜在的病因包括神经血管病理学、精神障碍和阿片类药物，但在大多数情况下这些病因并不存在。
本综述支持这样的观点，即耳科系统在音乐幻觉的发病机制中起作用。听力损伤可能是一个起始因素，主要的功能障碍是听觉联合皮层过度活跃，尽管高级抑制功能受损似乎也是必要的。一旦排除了潜在的严重病因，一线治疗应是解释病情和优化听力。药物仅适用于特定的患者群体。
