Berman I W
S Afr Med J. 1981 Jan 17;59(3):78-81.
Amusia is a condition in which musical capacity is impaired by organic brain disease. Music is in a sense a language and closely resembles speech, both executively and receptively. For musical functioning, rhythmic sense and sense of sounds are essential. Musical ability resides largely in the right (non-dominant) hemisphere. Tests have been devised for the assessment of musical capabilities by Dorgeuille, Grison and Wertheim. Classification of amusia includes vocal amusia, instrumental amnesia, musical agraphia, musical amnesia, disorders of rhythm, and receptive amusia. Amusia like aphasia has clinical significance, and the two show remarkable similarities and often co-exist. Usually executive amusia occurs with executive aphasia and receptive amusia with receptive aphasia, but amusias can exist without aphasia. Severely executive aphasics can sometimes sing with text (words), and this ability is used in the treatment of aphasia. As with aphasia, there is correlation between type of amusia and site of lesion. Thus in executive amusia, the lesion generally occurs in the frontal lobe. In receptive amusia, the lesion is mainly in the temporal lobe. If aphasia is also present the lesion will be in the left (dominant) hemisphere.
失歌症是一种因器质性脑疾病导致音乐能力受损的病症。从某种意义上说，音乐是一种语言，在执行和接受方面都与言语极为相似。对于音乐功能而言，节奏感和声音感知至关重要。音乐能力主要存在于右（非优势）半球。多热吉尔、格里松和韦特海姆已设计出评估音乐能力的测试方法。失歌症的分类包括声乐失歌症、器乐失歌症、音乐失写症、音乐失忆症、节奏障碍和感受性失歌症。失歌症与失语症一样具有临床意义，二者表现出显著的相似性且常同时存在。通常，执行性失歌症与执行性失语症同时出现，感受性失歌症与感受性失语症同时出现，但失歌症也可在无失语症的情况下存在。严重的执行性失语症患者有时能伴着歌词唱歌，这种能力可用于失语症的治疗。与失语症一样，失歌症的类型与病变部位之间存在关联。因此，在执行性失歌症中，病变通常发生在额叶。在感受性失歌症中，病变主要在颞叶。如果同时存在失语症，病变将位于左（优势）半球。
