Brust J C
Brain. 1980 Jun;103(2):367-92. doi: 10.1093/brain/103.2.367.
Two aphasic right-handed professional musicians with left hemispheric lesions had disturbed musical function, especially musical alexia and agraphia. In Case 1 aphasia was of transcortical sensory type, with severe agraphia and decreased comprehension of written words, although she could match them with pictures. Except for reading and writing, musical ability was normal; she could sing in five languages. Musical alexia and agraphia affected pitch symbols more than rhythm. Case 2 had conduction aphasia and severe expressive amusia, especially for rhythm. Although his language alexia and agraphia were milder than Case 1's, his musical alexia and agraphia were more severe, affecting rhythm as much as pitch. In neither patient were those aspects of musical notation either closest to verbal language or most dependent upon temporal (sequential) processing maximally impaired. These cases are consistent with the literature in suggesting that the presence or absence of aphasia or of right or left hemispheric damage fails to predict the presence, type, or severity of amusia, including musical alexia and agraphia. The popular notion that receptive amusia follows lesions of the language-dominant temporal lobe, whereas expressive amusia follows non-dominant frontal lobe damage, is an over-simplification, as is the view that increasing musical sophistication causes a shift of musical processing from the right hemisphere to the left.
两名患有左侧半球病变的右利手失语职业音乐家存在音乐功能障碍，尤其是音乐失读症和失写症。病例1为经皮质感觉性失语，伴有严重失写症以及对书面文字的理解能力下降，尽管她能将书面文字与图片匹配。除读写外，其音乐能力正常；她能用五种语言唱歌。音乐失读症和失写症对音高符号的影响大于节奏。病例2患有传导性失语和严重的表达性失乐症，尤其在节奏方面。尽管他的语言失读症和失写症比病例1轻，但他的音乐失读症和失写症更严重，对节奏和音高的影响程度相同。在这两名患者中，音乐记谱法中那些与语言最接近或最依赖时间（顺序）处理的方面均未受到最大程度的损害。这些病例与文献一致，表明失语症的存在与否或右半球或左半球损伤并不能预测失乐症（包括音乐失读症和失写症）的存在、类型或严重程度。流行的观点认为，感受性失乐症继发于语言优势颞叶病变，而表达性失乐症继发于非优势额叶损伤，这是一种过度简化的观点，同样，认为音乐复杂性增加会导致音乐处理从右半球向左半球转移的观点也是如此。
