Correlation of vocals and lyrics with left temporal musicogenic epilepsy

Abstract

Whether the cognitive processing of music and speech relies on shared or distinct neuronal mechanisms remains unclear. Music and language processing in the brain are right and left temporal functions, respectively. We studied patients with musicogenic epilepsy (ME) that was specifically triggered by popular songs to analyze brain hyperexcitability triggered by specific stimuli. The study included two men and one woman (all right-handed, aged 35-55 years). The patients had sound-triggered left temporal ME in response to popular songs with vocals, but not to instrumental, classical, or nonvocal piano solo versions of the same song. Sentimental lyrics, high-pitched singing, specificity/familiarity, and singing in the native language were the most significant triggering factors. We found that recognition of the human voice and analysis of lyrics are important causal factors in left temporal ME and provide observational evidence that sounds with speech structure are predominantly processed in the left temporal lobe. A literature review indicated that language-associated stimuli triggered ME in the left temporal epileptogenic zone at a nearly twofold higher rate compared with the right temporal region. Further research on ME may enhance understanding of the cognitive neuroscience of music.

Autoimmune musicogenic epilepsy associated with anti‐glutamic acid decarboxylase antibodies and Stiff‐person syndrome

“…Musicogenic epilepsy is a rare form of reflex epilepsy in which seizures are triggered by musical stimuli, ranging from simple tones to complex symphonic music . A literature review between 1884 and 2018 found 123 cases of MRS. Only two cases were related to anti‐GAD‐Ab but none of them had SPS .…”

“…None of the patients had musical training which was suggested to predispose to musicogenic epilepsy . The pathophysiology involved in MRS has not been well defined . Nevertheless, most reports emphasized the emotional component as the causal factor in stimulation of the epileptogenic zone, implying a complex evoked response involving multiple cortical areas and association cortex rather than a pure auditory evoked response …”

“…Musicogenic epilepsy is a rare form of reflex epilepsy in which seizures are triggered by musical stimuli, ranging from simple tones to complex symphonic music. 4,5 A literature review between 1884 and 2018 found 123 cases of MRS. Only two cases were related to anti-GAD-Ab but none of them had SPS. 3 Similar to our patient, these two patients had an adult-onset TL epilepsy, with automotor seizures induced by different musicogenic triggers, as well as spontaneous seizures (Table 1).…”

“…4 The pathophysiology involved in MRS has not been well defined. 4,5 Nevertheless, most reports emphasized the emotional component as the causal factor in stimulation of the epileptogenic zone, implying a complex evoked response involving multiple cortical areas and association cortex rather than a pure auditory evoked response. 4 Two epileptic clinical scenarios related to anti-GAD-Ab have been described: (a) an acute epilepsy associated with limbic encephalitis; (b) a chronic slowly evolving focal epilepsy, that can become pharmacoresistant.…”

Musicogenic Epilepsy: Clinical Features, Pathophysiology, and Review of Literature

“…7 Since the first description by Critchley, 1 it was noted that the semiology of MS is consistent with temporal lobe semiology. This includes abdominal aura, 7,19 aura of fear, 20,21 olfactory aura, 19,22 psychic aura of deja vu, 23 oral or manual automatisms, 7,24,25 and psychomotor behavior. 24 Autonomic changes in blood pressure, heart rate, and respiratory rate have been documented.…”