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. 2014 Sep 3:8:694.
doi: 10.3389/fnhum.2014.00694. eCollection 2014.

New learning of music after bilateral medial temporal lobe damage: evidence from an amnesic patient

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New learning of music after bilateral medial temporal lobe damage: evidence from an amnesic patient

Jussi Valtonen et al. Front Hum Neurosci. .

Abstract

Damage to the hippocampus impairs the ability to acquire new declarative memories, but not the ability to learn simple motor tasks. An unresolved question is whether hippocampal damage affects learning for music performance, which requires motor processes, but in a cognitively complex context. We studied learning of novel musical pieces by sight-reading in a newly identified amnesic, LSJ, who was a skilled amateur violist prior to contracting herpes simplex encephalitis. LSJ has suffered virtually complete destruction of the hippocampus bilaterally, as well as extensive damage to other medial temporal lobe structures and the left anterior temporal lobe. Because of LSJ's rare combination of musical training and near-complete hippocampal destruction, her case provides a unique opportunity to investigate the role of the hippocampus for complex motor learning processes specifically related to music performance. Three novel pieces of viola music were composed and closely matched for factors contributing to a piece's musical complexity. LSJ practiced playing two of the pieces, one in each of the two sessions during the same day. Relative to a third unpracticed control piece, LSJ showed significant pre- to post-training improvement for the two practiced pieces. Learning effects were observed both with detailed analyses of correctly played notes, and with subjective whole-piece performance evaluations by string instrument players. The learning effects were evident immediately after practice and 14 days later. The observed learning stands in sharp contrast to LSJ's complete lack of awareness that the same pieces were being presented repeatedly, and to the profound impairments she exhibits in other learning tasks. Although learning in simple motor tasks has been previously observed in amnesic patients, our results demonstrate that non-hippocampal structures can support complex learning of novel musical sequences for music performance.

Keywords: anterograde amnesia; brain damage; hippocampus; learning; memory; music performance; single-patient study.

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Figures

Figure 1
Figure 1
Magnetic resonance images of patient LSJ’s brain: axial (Top) and coronal (Bottom) view.
Figure 2
Figure 2
Two practice sessions were conducted during the same day, in which LSJ practiced two pieces on the viola. Piece A was practiced in Session 1, and Piece B in Session 2. LSJ’s performance on all pieces was evaluated at a tempo of 144 bpm in test trials before and after each practice session, and 14 days after practice.
Figure 3
Figure 3
Mean proportion of correctly played notes in LSJ’s sight-reading performances on the viola before practice, after practice on the same day, and after a 14-day delay (Test Trials 1, 4, and 5, respectively). Results have been collapsed across the two practiced pieces, Piece A and Piece B. Error bars represent standard error of the mean.
Figure 4
Figure 4
LSJ’s music performance on practiced and unpracticed pieces before and after practice on the same day and after a 14-day delay (Test Trials 1, 4, and 5, respectively) as evaluated by experienced string players. Performance was evaluated on a 1–5 scale separately for intonation (A), rhythm (B), tone (C), and overall (D). Results were collapsed across the two practiced pieces, Piece A and Piece B. Error bars represent standard errors of the mean.

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