Musical practice as an enhancer of cognitive function in healthy aging - A systematic review and meta-analysis.

Aging is accompanied by cognitive decline, although recent research indicates that the rate of decline depends on multiple lifestyle factors. One of such factors is musical practice, an activity that involves several sensory and motor systems and a wide range of high-level cognitive processes. This paper describes the first systematic review and meta-analysis, to our knowledge, of the impact of musical practice on healthy neurocognitive aging. The inclusion criteria for the review required that studies were empirical works in English or Spanish that they explored the effects of musical practice on older people; they included an assessment of cognitive functions and/or an assessment of brain status; and they included a sample of participants aged 59 years or older with no cognitive impairment or brain damage. This review led to the selection of 13 studies: 9 correlational studies involving older musicians and non-musicians and 4 experimental studies involving short-term musical training programs. The results of the meta-analysis showed cognitive and cerebral benefits of musical practice, both in domain-specific functions (auditory perception) and in other rather domain-general functions. Moreover, these benefits seem to protect cognitive domains that usually decline with aging and boost other domains that do not decline with aging. The origin of these benefits may reside, simultaneously, in the specific training of many of these cognitive functions during musical practice (specific training mechanism), in the improvement of compensatory cognitive processes (specific compensatory mechanism), and in the preservation of general functions with a global influence on others, such as perceptual capacity, processing speed, inhibition and attention (general compensatory mechanism). Therefore, musical practice seems to be a promising tool to reduce the impact of cognitive problems associated to aging.

Effectiveness of a neuropsychological treatment for confabulations after brain injury: A clinical trial with theoretical implications.

Confabulators consistently generate false memories without intention to deceive and with great feelings of rightness. However, to our knowledge, there is currently no known effective treatment for them. In order to fill this gap, our aim was to design a neuropsychological treatment based on current theoretical models and test it experimentally in 20 confabulators sequentially allocated to two groups: an experimental and a control group. The experimental group received nine sessions of treatment for three weeks (three sessions per week). The sessions consisted of some brief material that participants had to learn and recall at both immediate and delayed time points. After this, patients were given feedback about their performance (errors and correct responses). Pre- and post-treatment measurements were recorded. Confabulators in the control group were included in a waiting list for three weeks, performed the pre- and post- measurements without treatment, and only then received the treatment, after which a post-treatment measurement was recorded. This applied to only half of the participants; the other half quit the study prematurely. Results showed a significant decrease in confabulations and a significant increase in correct responses in the experimental group; by contrast, patients in the control group did not improve during the waiting list period. Only control group patients who subsequently received the treatment after serving as controls improved. The effects of the treatment were generalized to patients' everyday lives, as reported by relatives, and persisted over time. This treatment seems to be effective and easy to implement and consequently of clinical interest. Moreover, it also has theoretical implications regarding the processes related to the genesis and/or maintenance of confabulations. In particular, results point to a deficit in early stages of memory retrieval with the preservation of later strategic monitoring processes. Specifically, some of the processes involved may include selective attention or early conflict detection deficits. Future research should test these hypotheses.

Spatial learning in a virtual reality-based task is altered in very preterm children.

Very preterm births prevent a complete development of the nervous system. The hippocampus is especially vulnerable in this population since the perinatal period is critical for its growth and development. Learning and memory abilities, like spatial memory, depend on the hippocampal integrity. In this study we applied virtual-reality-based tasks to assess spatial memory in a sample of 20 very preterm children of 7 and 8 years of age. Two different conditions of difficulty were used. Very preterm children performed poorly in the task in comparison with the control group. They committed more errors than controls searching for the rewarded positions. However, no significant differences were observed in the mean speed, an index of the motor abilities and joystick handling. These results suggest that the hippocampal function is affected in this sample. Nevertheless, other variables to consider are discussed.

Neuropsychological deficits associated with destruction of the right nigrostriatal pathway.

Hemiparkinsonism secondary to a vascular mesencephalic lesion is infrequent; these patients offer an exceptional opportunity to study neuropsychological alterations attributable to unilateral dopaminergic denervation, shedding light on the pathophysiology of cognitive disorders in early-stage idiopathic Parkinson's disease (PD). From the investigation of our case, we conclude that destruction of the right nigrostriatal pathway is accompanied by deficits in executive functioning and verbal/visual memory similar to those observed in many patients with early-stage idiopathic PD. The more complex neuropsychological dysfunction developed by other PD patients must therefore be related to the additional involvement of other brain structures.

Rhythms can overcome temporal orienting deficit after right frontal damage.

The main aim of this study was to test whether the use of rhythmic information to induce temporal expectations can overcome the deficit in controlled temporal preparation shown by patients with frontal damage (i.e. temporal orienting and foreperiod effects). Two tasks were administered to a group of 15 patients with a frontal brain lesion and a group of 15 matched control subjects: a Symbolic Cued Task where the predictive information regarding the time of target appearance was provided by a symbolic cue (short line-early vs. long line-late interval) and a Rhythm Cued Task where the predictive temporal information was provided by a rhythm (fast rhythm-early vs. slow rhythm-late interval). The results of the Symbolic Cued Task replicated both the temporal orienting deficit in right frontal patients and the absence of foreperiod effects in both right and left frontal patients, reported in our previous study (Triviño, Correa, Arnedo, & Lupiañez, 2010). However, in the Rhythm Cued Task, the right frontal group showed normal temporal orienting and foreperiod effects, while the left frontal group showed a significant deficit of both effects. These findings show that automatic temporal preparation, as induced by a rhythm, can help frontal patients to make effective use of implicit temporal information to respond at the optimum time. Our neuropsychological findings also provide a novel suggestion for a neural model, in which automatic temporal preparation is left-lateralized and controlled temporal preparation is right-lateralized in the frontal lobes.

Temporal orienting deficit after prefrontal damage.

The aim of this study was to explore, for the first time in patients, the neural bases of temporal orienting of attention as well as the interrelations with two other effects of temporal preparation: the foreperiod effect and sequential effects. We administered an experimental task to a group of 14 patients with prefrontal lesion, a group of 15 control subjects and a group of 7 patients with a basal ganglia lesion. In the task, a cue was presented (a short versus long line) to inform participants about the time of appearance (early versus late) of a target stimulus, and the duration of the cue-target time intervals (400 versus 1400 ms) was manipulated. In contrast to the control group, patients with right prefrontal lesion showed a clear deficit in the temporal orienting effect. The foreperiod effect was also affected in the group of patients with prefrontal lesion (without lateralization of the deficit), whereas sequential effects were preserved. The group of basal ganglia patients did not show deficits in any of the effects. These findings support the voluntary and strategic nature of the temporal orienting and foreperiod effects, which depend on the prefrontal cortex, as well as the more automatic nature of sequential effects, which do not depend on either prefrontal cortex or frontobasal circuits.