Neural basis of music knowledge: evidence from the dementias.

The study of patients with semantic dementia has revealed important insights into the cognitive and neural architecture of semantic memory. Patients with semantic dementia are known to have difficulty understanding the meanings of environmental sounds from an early stage but little is known about their knowledge for famous tunes, which might be preserved in some cases. Patients with semantic dementia (n = 13), Alzheimer's disease (n = 14) as well as matched healthy control participants (n = 20) underwent a battery of tests designed to assess knowledge of famous tunes, environmental sounds and famous faces, as well as volumetric magnetic resonance imaging. As a group, patients with semantic dementia were profoundly impaired in the recognition of everyday environmental sounds and famous tunes with consistent performance across testing modalities, which is suggestive of a central semantic deficit. A few notable individuals (n = 3) with semantic dementia demonstrated clear preservation of knowledge of known melodies and famous people. Defects in auditory semantics were mild in patients with Alzheimer's disease. Voxel-based morphometry of magnetic resonance brain images showed that the recognition of famous tunes correlated with the degree of right anterior temporal lobe atrophy, particularly in the temporal pole. This area was segregated from the region found to be involved in the recognition of everyday sounds but overlapped considerably with the area that was correlated with the recognition of famous faces. The three patients with semantic dementia with sparing of musical knowledge had significantly less atrophy of the right temporal pole in comparison to the other patients in the semantic dementia group. These findings highlight the role of the right temporal pole in the processing of known tunes and faces. Overlap in this region might reflect that having a unique identity is a quality that is common to both melodies and people.