Oliver Sacks

Summary: It is clear from this book that music and its perception is very deeply engraved into our brain.

Score: 80 / 100

Probably the most interesting was the overwhelming amount of examples of various mind/brain defects and their relation to music.

Kindle clippings

In some people, music can provoke seizures.

Some people— a surprisingly large number— “see” color or “taste” or “smell” or “feel” various sensations as they listen to music— though such synesthesia may be accounted a gift more than a symptom.

there was virtually no neuroscience of music prior to the 1980s.

I felt that even the most exalted states of mind, the most astounding transformations, must have some physical basis or at least some physiological correlate in neural activity.

There is some evidence that both the visuospatial and vestibular aspects of out-of-body experiences are related to disturbed function in the cerebral cortex, especially at the junctional region between the temporal and parietal lobes.

Patients with degeneration of the front parts of the brain, so-called frontotemporal dementia, sometimes develop a startling emergence or release of musical talents and passions as they lose the powers of abstraction and language—

Since the mid-1990s, studies carried out by Robert Zatorre and his colleagues, using increasingly sophisticated brain-imaging techniques, have shown that imagining music can indeed activate the auditory cortex almost as strongly as listening to it. Imagining music also stimulates the motor cortex, and conversely, imagining the action of playing music stimulates the auditory cortex. This, Zatorre and Halpern noted in a 2005 paper, “corresponds to reports from musicians that they can ‘hear’ their instrument during mental practice.”

the activity in the basalganglia is running all the time, playing motor patterns and snippets of motor patterns amongst and between themselves— and because of the odd, re-entrant inhibitory connectivity amongst and between these nuclei, they seem to act as a continuous, random, motor pattern noise generator.

could not turn his musical hallucinations down or off,

These qualities of ignition, kindling, and self-perpetuation are epilepsy-like characteristics (though similar physiological qualities are also characteristic of migraine and of Tourette’s syndrome).15 They suggest some form of persistent, uninhibitable spreading electrical excitement in the musical networks of the brain. Perhaps it is not coincidental that drugs like gabapentin (originally designed as an antiepileptic) are sometimes also useful for musical hallucinations.

HALLUCINATIONS OF MANY SORTS, including musical ones, may also occur if the senses and the perceptual systems of the brain have too little stimulation.

Konorski inverted the question “Why do hallucinations occur?” to “Why do hallucinations not occur all the time? What constrains them?”

that there are not only afferent connections going from the sense organs to the brain, but “retro” connections going in the other direction. Such retro connections may be sparse compared to the afferent connections, and may not be activated under normal circumstances. But they provide, Konorski felt, the essential anatomical and physiological means by which hallucinations can be generated. What, then, normally prevents this from happening? The crucial factor, Konorski suggested, is the sensory input from eyes, ears, and other sense organs, which normally inhibits any backflow of activity from the highest parts of the cortex to the periphery. But if there is a critical deficiency of input from the sense organs, this will facilitate a backflow, producing hallucinations physiologically and subjectively indistinguishable from perceptions.

Even Tchaikovsky was keenly aware that his great fertility in melody was not matched by a comparable grasp of musical structure— but he had no desire to be a great architectonic composer like Beethoven; he was perfectly happy to be a great melodic one.1

the anatomical changes they observed with musicians’ brains were strongly correlated with the age at which musical training began and with the intensity of practice and rehearsal.

what is beyond dispute is the effect of intensive early musical training on the young, plastic brain. Takako Fujioka and her colleagues, using magnetoencephalography to examine auditory evoked potentials in the brain, have recorded striking changes in the left hemisphere of children who have had only a single year of violin training, compared to children with no training.

Having absolute pitch, for example, is highly dependent on early musical training, but such training cannot, by itself, guarantee absolute pitch.

In general, though, forms of rhythm deafness are rarely total, because rhythm is represented widely in the brain.

But there does not seem to be any innate neurological preference for particular types of music, any more than there are for particular languages. The only indispensable elements of music are discrete tones and rhythmic organization.

The ability to maintain a sense of timbre constancy is a multileveled and extremely complex process in the auditory brain that may have some analogies with color constancy—

Belin, Zatorre, and their colleagues have found “voice-selective” areas in the auditory cortex that are anatomically separate from the areas involved in the perception of musical timbre.)

They feel that there are two basic categories of musical perception, one involving the recognition of melodies, the other the perception of rhythm or time intervals. Impairments of melody usually go with right-hemisphere lesions, but representation of rhythm is much more widespread and robust and involves not only the left hemisphere, but many subcortical systems in the basal ganglia, the cerebellum, and other areas.7 There are many further distinctions; thus some individuals can appreciate rhythm but not meter, and others have the reverse problem.

There are many levels in the brain at which perceptions of music are integrated and many levels, therefore, at which integration may fail or be compromised.

Neurologists refer to this as simultagnosia, and it is more often visual than auditory.

“The real question concerning absolute pitch,” wrote Diana Deutsch et al. in 2004, “…is not why some people possess it, but rather why it is not universal.

Among musicians, absolute pitch is commoner in those who have had musical training from an early age. But the correlation does not always hold: many gifted musicians fail to develop absolute pitch, despite intensive early training.

Deutsch et al. suggested, therefore, that all infants might have the potential for acquiring absolute pitch, which could perhaps be “realized by enabling infants to associate pitches with verbal labels during the critical period” for language acquisition. (They did not exclude the possibility, nonetheless, that genetic differences might be important, too.)

in functional MRI studies; thus, if someone with absolute pitch is asked to name tones or intervals, MRIs will show focal activation in certain associative areas of the frontal cortex. In those with relative pitch, this region is activated only when naming intervals.

The infants, they found, relied much more heavily on absolute pitch cues; the adults, on relative pitch cues. This suggested to them that absolute pitch may be universal and highly adaptive in infancy but becomes maladaptive later and is therefore lost. “Infants limited to grouping melodies by perfect pitches,” they pointed out, “would never discover that the songs they hear are the same when sung in different keys or that words spoken at different fundamental frequencies are the same.”

In his book The Singing Neanderthals: The Origins of Music, Language, Mind and Body, Steven Mithen

organ of Corti, lying on the basilar membrane of the cochlea and containing about thirty-five hundred inner hair cells, the ultimate auditory receptors.

From top to bottom, we hear about fourteen hundred discriminable tones.

(each ambulance siren or garbage truck will destroy a few hair cells, to say nothing of airplanes, rock concerts, blaring iPods, and the like).

the cochlea’s output, all eight or ten octaves of audible sound, are mapped tonotopically onto the auditory cortex.

(Darold Treffert, in his remarkable book on savantism, Extraordinary People, notes that more than a third of all musical savants are blind or have very poor vision.)

The left hemisphere takes longer to develop, but continues to change in fundamental ways after birth. And as it develops and acquires its own (largely conceptual and linguistic) powers, it starts to suppress or inhibit some of the (perceptual) functions of the right hemisphere.

left hemispherectomy— a drastic procedure sometimes performed for intractable epilepsy, in which the entire left hemisphere is removed— does not render a young child permanently languageless but is followed by the development of language functions in the right hemisphere.)

For centuries, there was a tradition of blind church organists in Europe.

A third or more of the human cortex is concerned with vision, and if visual input is suddenly lost, very extensive reorganizations and remappings may occur in the cerebral cortex,

one person in twenty-three had some kind of synesthesia— most commonly for colored days— and that there was no significant gender difference.

There is some evidence that such “hyperconnectivity” is indeed present in primates and other mammals during fetal development and early infancy, but is reduced or “pruned” within a few weeks or months after birth. There have not been equivalent anatomical studies in human infants, but as Daphne Maurer of McMaster University notes, behavioral observations of infants suggest “that the newborn’s senses are not well differentiated, but are instead intermingled in a synaesthetic confusion.”

a variety of more recent studies agree that synesthesia is a good deal commoner in childhood and tends to disappear at adolescence. Whether this goes with hormonal changes or cerebral reorganizations, which are both occurring at this time, or with a movement to more abstract forms of thinking is unclear.

There are clearly many sorts of memory, and emotional memory is one of the deepest and least understood.

Episodic or explicit memory, we know, develops relatively late in childhood and is dependent on a complex brain system involving the hippocampi and temporal lobe structures,

(fetal horses, for example, may gallop in the womb).

expressive aphasia, a loss of spoken language.

Many aphasic patients can get not only the words of songs, but can learn to repeat sequences or series— days of the week, months of the year, numerals, etc. They may be able to do this as a series, but not to disembed a particular item from the series. So one of my patients, for instance, can recite all the months of the year in order (January, February, March, April, May…); he knows what the current month is, but when I ask him, he cannot respond, simply, “April.”

monograph, Traumatic Aphasia, in 1947,

Auditory cortex, it has been shown, can be reallocated for visual processing in congenitally deaf people, and the visual cortex in blind people may be recruited for auditory and tactile functions.

the right hemisphere, which in normal circumstances has only the most rudimentary linguistic capacities, can be turned into a reasonably efficient linguistic organ with less than three months of training— and that music is the key to this transformation.

Every culture has songs and rhymes to help children learn the alphabet, numbers, and other lists. Even as adults, we are limited in our ability to memorize series or to hold them in mind unless we use mnemonic devices or patterns— and the most powerful of these devices are rhyme, meter, and song.

Tom Lehrer’s song to remember all the chemical elements.

composer Ernst Toch (his grandson Lawrence Weschler tells me) could readily hold in his mind a very long string of numbers after a single hearing, and he did this by converting the string of numbers into a tune (a melody he shaped “corresponding” to the numbers).

Aniruddh Patel at the Neurosciences Institute has recently pointed out that “in every culture there is some form of music with a regular beat, a periodic pulse that affords temporal coordination between performers, and elicits synchronized motor response from listeners.”

But research has now shown that so-called responses to rhythm actually precede the external beat. We anticipate the beat, we get rhythmic patterns as soon as we hear them, and we establish internal models or templates of them. These internal templates are astonishingly precise and stable; as Daniel Levitin and Perry Cook have shown, humans have very accurate memories for tempo and rhythm.3

Keeping time, physically and mentally, depends, as Chen and her colleagues have found, on interactions between the auditory and the dorsal premotor cortex— and it is only in the human brain that a functional connection between these two cortical areas exists. Crucially, these sensory and motor activations are precisely integrated with each other.

We tend to hear the sound of a digital clock, for example, as “tick-tock, tick-tock”— even though it is actually “tick, tick, tick, tick.” Anyone who has been subjected to the monotonous volleys of noise from the oscillating magnetic fields that bombard one during an MRI has probably had a similar experience.

William Gooddy described this in his book Time and the Nervous System: “An observer may note how slowed a parkinsonian’s movements are, but the patient will say, ‘My own movements seem normal to me unless I see how long they take by looking at a clock. The clock on the wall of the ward seems to be going exceptionally fast.’ ” Gooddy wrote of the sometimes enormous disparities such patients can show between “personal time” and “clock time.”

In 1982, David Marsden, a pioneer investigator of movement disorders, suggested that writer’s cramp was an expression of disordered function in the basal ganglia— and that the disorder was akin to dystonia.

Hallett’s group found that the mapping of dystonic hands in the sensory cortex was disorganized both functionally and anatomically.

And unlearning, as all teachers and trainers know, is very difficult, sometimes impossible.

My mind seems to have become a sort of machine for grinding general laws out of large collections of fact…. The loss of these tastes, this curious and lamentable loss of the higher aesthetic tastes, is a loss of happiness, and may possibly be injurious to the intellect, and more probably to the moral character, by enfeebling the emotional part of our nature.

Lamentations of Jeremiah by Jan Dismus Zelenka

Music, uniquely among the arts, is both completely abstract and profoundly emotional. It has no power to represent anything particular or external, but it has a unique power to express inner states or feelings.

Williams syndrome

musical perception, musical sensibility, musical emotion, and musical memory can survive long after other forms of memory have disappeared.

Music is part of being human, and there is no human culture in which it is not highly developed and esteemed.

published: 2014-02-10
last modified: 2023-09-19