Music and the social brain
In this thesis we investigated the neurobiological foundations of musicality in dementia and its relationship with social cognition, focusing on behavioural variant frontotemporal dementia (bvFTD) and Alzheimer’s disease (AD). The first part examines hearing function, given its importance for musicality and its role as a risk factor for dementia. We found that age-related hearing loss was linked to cognitive decline and, in younger-old adults, to amyloid pathology—suggesting age-specific mechanisms connecting hearing-loss to dementia. Next, a case study showed that neurodegeneration can alter auditory experiences. In the second part we examined clinical and anatomical associations of musicality and social cognition. Using a meta-analytic approach, we found that brain regions involved in music perception overlap with those for social cognition and atrophy profiles in frontotemporal dementia, particularly within the salience, semantic appraisal, and ventral language network. We found that many bvFTD patients showed changes in music appreciation, especially musicophilia. Musical training and regular listening were associated with better social functioning in bvFTD, including improved perspective-taking, empathy and fewer behavioural problems. Next, we used validated musicality metrics and found impairments in tempo recognition and music emotion recognition in bvFTD, but not in AD. We found that brain regions involved in musicality overlapped with those for social cognition. Finally, using functional MRI we showed that bvFTD and AD patients process music differently, with altered activity in regions such as the supplementary motor area and caudate nucleus. Overall, our findings suggest that musicality and music processing differ in bvFTD and AD, and that music may be a valuable tool for understanding and assessing social cognition in dementia.
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