pitch and continued to listen to music critically—but he could no longer write or
dictate music and thus could not compose the pieces he heard ‘in his head’.40,41Following
excision of a meningioma beneath the left temporal lobe, a young voice student
had transcortical aphasia, alexia, and agraphia; she also had musical alexia and agraphia,
yet she could still identify pitch, interval, melody, harmony, timbre, rhythm, and meter,
and in a singing recital that included works in five languages, there were no apparent
musical errors (although there may have been occasional paraphasic errors in the foreign
languages).^42
Cases of amusia without language disturbance are also heterogeneous; not surprisingly,
in right-handers the lesions most often involve the right cerebral hemisphere. Reported
symptoms include difficulty recognizing sounds as musical,^43 loss of a sense of rhythm,^44
hearing musical sounds ‘out of tune’,^45 and hearing both voices and music as monotonal.^46
Following a right temporoparietal infarct a man could no longer play the organ, yet other
musical capabilities such as singing and imitating rhythm were intact (‘expressive instru-
mental amusia’).^47 Following a right temporal lobe infarct a man lost appreciation of
timbre, including nonmusical sounds and people’s voices; music sounded ‘low and dull’
with a kind of echo overlapping the sounds, and although he could recognize a guitar, a
trumpet, or a drum, he could not recognize a violin, a piano, or an organ.^48
A composer with right frontoparietotemporal infarction lost his emotional response to
music and could no longer compose meaningfully; he could still compose serial music, ‘...but
I have never been awed by the musical content of this style of composition’.^49 A man with a
right temporoparietal vascular malformation had ‘difficulty understanding the nuances of
words and the inflections of sentences’ and in understanding music; the relationship between
a soloist and an accompanist became blurred, and there was a loss of aesthetic pleasure, yet
there was no auditory agnosia, and he correctly recognized pitch, melody, timbre, harmony,
and rhythm.^50
A piano teacher with bilateral posterior cerebral atrophy of uncertain cause developed
object-use apraxia and could no longer write or play the piano with two hands; her
playing and singing were melodically disorganized and discontinuous, with poor rhythm
and meter, and she read music note for note, with loss of ‘global processing of pitch
sequences’.^38 Following surgical clipping of bilateral middle cerebral artery aneurysms, a
woman could no longer recognize or hum well-known tunes, and although she could tell
if piano tones were the same or different, she could not tell if melodies were the same or
different, whether melodic contour was preserved or violated, or whether a melody ended
on the tonic or a nontonic; rhythm recognition and production were intact, however.^51Studies of brain-damaged populations
Studies involving groups of patients with either left or right cerebral hemispheric
disruption have also been inconsistent. Subjects receiving right carotid artery amobarbital
injection could not sing properly, with pitch more distorted than rhythm, but they recogn-
ized their errors and identified songs sung to them.^52 Patients who had undergone either
left or right temporal lobectomy were studied using the Seashore Test of Musical Abilities,
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