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Musical hallucinations

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Abstract

Musical hallucinations have been described in numerous neurologic and psychiatric patients, but their pathophysiologic background is not understood. Analyzing the published cases, five subgroups can be separated according to their etiology: hypacusis, psychiatric disorders, focal brain lesions, epilepsy, and intoxication. There is a female preponderance of about 70%. Musical hallucinations most often occur in patients over age 60 years, although patients whose hallucinations are caused by focal brain lesions are significantly younger. Hemispheric dominance seems to play no major role in the pathogenesis of musical hallucinations, but hypacusis is present in the majority of all patients. Anticonvulsant and antidepressive agents have been effective in the treatment of some musical hallucinations. The discussion on the pathophysiology of musical hallucinations comprises theories of deafferentation (including auditory Charles Bonnet syndrome), of sensory auditory deprivation, of parasitic memory, and of spontaneous activity in a cognitive network module.

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References and Recommended Reading

  1. Berrios GE: Musical hallucinations: a historical and clinical study. Br J Psychiatry 1990, 156:188–194.

    PubMed  CAS  Google Scholar 

  2. Evers S, Ellger T: The clinical spectrum of musical hallucinations. J Neurol Sci 2004, 227:55–65. This is the largest analysis of all published case reports on musical hallucinations. It includes statistical analysis of subgroups divided by etiology.

    Article  PubMed  Google Scholar 

  3. Fischer CE, Marchie A, Norris M: Musical and auditory hallucinations: a spectrum. Psychiatry Clin Neurosci 2004, 58:96–98.

    Article  Google Scholar 

  4. Berrios GE: Musical hallucinosis: a statistical analysis of 46 cases. Psychopathology 1991, 24:356–360.

    PubMed  CAS  Google Scholar 

  5. Keshavan MS, Davis AS, Steingard S, Lishman WA: Musical hallucinosis: a review and synthesis. Neuropsychiatry Neuropsychol Behav Neurol 1992, 5:211–223.

    Google Scholar 

  6. Klostermann W, Vieregge P, Kömpf D: Musik-Pseudohalluzinose bei erworbener Schwerhörigkeit [in German]. Fortschr Neurol Psychiat 1992, 60:262–273.

    PubMed  CAS  Google Scholar 

  7. Pasquini F, Cole MG: Idiopathic musical hallucinations in the elderly. J Geriatr Psychiatry Neurol 1997, 10:11–14.

    PubMed  CAS  Google Scholar 

  8. Saba PR, Keshavan MS: Musical hallucinations and musical imagery: prevalence and phenomenology in schizophrenic patients. Psychopathology 1997, 30:185–190.

    PubMed  CAS  Google Scholar 

  9. Gordon AG: Drug-induced musical hallucinations. J Nerv Ment Dis 1998, 186:652–653.

    Article  PubMed  CAS  Google Scholar 

  10. Agrawal AK, Sherman LK: Voriconazole-induced musical hallucinations. Infection 2004, 32:293–295.

    Article  PubMed  CAS  Google Scholar 

  11. Davies AN, Quinn T: Opioid-related musical hallucinations. J Pain Symptom Manage 2005, 29:327–328.

    Article  PubMed  Google Scholar 

  12. Mori T, Ikeda M, Fukuhara R, et al.: Regional cerebral blood flow change in a case of Alzheimer’s disease with musical hallucinations. Eur Arch Psychiatry Clin Neurosci 2006, In press.

  13. Fukunishi I, Horikawa N, Onai H: Prevalence rate of musical hallucinations in a general hospital setting. Psychosomatics 1998, 39:175.

    PubMed  CAS  Google Scholar 

  14. Cole MG, Dowson L, Dendukuri N, Belzile E: The prevalence and phenomenology of auditory hallucinations among elderly subjects attending an audiology clinic. Int J Geriatr Psychiatry 2002, 17:444–452. This epidemiologic study of the prevalence of musical hallucinations in older people with hearing damage demonstrates the importance of hearing de.cits as an etiologic factor in musical hallucinations.

    Article  PubMed  Google Scholar 

  15. Hermesh H, Konas S, Shiloh R, et al.: Musical hallucinations: prevalence in psychotic and nonpsychotic outpatients. J Clin Psychiatry 2004, 65:191–197. This is one of the very rare epidemiologic studies on the prevalence of musical hallucinations. It shows a very high prevalence in psychiatric patients, particularly in obsessive-compulsive disorder.

    Article  PubMed  Google Scholar 

  16. Warner N, Aziz V: Hymns and arias: musical hallucinations in older people in Wales. Int J Geriatr Psychiatry 2005, 20:658–660.

    Article  PubMed  Google Scholar 

  17. Baba A, Hamada H, Kocha H: Musical hallucinations in schizophrenia. Psychopathology 2003, 36:104–110. This interesting observational study shows the importance of psychiatric disorders in the development of musical hallucinations.

    Article  PubMed  Google Scholar 

  18. Zatorre RJ: Musical perception and cerebral function: a critical review. Music Perception 1984, 2:196–221.

    Google Scholar 

  19. Bever TG, Chiarello RJ: Cerebral dominance in musicians and nonmusicians. Science 1974, 185:537–539.

    Article  PubMed  CAS  Google Scholar 

  20. Evers S, Dannert J, Rödding D, et al.: The cerebral haemodynamics of music perception. A transcranial Doppler sonography study. Brain 1999, 122:75–85.

    Article  PubMed  Google Scholar 

  21. Evers S, Ellger T, Ringelstein EB, Knecht S: Is hemispheric dominance relevant in musical hallucinations? Report of two cases. Eur Arch Psychiatry Clin Neurosci 2002, 252:299–302.

    Article  PubMed  Google Scholar 

  22. Knecht S, Dräger B, Deppe M, et al.: Handedness and hemispheric language dominance in healthy humans. Brain 2000, 12:2512–2518.

    Article  Google Scholar 

  23. Collins MN, Cull CA, Sireling L: Pilot study of treatment of persistent auditory hallucinations by modified auditory input. Br Med J 1989, 299:431–432.

    CAS  Google Scholar 

  24. Roberts DL, Tatini U, Zimmerman RS, et al.: Musical hallucinations associated with seizures originating from an intracranial aneurysm. Mayo Clin Proc 2001, 76:423–426.

    Article  PubMed  CAS  Google Scholar 

  25. Stephane M, Hsu LKG: Musical hallucinations: interplay of degenerative brain disease, psychosis, and culture in a Chinese woman. J Nerv Ment Dis 1996, 184:59–61.

    Article  PubMed  CAS  Google Scholar 

  26. Gordon AG: Do musical hallucinations always arise from the inner ear? Med Hypotheses 1997, 49:111–122.

    Article  PubMed  CAS  Google Scholar 

  27. Johns LC, Hemsley D, Kuipers E: A comparison of auditory hallucinations in a psychiatric and non-psychiatric group. Br J Clin Psychol 2002, 41:81–86.

    Article  PubMed  Google Scholar 

  28. Engelien A, Stern E, Silbersweig D: Functional neuroimaging of human central auditory processing in normal subjects and patients with neurological and neuropsychiatric disorders. J Clin Exp Neuropsychol 2001, 23:94–120.

    Article  PubMed  CAS  Google Scholar 

  29. Izumi Y, Terao T, Ishino Y, Nakamura J: Differences in regional cerebral blood flow during musical and verbal hallucinations. Psychiatry Res 2002, 116:119–123. This experimental brain imaging study shows differences between verbal and musical hallucinations with respect to activation of brain regions.

    Article  PubMed  Google Scholar 

  30. Matsui T, Matsunaga H, Ohya K, et al.: Clinical features in two cases with musical obsessions who successfully responded to clomipramine. Psychiatry Clin Neurosci 2003, 57:47–51.

    Article  PubMed  Google Scholar 

  31. Griffiths TD: Musical hallucinosis in acquired deafness. Phenomenology and brain substrate. Brain 2000, 123:2065–2076.

    Article  PubMed  Google Scholar 

  32. Dierks T, Linden DEJ, Jandl M, et al.: Activation of Heschl’s gyrus during auditory hallucinations. Neuron 1999, 22:615–621.

    Article  PubMed  CAS  Google Scholar 

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Correspondence to Stefan Evers MD, PhD.

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Evers, S. Musical hallucinations. Curr Psychiatry Rep 8, 205–210 (2006). https://doi.org/10.1007/s11920-006-0024-0

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