Tuesday, July 6, 2010

Brain Stimulation Can Stop the Rock

Isn't it annoying when you get a song stuck in your head? Like, say, this one:


Stop the rock, stop the rock
Stop the rock, stop the rock
Stop the rock, can't stop the rock
You can't stop the rock, stop the rock
Stop the rock, can't stop the rock
You can't stop the rock, can't stop the rock. etc.
- Apollo 440, "Stop the Rock"
You'll probably be stuck with that tune for a few minutes, but with any luck it'll go away eventually. However, for the 63-year old Italian man reported on in a new paper by Cosentino et al., the melodic misery never stopped.

The patient had suffered from partial hearing loss for 20 years, probably as a result of his work as a stonemason, which involved a lot of loud noise. His real problems started, however, when he suffered a car accident which cause damage to his right temporal pole. This caused
continuous musical hallucinations in the form of popular songs by Renato Carosone ... the songs were the ones he often used to listen to when he was younger. The volume of the musical hallucinations was initially low, and then became progressively louder; it was perceived in the middle of head and changed in severity over the course of the day. The intensity of the hallucinations evaluated through an arbitrary scale ranging from 0 (no hallucinations) to 10 (unbearable hallucinations) varied from 5 to 8 during the day.
The spectral songs didn't directly interfere with his life, but they were extremely annoying. He reported no other symptoms, his hearing was no worse than it had been before the accident, all neuropsychological tests were normal, and he had no history of any neurological or psychiatric problems.

Doctors tried to control the harmonic hallucinations with a range of anti-epileptic drugs, but they didn't work. A PET scan showed reduced brain activity in the area which was damaged, but increased activity in the posterior temporal lobe. Maybe this was to blame for the problems.

So Cosentino et al. decided to use repetitive transcranial magnetic stimulation (rTMS) to suppress activity in the offending part of the brain. rTMS uses strong magnetic fields to stimulate the brain; through some unknown neurobiological process, it can, in the long term, lead to reduced activity.

rTMS was given 5 days per week for 2 weeks. After the first week, the patient reported that the music had got a lot quieter and after another week, it was gone. A few months later it started again, but far quieter than before and only occasionally. The patient was offered more treatment but he said it wouldn't be worth it, because the hallucinations were no longer annoying. A second PET scan showed normalization of the activity...maybe (see the picture above; A=before B=after.)

There was no placebo condition, so it's hard to know whether this was a true effect of the magnetic stimulation, but the fact that a number of drugs hadn't worked suggests that it wasn't merely a placebo effect. So it turns out that you can Stop the Rock. Or at least, you can Stop the Canzone Napoletana of Renato Carosone. Whether the Rock is harder to Stop is a topic for future research.

ResearchBlogging.orgCosentino, G., Giglia, G., Palermo, A., Panetta, M., Lo Baido, R., Brighina, F., & Fierro, B. (2010). A case of post-traumatic complex auditory hallucinosis treated with rTMS Neurocase, 16 (3), 267-272 DOI: 10.1080/13554790903456191

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