Amusia como distúrbio auditivo central na esclerose múltipla: projeto de investigação sobre a sua ocorrência em pacientes com transtornos cognitivos

Abstract

Amusia, an auditory agnosia characterized by partial or absolute, permanent or temporary disability to perceive and to reproduce music, currently represents the best model for understanding the anatomical basis of musical processing and its integration with other cognitive functions. The method used for its detection is the MBEA (Montreal Battery of Evaluation of Amusia) proposed in 2003 and, since then, employed in different studies. Congenital amusia (tone deafness) is observed in 4% of the general population and is starting to be understood as an impairment of connectivity between the brain auditory area and inferior frontal cortex. Acquired amusias, which are more common than congenital form and found mainly after stroke, also represent a source of information on the relationship between musical processing and cognitive functions, specially attention, executive function and working memory, although the association of amusia and cognitive deficits has not been extensively investigated in patients with cerebral injuries so far. Multiple sclerosis is a demielinizating chronic disease of the central nervous system which, among its diverse manifestations, is characterized by cognitive dysfunction related to a number of mechanisms of disconnection and also by central auditory disorders. Studies focusing specifically on the finding of acquired amusia in patients of multiple sclerosis are still lacking in literature. The current project is designed to investigate the occurrence of amusia and its relations to cognitive dysfunction and to electrophysiological changes in multiple sclerosis patients. It is intended to be developed as a longitudinal study in 40 patients followed at the CIEM-Minas / UFMG and previously submitted - for the purposes of a previous study - to the Mismatch Negativity (MMN), a type of endogenous evoked potentials which evaluates auditory sensorial memory as well as to the PASAT (Paced Auditory Addition Task), used to examine cognitive functions. After a complete clinical and audiological re-evaluation the participants will be resubmitted to those tests and to a Brazilian adapted version of the MBEA. Analysis of the results will aim the observation of frequency of amusia and also the predictive value of the tests in its development. Identifying amusia as an additional central auditory and cognitive disorder in multiple sclerosis may have theoretical implications to understanding musical perception impairments related to cerebral disconnectivity, as well as practical implications to the uses of music in co-adjuvant therapeutical measures like music therapy.