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Music processing in behavioural variant frontotemporal dementia and Alzheimer's disease: a functional MRI study
Jochum J van 't Hooft1,2, Wietske van der Zwaag3,4, Alle Meije Wink5
1Alzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC Location VUmc, 1081 HZ Amsterdam, The Netherlands.
Brain Communications
|June 15, 2026
Summary
Patients with behavioral variant frontotemporal dementia (bvFTD) show altered music processing compared to Alzheimer's disease patients and healthy controls, particularly in the supplementary motor area. These differences impact music therapy effectiveness.
Area of Science:
- Neuroscience
- Neurology
- Cognitive Science
Background:
- Music processing involves perceptual, socio-emotional, and cognitive functions.
- Alzheimer's disease (AD) may preserve these functions, while behavioral variant frontotemporal dementia (bvFTD) affects them early.
- Neurophysiological differences in music processing between AD and bvFTD are unclear, impacting music therapy efficacy.
Purpose of the Study:
- To investigate differences in music processing between bvFTD, AD, and healthy controls.
- To explore the neurophysiological underpinnings of music processing in these dementia types.
- To determine if music processing variations correlate with disease severity.
Main Methods:
- Functional MRI (fMRI) was used in 60 participants (13 bvFTD, 22 AD, 25 controls).
- A novel sparse-sampling fMRI paradigm involved passive listening to favorite and unfamiliar music.
- Activation patterns and connectivity were compared across groups and correlated with disease severity.
Main Results:
- bvFTD patients exhibited reduced activation during favorite music listening compared to AD and controls.
- bvFTD patients showed decreased activation in the supplementary motor area when contrasting favorite vs. unfamiliar music.
- AD patients uniquely showed activation in the caudate nucleus during unfamiliar music, linked to reward processing.
- Connectivity of auditory cortices was increased in bvFTD, suggesting network immaturity.
- Disease severity correlated with distinct functional activation patterns in both AD and bvFTD.
Conclusions:
- Music processing differs significantly between bvFTD and AD patients.
- Reduced supplementary motor area activation may explain altered music processing in bvFTD.
- Distinct neural patterns in AD and bvFTD have implications for personalized music therapy selection.
