L’amusie congénitale chez l’adolescent : perspectives de réhabilitation

Congenital amusia is a neurodevelopmental disorder that specifically impairs melodic perception despite normal hearing and intelligence. The disorder is thought to arise from a deficit in perceiving fine-grained pitch changes. Studies that aimed to characterize the neural correlates of congenital amusia have highlighted anatomical and functional anomalies along the right fronto-temporal pathways. Notably, the amusic brain has been shown to perceive fine-grained pitch distinctions at an early and automatic level of processing, but this does not reach higher levels of conscious processing. To date, the majority of research on amusia has been performed with adults and consequently little information has been acquired on how this disorder manifests itself during development. The goal of this thesis is therefore to characterize the behavioral and neural correlates of congenital amusia during adolescence, and then to explore different rehabilitation strategies in an attempt to attenuate the perceptual deficits. In a first study, we documented how amusic adolescents process fine-grained pitch changes using event-related potentials, both in terms of early and automatic processing (as indexed by the mismatch negativity component; MMN) and conscious processing (associated with the P300 component) compared to controls. We also explored the effects of a month of daily music listening among these participants. A second study was then conducted to explore the impact of three months of weekly guitar lessons on fine-grained pitch processing in amusic adolescents and controls. In particular, we investigated the effects of musical training on various evoked-potential components, including the P300 and the MMN. The results show that amusia can be fully expressed in the developing brain with manifestations that are similar to those observed in adults. Specifically, the amusic adolescent brain does not elicit a normal positivity (P300) in response to small pitch changes, while early and automatic processing of these pitch deviations appears normal (as indexed by the MMN). In addition, it appears that a month of daily music listening is not an effective amusia remediation strategy, since all electrophysiological and behavioral manifestations were unchanged following this intervention. Furthermore, we show that it is possible for amusic adolescents to learn to play a musical instrument despite their perceptual deficit and this intervention as the potential to induce promising brain plasticity phenomena for some of them. Specifically, a P300 response elicited by fine-grained pitch changes was seen after three months of guitar lessons in three out of four amusic adolescents. Importantly, the emergence of the P300 was paralleled by an improved perceptual ability to detect fine-grained pitch changes. These findings add to our understanding of congenital amusia and its developmental trajectory, while motivating future research that could lead to the development of optimal interventions to help young people with amusia engage with music.

Keyphrases: Adolescence, P300, Congenital amusia, Rehabilitation, Music listening, Musical training, Pitch processing, Mmn, Event-related potentials