Musical hallucinations teach researchers about MS pathways

Whether it’s a jingle from a commercial or a snippet of a song, people occasionally get a so-called “earworm,” a bit of music stuck in their heads for a few minutes or hours. But an earworm that has plagued a multiple sclerosis patient for years is teaching scientists more about how the disease affects neural pathways.

Multiple sclerosis, or MS, is an autoimmune disease that affects the ability of the nervous system to carry signals to and from the brain. Inflammation can damage the myelin sheath, a protective covering that surrounds nerve cells, slowing and sometimes blocking nerve impulses.

“The damage caused by MS has both physical and mental repercussions,” said Oklahoma Medical Research Foundation scientist Farhat Husain, M.D. “In this case, a patient hears country music and the word ‘Jabberwocky’ over and over again. It’s quite distressing to her.”

Working with University of Oklahoma College of Medicine neuropsychologist Jim Scott, Ph.D., Husain reviewed the patient’s MRI scans and found multiple sclerosis had affected the areas of her brain required for perceiving music. The case study was published in the journal Multiple Sclerosis and Related Disorders.

“We found the inflammation had damaged an area of the brain called the auditory association cortex, which has pathways related not just to hearing, but also memory,” Husain said. “This created musical hallucinations. She didn’t just think about the music or the word, she thought she was hearing them.”

Musical hallucinations are rarely reported in MS, which led several doctors to dismiss the patient’s claims as a psychiatric problem, Husain said. That’s what led her to OMRF’s Multiple Sclerosis Center of Excellence.

“We’re able to take a more detailed history and go into real depth with patients,” she said. Spending time with the patient, they were able to pinpoint what was happening and understand more about the cause of the hallucinations.

Unfortunately, because MS is frequently a progressive disease, there is not yet a way to stop the patient’s hallucinations, Husain said. The patient wears headphones at night and plays other songs in order to sleep.

“We are lucky to have patients who want us to study and learn from them,” she said. “They come seeking treatment, but they also want us to advance the science to improve the lives of future patients.”