Abstract

BackgroundSeveral studies showed that patients with schizophrenia have a lower musical ability that correlates with poorer cognitive functions and severer negative symptoms. Despite the strong relevance of musical ability to cognitive functions and psychiatric symptoms, little is known about the correlation of each subscale of musical ability to cognitive functions and psychiatric symptoms. Therefore, we sought to analyze the correlations of the subtests of musical ability to cognitive functions and psychiatric symptoms.MethodsSixty-four patients with schizophrenia (36 males, mean age = 48.6 ± 10.9 years old) and 80 healthy control subjects (44 males, mean age = 45.3 ± 12.3 years old) consented to participate. We measured musical ability, cognitive functions, and symptom severity using the Montreal Battery for Evaluation of Amusia (MBEA), Brief Assessment of Cognition in Schizophrenia (BACS), and Positive and Negative Syndrome Scale (PANSS), respectively. MBEA subscales include melody discrimination, rhythm discrimination, and musical memory. BACS subscales are comprised of verbal memory, working memory, motor speed, word fluency, attention/processing speed, and executive function. We used the Bonferroni correction for multiple comparisons. For the BACS six subscales, and the three musical subscales, we considered p < 0.00278 to be significant (18 tests), and for PANSS three symptom subscale scores and three musical subscales, we considered p < 0.0056 to be significant (9 tests).ResultsAll musical subscale scores of patients were significantly lower than controls. Lower musical ability subscales were correlated with lower cognitive functions in both healthy controls and patients. In schizophrenia, as previously reported, there were associations between lower musical ability subscales, lower cognitive functions, and more severe psychiatric symptoms. In patients with schizophrenia, while melody discrimination was not correlated with cognitive functions, rhythm discrimination was correlated with verbal memory (beta = 0.378, SE= 0.010, t = 3.42, p = 0.0012) and attention/processing speed (beta = 0.433, SE= 0.013, t = 3.20, p = 0.0022) adjusted for age, gender, and years of musical education. PANSS negative symptoms were correlated with melody discrimination (beta = 0.346, SE= 0.051, t = -2.82, p = 0.0066) and rhythm discrimination (beta = 0.3259, SE= 0.045, t = -2.88, p = 0.0056), but not musical memory.DiscussionThis study revealed an association between performance on rhythm discrimination and both verbal memory and word fluency. Furthermore, more severe negative symptoms were associated with lower abilities in melody and rhythm discrimination. Rhythm discrimination could be associated with language disturbances, possibly providing a new insight into the language and musical deficits contributing to the pathophysiology of schizophrenia.

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