Melancholia In 100 Words

The British Journal of Psychiatry have a regular series called "In 100 Words", which produces some gems. This month they have Melanchola in 100 Words, featuring perhaps the most influential musician you haven't heard of, Robert Johnson.

I got stones in my pathway/And my road seems dark at night/I have pains in my heart/They have taken my appetite.

Robert Johnson, known as the King of the Delta blues singers, distilled into these lines the essence of severe depressive illness – somatic ills, fear and suspicion, emotional and physical pain, nocturnal troubles and struggle against obstacles. The words are one with the powerful, haunting music. ICD-10 and DSM-IV have their place, but poets have often been there before us, and done a better job. We can all learn from Robert Johnson, born just 100 years ago.

I've previously written about the blues and what shade of blue they were talking about, here. But this actually isn't the first Melancholia in 100 Words to appear in the BJP. Here's another one from 2009

Melancholia is a classical episodic depressive disorder that combines mood, psychomotor, cognitive and vegetative components with high suicide risk. In the present psychiatric classification it is buried as a modifier in both bipolar and unipolar depressions. It is hardly used to characterise patients in the clinic or research.

The syndrome is frequently recognised in delusional and agitated depression, and in the elderly. Cortisol or sleep EEG abnormalities are prognostically helpful. Melancholia is particularly responsive to tricyclic antidepressants and electroconvulsive therapy but not to selective serotonin reuptake inhibitors or psychotherapy. Recognising melancholia as a distinct disorder improves clinical care and research.

Melancholia In 100 Words

The British Journal of Psychiatry have a regular series called "In 100 Words", which produces some gems. This month they have Melanchola in 100 Words, featuring perhaps the most influential musician you haven't heard of, Robert Johnson.

I got stones in my pathway/And my road seems dark at night/I have pains in my heart/They have taken my appetite.

Robert Johnson, known as the King of the Delta blues singers, distilled into these lines the essence of severe depressive illness – somatic ills, fear and suspicion, emotional and physical pain, nocturnal troubles and struggle against obstacles. The words are one with the powerful, haunting music. ICD-10 and DSM-IV have their place, but poets have often been there before us, and done a better job. We can all learn from Robert Johnson, born just 100 years ago.

I've previously written about the blues and what shade of blue they were talking about, here. But this actually isn't the first Melancholia in 100 Words to appear in the BJP. Here's another one from 2009

Melancholia is a classical episodic depressive disorder that combines mood, psychomotor, cognitive and vegetative components with high suicide risk. In the present psychiatric classification it is buried as a modifier in both bipolar and unipolar depressions. It is hardly used to characterise patients in the clinic or research.

The syndrome is frequently recognised in delusional and agitated depression, and in the elderly. Cortisol or sleep EEG abnormalities are prognostically helpful. Melancholia is particularly responsive to tricyclic antidepressants and electroconvulsive therapy but not to selective serotonin reuptake inhibitors or psychotherapy. Recognising melancholia as a distinct disorder improves clinical care and research.

Turn That Off, I'm Writing

I listen to a lot of music.

Music is playing in the background most of the time whether I'm on the computer or not (thanks to my old, poorly-designed but still faithful Shuffle). However I've noticed that I find myself turning off iTunes when I'm writing.

Right now, for example, I have just put this song on pause because I'm writing this post (a post about why I paused that song - bit of a chicken-and-egg situation there.) I can't write with a song on, because the lyrics would be distracting.

However, I don't always do this when I'm typing. With some songs, and some kinds of writing, it's OK. I think this is how it works:

Instrumental songs are obviously OK. But I don't listen to many.

More interestingly, songs I've listened to many times are fine. I've just put on this which, according to iTunes, I have listened to no fewer than 140 times over the last three years. And this is fine. No distraction. I think the reason must be that I'm so used to the lyrics that the language part of my mind no longer needs to work out what they mean.

Some kinds of writing are compatible with songs. Blogging isn't and writing "important" emails aren't but a lot of emails are. Which I guess means that I'm not really putting much effort into writing them. I must be typing on auto-pilot, just repeating stock phrases ("Sounds good") rather than actually using my language areas, or at least, not using them very hard.

Psychologists are fond of using these kinds of selective distraction tasks to map out the architecture of the mind e.g. verbal ones distract verbal working memory but not spatial, and vice versa. So this is all pretty standard stuff, but what's interesting is that it's not intuitively obvious.

It doesn't feel like sometimes when I'm writing my language faculty is hard at work, and other times it's not. It feels like I'm thinking about what I type all the time. It's just typing. Sometimes I'll be replying to a bunch of emails, music on full blast, and then I'll find myself putting it on pause when I get to one particular email; but I couldn't tell you in advance which one it would be. It just feels right. Better turn the music off for this one, this one's serious - though even that's putting it too strongly. It doesn't feel serious, it just feels like the music needs to be off.

Our concious experience is smooth and seamless even though we're constantly switching between using different parts of our brains. This becomes all too evident in the case of brain lesions, which can rob us of capacities we never knew we had, because they were always there when we needed them. Some lesions, for example, render you completely unaware of anything that happens to your left. It doesn't seem like we're using a different part of our brain when dealing with stuff on the left as opposed to the right - but we are.

Turn That Off, I'm Writing

I listen to a lot of music.

Music is playing in the background most of the time whether I'm on the computer or not (thanks to my old, poorly-designed but still faithful Shuffle). However I've noticed that I find myself turning off iTunes when I'm writing.

Right now, for example, I have just put this song on pause because I'm writing this post (a post about why I paused that song - bit of a chicken-and-egg situation there.) I can't write with a song on, because the lyrics would be distracting.

However, I don't always do this when I'm typing. With some songs, and some kinds of writing, it's OK. I think this is how it works:

Instrumental songs are obviously OK. But I don't listen to many.

More interestingly, songs I've listened to many times are fine. I've just put on this which, according to iTunes, I have listened to no fewer than 140 times over the last three years. And this is fine. No distraction. I think the reason must be that I'm so used to the lyrics that the language part of my mind no longer needs to work out what they mean.

Some kinds of writing are compatible with songs. Blogging isn't and writing "important" emails aren't but a lot of emails are. Which I guess means that I'm not really putting much effort into writing them. I must be typing on auto-pilot, just repeating stock phrases ("Sounds good") rather than actually using my language areas, or at least, not using them very hard.

Psychologists are fond of using these kinds of selective distraction tasks to map out the architecture of the mind e.g. verbal ones distract verbal working memory but not spatial, and vice versa. So this is all pretty standard stuff, but what's interesting is that it's not intuitively obvious.

It doesn't feel like sometimes when I'm writing my language faculty is hard at work, and other times it's not. It feels like I'm thinking about what I type all the time. It's just typing. Sometimes I'll be replying to a bunch of emails, music on full blast, and then I'll find myself putting it on pause when I get to one particular email; but I couldn't tell you in advance which one it would be. It just feels right. Better turn the music off for this one, this one's serious - though even that's putting it too strongly. It doesn't feel serious, it just feels like the music needs to be off.

Our concious experience is smooth and seamless even though we're constantly switching between using different parts of our brains. This becomes all too evident in the case of brain lesions, which can rob us of capacities we never knew we had, because they were always there when we needed them. Some lesions, for example, render you completely unaware of anything that happens to your left. It doesn't seem like we're using a different part of our brain when dealing with stuff on the left as opposed to the right - but we are.

Neural Correlates of 80s Hip Hop

A ground-breaking new study reveals the neurological basis of seminal East Coast hip-hop pioneers Run-D.M.C.

The study is Diffusion tensor imaging of the hippocampus and verbal memory performance: The RUN DMC Study, and it actually has nothing to do with hip-hop, but it does have one of the best study acronyms I have ever seen.

RUN DMC stands for the "Radboud University Nijmegen Diffusion tensor and Magnetic resonance imaging Cohort study".

Or maybe it does relate to rapping. Because the paper is about verbal memory, and if there's one thing a rapper needs, it's a good memory for words, otherwise they'd forget their lyrics and... OK no, it doesn't relate to hip-hop.

It is however a very nice piece of research. They took no fewer than 503 elderly people - making this by far the single biggest neuroimaging study I have ever read. They used DTI to measure the quality of white-matter tracts in the brain and correlated this with verbal memory function. DTI is an extremely clever technique which allows you to measure the integrity of white matter pathways.

The theory behind the study is that in elderly people, white matter often shows degeneration. This is thought to be caused by vascular disease - problems with the blood flow to the brain, such as cerebral small-vessel disease which means, essentially, a series of mild strokes, which often go unnoticed at the time, but they build up to cause brain damage, specifically white matter disruption.

The symptoms of this are extremely varied and can range from cognitive and memory impairment, to depression, to motor problems (clumsiness), all depending on where in the brain it happens.

All of the people in this study had cerebral small-vessel disease as defined on the basis of symptoms and the presence of visible white matter lesions on the basic MRI scan. The authors found that the integrity of the white matter tracts in the area of the hippocampus, as measured with DTI, correlated with performance on a simple word learning task:


The healthier the hippocampal white matter, the better people did on the task. This makes sense as the hippocampus is a well known memory centre. This is only a correlation, and doesn't prove that the hippocampal damage caused the memory problems, but it seems entirely plausible. The authors controlled for things like age, gender, and the size of the hippocampus, as far as possible.

Should we all be worried about our white matter when we get older? Quite possibly - but luckily, the risk factors for vascular disease are quite well understood, and many of them are things you can change by having a healthy lifestyle.

Smoking is bad news, as are hypertension (high blood pressure), obesity, and high cholesterol. Diabetes is also a risk factor. So you should quit smoking, eat well, and ensure that you're getting tested and if necessary treated for hypertension and diabetes. All of which, of course, is a good idea from the point of view of general health as well.




van Norden AG, de Laat KF, Fick I, van Uden IW, van Oudheusden LJ, Gons RA, Norris DG, Zwiers MP, Kessels RP, & de Leeuw FE (2011). Diffusion tensor imaging of the hippocampus and verbal memory performance: The RUN DMC Study. Human brain mapping PMID: 21391278

Neural Correlates of 80s Hip Hop

A ground-breaking new study reveals the neurological basis of seminal East Coast hip-hop pioneers Run-D.M.C.

The study is Diffusion tensor imaging of the hippocampus and verbal memory performance: The RUN DMC Study, and it actually has nothing to do with hip-hop, but it does have one of the best study acronyms I have ever seen.

RUN DMC stands for the "Radboud University Nijmegen Diffusion tensor and Magnetic resonance imaging Cohort study".

Or maybe it does relate to rapping. Because the paper is about verbal memory, and if there's one thing a rapper needs, it's a good memory for words, otherwise they'd forget their lyrics and... OK no, it doesn't relate to hip-hop.

It is however a very nice piece of research. They took no fewer than 503 elderly people - making this by far the single biggest neuroimaging study I have ever read. They used DTI to measure the quality of white-matter tracts in the brain and correlated this with verbal memory function. DTI is an extremely clever technique which allows you to measure the integrity of white matter pathways.

The theory behind the study is that in elderly people, white matter often shows degeneration. This is thought to be caused by vascular disease - problems with the blood flow to the brain, such as cerebral small-vessel disease which means, essentially, a series of mild strokes, which often go unnoticed at the time, but they build up to cause brain damage, specifically white matter disruption.

The symptoms of this are extremely varied and can range from cognitive and memory impairment, to depression, to motor problems (clumsiness), all depending on where in the brain it happens.

All of the people in this study had cerebral small-vessel disease as defined on the basis of symptoms and the presence of visible white matter lesions on the basic MRI scan. The authors found that the integrity of the white matter tracts in the area of the hippocampus, as measured with DTI, correlated with performance on a simple word learning task:


The healthier the hippocampal white matter, the better people did on the task. This makes sense as the hippocampus is a well known memory centre. This is only a correlation, and doesn't prove that the hippocampal damage caused the memory problems, but it seems entirely plausible. The authors controlled for things like age, gender, and the size of the hippocampus, as far as possible.

Should we all be worried about our white matter when we get older? Quite possibly - but luckily, the risk factors for vascular disease are quite well understood, and many of them are things you can change by having a healthy lifestyle.

Smoking is bad news, as are hypertension (high blood pressure), obesity, and high cholesterol. Diabetes is also a risk factor. So you should quit smoking, eat well, and ensure that you're getting tested and if necessary treated for hypertension and diabetes. All of which, of course, is a good idea from the point of view of general health as well.




van Norden AG, de Laat KF, Fick I, van Uden IW, van Oudheusden LJ, Gons RA, Norris DG, Zwiers MP, Kessels RP, & de Leeuw FE (2011). Diffusion tensor imaging of the hippocampus and verbal memory performance: The RUN DMC Study. Human brain mapping PMID: 21391278

The Smiths

When Alex and I first started dating, I'd go over to his Brooklyn apartment and we'd drink wine and order dinner. (I remember always getting insane butterflies when I walked up the stairs to apartment! He would lean over the banister to say hello, and I would get all heart-pound-y.) Anyway, he'd usually put on music by The Zombies, Love and The Smiths, so I thought he might appreciate these clever limited-edition prints.

(Via Mixed Plate)

Elista's American Idol - Межрегиональный Фестиваль-Конкурс

This past weekend was full of events.  On Friday night, I bought a ticket to a concert and was invited to watch, what I assumed was going to be a series of dances, songs, perhaps poetry, etc about Kalmykia, in Kalmyk, etc in honor of the Day of the City, which was happening the next day.  What instead happened was, in a way, much more enjoyable, at least from a pure entertainment point of view.

This concert turned out to be the "American Idol" of Southern Russia.  It was the "Inter-regional Festival-Competition" and there were 13 contestants from all over.  There were contestants from Ossetia, Ingushetia, Dagestan, Volgograd Region, Kalmykia, Stavropolskii Region and a few others I can't remember.  Anyways, each person sang two songs and as far as I could tell, one was a traditional song (either Russian or from their region) and the next was a song of their choice.

Some the songs were slightly more than ridiculous, as was part of the contest in general.  Every so often, from one back corner of the stage a smoke machine would go off making it look more like there was a small, constant fire in the back that couldn't be put out rather than the mesmerizing effect I'm sure they were going for.  Some of the contestants were hilarious as well, particularly this one group of three women and a guy who was very ABBA-esque.

This guy was full of emotion and I don't really think he could sing that well.  His choice of Ricky Martin's "Mama Maria" may not have been the best Ricky Martin choice he could have made, but then again there's the fact he chose to sing a Ricky Martin song in the first place.

Another guy was also somewhat ridiculous, but actually my favorite contestant.  His name was Ruslan (Руслан)  He had a good voice and for his optional song he decided to sing Sinatra's "My Way", a great choice.  Check him out.

Finally, there was a local Kalmyk girl who ended up winning the contest the next day (I'll explain more in a bit).  She had a good voice (her optional song was Beyonce's "Halo" - haha) and this song is in the Kalmyk Language.  It was sort of a pop song, but people seemed to know it and sing along.  The guy on the left is playing the guitar for the song and the guy on the right is beat boxing and he did it quite nicely.  Check out this video!

As I said, this last girl ended up winning the next day.  This concert, it seemed, was just a warm up.  All the contestants performed the same songs the next night at the Day of the City Concert and it was there they were awarded their prizes and places.

So Dear Readers, while I may not be a Simon Cowell fan and I most certainly cannot stand Ryan Seacrest, I rather enjoyed this competition and found it extremely entertaining!

*Unfortunately, my internet here is too slow to upload videos to the internet, whether to my blog or elsewhere.  I'll keep trying, but in the meantime I apologize for not having video.*

Brain Stimulation Can Stop the Rock

Isn't it annoying when you get a song stuck in your head? Like, say, this one:

Stop the rock, stop the rock
Stop the rock, stop the rock
Stop the rock, can't stop the rock
You can't stop the rock, stop the rock
Stop the rock, can't stop the rock
You can't stop the rock, can't stop the rock. etc.

- Apollo 440, "Stop the Rock"

You'll probably be stuck with that tune for a few minutes, but with any luck it'll go away eventually. However, for the 63-year old Italian man reported on in a new paper by Cosentino et al., the melodic misery never stopped.

The patient had suffered from partial hearing loss for 20 years, probably as a result of his work as a stonemason, which involved a lot of loud noise. His real problems started, however, when he suffered a car accident which cause damage to his right temporal pole. This caused

continuous musical hallucinations in the form of popular songs by Renato Carosone ... the songs were the ones he often used to listen to when he was younger. The volume of the musical hallucinations was initially low, and then became progressively louder; it was perceived in the middle of head and changed in severity over the course of the day. The intensity of the hallucinations evaluated through an arbitrary scale ranging from 0 (no hallucinations) to 10 (unbearable hallucinations) varied from 5 to 8 during the day.

The spectral songs didn't directly interfere with his life, but they were extremely annoying. He reported no other symptoms, his hearing was no worse than it had been before the accident, all neuropsychological tests were normal, and he had no history of any neurological or psychiatric problems.

Doctors tried to control the harmonic hallucinations with a range of anti-epileptic drugs, but they didn't work. A PET scan showed reduced brain activity in the area which was damaged, but increased activity in the posterior temporal lobe. Maybe this was to blame for the problems.

So Cosentino et al. decided to use repetitive transcranial magnetic stimulation (rTMS) to suppress activity in the offending part of the brain. rTMS uses strong magnetic fields to stimulate the brain; through some unknown neurobiological process, it can, in the long term, lead to reduced activity.

rTMS was given 5 days per week for 2 weeks. After the first week, the patient reported that the music had got a lot quieter and after another week, it was gone. A few months later it started again, but far quieter than before and only occasionally. The patient was offered more treatment but he said it wouldn't be worth it, because the hallucinations were no longer annoying. A second PET scan showed normalization of the activity...maybe (see the picture above; A=before B=after.)

There was no placebo condition, so it's hard to know whether this was a true effect of the magnetic stimulation, but the fact that a number of drugs hadn't worked suggests that it wasn't merely a placebo effect. So it turns out that you can Stop the Rock. Or at least, you can Stop the Canzone Napoletana of Renato Carosone. Whether the Rock is harder to Stop is a topic for future research.

Cosentino, G., Giglia, G., Palermo, A., Panetta, M., Lo Baido, R., Brighina, F., & Fierro, B. (2010). A case of post-traumatic complex auditory hallucinosis treated with rTMS Neurocase, 16 (3), 267-272 DOI: 10.1080/13554790903456191

Brain Stimulation Can Stop the Rock

Isn't it annoying when you get a song stuck in your head? Like, say, this one:

Stop the rock, stop the rock
Stop the rock, stop the rock
Stop the rock, can't stop the rock
You can't stop the rock, stop the rock
Stop the rock, can't stop the rock
You can't stop the rock, can't stop the rock. etc.

- Apollo 440, "Stop the Rock"

You'll probably be stuck with that tune for a few minutes, but with any luck it'll go away eventually. However, for the 63-year old Italian man reported on in a new paper by Cosentino et al., the melodic misery never stopped.

The patient had suffered from partial hearing loss for 20 years, probably as a result of his work as a stonemason, which involved a lot of loud noise. His real problems started, however, when he suffered a car accident which cause damage to his right temporal pole. This caused

continuous musical hallucinations in the form of popular songs by Renato Carosone ... the songs were the ones he often used to listen to when he was younger. The volume of the musical hallucinations was initially low, and then became progressively louder; it was perceived in the middle of head and changed in severity over the course of the day. The intensity of the hallucinations evaluated through an arbitrary scale ranging from 0 (no hallucinations) to 10 (unbearable hallucinations) varied from 5 to 8 during the day.

The spectral songs didn't directly interfere with his life, but they were extremely annoying. He reported no other symptoms, his hearing was no worse than it had been before the accident, all neuropsychological tests were normal, and he had no history of any neurological or psychiatric problems.

Doctors tried to control the harmonic hallucinations with a range of anti-epileptic drugs, but they didn't work. A PET scan showed reduced brain activity in the area which was damaged, but increased activity in the posterior temporal lobe. Maybe this was to blame for the problems.

So Cosentino et al. decided to use repetitive transcranial magnetic stimulation (rTMS) to suppress activity in the offending part of the brain. rTMS uses strong magnetic fields to stimulate the brain; through some unknown neurobiological process, it can, in the long term, lead to reduced activity.

rTMS was given 5 days per week for 2 weeks. After the first week, the patient reported that the music had got a lot quieter and after another week, it was gone. A few months later it started again, but far quieter than before and only occasionally. The patient was offered more treatment but he said it wouldn't be worth it, because the hallucinations were no longer annoying. A second PET scan showed normalization of the activity...maybe (see the picture above; A=before B=after.)

There was no placebo condition, so it's hard to know whether this was a true effect of the magnetic stimulation, but the fact that a number of drugs hadn't worked suggests that it wasn't merely a placebo effect. So it turns out that you can Stop the Rock. Or at least, you can Stop the Canzone Napoletana of Renato Carosone. Whether the Rock is harder to Stop is a topic for future research.

Cosentino, G., Giglia, G., Palermo, A., Panetta, M., Lo Baido, R., Brighina, F., & Fierro, B. (2010). A case of post-traumatic complex auditory hallucinosis treated with rTMS Neurocase, 16 (3), 267-272 DOI: 10.1080/13554790903456191

Music Reviews?

Two sites I visit daily are Pitchfork and DrownedInSound. They're music review sites, which means they're full of stuff like this:

Major General moves a fair piece between the Hüsker Dü-like urgency of opener "Jeff Penalty" to the loungey, languid closer "I'm Done Singing", hitting mid-1990s alt-rock, tipsy Billy Joel balladry, Sunday afternoon swing, and Eastern European folk-tinged rave-ups along the way. I can't quite tell if "Jeff Penalty" is a highlight or the highlight, but it's certainly a winner, spinning a note-perfect yarn of seeing the Jello Biafra-less Dead Kennedys revue. In Nicolay's tale, the crowd reluctantly accepts "Jeff Whatisname" and refuses to stop believin'. It's as good a song about navigating aging in the scene-- never selling out, after all, just turns you into the old guy in the room-- as any on the Hold Steady's Stay Positive, and if they were to slip it into a setlist sometime soon, they wouldn't miss a step.

Now, I don't know if I'm alone in this, but I don't find that helpful. It would be interesting if you were really into the band in question & cared about every detail of what they do, but when you're looking for recommendations as to what to listen to, is that what you look for? And can a review really tell you why something is any good or not?

What I look for in these reviews is the bit where they tell you what other music it sounds like - because if it's similar to something I already like then I'll probably like it, if not I probably won't. Everyone has things they like, and there's little rhyme or reason to that - at the moment I'm listening to a lot of Darker My Love, The Aliens, and 1990s Greenday, but I couldn't tell you why. I just like them. And I'll probably like stuff which sounds like them. That's what having a certain taste is, surely.

That's why Pandora, last.fm and other automatic music-recommendation engines are rapidly becoming more useful to me than reviewers. You can type a band or a song into Pandora and it'll recommend other music that sounds like it. Perfect. Except that at the moment Pandora only works if you live in the US, for copyright reasons...