From time to time Dr. Oliver Sacks is haunted by musical symbols: notes, clefs, staffs and bar lines all fly by his eyes uninvited and in rapid succession. The celebrated neuroscientist can “see” the imaginary scores despite, or perhaps because of, his partial blindness.

As it turns out, Sacks is not alone. People from around the world have been writing him letters describing the music-oriented hallucinations that come unexpectedly and unbidden.  He’s described their experiences in a new report published in the journal Brain.

“When they happen you’re startled,” says Sacks, a professor of neurology at New York University and author of the 2012 bestseller, “Hallucinations.”

“It’s different from imagination. When you imagine something, it’s yours because you have imagined it. But when this happens to you, you’re startled. You wonder, ‘Who ordered this up? Where did it come from?’”

More often than not, people who are visited by these hallucinations of musical notation have problems with their eyesight like Sacks, but the visions can come to people suffering from Parkinson’s disease or even just a fever, he says. While they often come to people who are musically oriented, they can also appear to those who can’t read a note.

Sacks describes the case of 75-year-old Ted R., who developed Parkinson’s in his early 60s. Despite the disease, Ted is still an active scholar and writer - and a gifted pianist who’s been having musical hallucinations for the last two years.

The first time the musical notations appeared, he’d been reading a book. He turned away from it for a few seconds, and when he glanced back at the pages in front of him, the text had been replaced by a musical score.

Ted wondered whether the score was actual music and has tried many times to either transcribe or to perform it, but so far has found that “the music is scarcely playable because it is highly ornamented,” Sacks writes.

But Ted perseveres. Having discovered that he can summon up the hallucinations by staring at a text on a printed page, he will put a newspaper on his music stand and wait for the notes to appear. Hampered by their complexity and the speed with which they disappear, he’s had little success and so far, no great symphony has arisen from the elusive illusions.  

Another letter writer, whom Sacks calls Arthur S., finds the hallucinations to be irksome rather than entertaining. Arthur is a surgeon and an amateur pianist who is losing his eyesight to macular degeneration. “He was quite annoyed, as they would appear on a letter he was trying to write or something he was trying to read,” Sacks says.

The hallucinations may offer scientists more than merely some entertaining stories about brain quirks. Sacks hopes they will teach us something about the networks that process musical scores. Researchers have already scanned the brains of people who hallucinate faces, Sacks says. “One finds that the part of the brain in the back of the right hemisphere that is normally responsible for recognizing faces, has taken on a life of its own,” he says.

Scanning people who suffer musical hallucinations might be even more interesting.

“A musical score is a complicated sort of thing,” he explains. “It might show us how many parts of the brain can be integrated together as they are in reading music – and also presumably in hallucinating about it.”

Sacks hopes his article will spark more research and prompt scientists to scan the brains of people in the midst of a musical hallucination. “One of my reasons for publishing this in ‘Brain’ is to say to my colleagues, ‘Hey guys, this is something interesting. Take it and run with it.’”

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To most readers, this text looks black and white. But to a few, each letter possesses a different color, and reading becomes more than what’s in black and white.   

Those who read in color live with grapheme-color synesthesia, where the brain assigns colors to letter and numbers. Some synesthetes say words possess colors, too (someone might say truth looks gold, for example). Overall, 4 percent of the population experiences a form of synesthesia with 1 percent living with grapheme-color synesthesia.

Synesthesia gives many people a richer experience and it’s believed to be mostly harmless and fixed—people either have it or they don’t.

Until now.

Researchers at the University of Amsterdam found that people, without a history of grapheme-color synesthesia, who read books with some colored letters, associated those letters with the correlating hues. This is the first time anyone has taught synesthesia by reading books. 

“Whenever we give a talk or lecture, people ask if they can learn synesthesia,” says Olympia Colizoli, a doctoral student in the brain and cognition department at the University of Amsterdam.

“Most people would never want to give up their synesthesia and can’t imagine not having these experiences.”

To test whether people could learn grapheme-color synesthesia, Colizoli asked 15 subjects to read books that had four frequently occurring letters paired with four commonly seen colors. Each participant selected a book from Project Gutenberg and Colizoli applied color to the book (prior to the experiment she colored every letter in a book but it made it very difficult to read). Colizoli’s interest isn’t simply professional; she has "time form" synesthesia, which means she sees periods of times, such as days, weeks, or centuries, as shapes.

“Even though [synesthesia] seems to run in families and the evidences suggests it is genetic, language is learned and it comes from the environment … no one is born with the letter a in their brain,” she says. Yet, there seems to be little understanding of the role of environment and synesthesia. 

Prior to reading the colored book, Colizoli asked the participants to take a modified Stroop test, which detects grapheme-color synesthesia, to assure none of the subjects had it. In a modified Stroop test, people look at the words printed in different colored ink. Grapheme-color synethetes have delayed responses when identifying the letters’ colors.

After completing the book, the subjects re-took the Stroop test and showed behavioral signs of synesthesia. Colizoli does not believe these effects are permanent, noting more research needs to be conducted. She and her colleagues also replicated the results with participants who read in Dutch.

“We are bombarded by colored letters all the time,” Colizoli says. “It is interesting to see how adaptive [synesthesia] may be.”

Colizoli also asked the subjects if they noticed any differences since the experiment and they gave a variety of subjective responses (much like synesthetes would). One person claimed to dislike orange until reading in color, while two subjects say they now read faster. Another woman, a musician, enjoyed reading in color so much she asked if Colizoli could print all her sheet music in color for her. (This is not uncommon; artists frequently claim to be synesthetes. Vladimir Nabokov saw the alphabet in rainbow colors with each letter appearing the same shade each time he saw it.)   

“She could remember the music better and fell in love with it. Some people were really sensitive to it.”  

The paper appears in the online journal PLoS ONE. If you want to try reading like a grapheme-color synsethete, check out this link.

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Just when you thought those annoying Kardashians couldn’t mess with your head any more than they already do, consider “Mr. A.” When he first saw the psychiatrist, he demanded to speak to “the director” of the reality show in which he was starring.

When “Mr. B.” met psychiatric workers, he informed them that he was being continuously taped for national broadcast. “Mr. D.” really was working on a reality show -- until he came to believe that he was the actual star.

All these people, and others, suffered from the delusion that they were serving as entertainment for others. All of them specifically cited the 1998 movie “The Truman Show,” written by Andrew Niccol, directed by Peter Weir, and starring Jim Carrey. In the movie, Carrey plays an insurance man living in a town that’s actually a TV set and populated by actors he thinks are his friends, family and neighbors.

Psychiatrist Joel Gold, in private practice and a professor of psychiatry at New York University, and his brother Ian Gold, a philosopher of psychiatry at McGill University, writing in the most recent issue of the journal Cognitive Neuropsychiatry, dub this the "Truman Show" delusion. They ask “Can a case be made that the phenomenon of reality television might interact with the expression of psychotic symptoms?”

The answer, they argue, is most definitely yes.

They suggest that “reality television resonates with a common anxiety about one’s position in the social hierarchy…. Someone who is particularly anxious about their social status, therefore, might experience reality television as presenting a significant social threat, or a tantalizing possibility of success, or both. In the life of such a person, reality television might act as a significant stress, the effects of which might include a persecutory or grandiose delusion of the Truman Show type.”

It’s not that watching lots of reality TV causes a mental illness (believe it or not). Rather, an existing or nascent illness, like schizophrenia, interacts with the cultural pervasiveness of reality TV to give form to the delusion. It’s a little like those unstable people who go to Jerusalem and experience “Jerusalem Syndrome,” the belief that they’re characters from the Bible.

The Golds wrote the paper because they think the environmental associations with psychosis don’t get enough attention. “We think in North America that it’s overlooked,” he said in an interview.

“We are interested in the way society as a whole has changed,” he said, “With the advent of reality TV and closed circuit TVs in cities such as London where people are truly observed, and the Internet with YouTube, what impact might that have on people otherwise predisposed to grandiosity and paranoia?”

As the Golds point out, delusions fall into a limited number of standard types no matter where the sufferer lives. People from Saudi Arabia tend to have delusions about being covered in sand. People in the U.S. tend to have delusions about being followed by the CIA. The specific content of the delusion can be culturally based.

For example, in this month’s issue of the International Journal of Social Psychiatry, researchers from Maywood University studied records from a state psychiatric institution across the last century and found that while the categories of delusions were the same as today -- such as persecutory, religious or grandiose -- the content of the delusion depended on whatever was happening in the culture at the time.

At the moment, we’re steeped in “reality” television, so it’s no wonder, the Golds suggest, that people with a mental illness might get the idea they’re the next Bethenny Frankel.

Science has not yet pinned down the root biological causes of delusions. A leading theory involves the way the chemical dopamine activates motivational brain circuitry. A person suffering from a delusion may not just notice that there’s an anchorman on TV is wearing a yellow tie, he might attach enormous importance to that fact, and come to believe that the yellow tie is communicating some vital message. The social brain may also be impaired. What scientists call “Theory of Mind” -- the ability to figure out what others are thinking and feeling -- may be misfiring. The brains of the delusional may also be too quick to jump to conclusions about common experience.

“If a car is bearing down on you, you see it as a threat,” Gold explained. “You better get out of the way. Well, there are two blue cars parked outside my home, and two days ago, there was also a blue car. Is there something to that? Is it a threat? You could build a delusion around that.”

Brian Alexander (www.BrianRAlexander.com) is co-author, with Larry Young PhD., of "The Chemistry Between Us: Love Sex and the Science of Attraction," (www.TheChemistryBetweenUs.com)  to be published Sept. 13.

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By Jennifer Welsh
LiveScience 

What gives you the motivation to go the extra mile for a promotion or a perfect test score? It may be your levels of a brain chemical called dopamine. Researchers have found amounts of this chemical in three brain regions determine if a person is a go-getter or a procrastinator.

Dopamine does different things in different areas of the brain. So while high levels in some brain regions were associated with a high work ethic, a spike in another brain region seemed indicate just the opposite — a person more likely to slack off, even if it meant smaller monetary rewards.

"To our surprise, we also found a different region of the brain, the anterior insula, that showed a strong negative relationship between dopamine level and willingness to work hard," study researcher Michael Treadway, graduate student at Vanderbilt University, told LiveScience.

The fact that dopamine can have opposing effects on different parts of the brain puts a wrench in how psychotropic drugs that affect dopamine levels are used for the treatment of attention-deficit disorder (ADD), depression and schizophrenia, Treadway noted. The general assumption has been that these dopamine-releasing drugs have the same effect throughout the brain.

The researchers scanned the brains of 25 young adult volunteers and put them through a test to see how hard they were willing to work for a monetary reward. They would choose either an easy or a difficult button-pushing task, and get rewarded either $1 or a variablevalue of up to $4. They repeated these 30-second tasks for 20 minutes.

Some of the participants opted to work harder for the larger reward by completing thedifficult task, while others chose the easier task more often and accepted the small reward. Does this choice make them lazy? Maybe, Treadway said: "They were less motivated by this particular task. We suspect it predicts, to a certain extent, how motivated they might be in other contexts."

They compared testing data with brain scans of these patients, with and without administration of the dopamine-releasing drug amphetamine, which provides a reading of how much dopamine is normally released in different areas in the brain. [Inside the Brain: A Journey Through Time]

"You've got someone deciding, 'Do I want to work a bit more or a bit less? How do I factor in these odds?' Some people just went for it," Treadway said. The researchers found that these hardworking people had the most dopamine in two areas of the brain known to play an important role in reward and motivation, and low dopamine levels in the anterior insula, a region linked to motivation and risk perception.

These differences may mean that the choice between working hard and slacking off depend on how the brain weighs risk and reward, the researchers said. Some people are more wary about taking a risk and expending extra energy for an unlikely, but larger, reward. Other people concentrate more on the big reward they could get, and downplay the possible losses (of energy and time).

These findings could be important in getting a better grip on mental illnesses characterized by a lack of motivation, such as ADD, depression and schizophrenia, the researchers said. "Understanding some of these region-specific patterns may help us, at some point down the line, do a better job of predicting how patients may respond to different types of medication,"

"We think that part of what is going on in depression is some alteration in motivation pathways and part of the impetus for this study was working towards a model to be able to test the role of motivation in depression," Treadway said. "This may be a way to assess the motivational side of depression."

The study was published today (May 1) in the Journal of Neuroscience.

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Since the dawn of human art-making, the divide has been clear: There are people who can effortlessly sketch an object's likeness, and people who struggle for hours just to get the angles and proportions right (by which point the picture is scarred by eraser marks, anyway). What separates the drawers from the drawer-nots?

Ongoing research is revealing the answer to this longstanding question. It seems that realistic drawing ability hinges on three factors: how a person perceives reality, how well he or she remembers visual information from one moment to the next, and which elements of an object he or she selects to actually draw.

If you're stuck on stick figures, the good news, according to researchers at the University College London, is that people can improve at all these mental processes with practice.

First, people who can't draw well aren't seeing the world as it really is. When we look at an object, our visual systems automatically misjudge such attributes as size, shape and color; research over the past three years shows at least some of these misperceptions translate into drawing errors. Paradoxically, in other circumstances the misperceptions help us make sense of the world. For example, objects appear larger when they are closer than when they are far away. Even so, the visual system practices "size constancy" by perceiving the object as being approximately one size no matter how far away it is. The visual system, "knowing" a distant object is really bigger than it appears, sends false information to the brain about what the eyeball is seeing.

People who have the most trouble judging apparent size, shape, color and brightness may also be the worst at drawing, recent research by Justin Ostrofsky and his colleagues at Brooklyn College and the Graduate Center of the City University of New York suggests. Those who draw well are better able to override these visual misperceptions and perceive what their own eyeballs are really seeing. [ Red-Green & Blue-Yellow: The Stunning Colors You Can't See ]

However, inaccurately perceiving the image is only part of the story, said Rebecca Chamberlain, a psychologist at University College London. Chamberlain and her colleagues recently conducted experiments investigating the role of visual memory in the drawing process. They believe that drawing skill results in part from an ability to remember simple relationships in an object ― such as an angle between two lines ― from the moment the angle is perceived to the moment it is drawn. Additionally, "drawing seems to involve focusing on both holistic proportional relationships as well as focus on detail isolated from the whole. Perhaps it is the ability to switch between these two modes of seeing that underpins successful drawing," Chamberlain told Life's Little Mysteries.

Furthermore, as detailed in December in the journal Psychology of Aesthetics, Creativity, and the Arts, Ostrofsky and his colleagues found significant evidence that skilled artists are better at selecting which elements of an object need to be included to convey the object's form. And once the artists have selected an important element, they are better at focusing their attention on it and ignoring extraneous details nearby.

The devil is in the details, and the researchers are still working out the interplay between all the factors that affect drawing accuracy. However, they can all be learned. "There is no doubt that practice is an important component of being able to draw," Chamberlain said. While some may be predisposed to be better at perceptual accuracy and visual memory than others, "the rest of us use tricks to emulate this." [ 6 Fun Ways to Sharpen Your Memory ]

In research presented at a recent symposium at Columbia University and soon to be published by Columbia University Press, Chamberlain and her colleagues found practicing drawing significantly improved people's abilities over time, as rated by other people who participated in the study.

Based on their research, the psychologists recommended the following techniques for getting better at drawing: Focus on scaling a drawing to fit the size of the paper; anchor an object in its surroundings by showing how it sits in space; focus on the distance between elements of the object and on their relative sizes; and focus on the size and shape of "negative space," or the empty space between parts of the object. Lastly, they recommend thinking of "lines" as what they really are — boundaries between light and dark areas.

As Chris McManus, a member of the research team, noted, "There are few human skills which don't improve with practice."

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Jill, Ann, and Kimberly go off to college with warnings from their parents about sex and the “Freshman 15” ringing in their ears. Months later, Jill has gained 15 pounds and Ann has become a sexual adventurer. Kimberly, on the other hand, has not only maintained her weight, she's been too busy studying in the library stacks to hook up.

What accounts for the differences?

It could be the way each one’s brain reward center responds to food and sexual cues, reports a new study.

According to research out of Dartmouth College, in some people, hyperactivation of the nucleus accumbens, a key reward structure buried within the brain's striatum, predicted the eating and sexual behaviors of people (in this case, a group of freshmen women).

This suggests one’s ability to say “no” is not just a matter of willpower, but brain wiring.  

The study, published this week in the Journal of Neuroscience, used fMRI brain imaging and pictures depicting food, erotica, landscapes, and people to gauge how the test subjects' accumbens reacted to each stimulus. (The 48 women who completed the study had no idea what it was actually about.)

Six months later, the women returned to the lab where they were weighed and asked to fill out a questionnaire. Those whose accumbens reacted especially strongly to food cues had gained more weight. And those who reacted to sexual cues most strongly were more likely to have had sex and report stronger sexual desire.

Interestingly, their "appetites" did not cross over. The women with hyperactive responses to sex cues did not have a hyperactive response to food and vice versa.

Bill Kelley, associate professor of Dartmouth's department of psychological and brain sciences, says the study shows that the activation of one brain region proved to be a strong predictor of later behavior, demonstrating that the stronger the “liking” response to a stimulus, the less able we are to “hear” our rational brain saying “no.” 

But are we born this way, or do we acquire stronger craving for specific rewards?

“That’s a great question,” said Kathryn Demos, who led the study and is now an assistant professor of psychiatry and human behavior at Brown University.

Kelley thinks that since different women were tempted by different things, their brain wiring has developed through experience, aided by a genetic component.

Luckily, there are tools that can help people blunt the power of their brain wiring. Behavioral therapies, for example, have had some limited success in people who seem strongly stimulated by food. 

People can also try to replace various cravings with something more healthful, for instance, going for a run whenever they're tempted to eat a cheeseburger.

As for the findings, Demos says the idea that all people are equally capable of self-control is naïve.

Reward, she says, “is a very powerful system.”

Brian Alexander (www.BrianRAlexander.com) is co-author, with Larry Young PhD., of The Chemistry Between Us: Love Sex and the Science of Attraction, to be published September 13.

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“R.N.” was 57 when she came to see Paul McGeoch and V.S. Ramachandran at the Center for Brain and Cognition at the University of California San Diego. She had a constant burning sensation in her right hand.

But she hadn’t had a right hand for nearly 40 years, not since it had been amputated after an auto accident at age 18. And even before that, her right hand consisted of a normal-looking little finger, the bud of a thumb, and very short, immobile, ring and middle fingers. She had no index finger. Now, though, she was experiencing feeling in all five fingers, though they did not exist, and though her index finger had never existed because she’d been born with congenital phocomelia, a condition often linked to use of the drug thalidomide in pregnancy in the 1950s and 1960s, in which bones may be shortened or absent. 

Before the amputation, she did not have the phantom pain, nor did she experience the sensation of having five fingers. After the amputation, her brain filled in five fingers -- though her phantom index finger was about half the length of her normal left hand index finger -- and the pain.

She came to Ramachandran’s lab because he’s became famous for using a simple technique to trick the brain into seeing normal limbs where none exist as a way to ease phantom limb pain in amputees. Using mirrors, subjects see the reflection of their normal limb. The brain interprets the reflection as being that of the missing or damaged limb.

Because such patients often sense that their missing limb is trapped in an uncomfortable position from which it can’t escape, the pain persists. But with the mirror system, they appear to have control over the missing limb and can retrain their brain to believe it can move the phantom limb.

While the therapy has its doubters, McGeoch and Ramachandran reported that it worked on R.N. But what explains the appearance of R.N.’s phantom fingers where none existed in the first place?

Ramachandran sees the phenomenon in terms of nature and nurture. The nurture part refers to the way we perceive our own bodies. For example, he pointed out, people suffering from untreated leprosy can suffer the gradual loss of fingers, a whole hand, even part of a forearm. But they rarely experience phantom pain or sense a phantom limb, Ramachandran believes, because their brain has time to create a new brain map of their body. Amputees are faced with a sudden loss, and no map. So the brain fills in what was once there.  

This mapping of nurture, however, is laid down "on top of preexisting templates of body imagery," Ramachandran explained, created in utero as our brains were developing, following genetic instructions. He believes that map is permanent.

R.N. was born with this permanent map in her brain, he suggested. It was overridden by the one she created as she grew up with her malformed hand. When her hand was later amputated, however, the inhibition of the congenital map was removed, and it replaced the one she’d created through life.  

After two weeks of 30-minute daily training with the mirror apparatus, R.N. reported she’d gained more control over her phantom hand and fingers -- which now seemed almost completely normal -- and her pain was significantly reduced.

The case report is published in a recent issue of the journal Neurocase.

Brian Alexander is the author, with neuroscientist Larry Young, of "The Chemistry Between Us: Love, Sex and the Science of Attraction," coming in September. 

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