Is "singing out of tune" a disease? I never expected that it really is...

Singing is really a very popular form of entertainment.

I wonder if there is that kind of person around you, who can make people forget the original singer's song as soon as they start singing, and can even drive people away.

The key is that I don’t know that I am out of tune, commonly known as “tone-deaf”, it’s so unpleasant but I’m so confident…

Is “singing out of tune” a disease?

Unfortunately, it really is...

Is “singing out of tune” a disease?

Just as language disorders are called "aphasia", there can also be disorders in the perception of music, which is medically known as "amusia".

Research on amusia-related lesions has a long history. As early as 1825, there were studies on differences in human music perception. It was not until 1890 that German doctor Knoblock established a cognitive model of music processing and defined amusia for the first time.

Later, more and more scholars began to study the field of amusia, and the physiological differences of people who sing out of tune gradually became clear.

Currently, academia believes that amusia is a type of aphasia, caused by abnormal development of functional areas related to the dominant hemisphere of the brain or secondary to other lesions.

There are three common causes of amusia: congenital amusia, acquired amusia, and pseudoamusia.

Congenital amusia is caused by congenital abnormalities in the development of functional areas of the brain.

Acquired amusia refers to some diseases that affect the brain's language center and music processing function area, such as brain inflammation, hemorrhage, trauma, infarction, tumor, etc.

"Pseudo" amusia may be due to sudden reversible causes of stress.

Does “Amusia” mean “tone-deafness”?

First of all, it needs to be made clear that among the people we usually call "tone-deaf", a considerable number of them have poor musical sense because they have not received orthodox music training. As long as they undergo professional practice, they can sing beautifully.

Amusia generally presents with the following symptoms:

Hearing, intelligence and memory are normal, but musical perception is extremely poor;

They are unable to sing accurately, but are often unaware of it, and may even think that they sing very well;

Poor understanding and memory of music and often feel confused;

At the same time, 30% of amusia patients may also have communication problems.

Therefore, "Amusia" is not completely equivalent to "tone-deafness".

What causes amusia?

After scanning the brains of amusics, some scholars found that about 50% of amusics have rhythm recognition disorders. The right hemisphere of the human brain is responsible for music, rhythm, imagination, color, etc. Many factors, including abnormal genetic factors, can lead to music perception disorders.

Studies have also shown that amusia is also related to the left cerebral hemisphere: when the anterior left temporal lobe is damaged, the patient's ability to recognize notes, sing and play, and even appreciate music may be partially or completely lost, which manifests as a car accident scene where "other people sing for money but I sing to my life."

Damage to different brain functional areas results in different manifestations of amusia:

1. Expressive amusia: Impairment of the ability to sing, whistle, and hum due to damage to the right frontal and temporal lobes;

2. Receptive amusia: Impairment of the ability to distinguish different melodies due to bilateral or unilateral (left or right) temporal and parietal lesions;

3. Amnesia Amusia: Impairment in the ability to recognize familiar melodies (the existence of this condition is still controversial)

4. Musical alexia: impairment of the ability to write music due to damage to the left occipital and temporal lobes;

5. Musical alexia with agraphia: impaired ability to read and write musical notation, due to damage to the left angular gyrus;

6. Musical agraphia: impaired ability to write musical notation, due to lesions near the left intraparietal sulcus;

7. Instrumental Amusia: Impairment of the ability to play a musical instrument during music training due to damage to different areas.

Why don’t people who are “out of tune” realize it themselves?

Some scholars have proposed that the key process of singing includes four processing steps: "pitch perception, sensorimotor conversion, vocal motor control and memory". Problems in any one of these links may lead to "tone-deafness".

Among them, the biggest and most common problem for patients with amusia is often perceptual disorder, that is, they are unable to accurately identify the differences in timbre, pitch, rhythm or dynamics, and are unable to realize whether they or others are singing in tune, whether the rhythm is consistent and harmonious, etc.

Even if they have heard a song many times, the melody will still be unfamiliar to them. Just as color blind people cannot distinguish colors with similar wavelengths, amusics cannot distinguish notes with similar pitches.

Is there any hope for those who sing out of tune?

A person with ordinary tone-deafness can sing beautifully with professional practice.

Patients with acquired amusia need early diagnosis and treatment.

People with pseudo-amusia can restore normal musicality after improving external factors.

As for patients with congenital amusia, after excluding organic diseases, just let nature take its course.

After all, the incidence of amusia among humans is as high as 4%. That is to say, apart from "tone-deafness" caused by various reasons, four out of every hundred people are never in tune. We are not fighting alone.

Expert of this article: Meng Yao, Doctor of Medicine, Shanghai Jiao Tong University School of Medicine