Jean Langlais: Aphasia without Amusia

Fisher, C., & Larner, A. (2008). Jean Langlais (1907–91): an historical case of a blind organist with stroke-induced aphasia and Braille alexia but without amusia. Journal of Medical Biography, 16 (4), 232-234. Retrieved from http://jmb.rsmjournals.com.myaccess.library.utoronto.ca/content/16/4/232.full.pdf+html

 Summary            

This article reports a case of aphasia without amusia.  It tells the story of Jean Langlais, a blind organist who suffered from aphasia and Braille alexia, after his stroke in 1984 at the age of 77. 

                Jean Langlais lost his sight between age 2 and 3.  He learned to read Braille at age 10, including Braille for music which uses some of the same patterns as Braille for language.  In other words, the same pattern in Braille, depending on the context, may represent letters or musical notation.  Jean Langlais was a very accomplished musician.  He was a celebrated recitalist, composer, and noted improviser who won first prize at the Conservatory in Paris in 1930.  One of his signature compositional techniques is his use of name motifs in which names and even sentences become a musical theme. 

                His stroke at the age of 77 affected Wernicke’s area in particular, causing him to be diagnosed with Wernicke-like aphasia.  After his stroke, comprehension of simple questions, orders and familiar voices was still intact, but understanding more complex orders and speaking letter names was impossible.   He could, however, sing the letter names.  Jean Langlais was diagnosed with Braille agraphia which means he had extensive difficulty writing and spelling.  Interestingly, all his musical abilities seemed to still be intact.  He could still sing a melody, execute scales and modulations, and he could still both decode and play from musical Braille notation and compose music in Braille, often still incorporating name motifs in post-stroke pieces.  From this evidence, the author draws the conclusion that the functional and anatomical mental processes of language and music must be independent.

Response

                I find it interesting that there is such an overlap between notation for music and language in Braille.  Both this overlap and Jean Langlais’ interest in name motifs would seem to indicate a strong connection between music and language notation in Langlais’ everyday life.  Therefore, it is surprising to me that he would lose so much ability in speech and language and still retain such strong abilities in composition and musical perception.  However, Aniruddh D. Patel, who wrote the book Music, Language, and the Brain (2008), points out that musicians’ brains are actually quite different from those of non-musicians.  Therefore, it does not necessarily work to make a generalized statement about music and language processing since these processes probably relate differently for musicians and non-musicians.  Patel also states that all reported cases of aphasia without amusia have been in musicians.  It would be interesting to study aphasia in non-musicians to see if there is any decrease in ability to process music for these individuals.  Since music activates so many different areas of the brain, it is more likely that a musician, following damage to a specific area of the brain, would still retain the ability to process music, even if language and music processing abilities are somehow connected in the brain.