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The notion of a connection between autism and music is as old as the first reported cases of autism, and music has been used as a therapeutic tool for many decades. Music therapy holds promise as an intervention for individuals with autism, harnessing their strengths in music processing to enhance communication and expression. While previous randomized controlled trials have demonstrated positive outcomes in terms of global improvement and quality of life, their reliance on psychological outcomes restricts our understanding of underlying mechanisms. This paper introduces the protocol for the Music for Autism study, a randomized crossover trial designed to investigate the effects of a 12-week music therapy intervention on a range of psychometric, neuroimaging, and biological outcomes in school-aged children with autism. The protocol builds upon previous research and aims to both replicate and expand upon findings that demonstrated improvements in social communication and functional brain connectivity following a music intervention. The primary objective of this trial is to determine whether music therapy leads to improvements in social communication and functional brain connectivity as compared to play-based therapy. In addition, secondary aims include exploring various relevant psychometric, neuroimaging, and biological outcomes. To achieve these objectives, we will enroll 80 participants aged 6-12 years in this international, assessor-blinded, crossover randomized controlled trial. Each participant will be randomly assigned to receive either music therapy or play-based therapy for a period of 12 weeks, followed by a 12-week washout period, after which they will receive the alternate intervention. Assessments will be conducted four times, before and after each intervention period. The protocol of the Music for Autism trial provides a comprehensive framework for studying the effects of music therapy on a range of multidimensional outcomes in children with autism. The findings from this trial have the potential to contribute to the development of evidence-based interventions that leverage strengths in music processing to address the complex challenges faced by individuals with autism. Clinical Trial Registration : Clinicaltrials.gov identifier NCT04936048., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The author(s) declared that they were an editorial board member of Frontiers, at the time of submission. This had no impact on the peer review process and the final decision., (Copyright © 2023 Ruiz, Groessing, Guran, Koçan, Mikus, Nater, Kouwer, Posserud, Salomon-Gimmon, Todorova, Wagner, Gold, Silani and Specht.)

Longitudinal studies have become more common in the past years due to their superiority over cross-sectional samples. In light of the ongoing replication crisis, the factors that may introduce variability in resting-state networks have been widely debated. This publication aimed to address the potential sources of variability, namely, time of day, sex, and age, in longitudinal studies within individual resting-state fMRI data. DCM was used to analyze the fMRI time series, extracting EC connectivity measures and parameters that define the BOLD signal. In addition, a two-way ANOVA was used to assess the change in EC and parameters that define the BOLD signal between data collection waves. The results indicate that time of day and gender have significant model evidence for the parameters that define the BOLD signal but not EC. From the ANOVA analysis, findings indicate that there was a significant change in the two nodes of the DMN and their connections with the fronto-parietal network. Overall, these findings suggest that in addition to age and gender, which are commonly accounted for in the fMRI data collection, studies should note the time of day, possibly treating it as a covariate in longitudinal samples., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Vaisvilaite, Andersson, Salami and Specht.)

Our understanding of the cognitive functions of the human brain has tremendously benefited from the population functional Magnetic Resonance Imaging (fMRI) studies in the last three decades. The reliability and replicability of the fMRI results, however, have been recently questioned, which has been named the replication crisis. Sufficient statistical power is fundamental to alleviate the crisis, by either "going big," leveraging big datasets, or by "going small," densely scanning several participants. Here we reported a "going small" project implemented in our department, the Bergen breakfast scanning club (BBSC) project, in which three participants were intensively scanned across a year. It is expected this kind of new data collection method can provide novel insights into the variability of brain networks, facilitate research designs and inference, and ultimately lead to the improvement of the reliability of the fMRI results., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Wang, Korbmacher, Eikeland and Specht.)

The present study replicates a known visual language paradigm, and extends it to a paradigm that is independent from the sensory modality of the stimuli and, hence, could be administered either visually or aurally, such that both patients with limited sight or hearing could be examined. The stimuli were simple sentences, but required the subject not only to understand the content of the sentence but also to formulate a response that had a semantic relation to the content of the presented sentence. Thereby, this paradigm does not only test perception of the stimuli, but also to some extend sentence and semantic processing, and covert speech production within one task. When the sensory base-line condition was subtracted, both the auditory and visual version of the paradigm demonstrated a broadly overlapping and asymmetric network, comprising distinct areas of the left posterior temporal lobe, left inferior frontal areas, left precentral gyrus, and supplementary motor area. The consistency of activations and their asymmetry was evaluated with a conjunction analysis, probability maps, and intraclass correlation coefficients (ICC). This underlying network was further analyzed with dynamic causal modeling (DCM) to explore whether not only the same brain areas were involved, but also the network structure and information flow were the same between the sensory modalities. In conclusion, the paradigm reliably activated the most central parts of the speech and language network with a great consistency across subjects, and independently of whether the stimuli were administered aurally or visually. However, there was individual variability in the degree of functional asymmetry between the two sensory conditions., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Rødland, Melleby and Specht.)

Dichotic listening along with the right-ear advantage (REA) has been a standard method of investigating auditory laterality ever since it was first introduced into neuropsychology in the early 1960s. Beginning in the 1980s, authors reported that it was possible to modulate the bottom-up driven perceptual REA by instructing subjects to selectively attend to and report only from the right or left ear. In the present study, we investigated neuronal correlates of both the bottom-up and top-down modulation of the REA through two fMRI analysis approaches: a traditional region approach and a network connectivity approach. Blood-Oxygenation-Level-Dependent (BOLD) fMRI data were acquired while subjects performed the standard forced-attention paradigm. We asked two questions, could the behavioral REA be replicated in unique brain markers, and second if the profound instruction-induced modulation of the REA found in behavioral data would correspond to a similar modulation of brain activation, both region- and network-specific modulations. The subjects were 70 healthy adult right-handers, about half men and half women. fMRI data were acquired in a 3T MR scanner, and the behavioral results replicated previous findings with a REA in the non-forced (NF) and forced-right (FR) conditions, and a tendency for a left-ear advantage (LEA) in the FL-condition. The fMRI data showed unique activations in the speech perception areas of the left temporal lobe when directly contrasted with activations in the homologous right side. However, there were no remaining unique activations when the FR- and FL-conditions were contrasted against each other, and with the NF-condition, using a conservative significance thresholding. The fMRI results are conceptualized within a network connectivity frame of reference, especially with reference to the extrinsic mode network (EMN). The EMN is a generalized task-positive network that is upregulated whenever the task demands exceed a certain threshold irrespective of the specifics and demands of the task. This could explain the similarity of activations for the FR- and FL-conditions, despite the clear differences in behavior., Competing Interests: KH, LE, KS, and AC have shares in the NordicNeuroLab Inc. company that produced add-on equipment for the fMRI acquisition. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Kazimierczak, Craven, Ersland, Specht, Dumitru, Sandøy and Hugdahl.)

Auditory repetition suppression and omission activation are opposite neural phenomena and manifestations of principles of predictive processing. Repetition suppression describes the temporal decrease in neural activity when a stimulus is constant or repeated in an expected temporal fashion; omission activity is the transient increase in neural activity when a stimulus is temporarily and unexpectedly absent. The temporal, repetitive nature of musical rhythms is ideal for investigating these phenomena. During an fMRI session, 10 healthy participants underwent scanning while listening to musical rhythms with two levels of metric complexity, and with beat omissions with different positional complexity. Participants first listened to 16-s-long presentations of continuous rhythms, before listening to a longer continuous presentation with beat omissions quasi-randomly introduced. We found deactivation in bilateral superior temporal gyri during the repeated presentation of the normal, unaltered rhythmic stimulus, with more suppression of activity in the left hemisphere. Omission activation of bilateral middle temporal gyri was right lateralized. Persistent activity was found in areas including the supplementary motor area, caudate nucleus, anterior insula, frontal areas, and middle and posterior cingulate cortex, not overlapping with either listening, suppression, or omission activation. This suggests that the areas are perhaps specialized for working memory maintenance. We found no effect of metric complexity for either the normal presentation or omissions, but we found evidence for a small effect of omission position -at an uncorrected threshold-where omissions in the more metrical salient position, i.e., the first position in the bar, showed higher activation in anterior cingulate/medial superior frontal gyrus, compared to omissions in the less salient position, in line with the role of the anterior cingulate cortex for saliency detection. The results are consistent with findings in our previous studies on Parkinson's disease, but are put into a bigger theoretical frameset., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Færøvik, Specht and Vikene.)

Motion-sound synesthesia is characterized by illusory auditory sensations linked to the pattern and rhythms of motion (dubbed "Mickey Mousing" as in cinema) of visually experienced but soundless object, like an optical flow array, a ball bouncing or a horse galloping. In an MRI study with a group of three synesthetes and a group of eighteen control participants, we found structural changes in the brains of synesthetes in the subcortical multisensory areas of the superior and inferior colliculi. In addition, functional magnetic resonance imaging data showed activity in motion-sensitive regions, as well as temporal and occipital areas, and the cerebellum. However, the synesthetes had a higher activation within the left and right cuneus, with stronger activations when viewing optical flow stimuli. There was also a general difference in connectivity of the colliculi with the above mentioned regions between the two groups. These findings implicate low-level mechanisms within the human neuroaxis as a substrate for local connectivity and cross activity between perceptual processes that are "distant" in terms of cortical topography. The present findings underline the importance of considering the role of subcortical systems and their connectivity to multimodal regions of the cortex and they strengthen a parsimonious account of synesthesia, at the least of the visual-auditory type., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Laeng, Flaaten, Walle, Hochkeppler and Specht.)

Translational neuroscience is an important field that brings together clinical praxis with neuroscience methods. In this review article, the focus will be on functional neuroimaging (fMRI) and its applicability in clinical fMRI studies. In the light of the "replication crisis," three aspects will be critically discussed: First, the fMRI signal itself, second, current fMRI praxis, and, third, the next generation of analysis strategies. Current attempts such as resting-state fMRI, meta-analyses, and machine learning will be discussed with their advantages and potential pitfalls and disadvantages. One major concern is that the fMRI signal shows substantial within- and between-subject variability, which affects the reliability of both task-related, but in particularly resting-state fMRI studies. Furthermore, the lack of standardized acquisition and analysis methods hinders the further development of clinical relevant approaches. However, meta-analyses and machine-learning approaches may help to overcome current shortcomings in the methods by identifying new, and yet hidden relationships, and may help to build new models on disorder mechanisms. Furthermore, better control of parameters that may have an influence on the fMRI signal and that can easily be controlled for, like blood pressure, heart rate, diet, time of day, might improve reliability substantially., (Copyright © 2020 Specht.)

Damage to the orbitofrontal cortex (OFC) often occurs following a traumatic brain injury (TBI) and can lead to complex behavioral changes, including difficulty with attention and concentration. We investigated the effects of musical training on patients with behavioral and cognitive deficits following a mild traumatic brain injury (mTBI) and found significant functional neuro-plastic changes in the OFC's networks. The results from neuropsychological tests revealed an improved cognitive performance. Moreover, six out of seven participants in this group returned to work post intervention and reported improved well-being and social behavior. In this study, we explore the functional changes in OFC following music-supported intervention in reference to connecting networks that may be responsible for enhanced social interaction. Furthermore, we discuss the factor of dopamine release during playing as an element providing a possible impact on the results. The intervention consisted of playing piano, two sessions per week in 8 weeks, 30 min each time, with an instructor. Additional playing was required with a minimum of 15 min per day at home. Mean time playing piano in reference to participant's report was 3 h per week during the intervention period. Three groups participated, one mTBI group ( n = 7), two control groups consisting of healthy participants, one with music training ( n = 11), and one baseline group without music training ( n = 12). Participants in the clinical group had received standardized cognitive rehabilitation treatment during hospitalization without recovering from their impairments. The intervention took place 2 years post injury. All participants were assessed with neuropsychological tests and with both task and resting-state functional magnetic resonance imaging (fMRI) pre-post intervention. The results demonstrated a significant improvement of neuropsychological tests in the clinical group, consistent with fMRI results in which there were functional changes in the orbitofrontal networks (OFC). These changes were concordantly seen both in a simple task fMRI but also in resting-state fMRI, which was analyzed with dynamic causal modeling (DCM). We hypothesized that playing piano, as designed in the training protocol, may provide a positive increase in both well-being and social interaction. We suggest that the novelty of the intervention may have clinical relevance for patients with behavioral problems following a TBI.

Depression has been associated with changes in both functional and effective connectivity of large scale brain networks, including the default mode network, executive network, and salience network. However, studies of effective connectivity by means of spectral dynamic causal modeling (spDCM) are still rare and the interaction between the different resting state networks has not been investigated in detail. Thus, we aimed at exploring differences in effective connectivity among eight right hemisphere brain areas-anterior insula, inferior frontal gyrus, middle frontal gyrus (MFG), frontal eye field, anterior cingulate cortex, superior parietal lobe, amygdala, and hippocampus, between a group of healthy controls ( N  = 20) and medicated depressed patients ( N  = 20). We found that patients not only had significantly reduced strength of the connection from the anterior insula to the MFG (i.e., dorsolateral prefrontal cortex) but also a significant connection between the amygdala and the anterior insula. Moreover, depression severity correlated with connectivity of the hippocampal node. In conclusion, the results from this resting state spDCM study support and enrich previous data on the role of the right anterior insula in the pathophysiology of depression. Furthermore, our findings add to the growing evidence of an association between depression severity and disturbances of the hippocampal function in terms of impaired connectivity with other brain regions.

Music can trigger emotional responses in a more direct way than any other stimulus. In particular, music-evoked pleasure involves brain networks that are part of the reward system. Furthermore, rhythmic music stimulates the basal ganglia and may trigger involuntary movements to the beat. In the present study, we created a continuously playing rhythmic, dance floor-like composition where the ambient noise from the MR scanner was incorporated as an additional instrument of rhythm. By treating this continuous stimulation paradigm as a variant of resting-state, the data was analyzed with stochastic dynamic causal modeling (sDCM), which was used for exploring functional dependencies and interactions between core areas of auditory perception, rhythm processing, and reward processing. The sDCM model was a fully connected model with the following areas: auditory cortex, putamen/pallidum, and ventral striatum/nucleus accumbens of both hemispheres. The resulting estimated parameters were compared to ordinary resting-state data, without an additional continuous stimulation. Besides reduced connectivity within the basal ganglia, the results indicated a reduced functional connectivity of the reward system, namely the right ventral striatum/nucleus accumbens from and to the basal ganglia and auditory network while listening to rhythmic music. In addition, the right ventral striatum/nucleus accumbens demonstrated also a change in its hemodynamic parameter, reflecting an increased level of activation. These converging results may indicate that the dopaminergic reward system reduces its functional connectivity and relinquishing its constraints on other areas when we listen to rhythmic music.

This article explores the possibility of testing hypotheses about art production in the past by collecting data in the present. We call this enterprise "experimental art history". Why did medieval artists prefer to paint Christ with his face directed towards the beholder, while profane faces were noticeably more often painted in different degrees of profile? Is a preference for frontal faces motivated by deeper evolutionary and biological considerations? Head and gaze direction is a significant factor for detecting the intentions of others, and accurate detection of gaze direction depends on strong contrast between a dark iris and a bright sclera, a combination that is only found in humans among the primates. One uniquely human capacity is language acquisition, where the detection of shared or joint attention, for example through detection of gaze direction, contributes significantly to the ease of acquisition. The perceived face and gaze direction is also related to fundamental emotional reactions such as fear, aggression, empathy and sympathy. The fast-track modulator model presents a related fast and unconscious subcortical route that involves many central brain areas. Activity in this pathway mediates the affective valence of the stimulus. In particular, different sub-regions of the amygdala show specific activation as response to gaze direction, head orientation and the valence of facial expression. We present three experiments on the effects of face orientation and gaze direction on the judgments of social attributes. We observed that frontal faces with direct gaze were more highly associated with positive adjectives. Does this help to associate positive values to the Holy Face in a Western context? The formal result indicates that the Holy Face is perceived more positively than profiles with both direct and averted gaze. Two control studies, using a Brazilian and a Dutch database of photographs, showed a similar but weaker effect with a larger contrast between the gaze directions for profiles. Our findings indicate that many factors affect the impression of a face, and that eye contact in combination with face direction reinforce the general impression of portraits, rather than determine it.

In this paper we suggest the existence of a generalized task-related cortical network that is up-regulated whenever the task to be performed requires the allocation of generalized non-specific cognitive resources, independent of the specifics of the task to be performed. We have labeled this general purpose network, the extrinsic mode network (EMN) as complementary to the default mode network (DMN), such that the EMN is down-regulated during periods of task-absence, when the DMN is up-regulated, and vice versa. We conceptualize the EMN as a cortical network for extrinsic neuronal activity, similar to the DMN as being a cortical network for intrinsic neuronal activity. The EMN has essentially a fronto-temporo-parietal spatial distribution, including the inferior and middle frontal gyri, inferior parietal lobule, supplementary motor area, inferior temporal gyrus. We hypothesize that this network is always active regardless of the cognitive task being performed. We further suggest that failure of network up- and down-regulation dynamics may provide neuronal underpinnings for cognitive impairments seen in many mental disorders, such as, e.g., schizophrenia. We start by describing a common observation in functional imaging, the close overlap in fronto-parietal activations in healthy individuals to tasks that denote very different cognitive processes. We now suggest that this is because the brain utilizes the EMN network as a generalized response to tasks that exceeds a cognitive demand threshold and/or requires the processing of novel information. We further discuss how the EMN is related to the DMN, and how a network for extrinsic activity is related to a network for intrinsic activity. Finally, we discuss whether the EMN and DMN networks interact in a common single brain system, rather than being two separate and independent brain systems.

This fMRI study aimed to examine how differences in literacy processing demands may affect cortical activation patterns in 11- to 12-year-old children with dyslexia as compared to children with typical reading skills. Eleven children with and 18 without dyslexia were assessed using a reading paradigm based on different stages of literacy development. In the analyses, six regions showed an interaction effect between group and condition in a factorial ANOVA. These regions were selected as regions of interest (ROI) for further analyses. Overall, the dyslexia group showed cortical hyperactivation compared to the typical group. The difference between the groups tended to increase with increasing processing demands. Differences in cortical activation were not reflected in in-scanner reading performance. The six regions further grouped into three patterns, which are discussed in terms of processing demands, compensatory mechanisms, orthography and contextual facilitation. We conclude that the observed hyperactivation is chiefly a result of compensatory activity, modulated by other factors.

To differentiate between stop-consonants, the auditory system has to detect subtle place of articulation (PoA) and voice-onset time (VOT) differences between stop-consonants. How this differential processing is represented on the cortical level remains unclear. The present functional magnetic resonance (fMRI) study takes advantage of the superior spatial resolution and high sensitivity of ultra-high-field 7 T MRI. Subjects were attentively listening to consonant-vowel (CV) syllables with an alveolar or bilabial stop-consonant and either a short or long VOT. The results showed an overall bilateral activation pattern in the posterior temporal lobe during the processing of the CV syllables. This was however modulated strongest by PoA such that syllables with an alveolar stop-consonant showed stronger left lateralized activation. In addition, analysis of underlying functional and effective connectivity revealed an inhibitory effect of the left planum temporale (PT) onto the right auditory cortex (AC) during the processing of alveolar CV syllables. Furthermore, the connectivity result indicated also a directed information flow from the right to the left AC, and further to the left PT for all syllables. These results indicate that auditory speech perception relies on an interplay between the left and right ACs, with the left PT as modulator. Furthermore, the degree of functional asymmetry is determined by the acoustic properties of the CV syllables.

Recent models on speech perception propose a dual-stream processing network, with a dorsal stream, extending from the posterior temporal lobe of the left hemisphere through inferior parietal areas into the left inferior frontal gyrus, and a ventral stream that is assumed to originate in the primary auditory cortex in the upper posterior part of the temporal lobe and to extend toward the anterior part of the temporal lobe, where it may connect to the ventral part of the inferior frontal gyrus. This article describes and reviews the results from a series of complementary functional magnetic resonance imaging studies that aimed to trace the hierarchical processing network for speech comprehension within the left and right hemisphere with a particular focus on the temporal lobe and the ventral stream. As hypothesized, the results demonstrate a bilateral involvement of the temporal lobes in the processing of speech signals. However, an increasing leftward asymmetry was detected from auditory-phonetic to lexico-semantic processing and along the posterior-anterior axis, thus forming a "lateralization" gradient. This increasing leftward lateralization was particularly evident for the left superior temporal sulcus and more anterior parts of the temporal lobe.

Background: Impaired cognitive control in individuals with attention-deficit/hyperactivity disorder (ADHD) may be related to a prefrontal cortical glutamatergic deficit. We assessed the glutamate level in the left and the right midfrontal region including the anterior cingulate cortex in adults with ADHD and healthy controls., Methods: Twenty-nine adults with ADHD and 38 healthy controls were included. We used Proton Magnetic Resonance Imaging with single voxel point-resolved spectroscopy to measure the ratio of glutamate to creatine (Glu/Cre) in the left and the right midfrontal region in the two groups., Results: The ADHD group showed a significant reduction of Glu/Cre in the left midfrontal region compared to the controls., Conclusion: The reduction of Glu/Cre in the left midfrontal region in the ADHD group may reflect a glutamatergic deficit in prefrontal neuronal circuitry in adults with ADHD, resulting in problems with cognitive control.

In this article we review research in our laboratory on auditory hallucinations using behavioral and MRI measure. The review consists of both previously published and new data that for the first time is presented together in a cohesive way. Auditory hallucinations are among the most common symptoms in schizophrenia, affecting more than 70% of the patients. We here advance the hypothesis that auditory hallucinations are internally generated speech perceptions that are lateralized to the left temporal lobe, in the peri-Sylvian region. From this we predict that hallucinating patients should have problems identifying a simultaneously presented external speech sound, as measured through performance on the dichotic listening (DL) paradigm with consonant-vowel syllables, since this technique lateralizes the stimulus input. Across a series of behavioral experiments, we have shown that patients with schizophrenia who experience frequent auditory hallucinations fail to demonstrate an expected right ear advantage on the dichotic listening test. Absence of a right ear advantage is indicative of a functional deficit in the left peri-Sylvian region. The results also revealed that patients with ongoing auditory hallucinations were more impaired than patients with previous hallucinations, and that a higher score on the hallucination item in a standard symptom rating scale (BPRS) correlated negatively with number of correct reports for the right ear stimulus. Moreover, we have found that schizophrenia patients fail to shift attention to the left ear stimulus, when explicitly instructed to focus on the right or left ear stimulus only, thus showing a deficit in inhibition of attention and response-inhibition. The behavioral DL data are substantiated in two MR morphometry studies that revealed significant reductions in grey matter density in the left peri-Sylvian region in hallucinating patients, and patients with reduced left temporal lobe grey matter density. Hallucinating patients also failed to show a right ear advantage in the dichotic listening test. Ongoing fMRI studies are focused on the underlying synaptic and molecular mechanisms by investigating the effects of the glutamate antagonist drug memantine on auditory perception and speech lateralization, and examination of temporal cortex-specific gene expression in the left peri-Sylvian region.