Patient becomes virtuoso sax player amid frontotemporal dementia progression

South Korean researchers have just revealed details of an usual case which offers new insights into frontotemporal dementia (FTD).

Writing in the latest issue of the journal Neurocase, Dr Hanna Cho and her colleagues relate the story of a patient who, with no prior musical training, learned to play the saxophone after being diagnosed with a behavioural variant of FTD. 

In fact, over three years of daily practise in the face of otherwise "progressive cognitive decline and overall apathy", the patient mastered 10 Korean folk songs so well that he outshone the others in his class without a cognitive impairment.

The case of the middle-aged man known only as 'J.K.' is significant because while some patients with FTD experience "an artistic enhancement" of their existing visual or musical abilities, there has been no record to date of anyone learning to play an instrument after diagnosis.  

The researchers put forward three possible explanations for 'J.K''s unusual skill, mostly to do with the sparing by FTD of particular abilities or parts of his brain, in particular his basal ganglia and cerebellum (preserving his procedural, non-declarative forms of memory and basic motor skills), his visuo-constructive abilities (allowing him to sight-read and play music) and his right hemisphere (where 'asymmetric hemisphere degeneration' might have predisposed him to develop artistic talents. 

But whatever the reason for the patient's virtuoso saxophone playing, this study and the medical observations, case notes and images detailed within it pose interesting questions – and perhaps some answers – for dementia research.  It also has intriguing implications for the use of music therapy and music-based cognitive rehabilitation in FTD patients.