Scalpel. Forceps. Clamp…
Surgeons in Rochester, NY, asked a music teacher to play his saxophone while lying on an operating table during brain surgery to determine whether they had successfully avoided damaging his musical abilities while removing a tumor.
When the patient, Dan Fabbio, finished performing a two-minute long Korean folksong, the operating room burst into applause.
“They said I likely wouldn’t remember any of it,” Fabbio later told Seeker. “But I do remember being awake, and I do remember playing my saxophone. It was all kind of surreal.”
That musical moment was the culmination of an effort by the doctors working with a music theory professor to map out exactly which regions of Fabbio’s brain were involved in his musical abilities in order to navigate around them during surgery. They recently published a paper about their work in the journal Current Biology.
“He got out his saxophone, and lying there on his side he was able to play the piece,” Dr. Elizabeth Marvin, a professor of music theory at University of Rochester’s Eastman School of Music who was tapped brain surgeons to lend her expertise to the procedure, told Seeker. “It was one of the most amazing days of my professional life.”
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Fabbio, a substitute music teacher at a school in New Hartford, NY, was working on his master’s degree in music education in early 2015 when he began to feel dizzy and nauseous, and started to hallucinate.
“I was working in my office and all of a sudden I started seeing and hearing things that weren’t there,” Fabbio said. “The sounds were musical.”
Tests soon revealed the tumor in his head, which was benign and had likely been growing slowly since childhood. But the lump was located troublingly close to a brain region associated with musical functioning, suggesting that surgery could potentially have a dramatic impact on his professional and artistic life.
“I was very scared,” Fabbio said. “It was really hard to fathom losing my musical ability. I mean, it’s not something your really think about losing.”
Dr. Web Pilcher, a neurosurgeon with the University of Rochester, was tasked with removing the tumor. Pilcher and his colleague Dr. Brad Mahon, are collaborators in the university’s Translational Brain Mapping Program, which is dedicated to performing exactly the kind of operation Fabbio needed: locating the precise regions of the brain associated with specific activities to reduce the harm, and better predict the outcome, of brain surgery.
While cognitive processes typically take place in the same general areas across the population, the exact location of a given function may be differ slightly for each person.
“There can be a fair amount of variability among individuals,” Mahon said. “Your language region is more or less in the same place as mine, but they might be two centimeters apart.”
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Those two centimeters make an enormous difference when it comes to brain surgery.
Before operating on Fabbio, the doctors created an individualized map of the musical areas of his brain by placing him in an fMRI scanning machine while he hummed melodies. They checked those findings during surgery by zapping areas of his brain with an electrical stimulus that inhibited the functioning of the localized region.
The doctors would stimulate a given area and then ask Fabbio to repeat a melody and speak a sentence. Marvin, the music theory expert, was on hand in the operating room to judge whether he had reproduced the melody accurately. If his singing failed, or if he wobbled in his performance, then the doctors identified the region that they had stimulated as necessary for his music.
“We were able to definitively show that when the superior temporal gyrus in his right hemisphere was electrically stimulated, he was not able to perform the melody repetition task, but he was still able to repeat sentences,” Mahon said. “So that meant his inability to repeat the melodies wasn’t just because he was unable to repeat anything, but was really specific to music processing.”
Breaking out the saxophone to prove he could still play effectively after the tumor had been removed was the final test.
“He played flawlessly,” Mahon said. “It was a beautiful moment.”
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