The singing syndrome

They have pixie-like faces, a cheerful nature
and
a low IQ. But they sure can sing. ANNE McILROY delves
into the mysterious world of people with a rare genetic
disorder


By ANNE MCILROY


Saturday, January 11, 2003 – Toronto Globe and Mail
Lisa Walsh is preparing for a concert
in Montreal where she will sing a few jazz standards with
two of Duke Ellington's children. At 24, she has already
performed on stage in Los Angeles and Las Vegas and is
featured on a compact disc of hit tunes from musicals.
"I love to sing for people and I love
jazz," she says.
Ms. Walsh, a born performer, was also born with a rare
neurogenetic disorder called Williams syndrome. It has
given her a pixie-like face, starry eyes and an affinity
and talent for music. She has perfect pitch, can hear a
melody once and pick it out on the piano and can sing
pieces of classical music, such as Brahms's Requiem,by
heart.
But she can't add two plus two.
People with Williams syndrome have low IQs and trouble
reasoning. They also have poor spatial perception, which
makes it hard for them to tie their shoes or cross a
street safely. Most have to live with their parents or in
a group home.
They fascinate scientists because they are so talented
in some ways, so disabled in others. Many are musical, and
some, like Ms. Walsh, are gifted. New research, in which
she has participated, suggests that their brains are
actually wired differently when it comes to music. When
she sings Cry Me A River to a crowded concert hall
in June, a part of her brain that has nothing to do with
music in most people will be rippling with electrical and
chemical activity.
"Imagine opening up the hood of the car and finding all
the parts are doing things they weren't supposed to be
able to do," says Daniel Levitin, a professor at McGill
University in Montreal who does experiments on music and
the human mind.
Like many researchers, he is fascinated by Williams
syndrome, because it challenges our notions of
intelligence and because it offers a rare glimpse of the
role genes play in brain development, brain function and
human behaviour.
The syndrome is estimated to occur in one in 20,000
births, and has probably been around for centuries.
Afflicted children often have elfin features, including
small upturned noses, and some have a unique star patterns
in their irises. Their looks, cheerful and outgoing nature
and ability to make haunting and lyrical songs have led
some researchers to speculate that they were the original
pixies and "little people" in the folklore of different
cultures.
The syndrome was first identified 40 years ago, when J.
C. P. Williams, a heart specialist in New Zealand, noted
that a small group of his patients had distinct facial
features and similar cardiovascular problems and seemed to
be mentally retarded.
In the years that followed, doctors identified other
traits. Babies often have trouble digesting food and sleep
poorly, possibly because they are extremely sensitive to
noise. Children are slow to develop, are often short and
can wrinkle prematurely.
Doctors always suspected that it was genetic, and in
1993, the cause of the disorder was discovered. In 95 per
cent of cases, children born with Williams are missing a
tiny section of genetic material on one copy of chromosome
No. 7.
Every cell in our bodies, except for sperm and eggs,
has two copies of 23 chromosomes. In people with Williams
syndrome, one copy of No. 7 is perfect, but the other has
what is known as a micro-deletion. It means that they are
missing one copy of about 20 genes, including the gene for
elastin, the protein that gives skin and other organs
their elasticity and keeps blood vessels and arteries
flexible.
Recent research has shown that in the remaining 5 per
cent of people with Williams, that same section of
chromosome No. 7 is inverted, or flipped over, knocking
those genes out of operation.
Genes carry the directions for making proteins that
perform various crucial functions in the body. Because
they have only one copy of some genes, people with
Williams syndrome produce smaller amounts of some
proteins, which can have serious consequences in their
bodies. Their lack of elastin, for example, explains why
they suffer from heart problems and wrinkle prematurely.
Three of the genes they are missing have been generally
linked to the brain, although researchers don't know
exactly what they do. It seems likely that they don't make
enough of a protein crucial for the brain to develop or
function normally. That deficit has led to what
researchers call asymmetrical intelligence or fractionated
brain functioning. The people are disabled in some ways,
but normal or gifted in others.
People with Williams syndrome tend to have strong
verbal and social skills, and are good at recognizing
faces -- perfect cocktail party personalities. In some
cases, the people they meet don't realize at first that
there is anything different about them.
Their musicality has been documented only in recent
years. Howard Lenhoff, a professor emeritus of biological
sciences at the University of California, has a daughter
with Williams syndrome. He didn't notice Gloria's musical
talent until her bat mitzvah at the age of 13. He had
scheduled a private ceremony because he didn't think she
would be able to stand up and sing from the Bible in front
of a crowd. She performed flawlessly.
Dr. Lenhoff started wondering if other children like
Gloria might be musical, and conducted experiments that
revealed many were. Subsequent work by other researchers
showed that many people with Williams syndrome have
perfect pitch, love music more than the average person and
respond to it with great emotion.
"Music is my favourite way of thinking," one child once
told researchers.
Not all are musical. Some are deeply attracted to loud
noises, and love leaf blowers.
Others are like Gloria Lenhoff, now in her 40s, who can
sing 2,000 songs in 25 different languages and once
brought a Bosnian porter at the airport to tears by
singing him a song in his native tongue.
How does she do it?
There is some evidence that the actual physical
structure of the brain is different in people with
Williams syndrome. Autopsies have shown they have smaller
brains, and the upper back parts of the brain that deal
with spatial abilities are underdeveloped, says Albert
Galaburda, a neurology professor at Harvard University.
But parts of the brain known to be important to both
music and language have been found to be unusually large.
Dr. Galaburda's microscopic examinations have also found
larger cells in the part of the brain that processes
sound.
Dr. Levitin was building on Dr. Galaburda's work when
he decided to study how music is processed in the brains
of people with Williams syndrome. He used functional
Magnetic Resonance Imaging (fMRI), a new tool that allows
scientists to take pictures of living brains at work.
He compared people with Williams to a control group
without the disorder. The results were striking. Normal
people process music through intense activity in
well-defined network contained within a relatively small
region of the brain, but people with Williams recruit many
widely dispersed areas of the brain, calling on primitive
parts, such as the brain stem, and the amygdala, which is
tied to emotional responses.
"Their brains are wired differently," says Dr. Levitin,
who published his findings this week in the scientific
journal NeuroImage.
It is a rare glimpse of the role genes play in the
development of the brain, Dr. Levitin says. The picture is
still murky. It's not clear if the missing Williams
syndrome genes actually cause structural damage, and
whether the rewiring Dr. Levitin found was a response to
that damage.
There is some evidence that the human brain may be more
flexible, more adaptable than previously believed.
Research shows that people who have been profoundly deaf
from birth use the part of their brain that processes
sound for another purpose, Dr. Levitin says.
Ms. Walsh was one of the young adults who took part in
Dr. Levitin's brain-imaging experiment. Nancy Walsh,
Lisa's mother, was intrigued by the snapshot the results
have given her into the workings of her daughter's mind.
Her daughter was diagnosed with Williams syndrome when
she was a year old. By the time she was 3, she was
entranced by music, and could more easily pick up a song
off the television than talk. "The only toys she played
with were musical toys," her mother says. "It had to have
a musical element in it or she wasn't interested."
In school, she loved choir, and was never nervous about
performing. "In Grade 1, she was the little red hen in a
musical. And we were floored when she stepped up to the
stage and belted out that little red hen song."
When she was 14, she started going to a music camp in
Massachusetts that had been established by Dr. Lenhoff and
other parents of children with Williams syndrome. "She
found herself with that group of people, who had an
affinity for each other and for creating music," her
mother says.
Mrs. Walsh was inspired by Dr. Lenhoff and his daughter
Gloria, and decided that she and her husband would help
make music more important in Lisa's life. They found a
voice teacher for her, and she began performing in local
adult choirs.
After high school, Ms. Walsh attended Concordia
University's Centre for the Arts in Human Development,
which trains graduate students to use the arts as therapy
for the disabled. She starred in a musical it put on, and
her voice was so strong, so rich and vibrant, the centre
asked her to sing on a CD it produced.
The centre is organizing the June fundraising concert
at Montreal's Oscar Peterson Concert Hall where Ms. Walsh
will perform.
She now attends a special music school in Massachusetts
that was established to help children with Williams
syndrome take their musical skills to the next level, and
also to teach them how to live independently, how to tidy
their rooms and manage money.
There are two streams. One group of students is working
toward being an assistant to a music therapist, either at
a daycare centre or a seniors home. That wasn't
appropriate for Ms. Walsh. "If you asked to her take a
little old lady in a wheelchair somewhere, she might hit
the wall three times on her way," her mother says.
Instead, Ms. Walsh is perfecting her performing skills.
She and the other students in her group may start singing
in seniors homes. She sings with a Montreal classical
choir, and is in demand as a performer at fundraisers. She
brought down the house at the Beverly Hills Hilton and has
also sung at the Mirage Hotel in Las Vegas.
"It is amazing when you think about it. It is not like
a professional person doing this as her business, but it
is still amazing," Mrs. Walsh says.
Ms. Walsh says she sometimes gets nervous before she
goes on stage, but loves performing and seeing the
audience's reaction. "They listen to my music and they
think I do a good job."
Anne McIlroy writes on science for The Globe and
Mail.