Advances and Applications of Polygenic Scores for Coronary Artery Disease.

Polygenic scores quantify inherited risk by integrating information from many common sites of DNA variation into a single number. Rapid increases in the scale of genetic association studies and new statistical algorithms have enabled development of polygenic scores that meaningfully measure-as early as birth-risk of coronary artery disease. These newer-generation polygenic scores identify up to 8% of the population with triple the normal risk based on genetic variation alone, and these individuals cannot be identified on the basis of family history or clinical risk factors alone. For those identified with increased genetic risk, evidence supports risk reduction with at least two interventions, adherence to a healthy lifestyle and cholesterol-lowering therapies, that can substantially reduce risk. Alongside considerable enthusiasm for the potential of polygenic risk estimation to enable a new era of preventive clinical medicine is recognition of a need for ongoing research into how best to ensure equitable performance across diverse ancestries, how and in whom to assess the scores in clinical practice, as well as randomized trials to confirm clinical utility.

Vocal learning and flexible rhythm pattern perception are linked: Evidence from songbirds.

Rhythm perception is fundamental to speech and music. Humans readily recognize a rhythmic pattern, such as that of a familiar song, independently of the tempo at which it occurs. This shows that our perception of auditory rhythms is flexible, relying on global relational patterns more than on the absolute durations of specific time intervals. Given that auditory rhythm perception in humans engages a complex auditory-motor cortical network even in the absence of movement and that the evolution of vocal learning is accompanied by strengthening of forebrain auditory-motor pathways, we hypothesize that vocal learning species share our perceptual facility for relational rhythm processing. We test this by asking whether the best-studied animal model for vocal learning, the zebra finch, can recognize a fundamental rhythmic pattern-equal timing between event onsets (isochrony)-based on temporal relations between intervals rather than on absolute durations. Prior work suggests that vocal nonlearners (pigeons and rats) are quite limited in this regard and are biased to attend to absolute durations when listening to rhythmic sequences. In contrast, using naturalistic sounds at multiple stimulus rates, we show that male zebra finches robustly recognize isochrony independent of absolute time intervals, even at rates distant from those used in training. Our findings highlight the importance of comparative studies of rhythmic processing and suggest that vocal learning species are promising animal models for key aspects of human rhythm perception. Such models are needed to understand the neural mechanisms behind the positive effect of rhythm on certain speech and movement disorders.

Genetic, sociodemographic, lifestyle, and clinical risk factors of recurrent coronary artery disease events: a population-based cohort study.

AIMS: Complications of coronary artery disease (CAD) represent the leading cause of death among adults globally. This study examined the associations and clinical utilities of genetic, sociodemographic, lifestyle, and clinical risk factors on CAD recurrence. METHODS AND RESULTS: Data were from 7024 UK Biobank middle-aged adults with established CAD at enrolment. Cox proportional hazards regressions modelled associations of age at enrolment, age at first CAD diagnosis, sex, cigarette smoking, physical activity, diet, sleep, Townsend Deprivation Index, body mass index, blood pressure, blood lipids, glucose, lipoprotein(a), C reactive protein, estimated glomerular filtration rate (eGFR), statin prescription, and CAD polygenic risk score (PRS) with first post-enrolment CAD recurrence. Over a median [interquartile range] follow-up of 11.6 [7.2-12.7] years, 2003 (28.5%) recurrent CAD events occurred. The hazard ratio (95% confidence interval [CI]) for CAD recurrence was the most pronounced with current smoking (1.35, 1.13-1.61) and per standard deviation increase in age at first CAD (0.74, 0.67-0.82). Additionally, age at enrolment, CAD PRS, C-reactive protein, lipoprotein(a), glucose, low-density lipoprotein cholesterol, deprivation, sleep quality, eGFR, and high-density lipoprotein (HDL) cholesterol also significantly associated with recurrence risk. Based on C indices (95% CI), the strongest predictors were CAD PRS (0.58, 0.57-0.59), HDL cholesterol (0.57, 0.57-0.58), and age at initial CAD event (0.57, 0.56-0.57). In addition to traditional risk factors, a comprehensive model improved the C index from 0.644 (0.632-0.654) to 0.676 (0.667-0.686). CONCLUSION: Sociodemographic, clinical, and laboratory factors are each associated with CAD recurrence with genetic risk, age at first CAD event, and HDL cholesterol concentration explaining the most.

Music and Brain Circuitry: Strategies for Strengthening Evidence-Based Research for Music-Based Interventions.

The neuroscience of music and music-based interventions (MBIs) is a fascinating but challenging research field. While music is a ubiquitous component of every human society, MBIs may encompass listening to music, performing music, music-based movement, undergoing music education and training, or receiving treatment from music therapists. Unraveling the brain circuits activated and influenced by MBIs may help us gain better understanding of the therapeutic and educational values of MBIs by gathering strong research evidence. However, the complexity and variety of MBIs impose unique research challenges. This article reviews the recent endeavor led by the National Institutes of Health to support evidence-based research of MBIs and their impact on health and diseases. It also highlights fundamental challenges and strategies of MBI research with emphases on the utilization of animal models, human brain imaging and stimulation technologies, behavior and motion capturing tools, and computational approaches. It concludes with suggestions of basic requirements when studying MBIs and promising future directions to further strengthen evidence-based research on MBIs in connections with brain circuitry.SIGNIFICANCE STATEMENT Music and music-based interventions (MBI) engage a wide range of brain circuits and hold promising therapeutic potentials for a variety of health conditions. Comparative studies using animal models have helped in uncovering brain circuit activities involved in rhythm perception, while human imaging, brain stimulation, and motion capture technologies have enabled neural circuit analysis underlying the effects of MBIs on motor, affective/reward, and cognitive function. Combining computational analysis, such as prediction method, with mechanistic studies in animal models and humans may unravel the complexity of MBIs and their effects on health and disease.

Quantifying and Understanding the Higher Risk of Atherosclerotic Cardiovascular Disease Among South Asian Individuals: Results From the UK Biobank Prospective Cohort Study.

BACKGROUND: Individuals of South Asian ancestry represent 23% of the global population, corresponding to 1.8 billion people, and have substantially higher risk of atherosclerotic cardiovascular disease compared with most other ethnicities. US practice guidelines now recognize South Asian ancestry as an important risk-enhancing factor. The magnitude of enhanced risk within the context of contemporary clinical care, the extent to which it is captured by existing risk estimators, and its potential mechanisms warrant additional study. METHODS: Within the UK Biobank prospective cohort study, 8124 middle-aged participants of South Asian ancestry and 449 349 participants of European ancestry who were free of atherosclerotic cardiovascular disease at the time of enrollment were examined. The relationship of ancestry to risk of incident atherosclerotic cardiovascular disease-defined as myocardial infarction, coronary revascularization, or ischemic stroke-was assessed with Cox proportional hazards regression, along with examination of a broad range of clinical, anthropometric, and lifestyle mediators. RESULTS: The mean age at study enrollment was 57 years, and 202 405 (44%) were male. Over a median follow-up of 11 years, 554 of 8124 (6.8%) individuals of South Asian ancestry experienced an atherosclerotic cardiovascular disease event compared with 19 756 of 449 349 (4.4%) individuals of European ancestry, corresponding to an adjusted hazard ratio of 2.03 (95% CI, 1.86-2.22; P<0.001). This higher relative risk was largely consistent across a range of age, sex, and clinical subgroups. Despite the >2-fold higher observed risk, the predicted 10-year risk of cardiovascular disease according to the American Heart Association/American College of Cardiology Pooled Cohort equations and QRISK3 equations was nearly identical for individuals of South Asian and European ancestry. Adjustment for a broad range of clinical, anthropometric, and lifestyle risk factors led to only modest attenuation of the observed hazard ratio to 1.45 (95% CI, 1.28-1.65, P<0.001). Assessment of variance explained by 18 candidate risk factors suggested greater importance of hypertension, diabetes, and central adiposity in South Asian individuals. CONCLUSIONS: Within a large prospective study, South Asian individuals had substantially higher risk of atherosclerotic cardiovascular disease compared with individuals of European ancestry, and this risk was not captured by the Pooled Cohort Equations.

Lp(a) (Lipoprotein[a]) Concentrations and Incident Atherosclerotic Cardiovascular Disease: New Insights From a Large National Biobank.

OBJECTIVE: Lp(a) (lipoprotein[a]) concentrations are associated with atherosclerotic cardiovascular disease (ASCVD), and new therapies that enable potent and specific reduction are in development. In the largest study conducted to date, we address 3 areas of uncertainty: (1) the magnitude and shape of ASCVD risk conferred across the distribution of lipoprotein(a) concentrations; (2) variation of risk across racial and clinical subgroups; (3) clinical importance of a high lipoprotein(a) threshold to guide therapy. Approach and Results: Relationship of lipoprotein(a) to incident ASCVD was studied in 460 506 middle-aged UK Biobank participants. Over a median follow-up of 11.2 years, incident ASCVD occurred in 22 401 (4.9%) participants. Median lipoprotein(a) concentration was 19.6 nmol/L (25th-75th percentile 7.6-74.8). The relationship between lipoprotein(a) and ASCVD appeared linear across the distribution, with a hazard ratio of 1.11 (95% CI, 1.10-1.12) per 50 nmol/L increment. Substantial differences in concentrations were noted according to race-median values for white, South Asian, black, and Chinese individuals were 19, 31, 75, and 16 nmol/L, respectively. However, risk per 50 nmol/L appeared similar-hazard ratios of 1.11, 1.10, and 1.07 for white, South Asian, and black individuals, respectively. A high lipoprotein(a) concentration defined as ≥150 nmol/L was present in 12.2% of those without and 20.3% of those with preexisting ASCVD and associated with hazard ratios of 1.50 (95% CI, 1.44-1.56) and 1.16 (95% CI, 1.05-1.27), respectively. CONCLUSIONS: Lipoprotein(a) concentrations predict incident ASCVD among middle-aged adults within primary and secondary prevention contexts, with a linear risk gradient across the distribution. Concentrations are variable across racial subgroups, but the associated risk appears similar.

Mapping Specific Mental Content during Musical Imagery.

Humans can mentally represent auditory information without an external stimulus, but the specificity of these internal representations remains unclear. Here, we asked how similar the temporally unfolding neural representations of imagined music are compared to those during the original perceived experience. We also tested whether rhythmic motion can influence the neural representation of music during imagery as during perception. Participants first memorized six 1-min-long instrumental musical pieces with high accuracy. Functional MRI data were collected during: 1) silent imagery of melodies to the beat of a visual metronome; 2) same but while tapping to the beat; and 3) passive listening. During imagery, inter-subject correlation analysis showed that melody-specific temporal response patterns were reinstated in right associative auditory cortices. When tapping accompanied imagery, the melody-specific neural patterns were reinstated in more extensive temporal-lobe regions bilaterally. These results indicate that the specific contents of conscious experience are encoded similarly during imagery and perception in the dynamic activity of auditory cortices. Furthermore, rhythmic motion can enhance the reinstatement of neural patterns associated with the experience of complex sounds, in keeping with models of motor to sensory influences in auditory processing.

Musical and linguistic syntactic processing in agrammatic aphasia: An ERP study.

Language and music rely on complex sequences organized according to syntactic principles that are implicitly understood by enculturated listeners. Across both domains, syntactic processing involves predicting and integrating incoming elements into higher-order structures. According to the Shared Syntactic Integration Resource Hypothesis (SSIRH; Patel, 2003), musical and linguistic syntactic processing rely on shared resources for integrating incoming elements (e.g., chords, words) into unfolding sequences. One prediction of the SSIRH is that people with agrammatic aphasia (whose deficits are due to syntactic integration problems) should present with deficits in processing musical syntax. We report the first neural study to test this prediction: event-related potentials (ERPs) were measured in response to musical and linguistic syntactic violations in a group of people with agrammatic aphasia (n=7) compared to a group of healthy controls (n=14) using an acceptability judgement task. The groups were matched with respect to age, education, and extent of musical training. Violations were based on morpho-syntactic relations in sentences and harmonic relations in chord sequences. Both groups presented with a significant P600 response to syntactic violations across both domains. The aphasic participants presented with a reduced-amplitude posterior P600 compared to the healthy adults in response to linguistic, but not musical, violations. Participants with aphasia did however present with larger frontal positivities in response to violations in both domains. Intriguingly, extent of musical training was associated with larger posterior P600 responses to syntactic violations of language and music in both groups. Overall, these findings are not consistent with the predictions of the SSIRH, and instead suggest that linguistic, but not musical, syntactic processing may be selectively impaired in stroke-induced agrammatic aphasia. However, the findings also suggest a relationship between musical training and linguistic syntactic processing, which may have clinical implications for people with aphasia, and motivates more research on the relationship between these two domains.

Where they sing solo: Accounting for cross-cultural variation in collective music-making in theories of music evolution.

Collective, synchronous music-making is far from ubiquitous across traditional, small-scale societies. We describe societies that lack collective music and offer hypotheses to help explain this cultural variation. Without identifying the factors that explain variation in collective music-making across these societies, theories of music evolution based on social bonding (Savage et al.) or coalition signaling (Mehr et al.) remain incomplete.

Memory in time: Neural tracking of low-frequency rhythm dynamically modulates memory formation.

Time is a critical component of episodic memory. Yet it is currently unclear how different types of temporal signals are represented in the brain and how these temporal signals support episodic memory. The current study investigated whether temporal cues provided by low-frequency environmental rhythms influence memory formation. Specifically, we tested the hypothesis that neural tracking of low-frequency rhythm serves as a mechanism of selective attention that dynamically biases the encoding of visual information at specific moments in time. Participants incidentally encoded a series of visual objects while passively listening to background, instrumental music with a steady beat. Objects either appeared in-synchrony or out-of-synchrony with the background beat. Participants were then given a surprise subsequent memory test (in silence). Results revealed significant neural tracking of the musical beat at encoding, evident in increased electrophysiological power and inter-trial phase coherence at the perceived beat frequency (1.25 â€‹Hz). Importantly, enhanced neural tracking of the background rhythm at encoding was associated with superior subsequent memory for in-synchrony compared to out-of-synchrony objects at test. Together, these results provide novel evidence that the brain spontaneously tracks low-frequency musical rhythm during naturalistic listening situations, and that the strength of this neural tracking is associated with the effects of rhythm on higher-order cognitive processes such as episodic memory.

Race, socioeconomic deprivation, and hospitalization for COVID-19 in English participants of a national biobank.

Preliminary reports suggest that the Coronavirus Disease 2019 (COVID- 19) pandemic has led to disproportionate morbidity and mortality among historically disadvantaged populations. We investigate the racial and socioeconomic associations of COVID- 19 hospitalization among 418,794 participants of the UK Biobank, of whom 549 (0.13%) had been hospitalized. Both Black participants (odds ratio 3.7; 95%CI 2.5-5.3) and Asian participants (odds ratio 2.2; 95%CI 1.5-3.2) were at substantially increased risk as compared to White participants. We further observed a striking gradient in COVID- 19 hospitalization rates according to the Townsend Deprivation Index - a composite measure of socioeconomic deprivation - and household income. Adjusting for socioeconomic factors and cardiorespiratory comorbidities led to only modest attenuation of the increased risk in Black participants, adjusted odds ratio 2.4 (95%CI 1.5-3.7). These observations confirm and extend earlier preliminary and lay press reports of higher morbidity in non-White individuals in the context of a large population of participants in a national biobank. The extent to which this increased risk relates to variation in pre-existing comorbidities, differences in testing or hospitalization patterns, or additional disparities in social determinants of health warrants further study.

Songbirds use spectral shape, not pitch, for sound pattern recognition.

Humans easily recognize "transposed" musical melodies shifted up or down in log frequency. Surprisingly, songbirds seem to lack this capacity, although they can learn to recognize human melodies and use complex acoustic sequences for communication. Decades of research have led to the widespread belief that songbirds, unlike humans, are strongly biased to use absolute pitch (AP) in melody recognition. This work relies almost exclusively on acoustically simple stimuli that may belie sensitivities to more complex spectral features. Here, we investigate melody recognition in a species of songbird, the European Starling (Sturnus vulgaris), using tone sequences that vary in both pitch and timbre. We find that small manipulations altering either pitch or timbre independently can drive melody recognition to chance, suggesting that both percepts are poor descriptors of the perceptual cues used by birds for this task. Instead we show that melody recognition can generalize even in the absence of pitch, as long as the spectral shapes of the constituent tones are preserved. These results challenge conventional views regarding the use of pitch cues in nonhuman auditory sequence recognition.

Infants born preterm, stress, and neurodevelopment in the neonatal intensive care unit: might music have an impact?

AIM: The neonatal intensive care unit (NICU) provides life-saving medical care for an increasing number of newborn infants each year. NICU care, while lifesaving, does have attendant consequences which can include repeated activation of the stress response and reduced maternal interaction, with possible negative long-term impacts on brain development. Here we present a neuroscientific framework for considering the impact of music on neurodevelopment in the NICU of infants born preterm and evaluate current literature on the use of music with this population to determine what is most reliably known of the physiological effects of music interventions. METHOD: Using online academic databases we collected relevant, experimental studies aimed at determining effects of music listening in infants in the NICU. These articles were evaluated for methodological rigor, ranking the 10 most experimentally stringent as a representative sample. RESULTS: The selected literature seems to indicate that effects are present on the cardio-pulmonary system and behavior of neonates, although the relative effect size remains unclear. INTERPRETATION: These findings indicate a need for more standardized longitudinal studies aimed at determining not only whether NICU music exposure has beneficial effects on the cardio-pulmonary system, but also on the hypothalamic-pituitary-adrenal axis, brain structures, and cognitive behavioral status of these children as well. WHAT THIS PAPER ADDS: Provides a neuroscience framework for considering how music might attenuate stress in neonatal intensive care unit (NICU) infants. Considers how repeated stress may cause negative neurodevelopmental impacts in infants born preterm. Posits epigenetics can serve as a mechanistic pathway for music moderating the stress response.

Relationships between early literacy and nonlinguistic rhythmic processes in kindergarteners.

A growing number of studies report links between nonlinguistic rhythmic abilities and certain linguistic abilities, particularly phonological skills. The current study investigated the relationship between nonlinguistic rhythmic processing, phonological abilities, and early literacy abilities in kindergarteners. A distinctive aspect of the current work was the exploration of whether processing of different types of rhythmic patterns is differentially related to kindergarteners' phonological and reading-related abilities. Specifically, we examined the processing of metrical versus nonmetrical rhythmic patterns, that is, patterns capable of being subdivided into equal temporal intervals or not (Povel & Essens, 1985). This is an important comparison because most music involves metrical sequences, in which rhythm often has an underlying temporal grid of isochronous units. In contrast, nonmetrical sequences are arguably more typical to speech rhythm, which is temporally structured but does not involve an underlying grid of equal temporal units. A rhythm discrimination app with metrical and nonmetrical patterns was administered to 74 kindergarteners in conjunction with cognitive and preliteracy measures. Findings support a relationship among rhythm perception, phonological awareness, and letter-sound knowledge (an essential precursor of reading). A mediation analysis revealed that the association between rhythm perception and letter-sound knowledge is mediated through phonological awareness. Furthermore, metrical perception accounted for unique variance in letter-sound knowledge above all other language and cognitive measures. These results point to a unique role for temporal regularity processing in the association between musical rhythm and literacy in young children.

Association of low-frequency and rare coding-sequence variants with blood lipids and coronary heart disease in 56,000 whites and blacks.

Low-frequency coding DNA sequence variants in the proprotein convertase subtilisin/kexin type 9 gene (PCSK9) lower plasma low-density lipoprotein cholesterol (LDL-C), protect against risk of coronary heart disease (CHD), and have prompted the development of a new class of therapeutics. It is uncertain whether the PCSK9 example represents a paradigm or an isolated exception. We used the "Exome Array" to genotype >200,000 low-frequency and rare coding sequence variants across the genome in 56,538 individuals (42,208 European ancestry [EA] and 14,330 African ancestry [AA]) and tested these variants for association with LDL-C, high-density lipoprotein cholesterol (HDL-C), and triglycerides. Although we did not identify new genes associated with LDL-C, we did identify four low-frequency (frequencies between 0.1% and 2%) variants (ANGPTL8 rs145464906 [c.361C>T; p.Gln121*], PAFAH1B2 rs186808413 [c.482C>T; p.Ser161Leu], COL18A1 rs114139997 [c.331G>A; p.Gly111Arg], and PCSK7 rs142953140 [c.1511G>A; p.Arg504His]) with large effects on HDL-C and/or triglycerides. None of these four variants was associated with risk for CHD, suggesting that examples of low-frequency coding variants with robust effects on both lipids and CHD will be limited.

The evolutionary biology of musical rhythm: was Darwin wrong?

In The Descent of Man, Darwin speculated that our capacity for musical rhythm reflects basic aspects of brain function broadly shared among animals. Although this remains an appealing idea, it is being challenged by modern cross-species research. This research hints that our capacity to synchronize to a beat, i.e., to move in time with a perceived pulse in a manner that is predictive and flexible across a broad range of tempi, may be shared by only a few other species. Is this really the case? If so, it would have important implications for our understanding of the evolution of human musicality.

The motor origins of human and avian song structure.

Human song exhibits great structural diversity, yet certain aspects of melodic shape (how pitch is patterned over time) are widespread. These include a predominance of arch-shaped and descending melodic contours in musical phrases, a tendency for phrase-final notes to be relatively long, and a bias toward small pitch movements between adjacent notes in a melody [Huron D (2006) Sweet Anticipation: Music and the Psychology of Expectation (MIT Press, Cambridge, MA)]. What is the origin of these features? We hypothesize that they stem from motor constraints on song production (i.e., the energetic efficiency of their underlying motor actions) rather than being innately specified. One prediction of this hypothesis is that any animals subject to similar motor constraints on song will exhibit similar melodic shapes, no matter how distantly related those animals are to humans. Conversely, animals who do not share similar motor constraints on song will not exhibit convergent melodic shapes. Birds provide an ideal case for testing these predictions, because their peripheral mechanisms of song production have both notable similarities and differences from human vocal mechanisms [Riede T, Goller F (2010) Brain Lang 115:69-80]. We use these similarities and differences to make specific predictions about shared and distinct features of human and avian song structure and find that these predictions are confirmed by empirical analysis of diverse human and avian song samples.

Musical anhedonia, timbre, and the rewards of music listening.

Pleasure in music has been linked to predictive coding of melodic and rhythmic patterns, subserved by connectivity between regions in the brain's auditory and reward networks. Specific musical anhedonics derive little pleasure from music and have altered auditory-reward connectivity, but no difficulties with music perception abilities and no generalized physical anhedonia. Recent research suggests that specific musical anhedonics experience pleasure in nonmusical sounds, suggesting that the implicated brain pathways may be specific to music reward. However, this work used sounds with clear real-world sources (e.g., babies laughing, crowds cheering), so positive hedonic responses could be based on the referents of these sounds rather than the sounds themselves. We presented specific musical anhedonics and matched controls with isolated short pleasing and displeasing synthesized sounds of varying timbres with no clear real-world referents. While the two groups found displeasing sounds equally displeasing, the musical anhedonics gave substantially lower pleasure ratings to the pleasing sounds, indicating that their sonic anhedonia is not limited to musical rhythms and melodies. Furthermore, across a large sample of participants, mean pleasure ratings for pleasing synthesized sounds predicted significant and similar variance in six dimensions of musical reward considered to be relatively independent, suggesting that pleasure in sonic timbres play a role in eliciting reward-related responses to music. We replicate the earlier findings of preserved pleasure ratings for semantically referential sounds in musical anhedonics and find that pleasure ratings of semantic referents, when presented without sounds, correlated with ratings for the sounds themselves. This association was stronger in musical anhedonics than in controls, suggesting the use of semantic knowledge as a compensatory mechanism for affective sound processing. Our results indicate that specific musical anhedonia is not entirely specific to melodic and rhythmic processing, and suggest that timbre merits further research as a source of pleasure in music.

Weighting of cues to categorization of song versus speech in tone-language and non-tone-language speakers.

One of the most important auditory categorization tasks a listener faces is determining a sound's domain, a process which is a prerequisite for successful within-domain categorization tasks such as recognizing different speech sounds or musical tones. Speech and song are universal in human cultures: how do listeners categorize a sequence of words as belonging to one or the other of these domains? There is growing interest in the acoustic cues that distinguish speech and song, but it remains unclear whether there are cross-cultural differences in the evidence upon which listeners rely when making this fundamental perceptual categorization. Here we use the speech-to-song illusion, in which some spoken phrases perceptually transform into song when repeated, to investigate cues to this domain-level categorization in native speakers of tone languages (Mandarin and Cantonese speakers residing in the United Kingdom and China) and in native speakers of a non-tone language (English). We find that native tone-language and non-tone-language listeners largely agree on which spoken phrases sound like song after repetition, and we also find that the strength of this transformation is not significantly different across language backgrounds or countries of residence. Furthermore, we find a striking similarity in the cues upon which listeners rely when perceiving word sequences as singing versus speech, including small pitch intervals, flat within-syllable pitch contours, and steady beats. These findings support the view that there are certain widespread cross-cultural similarities in the mechanisms by which listeners judge if a word sequence is spoken or sung.