Melody transcatheter pulmonary valve replacement: a single-center case series in Southeast Asia.

BACKGROUND: Studies of transcatheter pulmonary valve replacement (TPVR) with the Melody valve have demonstrated good clinical and hemodynamic outcomes. Our study analyzes the midterm clinical and hemodynamic outcomes for patients who underwent Melody valve implantation in Southeast Asia. METHODS: Patients with circumferential conduits or bioprosthetic valves and experiencing post-operative right ventricular outflow tract (RVOT) dysfunction were recruited for Melody TPVR. RESULTS: Our cohort (n = 14) was evenly divided between pediatric and adult patients. The median age was 19 years (8-38 years), a male-to-female ratio of 6:1 with a median follow-up period of 48 months (16-79 months), and the smallest patient was an 8-year-old boy weighing 18 kg. All TPVR procedures were uneventful and successful with no immediate mortality or conduit rupture. The primary implant indication was combined stenosis and regurgitation. The average conduit diameter was 21 ± 2.3 mm. Concomitant pre-stenting was done in 71.4% of the patients without Melody valve stent fractures (MSFs). Implanted valve size included 22-mm (64.3%), 20-mm (14.3%), and 18-mm (21.4%). After TPVR, the mean gradient across the RVOT was significantly reduced from 41 mmHg (10-48 mmHg) to 16 mmHg (6-35 mmHg) at discharge, p < 0.01. Late follow-up infective endocarditis (IE) was diagnosed in 2 patients (14.3%). Overall freedom from IE was 86% at 79 months follow-up. Three patients (21.4%) developed progressive RVOT gradients. CONCLUSION: For patients in Southeast Asia with RVOT dysfunction, Melody TPVR outcomes are similar to those reported for patients in the US in terms of hemodynamic and clinical improvements. A pre-stenting strategy was adopted and no MSFs were observed. Post-implantation residual stenosis and progressive stenosis of the RVOT require long term monitoring and reintervention. Lastly, IE remained a concern despite vigorous prevention and peri-procedural bacterial endocarditis prophylaxis.

Eight-Month-Old Infants Are Susceptible to the Auditory Continuity Illusion.

The real world is full of noise and constantly overlapping sounds. However, our auditory system provides a solution to this, that is, the continuity illusion; when we hear a sound stream that is partially replaced by high-level noise, we can restore missing sound information and "fill in" the information as if it were smooth and continuous even against a background of noise. In the present study, we tested the preferences for familiar and novel melodies of 8-month-old infants after a 2-month memory retention interval following 1-week exposure to a specific melody. A preference for familiarity was seen not only when the melody was presented intact but also when it was periodically replaced by high-level noise, which elicits the continuity illusion in adults (Experiment 1). However, a trend toward preference for a novel melody was observed for stimuli periodically replaced by low-level noise that did not satisfy the ecological constraints for the elicitation of the illusion (Experiment 2). For the first time, this study showed that infants as young as 8 months of age are susceptible to the auditory continuity illusion. The study also revealed that the infants could recognize the melody they heard 2 months previously.

Predictors of Valve Failure Following Surgical Atrioventricular Valve Replacement with a Melody Valve in Infants and Children.

Options for atrioventricular (AV) valve replacement in small pediatric patients are very limited. The Melody valve has shown reasonable short-term outcomes. This study was aimed at identifying predictors of valve failure following AV valve replacement with a Melody valve at a single-center. 26 patients underwent 37 AV valve replacements with 31/37 (84%) of valves placed in the systemic AV valve position. Median age at procedure was 17 months (IQR 4-33) and weight was 8.5 kg (IQR 6.25-12.85). Median balloon size for valve implant was 20 mm (IQR 18-22). Repeat intervention occurred in 21 cases (57%) with repeat surgery in all but one. Median freedom from re-intervention was 31 months; 19% were free from re-intervention at 60 months. Age < 12 months weight < 10 kg and BSA < 0.4 m2 were all significant risk factors for early valve failure (p = 0.003, p 0.017, p 0.025, respectively). Valve longevity was greatest with balloon inflation to diameter 1.20-1.35 times the patient's expected annular diameter (Z0), relative to both smaller or larger balloons (p = 0.038). In patients less than 12 months of age, patients with single ventricle physiology had an increased risk of early valve failure (p = 0.004).

Melody of Vocants: Fixed Pattern or Shaped by Hearing?

INTRODUCTION: Vocants as infants' first vocalic utterances are produced laryngeally while the vocal tract is maintained in a neutral position. These "primitive" sounds have sometimes been described as largely innate and, therefore, as sounding alike in both healthy and hearing-impaired young infants. OBJECTIVE: The objective of this study is to compare melody features of vocants, recorded during face-to-face interaction, between infants (N = 8) with profound congenital sensorineural hearing loss (HI group) and age-matched (N = 18) controls (CO) group. The question was as follows: does a lack of auditory feedback have a noticeable effect on melodic features of vocants? METHODS: The cooing database totalled 6,998 vocalizations (HI: N = 2,847; CO: N = 4,151), all of which had been recorded during the observation period of 60-181 days of age. Identification of the vocants (N = 1,148) was based on broadband spectrograms (KAY-CSL) and auditory impressions. Fundamental frequency (F0) analyses were performed (PRAAT) and the pattern of the F0 contour (melody) analysed using specific in-lab software (CDAP, pw-project). Generalized mixed linear models were used to perform group comparisons. RESULTS: There was a clear predominance of a simple rising-falling pattern (single melody arcs) in vocants of both groups. Nonetheless, significantly more complex contours, particularly, double-arc structures, were found in vocants of the CO group. Moreover, vocants of the HI group were shorter than those uttered by the CO group, while the mean F0 did not significantly differ. CONCLUSION: Vocants are characterized by both, innate features, found in HI and CO groups, and features that additionally require a functioning auditory system. Even at an early pre-linguistic stage, somatosensory sensations cannot compensate for a lack of auditory feedback. Vocants might be relevant in the early diagnosis of hearing disorders and assessments of the effectiveness of, or adjustments required to, hearing aids.

Neurophysiological time course of timbre-induced music-like perception.

Traditionally, pitch variation in a sound stream has been integral to music identity. We attempt to expand music's definition, by demonstrating that the neural code for musicality is independent of pitch encoding. That is, pitchless sound streams can still induce music-like perception and a neurophysiological hierarchy similar to pitched melodies. Previous work reported that neural processing of sounds with no-pitch, fixed-pitch, and irregular-pitch (melodic) patterns, exhibits a right-lateralized hierarchical shift, with pitchless sounds favorably processed in Heschl's gyrus (HG), ascending laterally to nonprimary auditory areas for fixed-pitch and even more laterally for melodic patterns. The objective of this EEG study was to assess whether sound encoding maintains a similar hierarchical profile when musical perception is driven by timbre irregularities in the absence of pitch changes. Individuals listened to repetitions of three musical and three nonmusical sound-streams. The nonmusical streams were comprised of seven 200-ms segments of white, pink, or brown noise, separated by silent gaps. Musical streams were created similarly, but with all three noise types combined in a unique order within each stream to induce timbre variations and music-like perception. Subjects classified the sound streams as musical or nonmusical. Musical processing exhibited right dominant α power enhancement, followed by a lateralized increase in θ phase-locking and spectral power. The θ phase-locking was stronger in musicians than in nonmusicians. The lateralization of activity suggests higher-level auditory processing. Our findings validate the existence of a hierarchical shift, traditionally observed with pitched-melodic perception, underscoring that musicality can be achieved with timbre irregularities alone.NEW & NOTEWORTHY EEG induced by streams of pitchless noise segments varying in timbre were classified as music-like and exhibited a right-lateralized hierarchy in processing similar to pitched melodic processing. This study provides evidence that the neural-code of musicality is independent of pitch encoding. The results have implications for understanding music processing in individuals with degraded pitch perception, such as in cochlear-implant listeners, as well as the role of nonpitched sounds in the induction of music-like perceptual states.

Percutaneous heart valves demonstrating long-term durability: A case series of Melody valves in the pulmonary position lasting up to 19 years.

It is uncertain how long catheter delivered percutaneous heart valves may last. In congenital cardiology, stenosis and regurgitation of right ventricular to pulmonary artery conduits and valves is common, leading to repeated operations for young patients with concomitant mortality and morbidity. It has also been unclear whether percutaneous pulmonary valves last as long as surgical pulmonary valves. When the current generation of the percutaneous pulmonary valve was first implanted in the United Kingdom from 2003, randomized trials were initially not performed, decided on a case-by-case basis in congenital cardiology, nor long-term registries kept. We describe three cases where such percutaneous heart valves have lasted up to 19 years. All valves were working without significant stenosis and minor degrees of regurgitation on long-term echocardiographic follow-up, patients being asymptomatic. This demonstrates that percutaneous pulmonary valves can achieve long-term durability and may prevent the need for otherwise high-risk surgery in congenital cardiac patients.

Sequential percutaneous tricuspid and pulmonary valve implantation in a young child operated previously for Ebstein Anomaly.

We report a successful percutaneous tricuspid valve implantation followed by a percutaneous pulmonary valve implantation in a young child with Ebstein's anomaly of tricuspid valve and pulmonary stenosis who was previously treated surgically at 1 year of age with tricuspid ring annuloplasty and a transannular outflow patch. This article shows the feasibility of sequential implantation of two valves in young patients with severe tricuspid and pulmonary valve insufficiency.

Fundamental Frequency Contour (Melody) of Infant Vocalizations across the First Year.

INTRODUCTION: The fundamental frequency contour (melody) of cry and non-cry utterances becomes more complex with age. However, there is a lack of longitudinal analyses of melody development during the first year of life. OBJECTIVE: The aim of the study was to longitudinally analyze melody development in typical vocalization types across the first 12 months of life. The aim was twofold: (1) to answer the question whether melody becomes more complex in all vocalization types with age and (2) to characterize complex patterns in more detail. METHODS: Repeatedly recorded vocalizations (n = 10,988) of 10 healthy infants (6 female) over their first year of life were analyzed using frequency spectrograms and fundamental frequency (f0) analyses (PRAAT). Melody complexity analysis was performed using specific in-lab software (CDAP, pw-project) in a final subset of 9,237 utterances that contained noise-free, undisturbed contours. Generalized mixed linear models were used to analyze age and vocalization type effects on melody complexity. RESULTS: The vocalization repertoire showed a higher proportion of complex melodies from the second month onward. The age effect was significant, but no difference was found in melody complexity between cry and non-cry vocalizations across the first 6 months. From month 7-12, there was a further significant increase in complex structures only in canonical babbling not in marginal babbling. Melody segmentations by laryngeal constrictions prevailed among complex shapes. CONCLUSION: The study demonstrated the regularity of melody development in different vocalization types throughout the first year of life. In terms of prosodic features of infant sounds, melody contour is of primary importance, and further studies are required that also include infants at risk for language development.

Neural processing of poems and songs is based on melodic properties.

The neural processing of speech and music is still a matter of debate. A long tradition that assumes shared processing capacities for the two domains contrasts with views that assume domain-specific processing. We here contribute to this topic by investigating, in a functional magnetic imaging (fMRI) study, ecologically valid stimuli that are identical in wording and differ only in that one group is typically spoken (or silently read), whereas the other is sung: poems and their respective musical settings. We focus on the melodic properties of spoken poems and their sung musical counterparts by looking at proportions of significant autocorrelations (PSA) based on pitch values extracted from their recordings. Following earlier studies, we assumed a bias of poem-processing towards the left and a bias for song-processing on the right hemisphere. Furthermore, PSA values of poems and songs were expected to explain variance in left- vs. right-temporal brain areas, while continuous liking ratings obtained in the scanner should modulate activity in the reward network. Overall, poem processing compared to song processing relied on left temporal regions, including the superior temporal gyrus, whereas song processing compared to poem processing recruited more right temporal areas, including Heschl's gyrus and the superior temporal gyrus. PSA values co-varied with activation in bilateral temporal regions for poems, and in right-dominant fronto-temporal regions for songs. Continuous liking ratings were correlated with activity in the default mode network for both poems and songs. The pattern of results suggests that the neural processing of poems and their musical settings is based on their melodic properties, supported by bilateral temporal auditory areas and an additional right fronto-temporal network known to be implicated in the processing of melodies in songs. These findings take a middle ground in providing evidence for specific processing circuits for speech and music in the left and right hemisphere, but simultaneously for shared processing of melodic aspects of both poems and their musical settings in the right temporal cortex. Thus, we demonstrate the neurobiological plausibility of assuming the importance of melodic properties in spoken and sung aesthetic language alike, along with the involvement of the default mode network in the aesthetic appreciation of these properties.

Selective Valve Removal for Melody Valve Endocarditis: Practice Variations in a Multicenter Experience.

Guidelines for management of Melody transcatheter pulmonary valve (TPV) infective endocarditis (IE) are lacking. We aimed to identify factors associated with surgical valve removal versus antimicrobial therapy in Melody TPV IE. Multicenter retrospective analysis of all patients receiving Melody TPV from 10/2010 to 3/2019 was performed to identify cases of IE. Surgical explants versus non-surgical cases were compared. Of the 663 Melody TPV implants, there were 66 cases of IE in 59 patients (59/663, 8.8%). 39/66 (59%) were treated with IV antimicrobials and 27/66(41%) underwent valve explantation. 26/59 patients (44%) were treated medically without explantation or recurrence with average follow-up time of 3.5 years (range:1-9). 32% of Streptococcus cases, 53% of MSSA, and all MRSA cases were explanted. 2 of the 4 deaths had MSSA. CART analysis demonstrated two important parameters associated with explantation: a peak echo gradient ≥ 47 mmHg at IE diagnosis(OR 10.6, p < 0.001) and a peak echo gradient increase of > 24 mmHg compared to baseline (OR 6.7, p = 0.01). Rates of explantation varied by institution (27 to 64%). In our multicenter experience, 44% of patients with Melody IE were successfully medically treated without valve explantation or recurrence. The degree of valve stenosis at time of IE diagnosis was strongly associated with explantation. Rates of explantation varied significantly among the institutions.

Melody valve insertion for relief of "Tricuspid" stenosis in an unbalanced atrioventricular septal defect.

A Melody valve was successfully placed across a very stenotic right-sided component of a common atrioventricular valve because of ongoing troublesome arrhythmias in a young woman with an unbalanced atrioventricular septal defect, a very dilated right atrium and a hypoplastic right ventricle. Four years later, she remains well.

Can musical ability be tested online?

We sought to determine whether an objective test of musical ability could be successfully administered online. A sample of 754 participants was tested with an online version of the Musical Ear Test (MET), which had Melody and Rhythm subtests. Both subtests had 52 trials, each of which required participants to determine whether standard and comparison auditory sequences were identical. The testing session also included the Goldsmiths Musical Sophistication Index (Gold-MSI), a test of general cognitive ability, and self-report questionnaires that measured basic demographics (age, education, gender), mind-wandering, and personality. Approximately 20% of the participants were excluded for incomplete responding or failing to finish the testing session. For the final sample (N = 608), findings were similar to those from in-person testing in many respects: (1) the internal reliability of the MET was maintained, (2) construct validity was confirmed by strong associations with Gold-MSI scores, (3) correlations with other measures (e.g., openness to experience, cognitive ability, mind-wandering) were as predicted, (4) mean levels of performance were similar for individuals with no music training, and (5) musical sophistication was a better predictor of performance on the Melody than on the Rhythm subtest. In sum, online administration of the MET proved to be a reliable and valid way to measure musical ability.

Individual differences in musical ability are stable over time in childhood.

The development of human abilities stems from a complex interplay between genetic predispositions and environmental factors. Numerous studies have compared musicians with non-musicians on measures of musical and non-musical ability, frequently attributing musicians' superior performance to their training. By ignoring preexisting differences, however, this view assumes that taking music lessons is akin to random assignment. In the present longitudinal study, the musical ability of 5- to 10-year-olds was measured at Time 1 with a test of music perception and cognition. Five years later, at Time 2, the children took the same test and a second test designed for older listeners. The test-retest correlation for aggregate scores was remarkably high, r ≈ 0.7, and remained strong when confounding variables (age, cognitive abilities, personality) were held constant. At both time points, music training was associated with musical ability, but the association at Time 2 became nonsignificant when musical ability at Time 1 was held constant. Time 1 musical ability also predicted duration of subsequent music training. These data are consistent with results from genetic studies, which implicate genes in all aspects of musical behavior and achievement, and with meta-analyses, which indicate that transfer effects from music training are weak. In short, early musical abilities significantly predicted later abilities, demonstrating that individual differences are stable over time. We found no evidence, however, to suggest that music training predicted musical ability after accounting for prior ability. The results underscore the importance of considering preexisting abilities in any type of learning.

Melodic expectations in 5- and 6-year-old children.

It has been argued that children implicitly acquire the rules relating to the structure of music in their environment using domain-general mechanisms such as statistical learning. Closely linked to statistical learning is the ability to form expectations about future events. Whether children as young as 5 years can make use of such internalized regularities to form expectations about the next note in a melody is still unclear. The possible effect of the home musical environment on the strength of musical expectations has also been under-explored. Using a newly developed melodic priming task that included melodies with either "expected" or "unexpected" endings according to rules of Western music theory, we tested 5- and 6-year-old children (N = 46). The stimuli in this task were constructed using the information dynamics of music (IDyOM) system, a probabilistic model estimating the level of "unexpectedness" of a note given the preceding context. Results showed that responses to expected versus unexpected tones were faster and more accurate, indicating that children have already formed robust melodic expectations at 5 years of age. Aspects of the home musical environment significantly predicted the strength of melodic expectations, suggesting that implicit musical learning may be influenced by the quantity of informal exposure to the surrounding musical environment.

Replacement of the Mitral Valve Under One Year of Age: Size Matters.

Surgical management of mitral valve disease in neonates and infants is challenging. When repair is no longer feasible, replacement may become inevitable, but should only be considered as an option of last resort due to the remarkably high rate of associated morbidity and mortality. Mechanical valves are the preferred choice in large annuli, while stented conduits seem promising in smaller ones. In patients with a preoperative mitral valve annulus equal or larger than 15-16 mm, an intra-annular placement of the smallest mechanical valve available should be attempted. In patients with smaller annuli, the placement of a stented valved conduit seems to display a lower mortality risk. Supra-annular implantation of prostheses should be reserved for exceptional cases and to those familiar with this technique because of the high rate of associated complications.

Successful use of Protek Duo cannula to provide veno-venous extra-corporeal membrane oxygenation and right ventricular support for acute respiratory distress syndrome in an adolescent with complex congenital heart disease.

Rescuing patients with the development of acute respiratory distress syndrome and right heart failure after left ventricular assist device placement remains a challenge in patients with congenital heart disease. TandemLife Protek Duo (TandemLife, Pittsburg, PA) is a double-lumen cannula introduced via the internal jugular vein that can provide veno-venous extra-corporeal membrane oxygenation and right heart support. To our knowledge, we report the first case of successfully using the TandemLife Protek Duo cannula to provide veno-venous extra-corporeal membrane oxygenation and right ventricle support in an adolescent male with an existing right ventricle-pulmonary artery conduit and the melody pulmonary valve who developed severe acute respiratory distress syndrome after the placement of left ventricular assist device. The stability of the cannula enabled minimal recirculation-related hypoxia events, early mobilization, and ambulation. Our patient was discharged home after lung recovery and currently awaiting a heart transplant.

The Musical Ear Test: Norms and correlates from a large sample of Canadian undergraduates.

We sought to establish norms and correlates for the Musical Ear Test (MET), an objective test of musical ability. A large sample of undergraduates at a Canadian university (N > 500) took the 20-min test, which provided a Total score as well as separate scores for its Melody and Rhythm subtests. On each trial, listeners judged whether standard and comparison auditory sequences were the same or different. Norms were derived as percentiles, Z-scores, and T-scores. The distribution of scores was approximately normal without floor or ceiling effects. There were no gender differences on either subtest or the total score. As expected, scores on both subtests were correlated with performance on a test of immediate recall for nonmusical auditory stimuli (Digit Span Forward). Moreover, as duration of music training increased, so did performance on both subtests, but starting lessons at a younger age was not predictive of better musical abilities. Listeners who spoke a tone language exhibited enhanced performance on the Melody subtest but not on the Rhythm subtest. The MET appears to have adequate psychometric characteristics that make it suitable for researchers who seek to measure musical abilities objectively.

Musical Intervals in Infants' Spontaneous Crying over the First 4 Months of Life.

INTRODUCTION: Perception and memorizing of melody and rhythm start about the third trimester of gestation. Infants have astonishing musical predispositions, and melody contour is most salient for them. OBJECTIVE: To longitudinally analyse melody contour of spontaneous crying of healthy infants and to identify melodic intervals. The aim was 3-fold: (1) to answer the question whether spontaneous crying of healthy infants regularly exhibits melodic intervals across the observation period, (2) to investigate whether interval events become more complex with age and (3) to analyse interval size distribution. METHODS: Weekly cry recordings of 12 healthy infants (6 females) over the first 4 months of life were analysed (6,130 cry utterances) using frequency spectrograms and pitch analyses (PRAAT). A preselection of utterances containing a well-identifiable, noise-free and undisturbed melodic contour was applied to identify and measure melodic intervals in the final subset of 3,114 utterances. Age-dependent frequency of occurrence of melodic intervals was statistically analysed using generalized estimating equations. RESULTS: 85.3% of all preselected melody contours (n = 3,114) either contained single rising or falling melodic intervals or complex events as combinations of both. In total 6,814 melodic intervals were measured. A significant increase in interval occurrence was found characterized by a non-linear age effect (3 developmental phases). Complex events were found to significantly increase linearly with age. In both calculations, no sex effect was found. Interval size distribution showed a maximum of the minor second as the prevailing musical interval in infants' crying over the first 4 months of life. CONCLUSION: Melodic intervals seem to be a regular phenomenon of spontaneous crying of healthy infants. They are suggested to be a further candidate for developing an early risk marker of vocal control in infants. Subsequent studies are needed to compare healthy infants and infants at risk for respiratory-laryngeal dysfunction to investigate the diagnostic value of the occurrence of melodic intervals and their age-depending complexification.

Application of transcatheter valves for aortic valve replacement in pediatric patients: A case series.

OBJECTIVES: To describe our initial experience with pediatric transcatheter aortic valve replacement. BACKGROUND: Transcatheter aortic valve replacement (TAVR) has been approved and used to treat calcific aortic stenosis in adult patients. Select pediatric patients with congenital heart disease (CHD) who are poor candidates for conventional surgical aortic valve replacement can benefit from TAVR. METHODS: A retrospective review was performed to identify and describe pediatric patients with CHD who underwent transcatheter or hybrid aortic valve replacement using a Melody Valve (Medtronic, Minneapolis, MN), or Sapien S3/XT valve (Edwards Life sciences LLC, Irvine, CA). Patients in whom transcatheter valves were implanted on cardiopulmonary bypass were included. Imaging data, procedural elements, and clinical follow-up data were collected to evaluate acute and short-term results. RESULTS: A total of eight pediatric patients underwent treatment of aortic valvular disease using balloon expandable valves and delivery systems. Two patients had Melody valve implantation and six received a Sapien valve (one XT/five S3). In one patient, a Melody valve was placed surgically, failed, and was replaced with a Sapien valve 2 years later. Two patients were treated using a standard transfemoral route, four had the valve delivered on cardiopulmonary bypass via a median sternotomy, one was placed with a transapical approach, and one via a carotid cut down. Patients were followed for an average 16 months (range 1-208 weeks). There were no early or late deaths in this cohort. There were no embolic events, and all valves worked well in the immediate postoperative period. Both Melody implants developed moderate to severe regurgitation at 2 years and 4 years, respectively, and both required replacement at that time. One Sapien 3 valve developed a paravalvular leak that required reintervention within 6 months of implantation. CONCLUSIONS: Transcatheter valves offer a reasonable alternative to traditional surgical aortic valve replacement in certain pediatric patients who are suboptimal surgical candidates. Hybrid approaches and valve delivery on cardiopulmonary bypass has been used in smaller patients. Long-term performance of these valves in young patients has not been studied.

Embodying melody through a conducting baton: a pilot comparison between musicians and non-musicians.

Finger-tapping tasks have been widely adopted to investigate auditory-motor synchronization, i.e., the coupling of movement with an external auditory rhythm. However, the discrete nature of these movements usually limits their application to the study of beat perception in the context of isochronous rhythms. The purpose of the present pilot study was to test an innovative task that allows investigating bodily responses to complex, non-isochronous rhythms. A conductor's baton was provided to 16 healthy subjects, divided into 2 different groups depending on the years of musical training they had received (musicians or non-musicians). Ad hoc-created melodies, including notes of different durations, were played to the subjects. Each subject was asked to move the baton up and down according to the changes in pitch contour. Software for video analysis and modelling (Tracker®) was used to track the movement of the baton tip. The main parameters used for the analysis were the velocity peaks in the vertical axis. In the musician group, the number of velocity peaks exactly matched the number of notes, while in the non-musician group, the number of velocity peaks exceeded the number of notes. An exploratory data analysis using Poincaré plots suggested a greater degree of coupling between hand-arm movements and melody in musicians both with isochronous and non-isochronous rhythms. The calculated root mean square error (RMSE) between the note onset times and the velocity peaks, and the analysis of the distribution of velocity peaks in relationship to note onset times confirmed the effect of musical training. Notwithstanding the small number of participants, these results suggest that this novel behavioural task could be used to investigate auditory-motor coupling in the context of music in an ecologically valid setting. Furthermore, the task may be used for rhythm training and rehabilitation in neurological patients with movement disorders.