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A 63-year-old, right-handed professional chorus conductor developed right putaminal hemorrhage, and became unable to experience emotion while listening to music. Two years later, neurological examination revealed slight left hemiparesis. Neuromusicological assessments revealed impaired judgment of "musical sense," and the inability to discriminate the sound of chords in pure intervals from those in equal temperament. Brain MRI and tractography identified the old hemorrhagic lesion in the right putamen and impaired fiber connectivity between the right insula and superior temporal lobe. These findings suggest that musical anhedonia might be caused by a disconnection between the insula and auditory cortex.

<b><i>Introduction:</i></b> There are several problems with standard in-person neuropsychological assessments, such as habituation, necessity of human resources, and difficulty of in-person assessment under societal conditions during the outbreak of coronavirus disease 2019. Thus, we developed an online cognitive test (the Brain Assessment [BA]). In this study, we investigated the correlation between the results of the BA and those of established neuropsychological tests. <b><i>Participants and Methods:</i></b> Seventy-seven elderly persons (mean 71.3 ± 5.1 years old; range 65–86; male:female = 45:32) were recruited through the internet. Correlations were evaluated between the BA and the following widely used neuropsychological tests: the mini-mental state examination (MMSE), the Raven’s colored progressive matrices (RCPM), the logical memory I and II of the Rivermead Behavioral Memory Test, the word fluency (WF) test, and the Trail-Making TestA/B. <b><i>Results:</i></b> We found moderate correlations between the total cognitive score of the BA and the total score of the MMSE (<i>r</i> = 0.433, <i>p</i> &#x3c; 0.001), as well as between the total BA score and the total RCPM score (<i>r</i> = 0.582, <i>p</i> &#x3c; 0.001) and time to complete the RCPM (<i>r</i> = 0.455, <i>p</i> &#x3c; 0.001). Moderate correlations were also observed between the cognitive score of the memory of words BA subtest and the LM-I (<i>r</i> = 0.518, <i>p</i> &#x3c; 0.001), the mental rotation subtest and figure drawing (<i>r</i> = 0.404, <i>p</i> &#x3c; 0.001), the logical reasoning subtest and total RCPM score (<i>r</i> = 0.491, <i>p</i> &#x3c; 0.001), and the memory of numbers and words subtests and WF (memory of numbers and total WF: <i>r</i> = 0.456, <i>p</i> &#x3c; 0.001; memory of words and total WF: <i>r</i> = 0.571, <i>p</i> &#x3c; 0.001). <b><i>Discussion:</i></b> We found that the BA showed moderate correlations between established neuropsychological tests for intellect, memory, visuospatial function, and frontal function. The MMSE and the RCPM reflect Spearman’s s-factor and g-factor, respectively, and thus the BA also covered both factors. <b><i>Conclusion:</i></b> The BA is a useful tool for assessing the cognitive function of generally healthy elderly persons.

Background: Patient and public involvement (PPI) has become essential in health research. However, little is known about multiple stakeholders' perspectives on the implementation of PPI in community mental health research settings. The present study aimed to qualitatively analyse multiple stakeholders' views on PPI, including potential concerns, barriers and approaches.Methods: This study involved conducting focus group interviews and collecting qualitative data from 37 participants in multiple stakeholder groups (patients = 6, caregivers = 5, service providers = 7, government staff = 5 and researchers = 14) in the community mental health field. The data were qualitatively analysed using a data-driven approach that derived domains, themes and subthemes related to perspectives on PPI and to specific challenges and approaches for implementing PPI. Results: The qualitative analysis identified four domains. The 'Positive views and expectations regarding PPI' domain consisted of themes related to supportive views of PPI in a mental health service research setting and improvements in the quality of research and service. The 'General concerns about PPI' domain included themes concerning the need for non-PPI research and tokenism, excessive expectations concerning social changes and use of evidence from PPI research, and heavy burdens resulting from PPI. The 'Specific issues regarding the implementation of PPI' domain consisted of four themes, including academic systems, selection methods (e.g., representativeness and conflict of interest issues), relationship building, and ambiguous PPI criteria. In particular, all stakeholder groups expressed concerns about relational equality during PPI implementation in Japan. The 'Approaches to PPI implementation' domain included themes such as facilitating mutual