Wouldn’t it be great if you could enjoy new music endlessly, without any fear of growing tired of it? You could hear an unfamiliar song, one that carries the perfect thrum or lilt or twang, and hits in all the right places, and your brain would never habituate. If so, you’ll probably be jealous of Mr. B.

The Story Of Mr. B

Mr. B is 59 years old. He’s married, and at one point had a severe case of obsessive compulsive disorder (OCD). Now, whenever he undergoes deep brain stimulation (DBS), the only music he wants to hear is the growling, throaty, raw power of Johnny Cash. And every time he does, it’s as if his brain were hearing it for the first time.

As the sole subject of a recent study conducted by Dutch researchers, Mr. B’s case could represent the immense hidden power of the brain’s nucleus accumbens — a region behind your forehead that, when stimulated, could be entirely responsible for controlling Mr. B’s sudden fondness for the man in black.

According to the case study, Mr. B suffered from an extreme case of OCD, particularly with a focus on compulsions seeking reassurance and hoarding. On the Yale-Brown obsessive-compulsive scale, which measures obsessive-compulsive tendencies on a scale of 0 to 40, Mr. B scored a 33. This put him in the “extreme” category — the highest severity possible. Further tests showed he suffered from moderate clinical anxiety and mild depression. And despite “extensive treatment with pharmacotherapy and cognitive behavioral therapy,” the researchers wrote, “symptoms were still overpowering and Mr. B. remained extremely hindered in daily living.”

Then in 2006, Mr. B underwent a procedure that would change his life, and science, indefinitely. Researchers implanted four electrodes in Mr. B’s brain, the deepest of which sat squarely in the middle of brain, directly in front of a region known as the anterior commissure. Extending sensors ran from pockets beneath his collarbone to a stimulator that would send an electronic signal to targeted parts of Mr. B’s brain.

The main area they targeted was the nucleus accumbens. An area lodged deep behind your eyes, right where the frontal lobe ends, the nucleus accumbens wears a range of hats. It controls laughter, fear, aggression, reward, impulsivity, and addiction. Prior research has shown that depression and anxiety sufferers can experience dramatic declines in symptoms following DBS in this location. It’s in the nucleus accumbens that feelings of reward, be they with food, sex, or drugs, register most viscerally. Music, it turns out, falls into this group.

Music In The Brain

In 2005, scientists discovered that music produces verified feelings of reward, whether we’re actively seeking them or not. Neuroscience has known for some time that music produces some profound effects in the brain, but its effect on our emotions has been less studied. Scientists are just beginning to understand why our brains hear pleasant music, even passively, and regard it as something to seek out in the future — ultimately, until the brain stops sensing the sounds as rewarding, and the song now seems “played out.”

Of course, all this leaves the Dutch scientists studying Mr. B, who can’t stop listening to “Folsom Prison Blues” on repeat, scratching their heads. “There are two remarkable aspects in this clinical observation that may suggest an association between DBS and changed musical preference,” they note.

The first is your preference in music tends to gel sometime around age 20. Mr. B is unique because he never listened to Johnny Cash growing up, but by age 60, when his DBS was activated, he couldn’t get enough. (However, the team emphasizes that Mr. B’s obsession was not merely a replacement form of OCD, as he exhibited none of the telltale destructive signs.) The second is that the music never got old. He could listen to Johnny Cash for marathon sessions of music-listening and never tire of “Ring of Fire.”

“Contrary to our normal experiences where repetitive listening to the same music or song eventually results in a habituation to its rewarding properties, in this case, the Johnny Cash songs never started to annoy the patient and kept the enduring capacities of pleasure and reward.” It was only after the researchers turned off the stimulator that Mr. B’s old tastes resurfaced. The conclusion was clear: The nucleus accumbens was the linchpin.

The Flames Went Higher

Post-DBS, Mr. B fancied himself by a new name; he was now “Mr. B II.” He felt more confident, and his new persona was only emboldened by his new taste in music. This isn’t trivial, the researchers assert. Mr. B II liked Johnny Cash because the emotional boost he got from the DBS also compelled him to seek music from a person he could emulate, someone who seemed to feel equally confident in his art.

The research is a small, though important (and decidedly quirky) step forward in better understanding how the brain responds to deep brain stimulation, and apparently, to the low-pitched tones of a hobbled rock star with a troubled past.

Source: Mantione M, Figee M, Denys D. A case of musical preference for Johnny Cash following deep brain stimulation of the nucleus accumbens. frontiers in Behavioral Neuroscience. 2014.