Biomechanical Abnormalities in Musicians with Occupational Cramp/Focal Dystonia

Wilson, Frank; Wagner, Christoph; Hömberg, V.

doi:10.1016/s0894-1130(12)80331-0

Cited by 39 publications

(46 citation statements)

References 8 publications

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“…The findings from this study and those previously reported by Byl et al, 53,54 Charness, 3 and Wilson et al 7,8 suggest that there may be multiple risk factors for the development of movement dysfunction that can be categorized as focal hand dystonia. Whereas a genetic etiology may be predominant in some populations, [18][19][20] other physical and behavioral risk factors need to be FIG.…”

Section: Discussionsupporting

confidence: 78%

“…This type of anatomical restriction is consistent with the decrease in finger spread measured in patients with focal hand dystonia. 7,8 As observed in the present study, minor restrictions in endrange motions may not impair function under normal conditions (for example, digit 3 on the untrained side of OM311), but movement dysfunction may occur under conditions of highly attended, prolonged, repetitive, stereotypical, near-simultaneous digital movements. Unfortunately, monkeys cannot describe why their hands do not work normally.…”

Section: Discussionsupporting

confidence: 58%

“…5,6 When examined, poor posture, decreased range of motion, muscle imbalance, pain, inflammation, swelling, and sometimes numbness and tingling may be noted. 3,6,7,8 Some patients also report an awkwardness of the hand and others develop involuntary uncontrollable movements, typically referred to as a focal hand dystonia (for example, writer's cramp, occupational hand cramp, musician's cramp). 2,[9][10][11][12][13][14][15][16] Focal hand dystonia is characterized by poorly sequenced, arrhythmic co-contractions, and involuntary movements of the fingers and wrist during the performance of a specific target task.…”

mentioning

confidence: 99%

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Movement dysfunction following repetitive hand opening and closing: Anatomical analysis in owl monkeys

Topp

Byl

1999

Mov. Disord.

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Section: Discussionsupporting

confidence: 78%

Section: Discussionsupporting

confidence: 58%

mentioning

confidence: 99%

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Movement dysfunction following repetitive hand opening and closing: Anatomical analysis in owl monkeys

Topp

Byl

1999

Mov. Disord.

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“…The development of dystonic flexion of D4,5 in musicians with ulnar neuropathy may therefore be a specific occurrence of a focal dystonia resulting from the modification of a stable motor program. 45 Our data indicate that focal dystonia develops predominantly in highly skilled musicians, and arises rarely during the acquisition of the skill. Therefore, the plastic neural changes that underlie the acquisition of skilled movement may also contribute to the development of focal dystonia.…”

Section: Discussionmentioning

confidence: 62%

“…The study population included all patients examined by M. E. C. in performing arts clinics at the University jury.5,9,11,13,18,19,23,26,33-37, 45 How a peripheral injury initi-of California, San Francisco (1984Francisco ( -1989 or Brigham and Women's Hospital in Boston (1989Boston ( -1995. More than half of the patients were from cities outside of the Boston or San Francisco metropolitan regions or from different states.…”

Section: Methodsmentioning

confidence: 99%

Ulnar neuropathy and dystonic flexion of the fourth and fifth digits: Clinical correlation in musicians

1996

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Peripheral nerve lesions are sometimes associated with focal dystonia. We diagnosed ulnar neuropathy in 28 of 73 (40%) cases of occupational cramp in musicians. Focal slowing of ulnar conduction across the elbow was identified in 15 of 19 (79%) patients using the near nerve technique and in 5 of 17 (29%) patients using surface recording. Ulnar neuropathy was present in 24 of 31 (77%) cases with flexion dystonia of the fourth and fifth digits and only 4 of the remaining 42 (10%) cases with other patterns of focal dystonia. Focal dystonia improved in 13 of 14 patients whose ulnar neuropathy improved and appeared or worsened in 2 patients following ulnar nerve injury. These data, together with our recent observation of a dystonic pattern of antagonist bursting in patients with isolated ulnar neuropathy (Muscle Nerve 1995, 18:606-611), suggest that ulnar neuropathy may initiate or sustain a specific dystonia, flexion of the fourth and fifth digits, by inducing a central disorder of motor control.

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Defective inhibition and inter‐regional phase synchronization in pianists with musician's dystonia: An EEG study

Ruiz¹,

Senghaas²,

Großbach³

et al. 2008

Human Brain Mapping

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Recent neurophysiological studies have associated focal-task specific dystonia (FTSD) with impaired inhibitory function. However, it remains unknown whether FTSD also affects the inhibition (INH) of long-term overlearned motor programs. Consequently, we investigated in a Go/NoGo paradigm the neural correlates associated with the activation (ACT) and inhibition of long-term overlearned motor memory traces in pianists with musician's dystonia (MD), a form of FTSD, during a relevant motor task under constraint timing conditions with multichannel EEG. In NoGo trials, the movement related cortical potentials showed a positive shift after the NoGo signal related to inhibition and was significantly smaller over sensorimotor areas in musicians with MD. Further, we observed an increase at 850-900 ms in the power of beta oscillations which was significantly weaker for the patient group. The role of the inter-electrode phase coupling in the sensorimotor integration of inhibitory processes turned out to be the most relevant physiological marker: the global phase synchronization during INH exhibited an increase between 230 and 330 ms and 7-8 Hz, increase which was significantly smaller for pianists with MD. This effect was due to a weaker phase synchronization between the supplementary motor cortex and left premotor and sensorimotor electrodes in patients. Thus, our findings support the hypothesis of a deficient phase coupling between the neuronal assemblies required to inhibit motor memory traces in patients with MD. EMG recorded from the right flexor pollicis longus muscle confirmed that patients with MD had a disrupted INH in NoGo trials.

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Biomechanical Abnormalities in Musicians with Occupational Cramp/Focal Dystonia

Cited by 39 publications

References 8 publications

Movement dysfunction following repetitive hand opening and closing: Anatomical analysis in owl monkeys

Movement dysfunction following repetitive hand opening and closing: Anatomical analysis in owl monkeys

Ulnar neuropathy and dystonic flexion of the fourth and fifth digits: Clinical correlation in musicians

Defective inhibition and inter‐regional phase synchronization in pianists with musician's dystonia: An EEG study

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